Lens Opacities Classification System III. Cataract grading variability between junior and senior staff at a Singapore hospital

PURPOSE: To test the reliability of the Lens Opacities Classification System III (LOGS III) cataract grading between observers at different levels of ophthalmology experience. SETTING: Ophthalmology Department, National University Hospital, Singapore, Singapore. METHODS: In this comparative study, a non-ophthalmology trainee, a basic ophthalmology trainee, and an ophthalmology consultant graded cataracts in 28 patients preoperatively. The observers had a meeting to discuss their interpretations of the LOGS III manual to standardize the grading system and then graded 37 additional patients. RESULTS: There was a statistically significant increase in inter-observer agreement in all 3 LOGS III categories after standardization of the LOGS III system. The K values after standardization fell in the moderate (0.41 to 0.60) to substantial (0.61 to 0.80) range. There was no statistically significant relationship between the observer's experience and the K values. CONCLUSIONS: There was an increase in inter-observer agreement in all categories after standardization between operators.