Table 2.

Intergrader and algorithm performance at different operating points.

	Sensitivity	Specificity
Primary vs. secondary	90.01 (88.95–91.01)	96.09 (95.72–96.42)
Primary grades	86.67 (85.52–87.75)	98.43 (98.18–98.64)
Secondary grades	94.32 (93.52–95.05)	99.63 (99.50–99.73)
DLS (Youden’s J)	93.86 (91.34–96.08)	96.00 (94.68–98.09)
DLS (high sensitivity)	95.53 (93.64–97.41)	92.79 (88.96–97.40)
DLS (high specificity)	90.88 (88.80–95.23)	98.00 (96.29–98.88)

For intergrader agreement on referable DR detection, gradable person eyes for both primary and secondary graders are considered. In all cases, with the exception of Primary vs. Secondary intergrader assessment, Primary and secondary grade agreement with the reference standard (after arbitration) is reported.