Comparison of Glaucoma Diagnosis by Telemedicine, In-Person Ophthalmologist, and Optometrist.

IF 2 4区 医学 Q2 OPHTHALMOLOGY Journal of Glaucoma Pub Date : 2024-09-01 Epub Date: 2024-07-08 DOI:10.1097/IJG.0000000000002456
Poojitha Balakrishnan, Thomas A Swain, Gerald McGwin, Cynthia Owsley, Christopher A Girkin, Lindsay A Rhodes
{"title":"Comparison of Glaucoma Diagnosis by Telemedicine, In-Person Ophthalmologist, and Optometrist.","authors":"Poojitha Balakrishnan, Thomas A Swain, Gerald McGwin, Cynthia Owsley, Christopher A Girkin, Lindsay A Rhodes","doi":"10.1097/IJG.0000000000002456","DOIUrl":null,"url":null,"abstract":"<p><strong>Prcis: </strong>Diagnosis of glaucoma through telemedicine demonstrates moderate agreement with in-person ophthalmologist (MD) and in-person optometrist (OD) diagnosis, providing evidence that telemedicine is a timely, accurate screening method in settings where an in-person visit may not be feasible.</p><p><strong>Objective: </strong>To compare diagnostic agreement of glaucoma between in-person MD, in-person OD, and a simulated telemedicine program.</p><p><strong>Patients and methods: </strong>A cross-sectional study of patients with normal optic nerve structural and functional imaging and new patients referred for glaucoma evaluation examined in-person by an MD for glaucoma with a dilated examination and structural and functional optic nerve testing (optical coherence tomography, photos, and visual field); examined in person by an OD with a dilated examination and optic nerve testing; and structural and functional optic nerve testing reviewed separately by 2 ophthalmologists [telemedicine ophthalmologist reviewer 1 (TMD1), telemedicine ophthalmologist reviewer 2 (TMD2)] with masking of prior MD and OD diagnoses. Interrater agreement between each diagnostic method (MD, OD, TMD1, and TMD2) of normal versus disease (open angle glaucoma, normal tension glaucoma, other types of glaucoma, other optic nerve disorders, ocular hypertension, and glaucoma suspect) for each eye was calculated (Cohen unweighted kappa).</p><p><strong>Results: </strong>A total of 100 patients with a median age of 66 years (interquartile range: 59-72), male (40%) and white (62%) were analyzed. There was moderate agreement between MD and telemedicine [TMD1 kappa 0.49 (95% CI: 0.37-0.61), TMD2 kappa 0.44 (95% CI: 0.32-0.56)] and between MD and OD diagnosis [0.41 (95% CI: 0.28-0.54)] and fair-moderate agreement between OD and telemedicine [TMD1: 0.46 (95% CI: 0.34-0.58), TMD2: 0.61 (95% CI: 0.50-0.72)].</p><p><strong>Conclusions: </strong>The simulated telemedicine approach had comparable levels of agreement in glaucoma diagnosis with in-person fellowship-trained ophthalmologists, presenting a crucial complementary role in screening and increasing access to care, particularly in rural or underserved settings.</p>","PeriodicalId":15938,"journal":{"name":"Journal of Glaucoma","volume":" ","pages":"619-623"},"PeriodicalIF":2.0000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11365792/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Glaucoma","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/IJG.0000000000002456","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/8 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Prcis: Diagnosis of glaucoma through telemedicine demonstrates moderate agreement with in-person ophthalmologist (MD) and in-person optometrist (OD) diagnosis, providing evidence that telemedicine is a timely, accurate screening method in settings where an in-person visit may not be feasible.

Objective: To compare diagnostic agreement of glaucoma between in-person MD, in-person OD, and a simulated telemedicine program.

Patients and methods: A cross-sectional study of patients with normal optic nerve structural and functional imaging and new patients referred for glaucoma evaluation examined in-person by an MD for glaucoma with a dilated examination and structural and functional optic nerve testing (optical coherence tomography, photos, and visual field); examined in person by an OD with a dilated examination and optic nerve testing; and structural and functional optic nerve testing reviewed separately by 2 ophthalmologists [telemedicine ophthalmologist reviewer 1 (TMD1), telemedicine ophthalmologist reviewer 2 (TMD2)] with masking of prior MD and OD diagnoses. Interrater agreement between each diagnostic method (MD, OD, TMD1, and TMD2) of normal versus disease (open angle glaucoma, normal tension glaucoma, other types of glaucoma, other optic nerve disorders, ocular hypertension, and glaucoma suspect) for each eye was calculated (Cohen unweighted kappa).

Results: A total of 100 patients with a median age of 66 years (interquartile range: 59-72), male (40%) and white (62%) were analyzed. There was moderate agreement between MD and telemedicine [TMD1 kappa 0.49 (95% CI: 0.37-0.61), TMD2 kappa 0.44 (95% CI: 0.32-0.56)] and between MD and OD diagnosis [0.41 (95% CI: 0.28-0.54)] and fair-moderate agreement between OD and telemedicine [TMD1: 0.46 (95% CI: 0.34-0.58), TMD2: 0.61 (95% CI: 0.50-0.72)].

Conclusions: The simulated telemedicine approach had comparable levels of agreement in glaucoma diagnosis with in-person fellowship-trained ophthalmologists, presenting a crucial complementary role in screening and increasing access to care, particularly in rural or underserved settings.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
远程医疗、眼科医生和验光师对青光眼诊断的比较。
摘要目的:比较眼科医生(MD)、验光师(OD)和模拟远程医疗项目对青光眼诊断的一致性:横断面研究:视神经结构和功能成像正常的患者以及转诊进行青光眼评估的新患者,由医学博士亲自进行青光眼检查,并进行散瞳检查、视神经结构和功能检测(光学相干断层扫描(OCT))、照片和视野);由验光师亲自进行散瞳检查和视神经检测;由两名眼科医生(TMD1、TMD2)分别复查视神经结构和功能检测,并掩盖之前医学博士和验光师的诊断。主要结果测量:计算每只眼的正常与疾病(开角型青光眼、正常张力型青光眼、其他类型青光眼、其他视神经疾病、眼压过高、青光眼疑似患者)的每种诊断方法(MD、OD、TMD1、TMD2)之间的评分者间一致性(科恩非加权卡帕):共分析了 100 名患者,中位年龄为 66 岁(IQR 59-72),男性(40%),白人(62%)。医学诊断与远程医疗之间[TMD1 kappa 0.49 (95% CI 0.37-0.61),TMD2 kappa 0.44 (95% CI 0.32-0.56)]以及医学诊断与口腔科诊断之间[0.41 (95% CI 0.28-0.54)]存在中等程度的一致性,口腔科诊断与远程医疗之间[TMD1 0.46 (95% CI 0.34-0.58),TMD2 0.61 (95% CI 0.50-0.72)]存在中等程度的一致性:在青光眼诊断方面,模拟远程医疗方法与接受过研究员培训的眼科医生的诊断结果具有可比性,在筛查和增加治疗机会方面起到了重要的补充作用,尤其是在农村或服务不足的地区。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Journal of Glaucoma
Journal of Glaucoma 医学-眼科学
CiteScore
4.20
自引率
10.00%
发文量
330
审稿时长
4-8 weeks
期刊介绍: The Journal of Glaucoma is a peer reviewed journal addressing the spectrum of issues affecting definition, diagnosis, and management of glaucoma and providing a forum for lively and stimulating discussion of clinical, scientific, and socioeconomic factors affecting care of glaucoma patients.
期刊最新文献
Association of Social Determinants of Health With the Likelihood of Treatment With Laser Trabeculoplasty in a US Database. Neighborhood Poverty and Clinic Attendance in the Michigan Screening and Intervention for Glaucoma and Eye Health Through Telemedicine Program. Wipe-Out Following Gonioscopy-Assisted Transluminal Trabeculotomy Combined With Phacoemulsification. Assessment of Missing Data on Glaucoma Severity Among Participants in the NIH All of Us Research Program of the United States. Compliance With International Council of Ophthalmology Guidelines for Glaucoma Eye Care in Pakistan.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1