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Incorporation of a virtual assessment into a care pathway for initial glaucoma management: feasibility study
Author(s) -
Rathod Dinesh,
Win Thein,
Pickering Susan,
Austin Michael
Publication year - 2008
Publication title -
clinical and experimental ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 1442-6404
DOI - 10.1111/j.1442-9071.2008.01831.x
Subject(s) - medicine , glaucoma , technician , confidence interval , ophthalmoscopy , medical diagnosis , outpatient clinic , triage , ophthalmology , optometry , emergency medicine , radiology , retinal , electrical engineering , engineering
A bstract Purpose: To investigate the feasibility of a glaucoma triage assessment based on the consideration of clinical data in a virtual clinic environment. Methods: One hundred consecutive new patients were assessed by masked observers for a possible diagnosis of glaucoma or ocular hypertension by evaluation of clinical data compiled by a technician in the absence of the patient. The virtual clinic diagnoses were compared with those made by actual examination of the patient in the outpatient clinic. Results: A total of 22% of subjects were excluded from interobserver comparison because of atypical scanning laser ophthalmoscopy. Of the 78% of subjects completing virtual and actual clinical assessments diagnostic agreement was good, weighted Kappa was of 0.72 (95% confidence interval 0.85 to 0.59), sensitivity 94.4% and specificity 86.7%. No case of glaucoma was misdiagnosed as normal by virtual assessment. Conclusion: Clinical findings and data relating to glaucoma may be evaluated in a virtual clinic with satisfactory diagnostic accuracy.