Open AccessTeaming-up nurses with ophthalmologists to expand the reach of eye care in a middle-income country: Validation of health data acquisition by nursing staff in a telemedicine strategy
Author(s) -
Cassia Garcia Moraes,
Taís de Campos Moreira,
Daniel Sganzerla,
Ana Maria Frölich Matzenbacher,
Amanda Gomes Faria,
Lucas Matturro,
Felipe Cezar Cabral,
Dimitris Rucks Varvaki Rados,
Anelise Decavatá Szortyka,
Maicon Falavigna,
Maria Eulália Vinadé Chagas,
Erno Harzheim,
Marcelo Gonçalves,
Roberto Nunes Umpierre,
Aline Lütz de Araújo
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0260594
Subject(s) - technician , medicine , telemedicine , keratometer , optometry , cross sectional study , health care , ophthalmology , eye care , nursing , family medicine , visual acuity , engineering , pathology , electrical engineering , economics , economic growth
Telemedicine can be used to conduct ophthalmological assessment of patients, facilitating patient access to specialist care. Since the teleophthalmology models require data collection support from other health professionals, the purpose of our study was to assess agreement between the nursing technician and the ophthalmologist in acquisition of health parameters that can be used for remote analysis as part of a telemedicine strategy. A cross-sectional study was conducted with 140 patients referred to an ophthalmological telediagnosis center by primary healthcare doctors. The health parameters evaluated were visual acuity (VA), objective ophthalmic measures acquired by autorefraction, keratometry, and intraocular pressure (IOP). Bland-Altman plots were used to analyze agreement between the nursing technician and the ophthalmologist. The Bland-Altman analysis showed a mean bias equal to zero for the VA measurements [95%-LoA: -0.25–0.25], 0.01 [95%-LoA: -0.86–0.88] for spherical equivalent (M), -0.08 [95%-LoA: -1.1–0.95] for keratometry (K) and -0.23 [95%-LoA: -4.4–4.00] for IOP. The measures had a high linear correlation (R [95%CI]: 0.87 [0.82–0.91]; 0.97 [0.96–0.98]; 0.96 [0.95–0.97] and 0.88 [0.84–0.91] respectively). The results observed demonstrate that remote ophthalmological data collection by adequately trained health professionals is viable. This confirms the utility and safety of these solutions for scenarios in which access to ophthalmologists is limited.