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Telemedicine for ophthalmic consultation services: use of a portable device and layering information for graders.

Publication ,  Journal Article
Woodward, MA; Bavinger, JC; Amin, S; Blachley, TS; Musch, DC; Lee, PP; Newman-Casey, PA
Published in: J Telemed Telecare
February 2017

Introduction We compared remote, image-based patient consultations to in-person consultations at emergency department and inpatient hospital settings. Methods Patients evaluated by the ophthalmic consultation services (gold standard) were imaged over a two-week period. A trained study coordinator took anterior segment photographs (AS) and posterior segment photographs (PS) with a portable camera (PictorPlus, Volk Optical, Cleveland, OH). Ophthalmologists (graders) determined photograph quality, presence of pathology, and their confidence in disease detection. At a separate session, graders reassessed photographs accompanied by a one-sentence summary of demographics and chief complaint (CHx). We computed accuracy and reliability statistics. Results We took AS photographs of 24 eyes of 15 patients and PS photographs of 39 eyes of 20 patients. The majority of images were rated as acceptable or excellent in quality (AS: 89-96%; PS: 70-75%). Graders detected AS pathology with 62-81% sensitivity based on photographs, increasing to 87-88% sensitivity with photographs plus CHx. Graders detected PS pathology with 79-86% sensitivity based on a photograph only, increasing to 100% sensitivity with photographs plus CHx. Discussion In this pilot study, there is evidence that portable ophthalmic imaging technologies could enable ophthalmologists to remotely evaluate anterior and posterior segment eye diseases with good sensitivity. The ophthalmologist could detect ocular pathology on photographs more accurately if they were provided brief clinical information.

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Published In

J Telemed Telecare

DOI

EISSN

1758-1109

Publication Date

February 2017

Volume

23

Issue

2

Start / End Page

365 / 370

Location

England

Related Subject Headings

  • Sensitivity and Specificity
  • Reproducibility of Results
  • Remote Consultation
  • Pilot Projects
  • Photography
  • Medical Informatics
  • Inpatients
  • Humans
  • Fundus Oculi
  • Eye Diseases
 

Citation

APA
Chicago
ICMJE
MLA
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Woodward, M. A., Bavinger, J. C., Amin, S., Blachley, T. S., Musch, D. C., Lee, P. P., & Newman-Casey, P. A. (2017). Telemedicine for ophthalmic consultation services: use of a portable device and layering information for graders. J Telemed Telecare, 23(2), 365–370. https://doi.org/10.1177/1357633X16634544
Woodward, Maria A., J Clay Bavinger, Sejal Amin, Taylor S. Blachley, David C. Musch, Paul P. Lee, and Paula Anne Newman-Casey. “Telemedicine for ophthalmic consultation services: use of a portable device and layering information for graders.J Telemed Telecare 23, no. 2 (February 2017): 365–70. https://doi.org/10.1177/1357633X16634544.
Woodward MA, Bavinger JC, Amin S, Blachley TS, Musch DC, Lee PP, et al. Telemedicine for ophthalmic consultation services: use of a portable device and layering information for graders. J Telemed Telecare. 2017 Feb;23(2):365–70.
Woodward, Maria A., et al. “Telemedicine for ophthalmic consultation services: use of a portable device and layering information for graders.J Telemed Telecare, vol. 23, no. 2, Feb. 2017, pp. 365–70. Pubmed, doi:10.1177/1357633X16634544.
Woodward MA, Bavinger JC, Amin S, Blachley TS, Musch DC, Lee PP, Newman-Casey PA. Telemedicine for ophthalmic consultation services: use of a portable device and layering information for graders. J Telemed Telecare. 2017 Feb;23(2):365–370.
Journal cover image

Published In

J Telemed Telecare

DOI

EISSN

1758-1109

Publication Date

February 2017

Volume

23

Issue

2

Start / End Page

365 / 370

Location

England

Related Subject Headings

  • Sensitivity and Specificity
  • Reproducibility of Results
  • Remote Consultation
  • Pilot Projects
  • Photography
  • Medical Informatics
  • Inpatients
  • Humans
  • Fundus Oculi
  • Eye Diseases