Ophthalmic image acquired by ophthalmologists and by allied health personnel as part of a telemedicine strategy: a comparative study of image quality.

Autor: de Araujo AL; Núcleo de Telessaúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil. alinelutz.a@gmail.com.; Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil. alinelutz.a@gmail.com., Rados DRV; Núcleo de Telessaúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil., Szortyka AD; Núcleo de Telessaúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil., Falavigna M; Hospital Moinhos de Vento, Porto Alegre, RS, Brazil., Moreira TC; Hospital Moinhos de Vento, Porto Alegre, RS, Brazil., Hauser L; Núcleo de Telessaúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil., Gross PB; Núcleo de Telessaúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil., Lorentz AL; Núcleo de Telessaúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil., Maturro L; Ministry of Health, Brasília, DF, Brazil., Cabral F; Hospital Moinhos de Vento, Porto Alegre, RS, Brazil., Costa ALFA; Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil., Martins TGDS; Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil., da Silva RS; Núcleo de Telessaúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil., Schor P; Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil., Harzheim E; Programa de Pós-Graduação em Epidemiologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil., Gonçalves MR; Núcleo de Telessaúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.; Programa de Pós-Graduação em Epidemiologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil., Umpierre RN; Núcleo de Telessaúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Jazyk: angličtina
Zdroj: Eye (London, England) [Eye (Lond)] 2021 May; Vol. 35 (5), pp. 1398-1404. Date of Electronic Publication: 2020 Jun 18.
DOI: 10.1038/s41433-020-1035-5
Abstrakt: Objectives: This study evaluates the quality of ophthalmic images acquired by a nurse technician trained in teleophthalmology as compared with images acquired by an ophthalmologist, in order to provide a better understanding of the workforce necessary to operate remote care programs.
Methods: A cross-sectional study was performed on 2044 images obtained from 118 participants of the TeleOftalmo project, in Brazil. Fundus and slit-lamp photography were performed on site by an ophthalmologist and by a nurse technician under the supervision of a remote ophthalmologist. Image quality was then evaluated by masked ophthalmologists. Proportion of suitable images in each group was compared.
Results: The proportion of concordant classification regarding quality was 94.8%, with a corrected kappa agreement of 0.94. When analyzing each type of photo separately, there was no significant difference in the proportion of suitable images between on-site ophthalmologist and nurse technician with remote ophthalmologist assistance for the following: slit-lamp views of the anterior segment and anterior chamber periphery, and fundus photographs centered on the macula and on the optic disc (P = 0.825, P = 0.997, P = 0.194, and P = 0.449, respectively). For slit-lamp views of the lens, the proportion of suitable images was higher among those obtained by an ophthalmologist (99.6%) than by a technician (93.8%, P < 0.01).
Conclusions: Ophthalmic photographs acquired by a trained technician consistently achieved >90% adequacy for remote reading. Compared with ophthalmologist-acquired photos, the proportion of images deemed suitable achieved a high overall agreement. These findings provide favorable evidence of the adequacy of teleophthalmological imaging by nurse technicians.
Databáze: MEDLINE
Externí odkaz: