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, Aline Lutz, Rados, Dimitris Rucks Varvaki, Szortyka, Anelise Decavatá, Falavigna, Maicon, Moreira, Taís de Campos, Hauser, Lisiane, Gross, Paula Blasco, Lorentz, Andrea Longoni, Maturro, Lucas, Cabral, Felipe, Costa, Ana Luiza Fontes de Azevedo, Martins, Thiago Gonçalves dos Santos, da Silva, Rodolfo Souza, Schor, Paulo, Harzheim, Erno, Gonçalves, Marcelo Rodrigues, Umpierre, Roberto Nunes
Zdroj: Eye; May 2021, Vol. 35 Issue: 5 p1398-1404, 7p
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: Supplemental Index
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