An image-based eyelid lesion management service—evaluation of a pilot
| Autor: | Julie Connolly, Maria Elena Gregory, Magdalena Edington, K McFall, E Salina, Chadha, S R Drummond, Paul Cauchi, J Hind, C J Diaper, D Tejwani, Kevin P. Crofts |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Specialty Physical examination Malignancy Ambulatory Care Facilities Article 03 medical and health sciences 0302 clinical medicine Humans Medicine Outpatient clinic Eyelid Diseases Oculoplastics Medical diagnosis Referral and Consultation medicine.diagnostic_test business.industry General surgery COVID-19 Eyelids medicine.disease Eyelid diseases Ophthalmology medicine.anatomical_structure 030221 ophthalmology & optometry Eyelid business 030217 neurology & neurosurgery |
| Zdroj: | Eye |
| ISSN: | 1476-5454 0950-222X |
| Popis: | BACKGROUND/AIMS: Oculoplastics is a predominantly visual specialty and many of the pathologies can be diagnosed based on external appearance. An image-based eyelid lesion management service was piloted to reduce the number of patients who would require outpatient clinic review. The aim of this study was to determine its accuracy and feasibility, both as a hospital-based and community optometrist-based service. If successful, the service was envisaged to significantly reduce the number of patients that require face-to-face (F2F) review, in accordance with current post-COVID-19 principles of social distancing. METHODS: Patients with lid lesions attending an oculoplastics clinic were assessed by consultant oculoplastic surgeons in an F2F consultation (Arm A). The lesions were photographed by a professional clinical photographer (Arm B) and by an optometrist with a handheld digital camera (Arm C). These images were reviewed by independent consultants masked to the outcome of the F2F clinical encounter. Data were collected prospectively including patient demographics, diagnosis, suspicion of malignancy and management. The image-based clinic results were compared to the F2F clinic results. RESULTS: Ninety-five patients were included. Clinical diagnoses were compared for intra-observer variability and substantial agreement was demonstrated between gold-standard F2F clinic visit (Arm A) and Arm B (AE = 0.708) and C (AE = 0.776). There was no statistically significant difference in the rate of discharge and all cases of malignancy were either identified or flagged for F2F review in the image-based arms. CONCLUSION: This pilot demonstrated substantial diagnostic agreement of image-based diagnoses with F2F consultation and image review alone did not miss any cases of malignancy. |
| Databáze: | OpenAIRE |
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