Application of tele-ophthalmology in remote diagnosis and management of adnexal and orbital diseases

Verma, Malay; Raman, Rajiv; Mohan, Ravindra E

doi:10.4103/0301-4738.55078

Cited by 49 publications

(19 citation statements)

References 6 publications

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“…Key activities covered included patient consultations, remote diagnosis, and follow-up through videoconferencing. Mobile phones were primarily used for treatment adherence reminders (text and Interactive Voice Response), appointment reminders, and behavior change messaging (n=8) [ 18 , 21 , 28 - 33 ]. Development process was described in 21 articles, 32 articles reported utility [ 16 - 25 , 30 , 31 , 34 - 57 ], and 20 articles reported user acceptability of the initiative [ 28 , 32 , 33 , 58 - 74 ].…”

Section: Resultsmentioning

confidence: 99%

“…Mobile phones were primarily used for treatment adherence reminders (text and Interactive Voice Response), appointment reminders, and behavior change messaging (n=8) [ 18 , 21 , 28 - 33 ]. Development process was described in 21 articles, 32 articles reported utility [ 16 - 25 , 30 , 31 , 34 - 57 ], and 20 articles reported user acceptability of the initiative [ 28 , 32 , 33 , 58 - 74 ]. Other aspects explored were technology-related perception of the end users (n=13) [ 29 , 75 - 85 ], patient satisfaction (n=2) [ 86 , 87 ], assessment of health care professional needs, and challenges related to health service delivery using IT (n=2) [ 88 , 89 ].…”

Section: Resultsmentioning

confidence: 99%

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Current Status and Future Directions of mHealth Interventions for Health System Strengthening in India: Systematic Review

Bassi¹,

John²,

Praveen³

et al. 2018

JMIR Mhealth Uhealth

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BackgroundWith the exponential increase in mobile phone users in India, a large number of public health initiatives are leveraging information technology and mobile devices for health care delivery. Given the considerable financial and human resources being invested in these initiatives, it is important to ascertain their role in strengthening health care systems.ObjectiveWe undertook this review to identify the published mobile health (mHealth) or telemedicine initiatives in India in terms of their current role in health systems strengthening. The review classifies these initiatives based on the disease areas, geographical distribution, and target users and assesses the quality of the available literature.MethodsA search of the literature was done to identify mHealth or telemedicine articles published between January 1997 and June 2017 from India. The electronic bibliographic databases and registries searched included MEDLINE, EMBASE, Joanna Briggs Institute Database, and Clinical Trial Registry of India. The World Health Organization health system building block framework was used to categorize the published initiatives as per their role in the health system. Quality assessment of the selected articles was done using the Cochrane risk of bias assessment and National Institutes of Health, US tools.ResultsThe combined search strategies yielded 2150 citations out of which 318 articles were included (primary research articles=125; reviews and system architectural, case studies, and opinion articles=193). A sharp increase was seen after 2012, driven primarily by noncommunicable disease–focused articles. Majority of the primary studies had their sites in the south Indian states, with no published articles from Jammu and Kashmir and north-eastern parts of India. Service delivery was the primary focus of 57.6% (72/125) of the selected articles. A majority of these articles had their focus on 1 (36.0%, 45/125) or 2 (45.6%, 57/125) domains of health system, most frequently service delivery and health workforce. Initiatives commonly used client education as a tool for improving the health system. More than 91.2% (114/125) of the studies, which lacked a sample size justification, had used convenience sampling. Methodological rigor of the selected trials (n=11) was assessed to be poor as majority of the studies had a high risk for bias in at least 2 categories.ConclusionsIn conclusion, mHealth initiatives are being increasingly tested to improve health care delivery in India. Our review highlights the poor quality of the current evidence base and an urgent need for focused research aimed at generating high-quality evidence on the efficacy, user acceptability, and cost-effectiveness of mHealth interventions aimed toward health systems strengthening. A pragmatic approach would be to include an implementation research component into the existing and proposed digital health initiatives to support the generation of evidence for health systems strengthening on strategically important outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Current Status and Future Directions of mHealth Interventions for Health System Strengthening in India: Systematic Review

Bassi¹,

John²,

Praveen³

et al. 2018

JMIR Mhealth Uhealth

View full text Add to dashboard Cite

show abstract

“…40 Other research has focused on telemedicine using the standing slit-lamp photography, but this method lacks feasibility to implement in non-ophthalmic settings because of personnel and equipment requirements. 38–40,42,45,47–49,53 Some research did not include sensitivity analyses 43,46,51,53,54 and some research describes implementation of technologies rather than validation. 43,46,48,52,53 Portable anterior segment photography with mobile phone camera devices has been evaluated.…”

Section: Discussionmentioning

confidence: 99%

Teleophthalmic Approach for Detection of Corneal Diseases: Accuracy and Reliability

Woodward

Musch

Hood

et al. 2017

Cornea

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Purpose Corneal and anterior segment diseases cause the majority of urgent visits to eye-care professionals. We evaluated the diagnostic accuracy of detecting corneal diseases using external photographs from two portable cameras for telemedicine purposes. Methods A prospective study of adults with a clinical diagnosis of corneal pathology including corneal abrasions, ulcers, scars, and pterygia. A corneal specialist provided the gold-standard diagnosis by slit-lamp examination. Images of both eyes were obtained using iTouch 5S and Nidek VersaCam cameras in multiple gazes and interpreted by 3 cornea specialists for presence of pathology. Accuracy to detect disease was compared to gold standard diagnosis, stratified by camera and grader. Reliability was evaluated with weighted kappa statistics. Graders assessed image quality on a Likert scale from 1 (poor) to 9 (optimal). Results 198 eyes (110 subjects) were photographed. By gold standard diagnosis, 59 eyes (30%) had corneal scars, 34 (17%) had ulcers, 13 (7%) had abrasions, 10 (5%) had pterygia, and 82 (41%) were normal. Sensitivity to detect AS pathology ranged from 54–71% for iTouch and 66–75% for Nidek, across graders; specificity ranged from 82–96% for iTouch and 91–98% for Nidek. Inter-grader reliability was moderate to strong (kappa ranges: 0.54–0.71 for iTouch; 0.75–0.76 for Nidek. Quality ratings were variable between graders. Conclusions External photographs taken by standard, non-enhanced portable cameras and interpreted remotely by ophthalmologist graders yielded sensitivity values that are not yet suitable for telemedicine applications. Additional work is needed to improve the ability to detect AS pathology remotely.

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“…Major cause of avoidable blindness was refractive error (59%) followed by cataract (30%), retinal diseases (3.3%), and corneal diseases 1%. Verma et al 65 reported remote diagnosis of adnexal and orbital diseases. The study was done in a rural region that does not have quality medical care.…”

Section: Methodsmentioning

confidence: 99%

Teleophthalmology: improving patient outcomes?

Sreelatha

Ramesh

2016

OPTH

117

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Teleophthalmology is gaining importance as an effective eye care delivery modality worldwide. In many developing countries, teleophthalmology is being utilized to provide quality eye care to the underserved urban population and the unserved remote rural population. Over the years, technological innovations have led to improvement in evidence and teleophthalmology has evolved from a research tool to a clinical tool. The majority of the current teleophthalmology services concentrate on patient screening and appropriate referral to experts. Specialty care using teleophthalmology services for the pediatric group includes screening as well as providing timely care for retinopathy of prematurity (ROP). Among geriatric eye diseases, specialty teleophthalmology care is focused toward screening and referral for diabetic retinopathy (DR), glaucoma, age-related macular degeneration (ARMD), and other sight-threatening conditions. Comprehensive vision screening and refractive error services are generally covered as part of most of the teleophthalmology methods. Over the past decades, outcome assessment of health care system includes patients’ assessments on their health, care, and services they receive. Outcomes, by and large, remain the ultimate validators of the effectiveness and quality of medical care. Teleophthalmology produces the same desired clinical outcome as the traditional system. Remote portals allow specialists to provide care over a larger region, thereby improving health outcomes and increasing accessibility of specialty care to a larger population. A high satisfaction level and acceptance is reported in the majority of the studies because of increased accessibility and reduced traveling cost and time. Considering the improved quality of patient care and patient satisfaction reported for these telemedicine services, this review explores how teleophthalmology helps to improve patient outcomes.

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Application of tele-ophthalmology in remote diagnosis and management of adnexal and orbital diseases

Cited by 49 publications

References 6 publications

Current Status and Future Directions of mHealth Interventions for Health System Strengthening in India: Systematic Review

Current Status and Future Directions of mHealth Interventions for Health System Strengthening in India: Systematic Review

Teleophthalmic Approach for Detection of Corneal Diseases: Accuracy and Reliability

Teleophthalmology: improving patient outcomes?

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