Development of a store-and-forward telescreening system of diabetic retinopathy: lessons learned from Iran

Abstract

Background The present study describes the development and identity phases of a teleophthalmology system used for screening of diabetic retinopathy. Methods A questionnaire was used to identify the main factors necessary for diagnosis of diabetic retinopathy and the features required for a teleophthalmology system. In the second phase, a web-based prototype of the system was designed using the data collected in the previous phase. In the final phase, the system was optimized based on the users' ideas and comments; then, it was evaluated through a standard usability testing questionnaire.Results The results showed that the lowest average percentages were related to ethnicity (61%), optometrist's office address (61%), and consultant physician's office address (65%). A web-based prototype was designed using the Visual Studio and Dreamweaver programming tools. This system comprised patient identity data, medical history, clinical data, and retinal images of the patient. The mean score of usability testing and user satisfaction including specialists, residents, and optometrist was 7.3, 7.1 and 7.3 (out of a total 9), respectively. The evaluation results revealed that the system was classified as good. Conclusion The telescreening system suggested in the current study could be helpful in timely diagnosis. Moreover, it would reduce the treatment costs and complexities. Regardless of the positive points of telemedicine systems, one of the most challenges in this study was the Internet infrastructure to design and apply the system. The future studies, therefore, could focus on the application of cell phone technology for rendering teleophthalmology.

The Role of Telemedicine, In-Home Testing and Artificial Intelligence to Alleviate an Increasingly Burdened Healthcare System: Diabetic Retinopathy

“…It was possible to transfer the data via web and receive immediate online diagnosis [ 25 , 29 ]. There was also a special teleretinal screening software platform used [ 16 , 22 , 26 , 27 , 29 , 30 , 35 , 37 , 44 , 47 , 51 , 54 , 56 , 59 , 65 – 67 , 69 , 70 , 72 , 75 , 81 , 97 ] or, alternatively, access to all information could be obtained through a special account on a medical platform.…”

“…In 2017, Xiao et al presented a comprehensive teleretinal eye treatment plan with SMS [short messaging service] patient information on the date of eye examination. To improve the quality of telescreening, internal self-checking of image system quality was assessed [ 99 ], and a development scheme was used to design a DR telemedicine screening program [ 37 ]. To improve access to DR screening, local women’s self-help groups were tasked with its implementation [ 74 ].…”

Development and Evaluation of a Teleoncology System for Breast Cancer During the COVID-19 Pandemic

“…As mentioned in the previous sections, the usability of the final version of the teleoncology system was evaluated by using the QUIS questionnaire. Similarly, some researchers in their studies have used the QUIS questionnaire to evaluate the usability of telemedicine systems [ 43 , 56 , 57 ]. In addition, some studies have used the System Usability Scale (SUS) questionnaire to assess usability [ 46 , 58 ].…”

The most used questionnaires for evaluating telemedicine services

“…The final list of articles showed that the Telehealth Usability Questionnaire (TUQ) (n = 10, 19%) [10][11][12][13][14][15][16][17][18][19] and Telemedicine Satisfaction Questionnaire (TSQ) (n = 7, 13%) [20][21][22][23][24][25][26] were the most commonly used. Then, the Service User Technology Acceptability Questionnaire (SUTAQ) (n = 3, 5.5%) [27][28][29], the Client Satisfaction Questionnaire (CSQ) (n = 3, 5.5%) [30][31][32], the Questionnaire for User Interaction Satisfaction (QUIS) (n = 3, 5.5%) [33][34][35], the System Usability Scale (SUS) questionnaire (n = 3, 5.5%) [36][37][38], the Patient Satisfaction Questionnaire (PSQ) (n = 3, 5.5%) [22,39,40], the Telemedicine Satisfaction and Usefulness Questionnaire (TSUQ) (n = 2, 3.5%) [41,42], the Patient Assessment of Communication during Telemedicine (PACT) questionnaire (n = 2, 3.5%) [43,44], the Post Study System Usability Questionnaire (PSSUQ) (n = 2, 3.5%) [19,45] and the Technology Acceptance Model (TAM) (n = 2, 3.5%) [46,47] were the most used questionnaires, respectively. The rest of the articles had used other questionnaires (n = 18, 34%)…”