Glaucoma screening: analysis of conventional and telemedicine‐friendly devices

Kumar, Satinder; Giubilato, Antonio; Morgan, William H.; Jitskaia, Ludmila; Barry, Chris; Bulsara, Max; Constable, Ian J.; Kanagasingam, Yogesan

doi:10.1111/j.1442-9071.2007.01457.x

Cited by 47 publications

(26 citation statements)

References 44 publications

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“…The reason for this investigation was that non-population-based public glaucoma screening is frequently organised in different communities, and recent data suggest that by combining different diagnostic methods and/or criteria, the accuracy and the positive likelihood ratio of the screening can be significantly increased. 13,14 However, as the prevalence of glaucoma in the adult Caucasian general population is far below the value optimal for screening, [2][3][4][5][6][7] it is very desirable to increase the prevalence of glaucoma among the self-recruited screening participants. 11,13 To specifically motivate persons to attend who have a high probability of having the disease, information on the risk factors for glaucoma needs to be provided when the screening event is publicised in the media.…”

Section: Discussionmentioning

confidence: 99%

“…Such non-population-based screenings, however, can only be accurate if the diagnostic methods (or combination of methods) used have high positive likelihood ratio, and if the prevalence of glaucoma in the screened population is relatively high. 13,14 Thus, non-population-based glaucoma screening should ideally be focused on a target population with high risk for glaucoma. 11,[13][14][15][16] To increase the prevalence of glaucoma among the self-recruited participants (as compared with the general population), such screening sessions may need pre-publicity, and the information given should focus on the risk factors for chronic open-angle glaucoma, encouraging those with glaucoma risk factors to attend.…”

Section: Introductionmentioning

confidence: 99%

“…13,14 Thus, non-population-based glaucoma screening should ideally be focused on a target population with high risk for glaucoma. 11,[13][14][15][16] To increase the prevalence of glaucoma among the self-recruited participants (as compared with the general population), such screening sessions may need pre-publicity, and the information given should focus on the risk factors for chronic open-angle glaucoma, encouraging those with glaucoma risk factors to attend. Screening for a severe disease, however, can induce anxiety among potential participants, which might reduce their willingness to attend.…”

Section: Introductionmentioning

confidence: 99%

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Health anxiety in a non-population-based, pre-publicised glaucoma screening exercise

Holló

Kóthy

Géczy

et al. 2009

Eye

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Objective To investigate whether anxiety plays a role in self-recruitment for non-population-based glaucoma screening. Methods In a non-population-based pre-publicised trial, self-recruited Caucasian participants were screened for glaucoma, and also completed the Trait Anxiety Inventory and Shortened Health Anxiety Inventory questionnaires. In pre-publicity for the trial, information on risk factors for glaucoma was given. Participants classified as possible glaucoma cases later underwent a detailed glaucoma investigation. Results Of the 120 total participants (72 females, 48 males), 12 were considered glaucoma suspects at the screening, although only three (2.5%) were ultimately diagnosed with glaucoma. Health anxiety showed significant correlation with trait anxiety (r ¼ 0.525, Po0.001). Trait anxiety was similar for both the genders; this score was significantly below the normal Hungarian population value in women (Po0.001) and at the normal population level in men (P ¼ 0.560). In contrast, health anxiety was significantly higher than for both the 'normal' and 'anxious' reference groups (Po0.001), although smaller than that for hypochondriacs (Po0.001). Participants with pre-existing ocular symptoms, and those who attended because of fear of blindness, had significantly higher trait-and health-anxiety scores (Po0.05 for all comparisons). Conclusion In this screening trial, the health anxiety of the self-recruited participants was significantly above normal, whereas the prevalence of glaucoma was within the usual range for a Caucasian population. This suggests that providing pre-publicity information on risk factors for glaucoma does not necessarily increase the prevalence of glaucoma among self-recruited participants in non-population-based screening, as some individuals may participate on account of elevated health anxiety, rather than because of higher potential risk for glaucoma.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Health anxiety in a non-population-based, pre-publicised glaucoma screening exercise

Holló

Kóthy

Géczy

et al. 2009

Eye

View full text Add to dashboard Cite

show abstract

“…Such nonpopulation-based screening events, however, can only be accurate if the prevalence of glaucoma in the screened population is relatively high. 13,14 To increase the prevalence of glaucoma among the screening session participants, information on the risk factors for glaucoma is frequently prepublicized in the printed and electronic media, encouraging those with glaucoma risk factors to attend sessions.…”

mentioning

confidence: 99%

Nonpopulation-Based Glaucoma Screening Exercise in an Osteoporosis Patient Organization

Holló¹,

Kóthy²,

Garas³

et al. 2012

Journal of Glaucoma

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“…Hence, innovation is required to optimally use the human and financial resources, so as to achieve timely access to treatment, whilst coping with an increasing workload. The Virtual Glaucoma Clinic (VGC) is a relatively new screening and diagnostic tool to manage glaucoma patients at a distance [9][10][11]. Clinical information, ocular imaging and diagnostic tests e.g.…”

Section: Introductionmentioning

confidence: 99%

Virtual Glaucoma Clinic: Do Consultants Agree on Management Outcomes?

Kwun¹,

Nikita²

2016

J Clin Exp Ophthalmol

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Objective: To evaluate inter-examiner variations in glaucoma management amongst consultants with different levels of experience in Virtual Glaucoma Clinic. Methods:Three glaucoma specialist consultants with varying years of experience (1, 5 and 15 years) independently reviewed 112 consecutive cases. The management outcomes of the three consultants were recorded for each case on a specially designed proforma. Inter-consultant agreement on recall time, review place and treatment plan was analysed using kappa coefficient. The cohort was classified into two groups for further analysis. The first group consisted of patients in whom all three consultants agreed on management outcomes. The second group consisted of patients in whom at least one consultant disagreed on management outcomes. Unpaired student-t-test was used to calculate the difference in mean values of age, visual acuity, intraocular pressure, cup-todisc ratio and visual field mean deviation between both groups for each management outcome. Results:The percentage of overall agreement on recall time (25%) and review place (45%) was fair and moderate respectively. The overall agreement on treatment plan was superior (86%). We found significant disagreement between the senior consultant and the newly appointed consultant with lowest Kappa agreement on recall time and on review place (κ 0.14 and κ 0.22 respectively). On overall, the level of complete agreement amongst ocular hypertension was best when compared to glaucoma suspect and glaucoma. Statistical analysis revealed a tendency for disagreement amongst consultants' management outcomes on patients having more abnormal visual field and raised intraocular pressure. Conclusions:Our study demonstrates that greater difference in years of experience between consultants is associated with more disagreement in management outcomes. Discrepancies on management outcomes impact on uniformity of care and service delivery in a virtual clinic setting. We suggest the need for implementing structured management guidance in virtual glaucoma clinic to reduce discrepancies amongst consultants.Keywords: Glaucoma; Telemedicine; Virtual clinic; Inter-examiner variation; Agreement SynopsisWe found considerable disagreements amongst consultants in virtual clinic. These discrepancies were more likely the greater the difference in levels of experience separating consultants and when mean visual field was abnormal and intraocular pressure was raised.

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Glaucoma screening: analysis of conventional and telemedicine‐friendly devices

Abstract: This study indicates that evaluations of cup-to-disc ratio and visual field, using telemedicine-friendly devices, are most useful tools in screening for glaucoma. When used together these devices may be an alternative for conventional glaucoma screenings.

Cited by 47 publications

References 44 publications

Health anxiety in a non-population-based, pre-publicised glaucoma screening exercise

Health anxiety in a non-population-based, pre-publicised glaucoma screening exercise

Nonpopulation-Based Glaucoma Screening Exercise in an Osteoporosis Patient Organization

Virtual Glaucoma Clinic: Do Consultants Agree on Management Outcomes?

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