Provider Agreement in the Assessment of Glaucoma Progression Within a Team Model

Abstract

Fair to moderate agreement levels were found among providers in their assessment of glaucoma progression, suggesting that a team approach to glaucoma management may be effective. Further work is needed to investigate ways to optimize consistency within the glaucoma team.

Shared Care and Virtual Clinics for Glaucoma in a Hospital Setting

“…These articles compared the performance of the non-medical staff with that of the GE, or compared SC in general with StC [ 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 ]. All articles concentrated on an actual clinic performing SC, including the glaucoma follow-up unit in the Rotterdam Eye Hospital (SC-GFU) [ 36 , 37 , 38 ], the Mayo clinic (SC-MC) [ 33 , 34 , 35 ], the Moorfield Eye Hospital (SC-MEH) [ 40 , 42 ], the Queen’s medical centre (SC-QMC) [ 39 ], the Stable Glaucoma Clinic in New Zealand (SC-SGC) [ 43 ], the Glaucoma Management Clinic in Australia (SC-GMC) [ 44 ] and one established between the Royal Victorian Eye & Ear Hospital and the Australian College of Optometry (SC-RVAC) [ 41 ]. The corresponding StC clinic in each hospital is referred as “StC—(name of the corresponding clinic/hospital)”.…”

“…Agreement between GEs and optometrists on IOP was evaluated in two studies [ 33 , 40 ] and was found to be good. Banes et al [ 40 ] noted that optometrists tended to record lower IOP, but differences were small.…”

“…Agreement on structural glaucomatous damage was evaluated in three studies [ 33 , 40 , 42 ]. When performing slit-lamp examination, the optometrist’s cup/disc ratio was comparable to that of GEs [ 40 ] and the optometrist’s ability to decide whether or not an optic disc was glaucomatous was also found to be good (sensitivity and specificity ~83.0%) [ 42 ].…”

“…When performing slit-lamp examination, the optometrist’s cup/disc ratio was comparable to that of GEs [ 40 ] and the optometrist’s ability to decide whether or not an optic disc was glaucomatous was also found to be good (sensitivity and specificity ~83.0%) [ 42 ]. When evaluating fundus photographs on stability, the agreement between all HCP (GEs and optometrists) of the SC-MC [ 33 ] was found to be good and comparable to the agreement between GEs alone. Banes et al [ 40 ] demonstrated the (dis)agreement rate to be independent of the cup/disc ratio values.…”

Management of open‐angle glaucoma by primary eye‐care practitioners: toward a personalised medicine approach

“…7,8 The definition and diagnosis of glaucoma, although 'classically' understood, 9 remains nebulous and agreement of the interpretation of test results within and between clinicians -optometrists and ophthalmologistsremains variable. [10][11][12][13][14][15][16][17] Adjunctively to this, unusually, there is also the proposed issue of over-treatment or overdiagnosis of glaucoma. 18,19 Large-scale clinical trials have frequently reported a subset of patients who almost never progress even without treatment.…”