Use of Expectation Disconfirmation Theory to Test Patient Satisfaction with Asynchronous Telemedicine for Diabetic Retinopathy Detection

Abstract

Objective The purpose of the study is to extend research on patient satisfaction with telemedicine services by employing the theoretical framework of Expectation Disconfirmation Theory (EDT) for diabetic retinopathy screenings focusing on rural patients. Method Adult subjects (n=220) with diabetes were recruited from a single family practice office in rural Iowa. Subjects completed a “pre” survey concerning their forward-looking perceptions of telemedicine prior to using telemedicine for detection of diabetic retinopathy and a “post” survey after they received recommendations from the distant ophthalmologists. Results All hypotheses of the EDT model were supported. Patient satisfaction is influenced by both patients' expectations (P<.001) and disconfirmation of expectations (P<.001), and patient satisfaction has a positive impact on patient preference for telemedicine services (P<.001). Overall, patients who received telemedicine services were highly satisfied with telemedicine and developed a favorable disposition towards telemedicine services. Conclusions The EDT model is a viable framework to study patient satisfaction of telemedicine services. While previous feasibility studies have shown that telemedicine for diabetic retinopathy screenings yields diagnostic efficacy, this study applies a theoretical framework to demonstrate the viability of telemedicine for diabetic retinopathy screenings in rural areas.

Feasibility, Acceptability, and Influence of mHealth-Supported N-of-1 Trials for Enhanced Cognitive and Emotional Well-Being in US Volunteers

“…A plausible implication is that investigators should explicitly account for participants' prior beliefs in the context of N-of-1 experiments and, indeed, use them in constructing posterior probabilities that are returned to patients. Another possible explanation, drawing on expectation disconfirmation theory (41), is that participants who were pleasantly surprised by a positive result (despite expecting a negative outcome) were more likely to be enthused about the activity going forward.…”

Diabetic Retinopathy Detection Using Prognosis of Microaneurysm and Early Diagnosis System for Non-Proliferative Diabetic Retinopathy Based on Deep Learning Algorithms

“…This way, LoG filters together with Matched Filter are utilized to identify the transient bright lesions and the Gaussian intensity-like dark lesions. The 2-dimensional MF and LoG prototype kernel mathematical expressions are given respectively via equation 2and (3).…”

“…the retinopathy can only be slower during the early stages of the disease [3]. The identification by repeated examination of patients affected of these initial lesions (mainly Microaneurysms and small blood cells) is expected as a new possibility of improving retinopathy treatment.…”

Review of the Effectiveness of Information and Communication Technology (ICTs) in the Treatment of Type 1 and Type 2 Diabetes

“…In studies conducted on diabetic patients, telemedicine screening was found to be a valid screening method, and most people wanted to use this method in subsequent experiments [50][51][52]. Studies in remote surveillance centers have shown that a remote medical screening program is a safe and efficient device for the diagnosis and treatment of diabetic retinopathy.…”

“…Studies in remote surveillance centers have shown that a remote medical screening program is a safe and efficient device for the diagnosis and treatment of diabetic retinopathy. Data suggest that diabetic diagnostic retinopathy screening program can be prevented to prevent blindness in diabetic patients, and the integration of telemedicine and screening is a collaborative effort between primary care physicians and ophthalmologists in timely and effective screening and treatment [50,53].…”