ArticleOphthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)2019
Impact of optical coherence tomography on diagnostic decision-making by UK community optometrists: a clinical vignette study.
Article in Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed.
- Investigation of the efficacy of an online tool for improving the diagnosis of macular lesions imaged by optical coherence tomography.Journal of optometryTrial
- Who Gets Referred for What? Large Scale Analysis of Clinical, Socioeconomic and Demographic Drivers Within Electronic Optometry Referrals.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2026Article
- I-SCREEN: Development of an AI-based infrastructure for community-wide screening and prediction of progression in age-related macular degeneration providing accessible shared care.Eye (London, England) · 2026Article
- National UK optometry clinical practice survey: implications for developing glaucoma services in primary care.Eye (London, England) · 2026Article
- Clinical and economic impacts of optical coherence tomography prior to cataract surgery in a low-to-middle-income country.Frontiers in ophthalmology · 2026Article
- The quality, accuracy and appropriateness of UK optometric age-related macular degeneration referrals.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2025Article
- An education-based intervention investigating the accuracy of community-based optometrists evaluating limbal anterior chamber depth.Eye (London, England) · 2025Article
- Applying Nociplastic Pain Criteria in Chronic Musculoskeletal Conditions: A Vignette Study.Journal of clinical medicine · 2025Article
- Developing clinical reasoning along the cognitive continuum: a mixed methods evaluation of a novel Clinical Diagnosis Assessment.BMC medical education · 2025Article
- Clinical Performance of Semi-Automated Spectral-Domain Optical Coherence Tomography Angiography.Journal of clinical medicine · 2024Article
- Diagnostic decisions of specialist optometrists exposed to ambiguous deep-learning outputs.Scientific reports · 2024Article
- Detecting Established Glaucoma Using OCT Alone: Utilizing an OCT Reading Center in a Real-World Clinical Setting.Translational vision science & technology · 2024Article
- Establishing the Normative Data Set Necessary for Imaging-Based Childhood Uveitis Surveillance: A Cross-Sectional Study.Investigative ophthalmology & visual science · 2024Observational
- The effectiveness of interventions for optometric referrals into the hospital eye service: A review.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2023Review
- Assessment of optometrists' referral accuracy and contributing factors: A review.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2023Review
- Nociplastic Pain Criteria or Recognition of Central Sensitization? Pain Phenotyping in the Past, Present and Future.Journal of clinical medicine · 2021Review
- Importance of Anatomical Efficacy for Disease Control in Neovascular AMD: An Expert Opinion.Ophthalmology and therapy · 2021Review
- A Simple Subjective Evaluation of Enface OCT Reflectance Images Distinguishes Glaucoma From Healthy Eyes.Translational vision science & technology · 2021Article
- Retinal Features in Cynomolgus Macaques (Comparative medicine · 2020Article
- Impact of optical coherence tomography on diagnostic decision-making by UK community optometrists: a clinical vignette study.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2019Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeIn recent years, there has been widespread investment in imaging technologies by community optometrists in the UK, most notably optical coherence tomography (OCT). The aim of the current study was to determine the value of OCT in the diagnosis of posterior segment diseases in a representative sample of community optometrists using a clinical vignette methodology.
methodsA group of community optometrists (n = 50) initially completed a standardised training package on OCT interpretation followed by a computer-based assessment featuring 52 clinical vignettes, containing images of healthy (n = 8) or glaucomatous (n = 18) discs or healthy (n = 8) or diseased (n = 18) fundi. Each vignette featured either a single fundus/disc photographic image, or a combination of a fundus/disc image with the corresponding OCT scan. An expert panel confirmed that the fundus images presented alone and those in combination with OCT data were of a similar level of difficulty and that the cases were typical of those seen in primary care. For each case, the optometrist selected their diagnosis from a pull-down list and reported their confidence in their decision using a 10-point Likert scale. Pairwise comparisons of the fundus image alone and fundus image/OCT combination were made for both diagnostic performance and confidence.
resultsThe mean percentage of correct diagnoses using fundus imaging alone was 62% (95% CI 59-64%) and for the combination of fundus image/OCT was 80% (95% CI 77-82%). The mean false negative rate with fundus alone was 27% reducing to 13% with the OCT combination. Median confidence scores for fundus imaging alone was 8.0 (IQR 7.0-8.0) and 8.3 (IQR 8.0-9.0) for the combination. Improvements in performance and confidence were statistically significant (p < 0.001).
conclusionThe results from this vignette study suggests that OCT improves optometrists' diagnostic performance compared to fundus observation alone. These initial results suggest that OCT provides valuable additional data that could augment case-finding for glaucoma and retinal disease; however, further research is needed to assess its diagnostic performance in a routine clinical practice setting.
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