Evidence map›Paper›PMID 35531644›Full record

Trial reportEuropean journal of neurology2022

Fundoscopy use in neurology departments and the utility of smartphone photography: a prospective prevalence and crossover diagnostic accuracy study amongst neurology inpatients.

George He, Hamish P Dunn, Kate E Ahmad, Eloise Watson, Andrew Henderson, Dominique Tynan, John Leaney, Andrew J White, Alex W Hewitt, Clare L Fraser

Open access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European journal of neurology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
3.1field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 15 citations in OpenAlex.

  1. Trial
  2. Article
  3. Review
  4. Article
  5. Article
  6. Article
  7. Article
  8. The Use Of Fundus Photography In The Emergency Room-A Review.Current neurology and neuroscience reports · 2025
    Review
  9. Review
  10. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 1 country.

George HeUniversity of Melbourne, Melbourne, Vic., Australia.ORCID 0000-0003-0661-0005
Hamish P DunnUniversity of Sydney, Faculty of Medicine and Health, Sydney, NSW, Australia.ORCID 0000-0002-4632-9712
Kate E AhmadRoyal North Shore Hospital, Department of Neurology, Sydney, NSW, Australia.
Eloise WatsonRoyal North Shore Hospital, Department of Neurology, Sydney, NSW, Australia.ORCID 0000-0002-1769-9722
Andrew HendersonWestmead Hospital, Department of Neurology, Sydney, NSW, Australia.
Dominique TynanUniversity of Sydney, Faculty of Medicine and Health, Sydney, NSW, Australia.
John LeaneyUniversity of Sydney, Faculty of Medicine and Health, Sydney, NSW, Australia.
Andrew J WhiteUniversity of Sydney, Faculty of Medicine and Health, Sydney, NSW, Australia.
Alex W HewittUniversity of Melbourne, Melbourne, Vic., Australia.
Clare L FraserUniversity of Sydney, Faculty of Medicine and Health, Sydney, NSW, Australia.ORCID 0000-0002-0379-7743
The University of Sydney · AURoyal North Shore Hospital · AUThe University of Melbourne · AUWestmead Hospital · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeAlthough fundoscopy is a crucial part of the neurological examination, it is challenging, under-utilized and unreliably performed. The aim was to determine the prevalence of fundus pathology amongst neurology inpatients and the diagnostic accuracy of current fundoscopy practice compared with systematic screening with smartphone fundoscopy (SF) and portable non-mydriatic fundus photography (NMFP).

methodsThis was a prospective cross-sectional surveillance and diagnostic accuracy study on adult patients admitted under neurology in an Australian hospital. Inpatients were randomized to initial NMFP (RetinaVue 100, Welch Allyn) or SF (D-EYE) followed by a crossover to the alternative modality. Images were graded by neurology doctors, using telemedicine consensus neuro-ophthalmology NMFP grading as the reference standard. Feasibility parameters included ease, comfort and speed.

resultsOf 79 enrolled patients, 14.1% had neurologically relevant pathology (seven, disc pallor; one, hypertensive retinopathy; three, disc swelling). The neurology team performed direct ophthalmoscopy in 6.6% of cases and missed all abnormalities. SF had a sensitivity of 30%-40% compared with NMFP (45.5%); however, it had a lower rate of screening failure (1% vs. 13%, p < 0.001), a shorter examination time (1.10 vs. 2.25 min, p < 0.001) and a slightly higher patient comfort rating (9.2 vs. 8/10, p < 0.001).

conclusionOur study demonstrates a clinically significant prevalence of fundus pathology amongst neurology inpatients which was missed by current fundoscopy practices. Portable NMFP screening appears more accurate than SF, whilst both are diagnostically superior to routine fundoscopic practice, feasible and well tolerated by patients.

Indexed as

NeurologySmartphoneAdultAustraliaCross-Sectional StudiesHumansInpatientsNeurologic ExaminationOphthalmoscopyPhotographyPrevalenceProspective Studiesfundus oculineurologyophthalmoscopyphotographysensitivity and specificity

Identifiers

PMID35531644
PMCPMC9541490
OpenAlexW4229377180

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.