Effective Validation of Primary Care Patient Triage Classification Via Tele-Ophthalmology With Optometrist Support

The triage classification and diagnosis of eye diseases in primary care patients through teleophthalmology were performed by ophthalmologists, optometrists, and family physicians. The agreement in triage classification and diagnosis between observers, as well as the quality of referrals from primary...

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Autores: Carrasco Solís, Rafael, Rodríguez Griñolo, María Rosario, Ponte Zúñiga, Beatriz, Mataix Albert, Beatriz, González Troncoso, María José, Martínez de Pablos, Rocío, Rodríguez de la Rúa Franch, Enrique
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Universidad de Sevilla (US)
Repositorio:idUS. Depósito de Investigación de la Universidad de Sevilla
OAI Identifier:oai:idus.us.es:11441/179768
Acceso en línea:https://hdl.handle.net/11441/179768
https://doi.org/10.1177/00469580251367231
Access Level:acceso abierto
Palabra clave:Referrals
Optometry
Primary care
Ophthalmology
Teleophthalmology
Triage
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spelling Effective Validation of Primary Care Patient Triage Classification Via Tele-Ophthalmology With Optometrist SupportCarrasco Solís, RafaelRodríguez Griñolo, María RosarioPonte Zúñiga, BeatrizMataix Albert, BeatrizGonzález Troncoso, María JoséMartínez de Pablos, RocíoRodríguez de la Rúa Franch, EnriqueReferralsOptometryPrimary careOphthalmologyTeleophthalmologyTriageThe triage classification and diagnosis of eye diseases in primary care patients through teleophthalmology were performed by ophthalmologists, optometrists, and family physicians. The agreement in triage classification and diagnosis between observers, as well as the quality of referrals from primary care to ophthalmology, were evaluated. Study to compare methods using a non-inferiority method approach. The sample comprised 220 patients with suspected ocular problems evaluated by family physicians. These patients were examined by an optometrist (observer 1) using a Visionix VX650 multi-diagnostic platform. The optometrist provided a suspected diagnosis and a referral. The tests were forwarded electronically to an ophthalmologist (observer 2), who provided a diagnosis and referral. Subsequently, they were reviewed in person by an ophthalmologist (observer 3) who provided a diagnosis and referral. The observers worked independently and at different times, without knowledge of each other’s evaluations, ensuring the objectivity of the analysis. We analyzed interobserver agreement in triage referrals and diagnosis using the Kappa index. The triage classification of patients by teleophthalmology coincides with that of in-person ophthalmology in 91.2% of the cases (Kappa = 0.819). The optician’s triage classification coincided with in-person ophthalmology in 91.3% (Kappa = 0.858) and with teleophthalmology in 92.3% (Kappa = 0.851). The diagnostic categories, teleophthalmology and in-person ophthalmology coincided in 84.61% of the cases (Kappa = 0.80). The optician coincided with in-person ophthalmology in 90.65% (Kappa = 0.88) and with teleophthalmology in 90.9% of the diagnoses (Kappa = 0.87). There was a very high level interobserver agreement for both triage classification and diagnostic categories. This validates our teleophthalmology approach, conducted in a primary care setting by optometrists, family physicians, and ophthalmologists, for an effective triage classification of patients referred to ophthalmology services. This telemedicine also accurately categorizes patients based on their conditions, optimizing resources, reducing waiting times and waiting lists.SAGE PublicationsBioquímica y Biología MolecularCirugíaInstituto de Salud Carlos III2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://hdl.handle.net/11441/179768https://doi.org/10.1177/00469580251367231reponame:idUS. Depósito de Investigación de la Universidad de Sevillainstname:Universidad de Sevilla (US)InglésINQUIRY: The Journal of Health Care Organization, Provision, and Financing, 62, 00469580251367231.RD21/0002/00100469580251367231info:eu-repo/semantics/openAccessoai:idus.us.es:11441/1797682026-06-17T12:51:07Z
dc.title.none.fl_str_mv Effective Validation of Primary Care Patient Triage Classification Via Tele-Ophthalmology With Optometrist Support
title Effective Validation of Primary Care Patient Triage Classification Via Tele-Ophthalmology With Optometrist Support
spellingShingle Effective Validation of Primary Care Patient Triage Classification Via Tele-Ophthalmology With Optometrist Support
Carrasco Solís, Rafael
Referrals
Optometry
Primary care
Ophthalmology
Teleophthalmology
Triage
title_short Effective Validation of Primary Care Patient Triage Classification Via Tele-Ophthalmology With Optometrist Support
title_full Effective Validation of Primary Care Patient Triage Classification Via Tele-Ophthalmology With Optometrist Support
title_fullStr Effective Validation of Primary Care Patient Triage Classification Via Tele-Ophthalmology With Optometrist Support
title_full_unstemmed Effective Validation of Primary Care Patient Triage Classification Via Tele-Ophthalmology With Optometrist Support
title_sort Effective Validation of Primary Care Patient Triage Classification Via Tele-Ophthalmology With Optometrist Support
dc.creator.none.fl_str_mv Carrasco Solís, Rafael
Rodríguez Griñolo, María Rosario
Ponte Zúñiga, Beatriz
Mataix Albert, Beatriz
González Troncoso, María José
Martínez de Pablos, Rocío
Rodríguez de la Rúa Franch, Enrique
author Carrasco Solís, Rafael
author_facet Carrasco Solís, Rafael
Rodríguez Griñolo, María Rosario
Ponte Zúñiga, Beatriz
Mataix Albert, Beatriz
González Troncoso, María José
Martínez de Pablos, Rocío
Rodríguez de la Rúa Franch, Enrique
author_role author
author2 Rodríguez Griñolo, María Rosario
Ponte Zúñiga, Beatriz
Mataix Albert, Beatriz
González Troncoso, María José
Martínez de Pablos, Rocío
Rodríguez de la Rúa Franch, Enrique
author2_role author
author
author
author
author
author
dc.contributor.none.fl_str_mv Bioquímica y Biología Molecular
Cirugía
Instituto de Salud Carlos III
dc.subject.none.fl_str_mv Referrals
Optometry
Primary care
Ophthalmology
Teleophthalmology
Triage
topic Referrals
Optometry
Primary care
Ophthalmology
Teleophthalmology
Triage
description The triage classification and diagnosis of eye diseases in primary care patients through teleophthalmology were performed by ophthalmologists, optometrists, and family physicians. The agreement in triage classification and diagnosis between observers, as well as the quality of referrals from primary care to ophthalmology, were evaluated. Study to compare methods using a non-inferiority method approach. The sample comprised 220 patients with suspected ocular problems evaluated by family physicians. These patients were examined by an optometrist (observer 1) using a Visionix VX650 multi-diagnostic platform. The optometrist provided a suspected diagnosis and a referral. The tests were forwarded electronically to an ophthalmologist (observer 2), who provided a diagnosis and referral. Subsequently, they were reviewed in person by an ophthalmologist (observer 3) who provided a diagnosis and referral. The observers worked independently and at different times, without knowledge of each other’s evaluations, ensuring the objectivity of the analysis. We analyzed interobserver agreement in triage referrals and diagnosis using the Kappa index. The triage classification of patients by teleophthalmology coincides with that of in-person ophthalmology in 91.2% of the cases (Kappa = 0.819). The optician’s triage classification coincided with in-person ophthalmology in 91.3% (Kappa = 0.858) and with teleophthalmology in 92.3% (Kappa = 0.851). The diagnostic categories, teleophthalmology and in-person ophthalmology coincided in 84.61% of the cases (Kappa = 0.80). The optician coincided with in-person ophthalmology in 90.65% (Kappa = 0.88) and with teleophthalmology in 90.9% of the diagnoses (Kappa = 0.87). There was a very high level interobserver agreement for both triage classification and diagnostic categories. This validates our teleophthalmology approach, conducted in a primary care setting by optometrists, family physicians, and ophthalmologists, for an effective triage classification of patients referred to ophthalmology services. This telemedicine also accurately categorizes patients based on their conditions, optimizing resources, reducing waiting times and waiting lists.
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/11441/179768
https://doi.org/10.1177/00469580251367231
url https://hdl.handle.net/11441/179768
https://doi.org/10.1177/00469580251367231
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 62, 00469580251367231.
RD21/0002/001
00469580251367231
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv SAGE Publications
publisher.none.fl_str_mv SAGE Publications
dc.source.none.fl_str_mv reponame:idUS. Depósito de Investigación de la Universidad de Sevilla
instname:Universidad de Sevilla (US)
instname_str Universidad de Sevilla (US)
reponame_str idUS. Depósito de Investigación de la Universidad de Sevilla
collection idUS. Depósito de Investigación de la Universidad de Sevilla
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.811543

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