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Impact of a short online course on the accuracy of non-ophthalmic diabetic retinopathy graders in recognising glaucomatous optic nerves in Vietnam

PURPOSE: To test an online training course for non-ophthalmic diabetic retinopathy (DR) graders for recognition of glaucomatous optic nerves in Vietnam. METHODS: This was an uncontrolled, experimental, before-and-after study in which 43 non-ophthalmic DR graders underwent baseline testing on a stand...

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Autores principales: Olawoye, Olusola Oluyinka, Ha, Thu Huong, Pham, Ngoc, Nguyen, Lam, Cherwek, David Hunter, Fowobaje, Kayode Raphael, Ross, Craig, Coote, Michael, Chan, Ving Fai, Kahook, Malik, Peto, Tunde, Azuara-Blanco, Augusto, Congdon, Nathan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10649381/
https://www.ncbi.nlm.nih.gov/pubmed/37945295
http://dx.doi.org/10.1136/bmjopen-2023-076623
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author Olawoye, Olusola Oluyinka
Ha, Thu Huong
Pham, Ngoc
Nguyen, Lam
Cherwek, David Hunter
Fowobaje, Kayode Raphael
Ross, Craig
Coote, Michael
Chan, Ving Fai
Kahook, Malik
Peto, Tunde
Azuara-Blanco, Augusto
Congdon, Nathan
author_facet Olawoye, Olusola Oluyinka
Ha, Thu Huong
Pham, Ngoc
Nguyen, Lam
Cherwek, David Hunter
Fowobaje, Kayode Raphael
Ross, Craig
Coote, Michael
Chan, Ving Fai
Kahook, Malik
Peto, Tunde
Azuara-Blanco, Augusto
Congdon, Nathan
author_sort Olawoye, Olusola Oluyinka
collection PubMed
description PURPOSE: To test an online training course for non-ophthalmic diabetic retinopathy (DR) graders for recognition of glaucomatous optic nerves in Vietnam. METHODS: This was an uncontrolled, experimental, before-and-after study in which 43 non-ophthalmic DR graders underwent baseline testing on a standard image set, completed a self-paced, online training course and were retested using the same photographs presented randomly. Twenty-nine local ophthalmologists completed the same test without the training course. DR graders then underwent additional one–to-one training by a glaucoma specialist and were retested. Test performance (% correct, compared with consensus grades from four fellowship-trained glaucoma experts), sensitivity, specificity, positive and negative predictive value, and area under the receiver operating (AUC) curve, were computed. RESULTS: Mean age of DR graders (32.6±5.5 years) did not differ from ophthalmologists (32.3±7.3 years, p=0.13). Online training required a mean of 297.9 (SD 144.6) minutes. Graders’ mean baseline score (33.3%±14.3%) improved significantly after training (55.8%±12.6%, p<0.001), and post-training score did not differ from ophthalmologists (58.7±15.4%, p=0.384). Although grader sensitivity reduced before [85.5% (95% CI 83.5% to 87.3%)] versus after [80.4% (78.3% to 82.4%)] training, specificity improved significantly [47.8 (44.9 to 50.7) vs 79.8 (77.3 to 82.0), p<0.001]. Grader AUC also improved after training [66.6 (64.9 to 68.3)] to [80.1 (78.5 to 81.6), p<0.001]. Additional one-to-one grader training by a glaucoma specialist did not further improve grader scores. CONCLUSION: Non-ophthalmic DR graders can be trained to recognise glaucoma using a short online course in this setting, with no additional benefit from more expensive one–to-one training. After 5-hour online training in recognising glaucomatous optic nerve head, scores of non-ophthalmic DR graders doubled, and did not differ from local ophthalmologists. Intensive one-to-one training did not further improve performance
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spelling pubmed-106493812023-11-09 Impact of a short online course on the accuracy of non-ophthalmic diabetic retinopathy graders in recognising glaucomatous optic nerves in Vietnam Olawoye, Olusola Oluyinka Ha, Thu Huong Pham, Ngoc Nguyen, Lam Cherwek, David Hunter Fowobaje, Kayode Raphael Ross, Craig Coote, Michael Chan, Ving Fai Kahook, Malik Peto, Tunde Azuara-Blanco, Augusto Congdon, Nathan BMJ Open Ophthalmology PURPOSE: To test an online training course for non-ophthalmic diabetic retinopathy (DR) graders for recognition of glaucomatous optic nerves in Vietnam. METHODS: This was an uncontrolled, experimental, before-and-after study in which 43 non-ophthalmic DR graders underwent baseline testing on a standard image set, completed a self-paced, online training course and were retested using the same photographs presented randomly. Twenty-nine local ophthalmologists completed the same test without the training course. DR graders then underwent additional one–to-one training by a glaucoma specialist and were retested. Test performance (% correct, compared with consensus grades from four fellowship-trained glaucoma experts), sensitivity, specificity, positive and negative predictive value, and area under the receiver operating (AUC) curve, were computed. RESULTS: Mean age of DR graders (32.6±5.5 years) did not differ from ophthalmologists (32.3±7.3 years, p=0.13). Online training required a mean of 297.9 (SD 144.6) minutes. Graders’ mean baseline score (33.3%±14.3%) improved significantly after training (55.8%±12.6%, p<0.001), and post-training score did not differ from ophthalmologists (58.7±15.4%, p=0.384). Although grader sensitivity reduced before [85.5% (95% CI 83.5% to 87.3%)] versus after [80.4% (78.3% to 82.4%)] training, specificity improved significantly [47.8 (44.9 to 50.7) vs 79.8 (77.3 to 82.0), p<0.001]. Grader AUC also improved after training [66.6 (64.9 to 68.3)] to [80.1 (78.5 to 81.6), p<0.001]. Additional one-to-one grader training by a glaucoma specialist did not further improve grader scores. CONCLUSION: Non-ophthalmic DR graders can be trained to recognise glaucoma using a short online course in this setting, with no additional benefit from more expensive one–to-one training. After 5-hour online training in recognising glaucomatous optic nerve head, scores of non-ophthalmic DR graders doubled, and did not differ from local ophthalmologists. Intensive one-to-one training did not further improve performance BMJ Publishing Group 2023-11-09 /pmc/articles/PMC10649381/ /pubmed/37945295 http://dx.doi.org/10.1136/bmjopen-2023-076623 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Ophthalmology
Olawoye, Olusola Oluyinka
Ha, Thu Huong
Pham, Ngoc
Nguyen, Lam
Cherwek, David Hunter
Fowobaje, Kayode Raphael
Ross, Craig
Coote, Michael
Chan, Ving Fai
Kahook, Malik
Peto, Tunde
Azuara-Blanco, Augusto
Congdon, Nathan
Impact of a short online course on the accuracy of non-ophthalmic diabetic retinopathy graders in recognising glaucomatous optic nerves in Vietnam
title Impact of a short online course on the accuracy of non-ophthalmic diabetic retinopathy graders in recognising glaucomatous optic nerves in Vietnam
title_full Impact of a short online course on the accuracy of non-ophthalmic diabetic retinopathy graders in recognising glaucomatous optic nerves in Vietnam
title_fullStr Impact of a short online course on the accuracy of non-ophthalmic diabetic retinopathy graders in recognising glaucomatous optic nerves in Vietnam
title_full_unstemmed Impact of a short online course on the accuracy of non-ophthalmic diabetic retinopathy graders in recognising glaucomatous optic nerves in Vietnam
title_short Impact of a short online course on the accuracy of non-ophthalmic diabetic retinopathy graders in recognising glaucomatous optic nerves in Vietnam
title_sort impact of a short online course on the accuracy of non-ophthalmic diabetic retinopathy graders in recognising glaucomatous optic nerves in vietnam
topic Ophthalmology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10649381/
https://www.ncbi.nlm.nih.gov/pubmed/37945295
http://dx.doi.org/10.1136/bmjopen-2023-076623
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