Abstract
Purpose :
This study evaluates a portable, web-linked smartphone fundus camera integrated with a HIPAA-compliant image sharing platform. The technology aims to provide immediate bedside feedback to residents-in-training in hospital or acute care settings, thereby expediting diagnosis and aiding in prompt treatment decisions. The study assesses the agreement between device-assisted remotely supervised inpatient resident examinations (DARE) and subsequent examinations by attending ophthalmologists (AOE).
Methods :
Utilizing the VistaView™ Portable Mydriatic Fundus Camera (Volk Optical, Mentor, OH, USA), this prospective study captured fundus images during initial in-patient consults. Images of both anterior and posterior segments were obtained as clinically indicated. Exclusion criteria included patients unable or unwilling to cooperate. Images were anonymized, transmitted to off-site attending ophthalmologists for review, and followed by in-person examinations either later the same day or the next. Data was categorized by patient demographics, resident training level, and disease severity. Concordance between DARE and AOE was analyzed using the Kappa statistic.
Results :
The study encompassed 114 eyes from 57 patients (32 male, 25 female) with an average age of 57 years. There was a notable agreement between DARE and AOE, with a Cohen's Kappa inter-rater reliability score of 0.886 (p<0.002). Discrepancies in diagnoses were noted in 5 cases (8.8%) involving varied conditions. The study also found that the concordance rate increased and discrepancy rate decreased with the rising experience level of residents (from PGY-2 to PGY-3).
Conclusions :
The study concludes that in a hospital setting, there is significant concordance between resident examinations assisted by the device and those conducted by attending ophthalmologists. The portable, HIPAA-compliant, web-connected camera proved to be a reliable tool for remote supervision of ophthalmology residents, potentially enhancing their learning and aiding in the supervisory and patient care responsibilities of attending ophthalmologists.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.