Literature DB >> 24766864

The primary eye care examination: opening the case history and the patient's uninterrupted initial talking time.

Jonathan S Pointer1.   

Abstract

PURPOSE: The uninterrupted initial talking time (UITT) of optometric patients was measured in response to the clinician's opening question: "Do you have any problems with your eyes or your sight?"
METHODS: UITT was measured surreptitiously by the optometrist. Also noted was whether an eye/sight problem was claimed by the patient and whether or not this was subsequently confirmed by the examination.
RESULTS: Data were collected from 822 adults, mean age 59.1yrs (SD 17.6), range 16.0-92.0yrs. UITT data were positively skewed; median value 28.87s (IQR 19.81-43.03s) and no statistically significant difference between genders (p=0.9). 53% of patients had completed their opening statement by 30s, and 90% after 1min. 75% of these individuals (age range 26-75yrs) had a median UITT 27.82s; younger patients (16-25yrs) spoke for a significantly shorter time (18.39s: p=0.002) and elderly patients (≥76yrs) a significantly longer time (37.27s: p=0.003) than the majority value. Previously unexamined patients, habitual spectacle wearers, and individuals presenting with an eye/sight problem all recorded a significantly longer UITT (p≤0.006) than their peers. The practitioner's opening question had a sensitivity of 0.54/specificity of 0.95, and a positive predictive value (PV) of 0.78/negative PV of 0.87: with a calculated value of κ=0.53, the strength of agreement between subjective claim and objective outcome could be regarded as 'moderate'.
CONCLUSION: These data suggest that an optometric patient's UITT of <30s is unlikely to prove disruptive to the clinical routine.
Copyright © 2013 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

Entities:  

Keywords:  Historia optométrica; Optometric case history; Patient's talking time; Primary eye care examination; Primer examen visual; Prueba de visión; Sight test; Tiempo de conversación del paciente

Mesh:

Year:  2013        PMID: 24766864      PMCID: PMC4009463          DOI: 10.1016/j.optom.2013.05.002

Source DB:  PubMed          Journal:  J Optom        ISSN: 1989-1342


  9 in total

1.  Spontaneous talking time at start of consultation in outpatient clinic: cohort study.

Authors:  Wolf Langewitz; Martin Denz; Anne Keller; Alexander Kiss; Sigmund Rüttimann; Brigitta Wössmer
Journal:  BMJ       Date:  2002-09-28

2.  Length of patient's monologue, rate of completion, and relation to other components of the clinical encounter: observational intervention study in primary care.

Authors:  Israel Rabinowitz; Rachel Luzzati; Ada Tamir; Shmuel Reis; Rachel Lazzatti
Journal:  BMJ       Date:  2004-02-28

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Authors:  Laurence H Baker; Daniel O'connell; Frederic W Platt
Journal:  Ann Intern Med       Date:  2005-11-15       Impact factor: 25.391

4.  Habitual vs optimal distance visual acuity.

Authors:  Jonathan S Pointer
Journal:  Ophthalmic Physiol Opt       Date:  2008-09       Impact factor: 3.117

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Authors:  J N Blau
Journal:  BMJ       Date:  1989-01-07

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Journal:  Biometrics       Date:  1977-03       Impact factor: 2.571

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Authors:  I Svab; M Katic; C Cuk
Journal:  Aten Primaria       Date:  1993-03-15       Impact factor: 1.137

8.  The effect of physician behavior on the collection of data.

Authors:  H B Beckman; R M Frankel
Journal:  Ann Intern Med       Date:  1984-11       Impact factor: 25.391

9.  Soliciting the patient's agenda: have we improved?

Authors:  M K Marvel; R M Epstein; K Flowers; H B Beckman
Journal:  JAMA       Date:  1999-01-20       Impact factor: 56.272

  9 in total

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