Michael Yim1, Anat Galor2, Afshan Nanji1, Madhura Joag1, Sotiria Palioura1, William Feuer1, Carol L Karp3. 1. Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL. 2. Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL; Ophthalmology Department, Miami Veterans Administration Medical Center, Miami, FL. 3. Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL. Electronic address: ckarp@med.miami.edu.
Abstract
OBJECTIVE: To assess the ability of novice clinicians to use a commercially available high-resolution anterior segment optical coherence tomography (HR-OCT) device to diagnose various lesions of the ocular surface and cornea. METHODS: Cross-sectional study. Twenty-six black-and-white HR-OCT images were projected, and clinicians were asked to determine whether the lesions represented ocular surface squamous neoplasia (OSSN) or another ocular surface pathology. A 20-minute instructional lecture was given on HR-OCT interpretation, and the same 26 images were shown. The clinicians were asked to repeat their assessment of the lesions. Thirty-four novice clinicians at the Bascom Palmer Eye Institute, Miami, FL, participated. A commercially available device (RTVue, Optovue, Fremont, Calif.) was specifically chosen for this study. RESULTS: The mean frequency of correct identification of the 26 lesions was 70% (standard deviation [SD] 15%) before instruction; after a short lecture, the frequency of correct identification improved to 84% (SD 9%, p = 0.002). Novice clinicians were more accurate in correctly determining that a lesion was not an OSSN (ruling it out as a diagnosis) than in determining that a lesion was an OSSN (p = 0.001). Some lesions (both OSSN and not OSSN), however, were more difficult to interpret than others. CONCLUSION: This study demonstrated that all levels of novice clinicians can quickly improve diagnostic accuracy with a commercially available HR-OCT after a short training session.
OBJECTIVE: To assess the ability of novice clinicians to use a commercially available high-resolution anterior segment optical coherence tomography (HR-OCT) device to diagnose various lesions of the ocular surface and cornea. METHODS: Cross-sectional study. Twenty-six black-and-white HR-OCT images were projected, and clinicians were asked to determine whether the lesions represented ocular surface squamous neoplasia (OSSN) or another ocular surface pathology. A 20-minute instructional lecture was given on HR-OCT interpretation, and the same 26 images were shown. The clinicians were asked to repeat their assessment of the lesions. Thirty-four novice clinicians at the Bascom Palmer Eye Institute, Miami, FL, participated. A commercially available device (RTVue, Optovue, Fremont, Calif.) was specifically chosen for this study. RESULTS: The mean frequency of correct identification of the 26 lesions was 70% (standard deviation [SD] 15%) before instruction; after a short lecture, the frequency of correct identification improved to 84% (SD 9%, p = 0.002). Novice clinicians were more accurate in correctly determining that a lesion was not an OSSN (ruling it out as a diagnosis) than in determining that a lesion was an OSSN (p = 0.001). Some lesions (both OSSN and not OSSN), however, were more difficult to interpret than others. CONCLUSION: This study demonstrated that all levels of novice clinicians can quickly improve diagnostic accuracy with a commercially available HR-OCT after a short training session.
Authors: Jeremy Z Kieval; Carol L Karp; Mohamed Abou Shousha; Anat Galor; Rodrigo A Hoffman; Sander R Dubovy; Jianhua Wang Journal: Ophthalmology Date: 2011-12-09 Impact factor: 12.079
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