Using non?mydriatic fundus photography to detect fundus pathology in Australian metropolitan emergency departments: A prospective prevalence and diagnostic accuracy study
Field | Value | Language |
dc.contributor.author | Dunn, Hamish P | en_AU |
dc.contributor.author | Teo, Kai Zong | en_AU |
dc.contributor.author | Smyth, James WP | en_AU |
dc.contributor.author | Weerasinghe, Lakni S | en_AU |
dc.contributor.author | Costello, Julia | en_AU |
dc.contributor.author | Pampapathi, Preethi | en_AU |
dc.contributor.author | Keay, Lisa | en_AU |
dc.contributor.author | Green, Tim | en_AU |
dc.contributor.author | Vukasovic, Matthew | en_AU |
dc.contributor.author | Bruce, Beau B | en_AU |
dc.contributor.author | Newman, Nancy J | en_AU |
dc.contributor.author | Biousse, Valérie | en_AU |
dc.contributor.author | White, Andrew J | en_AU |
dc.contributor.author | McCluskey, Peter | en_AU |
dc.contributor.author | Fraser, Clare L | en_AU |
dc.date.accessioned | 2020-09-24 | |
dc.date.available | 2020-09-24 | |
dc.date.issued | 2020 | en_AU |
dc.identifier.uri | https://hdl.handle.net/2123/23431 | |
dc.description.abstract | OBJECTIVE: To determine the prevalence of fundus pathology in metropolitan Australian EDs utilising a non-mydriatic fundus photography screening programme. Secondary objectives include diagnostic accuracy among emergency physicians compared to telehealth ophthalmologist review. METHODS: Prospective cross-sectional study investigating non-mydriatic fundus photography as a new diagnostic test in two tertiary Australian EDs. Consecutive adult patients were enrolled if they presented with headache, focal neurological deficit, visual disturbance or diastolic BP >120 mmHg. Diagnostic agreement was determined using kappa statistics and sensitivity and specificity using a reference standard consensus ophthalmology review. RESULTS: A total of 345 consecutive patients were enrolled among whom 56 (16%, 95% confidence interval [CI] 13-21) had urgent fundus pathology. Agreement between emergency physician and ophthalmic assessment of fundus photographs was 74% (kappa = 0.196, P = 0.001). Emergency physicians had 40% sensitivity (95% CI 27-54) and 82% specificity (95% CI 76-86) for detecting urgent pathology on photographs. CONCLUSIONS: Fundus photography detects a clinically significant proportion of fundus pathology and urgent diagnoses. Telehealth specialist image review is important to detect some important, time-critical illnesses that can be missed in routine care. This offers an accurate alternative to direct ophthalmoscopy that warrants further research in Australian EDs. | en_AU |
dc.language.iso | en | en_AU |
dc.subject | COVID-19 | en_AU |
dc.subject | Coronavirus | en_AU |
dc.title | Using non?mydriatic fundus photography to detect fundus pathology in Australian metropolitan emergency departments: A prospective prevalence and diagnostic accuracy study | en_AU |
dc.type | Article | en_AU |
dc.identifier.doi | 10.1111/1742-6723.13619 |
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