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Assessing Early Stage Open-Angle Glaucoma in Patients by Isolated-Check Visual Evoked Potential
Published on: May 25, 2020
The Portsmouth-based glaucoma refinement scheme: a role for virtual clinics in the future?
S Trikha1, C Macgregor, M Jeffery
1Department of Ophthalmology, Queen Alexandra Hospital, Cosham, Portsmouth PO6 3LY,, UK. strikha@doctors.org.uk
Eye (London, England)
|July 7, 2012
Summary
The Portsmouth glaucoma scheme effectively streamlines referrals using virtual clinics and community optometrists. This approach significantly improves the positive predictive rate for glaucoma diagnosis and reduces hospital burden.
Area of Science:
- Ophthalmology
- Public Health
- Health Services Research
Background:
- Hospital Eye Services (HES) face significant burdens from glaucoma referrals.
- A high proportion of these referrals are false positives, impacting efficiency.
Purpose of the Study:
- To evaluate the Portsmouth glaucoma scheme.
- Assess the scheme's use of virtual clinics, digital technology, and community optometrists to streamline glaucoma referrals.
Main Methods:
- Mapped patient pathways and analyzed 100 consecutive decisions at each stage.
- Assessed diagnostic outcomes for 50 patients referred from the refinement scheme to HES.
Main Results:
- 76% of glaucoma referrals were suitable for the refinement scheme.
- The scheme increased the positive predictive value for glaucoma/ocular hypertension/suspect referrals to 0.78 (vs. 0.37 previously).
- Generated £244,200 annual cost savings and freed up 1400 HES clinic slots per year.
Conclusions:
- The refinement scheme successfully streamlines glaucoma referrals and enhances diagnostic accuracy.
- Widespread adoption could lead to substantial cost savings within the NHS while maintaining high-quality patient care.
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