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Development and evaluation of a nurse-administered triage questionnaire for ophthalmic emergencies during on-call
M Jacquet1, J Poret1, J-L Bourges2
1Department of Ophthalmology, Amiens Picardie Hospital, University of Picardie Jules-Verne, Amiens, France.
Objective:
To develop and evaluate a nurse-administered triage questionnaire for unscheduled ophthalmic care requests during on-call hours, using the BaSe SCOrE as the reference standard.
Design:
Multicenter retrospective diagnostic accuracy study.
Participants:
Adults presenting with unscheduled ophthalmic care requests during on-call hours at a university hospital ophthalmic emergency unit and a general hospital emergency department in Hauts-de-France, France.
Methods:
Nurses administered a standardized checklist combining a brief naked-eye examination and an 8-item questionnaire and classified each case as RED (immediate ophthalmic emergency) or GREEN (non-immediate). The ophthalmologist's final diagnosis, blinded to the checklist, was mapped to the BaSe SCOrE. BaSe SCOrE stages 4-5 were considered RED, and stages 1-3 GREEN. Sensitivity, specificity, predictive values, likelihood ratios, and accuracy were calculated.
Results:
A total of 629 questionnaires were analyzed (447 university hospital; 182 general hospital). Severe diagnoses (BaSe SCOrE 4-5) represented 6.4% (40/629) of cases. Overall sensitivity for identifying RED cases was 85% (95% CI, 70-94) and specificity was 86% (83-89); negative predictive value was 99% (97-100), and overall accuracy was 86%. Six BaSe SCOrE 4 cases were triaged as GREEN; no BaSe SCOrE 5 case was missed.
Conclusion:
This nurse-administered triage questionnaire showed good diagnostic performance during on-call hours in both a specialized ophthalmic emergency unit and a general emergency department. Prospective multicenter validation and assessment of implementation strategies are warranted.
