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首页> 外文期刊>Eye >Can a community optometrist-based referral refinement scheme reduce false-positive glaucoma hospital referrals without compromising quality of care? The community and hospital allied network glaucoma evaluation scheme (CHANGES).
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Can a community optometrist-based referral refinement scheme reduce false-positive glaucoma hospital referrals without compromising quality of care? The community and hospital allied network glaucoma evaluation scheme (CHANGES).

机译：可以在不影响医疗质量的前提下，以社区视光师为基础的转诊优化方案减少假阳性青光眼医院的转诊吗？社区和医院联合网络青光眼评估方案（CHANGES）。

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BACKGROUND/AIMS: To describe the design, activity, and quality of the referral refinement phase of a novel glaucoma shared-care scheme. METHODS: Eight Optometrists with a Specialist Interest in glaucoma (OSI) were trained to perform a community-based comprehensive glaucoma evaluation of low-risk glaucoma hospital referrals (only oneone of the following factors noted for either eye: abnormal optic disc, abnormal visual field, abnormal intraocular pressure (IOP; 22-28 mmHg or IOP asymmetry)) using equipment standardized to that of the hospital glaucoma service. RESULTS: One hundred and thirty-eight (27%) of a total of 512 glaucoma-related referrals were deemed 'low risk'. Their choice of OSI discharged 40 (35%). The consultant agreed (virtually) with the decision to discharge with 28 (70%) and disagreed with 12 (30%). Comparing findings between OSI and consultant for 99 referred patients, sensitivity, specificity, and negative predictive values for a suspicious optic disc were 78, 61, and 79%, respectively. For an IOP of >21 mmHg, they were 74, 85, and 90%, respectively. For an occludable anterior chamber angle (Van Herick's versus gonioscopy), they were 69, 88, and 94%, respectively. CONCLUSION: This referral refinement process can reduce numbers of false-positive referrals attending the hospital glaucoma service while retaining a relatively high level of examination quality.
机译：背景/目的：描述一种新型青光眼共享护理计划的转诊优化阶段的设计，活动和质量。方法：对八名对青光眼有特殊兴趣的验光师进行了培训，以对低危青光眼医院转诊进行社区综合青光眼评估（两只眼睛中只有以下一项/一项没有发现：视盘异常，异常视野，异常眼内压（IOP; 22-28 mmHg或IOP不对称），使用与医院青光眼服务相同的标准化设备。结果：512例青光眼相关转诊中的138例（27％）被认为是“低风险”。他们选择的OSI排放了40（35％）。顾问（实际上）同意决定解雇28人（70％），不同意12人（30％）。 OSI和顾问对99名转诊患者的调查结果比较，可疑视盘的敏感性，特异性和阴性预测值分别为78％，61％和79％。对于大于21 mmHg的IOP，它们分别为74％，85％和90％。对于可闭合的前房角（Van Herick vs角膜镜检查），它们分别为69％，88％和94％。结论：这种转诊细化过程可以减少参加医院青光眼服务的假阳性转诊的数量，同时保持较高水平的检查质量。

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