{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T04:37:23Z","timestamp":1788237443958,"version":"build-2803163510"},"reference-count":36,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,8,8]],"date-time":"2021-08-08T00:00:00Z","timestamp":1628380800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Exper Ophthalmology"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Ophthalmoscopy and its interpretation are complex. We aimed to compare the diagnostic accuracy of smartphone fundoscopy with traditional direct ophthalmoscopy for optic disc interpretation, with e\u2010learning support.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a randomised, crossover study of 102 medical students. Students were offered e\u2010learning for optic disc interpretation. A fundoscopy objective structured clinical examination was conducted after an introductory lecture and 10\u2010min practical training session on smartphone fundoscopy and traditional ophthalmoscopy. Participants examined patients and simulator slides with a randomised crossover between smartphone [D\u2010eye (Padova, Italy) or iExaminer (Welch Allyn, Macquarie Park, Australia)] and traditional ophthalmoscopy (Welch Allyn). Optic discs were graded independently by three masked ophthalmologists. The primary outcome was the ability to interpret an optic disc as normal or abnormal. Secondary outcomes included other optic disc aspects; student preferences; and e\u2010learning performance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Students' agreement with the gold standard for an abnormal or normal disc was significantly greater using a smartphone (74.4%) than with direct ophthalmoscopy (68.1%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.032). More students preferred smartphone (74%) over direct ophthalmoscopy (26%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). E\u2010learning led to an improvement in optic disc interpretation scores (mean improvement\u00a0=\u00a04.5%, 95% CI\u00a0=\u00a03.7\u20135.2, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Medical students are more accurate at recognising an abnormal optic disc using smartphone fundoscopy than traditional direct ophthalmoscopy, and have a strong preference for smartphone fundoscopy. E\u2010learning may improve the interpretation of optic disc abnormalities. Smartphone fundoscopy may mitigate some technical challenges of fundoscopy and reinvigorate use of this valuable clinical examination.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ceo.13977","type":"journal-article","created":{"date-parts":[[2021,7,22]],"date-time":"2021-07-22T12:10:52Z","timestamp":1626955852000},"page":"704-713","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["<scp>eFOCUS<\/scp> 2: A randomised crossover trial of smartphone fundoscopy and direct ophthalmoscopy aiming to improve optic disc interpretation by medical students with e\u2010learning support"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4632-9712","authenticated-orcid":false,"given":"Hamish P.","family":"Dunn","sequence":"first","affiliation":[{"name":"Northern Clinical School, Royal North Shore Hospital University of Sydney  St Leonards New South Wales Australia"},{"name":"Westmead Hospital, Department 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