{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T01:39:24Z","timestamp":1773279564804,"version":"3.50.1"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2015,6,18]],"date-time":"2015-06-18T00:00:00Z","timestamp":1434585600000},"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":["Ophthalmic Physiologic Optic"],"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>\n                      To establish the safety of the\n                      <jats:styled-content style=\"fixed-case\">CHANGES<\/jats:styled-content>\n                      glaucoma referral refinement scheme (\n                      <jats:styled-content style=\"fixed-case\">GRRS<\/jats:styled-content>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The\n                      <jats:styled-content style=\"fixed-case\">CHANGES<\/jats:styled-content>\n                      scheme risk stratifies glaucoma referrals, with low risk referrals seen by a community based specialist optometrist (\n                      <jats:styled-content style=\"fixed-case\">OSI<\/jats:styled-content>\n                      ) while high risk referrals are referred directly to the hospital. In this study, those patients discharged by the\n                      <jats:styled-content style=\"fixed-case\">OSI<\/jats:styled-content>\n                      were reviewed by the consultant ophthalmologist to establish a \u2018false negative\u2019 rate (\n                      <jats:italic>Study 1<\/jats:italic>\n                      ). Virtual review of optic disc photographs was carried out both by a hospital\u2010based specialist optometrist as well as the consultant ophthalmologist (\n                      <jats:italic>Study 2<\/jats:italic>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      None of these 34 discharged patients seen by the consultant were found to have glaucoma or started on treatment to lower the intra\u2010ocular pressure. Five of the 34 (15%) were classified as \u2018glaucoma suspect\u2019 based on the appearance of the optic disc and offered a follow\u2010up appointment. Virtual review by both the consultant and optometrist had a sensitivity of 80%, whilst the false positive rate for the optometrist was 3.4%, and 32% for the consultant (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      The false negative rate of the\n                      <jats:styled-content style=\"fixed-case\">OSI<\/jats:styled-content>\n                      s in the\n                      <jats:styled-content style=\"fixed-case\">CHANGES<\/jats:styled-content>\n                      scheme was 15%, however there were no patients where glaucoma was missed. Virtual review in experienced hands can be as effective as clinical review by a consultant, and is a valid method to ensure glaucoma is not missed in\n                      <jats:styled-content style=\"fixed-case\">GRRS<\/jats:styled-content>\n                      . The\n                      <jats:styled-content style=\"fixed-case\">CHANGES<\/jats:styled-content>\n                      scheme, which includes virtual review, is effective at reducing referrals to the hospital whilst not compromising patient safety.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/opo.12224","type":"journal-article","created":{"date-parts":[[2015,6,18]],"date-time":"2015-06-18T19:19:56Z","timestamp":1434655196000},"page":"577-581","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["The false negative rate and the role for virtual review in a nationally evaluated glaucoma referral refinement scheme"],"prefix":"10.1007","volume":"35","author":[{"given":"Gokulan","family":"Ratnarajan","sequence":"first","affiliation":[{"name":"Vision and Eye Research Unit Anglia Ruskin University Cambridge UK"},{"name":"UCL Institute of Ophthalmology University of London London UK"},{"name":"Oxford Eye Hospital John Radcliffe Hospital Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane","family":"Kean","sequence":"additional","affiliation":[{"name":"Huntingdon Glaucoma Diagnostic &amp; Research Centre at Hinchingbrooke Hospital Huntingdon UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"French","sequence":"additional","affiliation":[{"name":"Huntingdon Glaucoma Diagnostic &amp; Research Centre at Hinchingbrooke Hospital Huntingdon UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mike","family":"Parker","sequence":"additional","affiliation":[{"name":"Postgraduate Medical Institute Anglia Ruskin University Cambridge UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rupert","family":"Bourne","sequence":"additional","affiliation":[{"name":"Vision and Eye Research Unit Anglia Ruskin University Cambridge UK"},{"name":"Huntingdon Glaucoma Diagnostic &amp; Research Centre at Hinchingbrooke Hospital Huntingdon UK"},{"name":"NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2015,6,18]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(13)70113-X"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60355-4"},{"key":"e_1_2_6_4_1","unstructured":"National Institute for Health and Clinical Excellence. Glaucoma: Diagnosis and Management of chronic open angle glaucoma and ocular hypertension. Costing report2009 https:\/\/www.nice.org.uk\/guidance\/cg85\/resources\/cg85-glaucoma-costing-report2(accessed 14\/6\/15)."},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-1313.2010.00797.x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2012-302352"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/eye.1998.217"},{"key":"e_1_2_6_8_1","unstructured":"NICE. Glaucoma: diagnosis and management of chronic open angle glaucoma and ocular hypertension2009 http:\/\/guidance.nice.org.uk\/CG85\/NiceGuidance\/pdf\/English accessed 14\/6\/2015."},{"key":"e_1_2_6_9_1","unstructured":"Association of Optometrists. Advice on NICE glaucoma guidelines2010 http:\/\/www.aop.org.uk\/practitioner-advice\/enhanced-services\/glaucoma-nice-guidelines\/ accessed 14\/6\/2015."},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/opo.12029"},{"key":"e_1_2_6_11_1","unstructured":"College of Optometrists.Guidance on the referral of Glaucoma suspects by community optometrists2010 http:\/\/www.college-optometrists.org\/en\/utilities\/document-summary.cfm\/docid\/B7251E0C-2436-455A-B15F1E43B6594206 accessed 14\/6\/2015."},{"key":"e_1_2_6_12_1","volume-title":"Services for People at Risk of Developing Glaucoma","author":"NICE","year":"2012"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.eye.6703045"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/eye.2009.190"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/eye.2010.136"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.eye.6700261"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-1313.2011.00853.x"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/eye.2009.327"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-002715"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/opo.12066"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/eye.2014.9"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2009.09.026"}],"container-title":["Ophthalmic and Physiological Optics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fopo.12224","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/opo.12224","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T11:24:07Z","timestamp":1767785047000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/opo.12224"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,6,18]]},"references-count":21,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2015,9]]}},"alternative-id":["10.1111\/opo.12224"],"URL":"https:\/\/doi.org\/10.1111\/opo.12224","archive":["Portico"],"relation":{},"ISSN":["0275-5408","1475-1313"],"issn-type":[{"value":"0275-5408","type":"print"},{"value":"1475-1313","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,6,18]]},"assertion":[{"value":"2015-02-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-05-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-06-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}