{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T04:38:46Z","timestamp":1790483926642,"version":"4.1.0"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2019,4,17]],"date-time":"2019-04-17T00:00:00Z","timestamp":1555459200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012909","name":"College of Optometrists","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012909","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ophthalmic Physiologic Optic"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>\n                      In recent years, there has been widespread investment in imaging technologies by community optometrists in the\n                      <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>\n                      , most notably optical coherence tomography (\n                      <jats:styled-content style=\"fixed-case\">OCT<\/jats:styled-content>\n                      ). The aim of the current study was to determine the value of\n                      <jats:styled-content style=\"fixed-case\">OCT<\/jats:styled-content>\n                      in the diagnosis of posterior segment diseases in a representative sample of community optometrists using a clinical vignette methodology.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A group of community optometrists (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a050) initially completed a standardised training package on\n                      <jats:styled-content style=\"fixed-case\">OCT<\/jats:styled-content>\n                      interpretation followed by a computer\u2010based assessment featuring 52 clinical vignettes, containing images of healthy (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a08) or glaucomatous (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a018) discs or healthy (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a08) or diseased (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a018) fundi. Each vignette featured either a single fundus\/disc photographic image, or a combination of a fundus\/disc image with the corresponding\n                      <jats:styled-content style=\"fixed-case\">OCT<\/jats:styled-content>\n                      scan. An expert panel confirmed that the fundus images presented alone and those in combination with\n                      <jats:styled-content style=\"fixed-case\">OCT<\/jats:styled-content>\n                      data were of a similar level of difficulty and that the cases were typical of those seen in primary care. For each case, the optometrist selected their diagnosis from a pull\u2010down list and reported their confidence in their decision using a 10\u2010point Likert scale. Pairwise comparisons of the fundus image alone and fundus image\/\n                      <jats:styled-content style=\"fixed-case\">OCT<\/jats:styled-content>\n                      combination were made for both diagnostic performance and confidence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean percentage of correct diagnoses using fundus imaging alone was 62% (95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      59\u201364%) and for the combination of fundus image\/\n                      <jats:styled-content style=\"fixed-case\">OCT<\/jats:styled-content>\n                      was 80% (95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      77\u201382%). The mean false negative rate with fundus alone was 27% reducing to 13% with the\n                      <jats:styled-content style=\"fixed-case\">OCT<\/jats:styled-content>\n                      combination. Median confidence scores for fundus imaging alone was 8.0 (\n                      <jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>\n                      7.0\u20138.0) and 8.3 (\n                      <jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>\n                      8.0\u20139.0) for the combination. Improvements in performance and confidence were statistically significant (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The results from this vignette study suggests that\n                      <jats:styled-content style=\"fixed-case\">OCT<\/jats:styled-content>\n                      improves optometrists\u2019 diagnostic performance compared to fundus observation alone. These initial results suggest that\n                      <jats:styled-content style=\"fixed-case\">OCT<\/jats:styled-content>\n                      provides valuable additional data that could augment case\u2010finding for glaucoma and retinal disease; however, further research is needed to assess its diagnostic performance in a routine clinical practice setting.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/opo.12613","type":"journal-article","created":{"date-parts":[[2019,4,17]],"date-time":"2019-04-17T07:12:21Z","timestamp":1555485141000},"page":"205-215","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Impact of optical coherence tomography on diagnostic decision\u2010making by\n                    <scp>UK<\/scp>\n                    community optometrists: a clinical vignette 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