{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T21:59:21Z","timestamp":1791928761221,"version":"4.3.4"},"reference-count":66,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2023,7,3]],"date-time":"2023-07-03T00:00:00Z","timestamp":1688342400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000266","name":"Engineering and Physical Sciences Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000266","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":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>In the UK, ophthalmology has the highest number of outpatient appointments within the National Health Service. False\u2010positive referrals from primary care are one of the main factors contributing to the oversubscription of hospital eye services (HESs). We reviewed the accuracy of referrals originating from primary care optometrists and contributing factors, such as condition type and years since registration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Recent findings<\/jats:title>\n                    <jats:p>\n                      Of the 31 studies included in the review, 22 were retrospective analyses of referrals and appointments at the HES. Eight were prospective studies, and one used online clinical vignettes. Seven assessed the accuracy of referrals for all ocular conditions. The remaining studies focused on glaucoma (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200911), cataracts (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20097), emergency conditions (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094), neovascular age\u2010related macular degeneration (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091) and paediatric binocular vision (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091). The diagnostic agreement for suspected emergency ocular conditions was the lowest, with only 21.1% of referrals considered to require urgent attention in one study. For glaucoma, the first\u2010visit discharge rate was high (16.7%\u201348%). Optometrist referral accuracy was overall 18.6% higher than General Medical Practitioners'; however, the two mainly referred different ocular conditions. Female optometrists made more false\u2010positive referrals than males (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008). The proportion of false positives decreased by 6.2% per year since registration (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>There was significant variation in referral accuracy across different ocular conditions, partly due to differences when defining accurate referrals. Optometrists working in primary care are generally more limited in their resources than the HES. Thus, choosing the cautious option of referral when they are unsure could be in the patients' best interests. The possible effect of increased use of advanced imaging on referrals requires evaluation. Although interventions such as refinement schemes have been put in place, these vary across regions, and their approaches such as virtual referral triaging may reduce unnecessary HES face\u2010to\u2010face appointments and promote communication between primary and secondary care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/opo.13183","type":"journal-article","created":{"date-parts":[[2023,7,3]],"date-time":"2023-07-03T03:41:36Z","timestamp":1688355696000},"page":"1255-1277","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Assessment of optometrists' referral accuracy and contributing factors: A review"],"prefix":"10.1007","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4689-4786","authenticated-orcid":false,"given":"Josie","family":"Carmichael","sequence":"first","affiliation":[{"name":"University College London Interaction Centre (UCLIC), UCL  London UK"},{"name":"NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Abdi","sequence":"additional","affiliation":[{"name":"University College London Interaction Centre (UCLIC), UCL  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Balaskas","sequence":"additional","affiliation":[{"name":"NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Costanza","sequence":"additional","affiliation":[{"name":"University College London Interaction Centre (UCLIC), UCL  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Blandford","sequence":"additional","affiliation":[{"name":"University College London Interaction Centre (UCLIC), UCL  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,7,3]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"NHS Digital.Hospital outpatient activity. 2019\u201320. 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