{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T21:59:06Z","timestamp":1791928746762,"version":"4.3.4"},"reference-count":43,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"The Carlos III Health Institute. Next Generation EU Funds, which finance the actions of the recovery and resilience mechanism (MRR) integrated in the PRTR.","award":["Financed by RD21\/0002\/0011: Next Generation EU Fun"],"award-info":[{"award-number":["Financed by RD21\/0002\/0011: Next Generation EU Fun"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["INQUIRY"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:p>\n                    The triage classification and diagnosis of eye diseases in primary care patients through teleophthalmology were performed by ophthalmologists, optometrists, and family physicians. The agreement in\n                    <jats:italic>triage classification<\/jats:italic>\n                    and diagnosis between observers, as well as the quality of referrals from primary care to ophthalmology, were evaluated. Study to compare methods using a non-inferiority method approach. The sample comprised 220 patients with suspected ocular problems evaluated by family physicians. These patients were examined by an optometrist\n                    <jats:italic>(observer 1<\/jats:italic>\n                    ) using a Visionix VX650 multi-diagnostic platform. The optometrist provided a suspected diagnosis and a referral. The tests were forwarded electronically to an ophthalmologist (observer 2), who provided a diagnosis and referral. Subsequently, they were reviewed in person by an ophthalmologist (observer 3) who provided a diagnosis and referral. The observers worked independently and at different times, without knowledge of each other\u2019s evaluations, ensuring the objectivity of the analysis. We analyzed interobserver agreement in\n                    <jats:italic>triage referrals<\/jats:italic>\n                    and diagnosis using the Kappa index. The\n                    <jats:italic>triage classification<\/jats:italic>\n                    of patients by teleophthalmology coincides with that of in-person ophthalmology in 91.2% of the cases (Kappa\u2009=\u20090.819). The optician\u2019s\n                    <jats:italic>triage classification<\/jats:italic>\n                    coincided with in-person ophthalmology in 91.3% (Kappa\u2009=\u20090.858) and with teleophthalmology in 92.3% (Kappa\u2009=\u20090.851). The diagnostic categories, teleophthalmology and in-person ophthalmology coincided in 84.61% of the cases (Kappa\u2009=\u20090.80). The optician coincided with in-person ophthalmology in 90.65% (Kappa\u2009=\u20090.88) and with teleophthalmology in 90.9% of the diagnoses (Kappa\u2009=\u20090.87). There was a very high level interobserver agreement for both\n                    <jats:italic>triage classification<\/jats:italic>\n                    and diagnostic categories. This validates our teleophthalmology approach, conducted in a primary care setting by optometrists, family physicians, and ophthalmologists, for an effective triage classification of patients referred to ophthalmology services. This t\n                    <jats:italic>elemedicine<\/jats:italic>\n                    also accurately categorizes patients based on their conditions, optimizing resources, reducing waiting times and waiting lists.\n                  <\/jats:p>","DOI":"10.1177\/00469580251367231","type":"journal-article","created":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:56:17Z","timestamp":1756342577000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Effective Validation of Primary Care Patient Triage Classification Via Tele-Ophthalmology With Optometrist Support"],"prefix":"10.1177","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4131-9171","authenticated-orcid":false,"given":"Rafael","family":"Carrasco Sol\u00eds","sequence":"first","affiliation":[{"name":"Universidad de Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00aa Rosario","family":"Rodr\u00edguez Gri\u00f1olo","sequence":"additional","affiliation":[{"name":"Universidad Pablo de Olavide, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Ponte Z\u00fa\u00f1iga","sequence":"additional","affiliation":[{"name":"Hospital Universitario Virgen Macarena, Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Mataix Albert","sequence":"additional","affiliation":[{"name":"Hospital Universitario Virgen Macarena, Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Leticia","family":"Lled\u00f3 de Villar","sequence":"additional","affiliation":[{"name":"Hospital Universitario Virgen Macarena, Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Jos\u00e9","family":"Gonz\u00e1lez Troncoso","sequence":"additional","affiliation":[{"name":"Sevilla Health District, Ministry of Health and Consumer Affairs, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roc\u00edo","family":"Mart\u00ednez de Pablos","sequence":"additional","affiliation":[{"name":"Universidad de Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrique","family":"Rodr\u00edguez de La R\u00faa Franch","sequence":"additional","affiliation":[{"name":"RICORS-REI, Project Exp. RD21\/0002\/0011, ISCIII, Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,8,27]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/cxo.12334"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/cxo.12658"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S185186"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.22608\/APO.2016110"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2019-314161"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjophth-2020-000671"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2021.02.010"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.4103\/ijo.IJO_1784_20"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.3390\/medicina57090978"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.oftal.2019.01.007"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.optom.2024.100521"},{"key":"e_1_3_3_13_2","unstructured":"Sanidad MD. 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