Taleb Alexandre Chater, Böhm György M, Avila Marcos, Wen Chao Lung
Reference Centre in Ophthalmology, Federal University of Goiás, Brazil.
J Telemed Telecare. 2005;11 Suppl 1:83-5. doi: 10.1258/1357633054461958.
Although there are enough ophthalmologists for the Brazilian population, they are not evenly distributed throughout the country. Tele-ophthalmology may therefore be a useful tool. We have examined the feasibility of ophthalmology triage, performed by a general practitioner (GP) with remote support from an ophthalmologist. Forty patients with a variety of external and internal eye disorders were examined by the GP and also reassessed by an ophthalmologist, face to face, and then remotely by another ophthalmologist. There was agreement in 95% of the diagnoses between face-to-face and distant evaluation. The use of a digital camera and slit-lamp allowed greater accuracy of telediagnosis than the use of a digital camera alone. The GP would have referred 36 patients to an ophthalmologist, while both the local and the remote ophthalmologist saw the need for referral in 31 cases, i.e. assessment by tele-ophthalmology resulted in a 14% decrease in referrals. GP triage therefore appears to be feasible after appropriate training.
尽管巴西有足够数量的眼科医生服务于本国人口，但他们在全国的分布并不均匀。因此，远程眼科可能是一种有用的工具。我们研究了由全科医生（GP）在眼科医生的远程支持下进行眼科分诊的可行性。40例患有各种眼内外疾病的患者先由全科医生进行检查，然后由一名眼科医生进行面对面重新评估，接着再由另一名眼科医生进行远程评估。面对面评估和远程评估之间的诊断一致性为95%。与仅使用数码相机相比，使用数码相机和裂隙灯可使远程诊断的准确性更高。全科医生本会将36例患者转诊给眼科医生，而本地和远程眼科医生均认为有31例需要转诊，即通过远程眼科评估使转诊率降低了14%。因此，经过适当培训后，全科医生分诊似乎是可行的。
