Physician recognition of ophthalmoscopic signs of open-angle glaucoma: effect of an educational program.

OBJECTIVE

To evaluate a short educational intervention instructing primary care physicians in the recognition of glaucomatous changes of the optic disc.

DESIGN

Comparison of performances on a pretest and a posttest consisting of fundus slides in color.

SETTING

Educational conferences at two university-affiliated teaching hospitals and one staff-model health maintenance organization.

SUBJECTS

Thirty-six internal medicine residents and ten practicing internists.

INTERVENTION

A 20-minute slide/narration educational program, which covered diagnostic criteria for open-angle glaucoma, normal and abnormal optic disc anatomy, and funduscopic signs of open-angle glaucoma.

MEASUREMENTS AND MAIN RESULTS

Following the intervention, residents showed improved sensitivity (0.76 to 0.88, p = 0.007), specificity (0.65 to 0.88, p less than 0.001), and accuracy (0.71 to 0.88, p less than 0.001). Internists showed similar increments in sensitivity, specificity, and accuracy: 0.67 to 0.86 (p = 0.01), 0.59 to 0.84 (p = 0.01), and 0.63 to 0.85 (p = 0.002), respectively.

CONCLUSION

A brief educational intervention can result in meaningful improvement in physician diagnostic accuracy in recognizing ophthalmoscopic signs of open-angle glaucoma.