Teleoftalmologia como auxílio diagnóstico nas doenças infecciosas e inflamatórias oculares
Autor(a) principal: | |
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Data de Publicação: | 2005 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://dx.doi.org/10.1590/S0104-42302005000500020 http://repositorio.unifesp.br/handle/11600/2702 |
Resumo: | PURPOSE: The purpose of this study was to evaluate the efficacy of teleophthalmology as an auxiliary approach for diagnosis of infectious and inflammatory ocular diseases and to study the main problems associated with the conclusion reached by consultation. METHODS: Two hundred and thirty three 35 mm slides (retinography or biomicroscopy photos) were digitalized and stored in a Compact Disc to be later analyzed in a computer monitor by two consultants, specialists in uveitis. The consultants filled out a form and a questionnaire, indicating the diagnosis and probable treatment for the analyzed cases also the main difficulties found to reach a conclusion of the consultation. The Kappa statistic, an assessment of the change-corrected agreement (reproducibility) among consultants, was calculated. Kappa values of > 0.7 indicated excellent agreement; values between 0.4 and 0.7 indicated fair to good agreement and values of < 0.4 indicated poor agreement. RESULTS: Agreement between the consultants and the final diagnosis was of 73.5%. Treatment suggestion or management was not possible in 8% of the cases for consultant A and in 10.4% for consultant B. The higher agreement rate among consultants, relating to the reasons that rendered diagnosis difficult, was found in relation to lack of clinical data and low quality of images. CONCLUSION: Teleophthalmology, through the asynchronous method, was an efficient means for diagnosis of patients with infectious and inflammatory ocular diseases. The main problems affecting the teleophthalmology consultation were lack of detailed clinical data and low quality of the images. |
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Teleoftalmologia como auxílio diagnóstico nas doenças infecciosas e inflamatórias ocularesTeleophthalmology as an auxiliary approach for the diagnosis of infectious and inflammatory ocular diseases: evaluation of an asynchronous method of consultationTelemedicineOphthalmologyDiagnosisUveitisAIDSTelemedicinaOftalmologiaDiagnósticoUveítesSíndrome de imunodeficiência adquiridaPURPOSE: The purpose of this study was to evaluate the efficacy of teleophthalmology as an auxiliary approach for diagnosis of infectious and inflammatory ocular diseases and to study the main problems associated with the conclusion reached by consultation. METHODS: Two hundred and thirty three 35 mm slides (retinography or biomicroscopy photos) were digitalized and stored in a Compact Disc to be later analyzed in a computer monitor by two consultants, specialists in uveitis. The consultants filled out a form and a questionnaire, indicating the diagnosis and probable treatment for the analyzed cases also the main difficulties found to reach a conclusion of the consultation. The Kappa statistic, an assessment of the change-corrected agreement (reproducibility) among consultants, was calculated. Kappa values of > 0.7 indicated excellent agreement; values between 0.4 and 0.7 indicated fair to good agreement and values of < 0.4 indicated poor agreement. RESULTS: Agreement between the consultants and the final diagnosis was of 73.5%. Treatment suggestion or management was not possible in 8% of the cases for consultant A and in 10.4% for consultant B. The higher agreement rate among consultants, relating to the reasons that rendered diagnosis difficult, was found in relation to lack of clinical data and low quality of images. CONCLUSION: Teleophthalmology, through the asynchronous method, was an efficient means for diagnosis of patients with infectious and inflammatory ocular diseases. The main problems affecting the teleophthalmology consultation were lack of detailed clinical data and low quality of the images.OBJETIVOS: Avaliar a eficácia da teleoftalmologia como auxílio diagnóstico nas doenças infecciosas e inflamatórias oculares, assim como avaliar os principais fatores limitantes para a realização e conclusão de consultoria em oftalmologia. MÉTODOS: Duzentas e trinta e três fotos (retinografias e/ou exames de biomicroscopia), em diapositivos 35-mm de 87 pacientes, foram digitalizadas e armazenadas em CD-ROM, para posterior análise, em monitor de computador, por dois consultores especialistas em uveítes, que responderam formulário e questionário indicando o diagnóstico provável, tratamento e/ou conduta e as dificuldades encontradas para a conclusão da consultoria. Teste estatístico Kappa foi utilizado para avaliação da concordância entre os observadores. Valores de Kappa acima de 0,7 indicam concordância excelente; valores entre 0,4 e 0,7 indicam concordância moderada/boa e valores menores que 0,4 indicam concordância ruim. RESULTADOS: A concordância diagnóstica observada na consultoria, em relação ao padrão ouro, foi de 73,5% para ambos os consultores. Sugestão de tratamento e/ou conduta não foi possível em 8% dos casos para o consultor A, e em 10,4% para o consultor B. A falta de dados clínicos (Kappa: 0,8) e a má qualidade das imagens (Kappa: 0,74) foram os motivos com maior concordância em relação às dificuldades para conclusão da consultoria. CONCLUSÃO: A teleoftalmologia por meio de consultoria por método assíncrono foi eficaz para o diagnóstico de doenças infecciosas e inflamatórias oculares. A falta de dados clínicos detalhados e a má qualidade das imagens foram os principais fatores limitantes para a conclusão da consultoria.Universidade Federal de São Paulo (UNIFESP) Departamento de Informática em Saúde Departamento de OftalmologiaUNIFESP, Depto. de Informática em Saúde Depto. de OftalmologiaSciELOAssociação Médica BrasileiraUniversidade Federal de São Paulo (UNIFESP)Finamor, Luciana Peixoto dos Santos [UNIFESP]Martins, Maria Cristina [UNIFESP]Muccioli, Cristina [UNIFESP]Singulem, Daniel [UNIFESP]Lopes, Paulo R. L. [UNIFESP]Belfort, Rubens Junior [UNIFESP]2015-06-14T13:31:45Z2015-06-14T13:31:45Z2005-10-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion279-284application/pdfhttp://dx.doi.org/10.1590/S0104-42302005000500020Revista da Associação Médica Brasileira. Associação Médica Brasileira, v. 51, n. 5, p. 279-284, 2005.10.1590/S0104-42302005000500020S0104-42302005000500020.pdf0104-4230S0104-42302005000500020http://repositorio.unifesp.br/handle/11600/2702porRevista da Associação Médica Brasileirainfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-07-29T22:17:45Zoai:repositorio.unifesp.br/:11600/2702Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-07-29T22:17:45Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.none.fl_str_mv |
Teleoftalmologia como auxílio diagnóstico nas doenças infecciosas e inflamatórias oculares Teleophthalmology as an auxiliary approach for the diagnosis of infectious and inflammatory ocular diseases: evaluation of an asynchronous method of consultation |
title |
Teleoftalmologia como auxílio diagnóstico nas doenças infecciosas e inflamatórias oculares |
spellingShingle |
Teleoftalmologia como auxílio diagnóstico nas doenças infecciosas e inflamatórias oculares Finamor, Luciana Peixoto dos Santos [UNIFESP] Telemedicine Ophthalmology Diagnosis Uveitis AIDS Telemedicina Oftalmologia Diagnóstico Uveítes Síndrome de imunodeficiência adquirida |
title_short |
Teleoftalmologia como auxílio diagnóstico nas doenças infecciosas e inflamatórias oculares |
title_full |
Teleoftalmologia como auxílio diagnóstico nas doenças infecciosas e inflamatórias oculares |
title_fullStr |
Teleoftalmologia como auxílio diagnóstico nas doenças infecciosas e inflamatórias oculares |
title_full_unstemmed |
Teleoftalmologia como auxílio diagnóstico nas doenças infecciosas e inflamatórias oculares |
title_sort |
Teleoftalmologia como auxílio diagnóstico nas doenças infecciosas e inflamatórias oculares |
author |
Finamor, Luciana Peixoto dos Santos [UNIFESP] |
author_facet |
Finamor, Luciana Peixoto dos Santos [UNIFESP] Martins, Maria Cristina [UNIFESP] Muccioli, Cristina [UNIFESP] Singulem, Daniel [UNIFESP] Lopes, Paulo R. L. [UNIFESP] Belfort, Rubens Junior [UNIFESP] |
author_role |
author |
author2 |
Martins, Maria Cristina [UNIFESP] Muccioli, Cristina [UNIFESP] Singulem, Daniel [UNIFESP] Lopes, Paulo R. L. [UNIFESP] Belfort, Rubens Junior [UNIFESP] |
author2_role |
author author author author author |
dc.contributor.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) |
dc.contributor.author.fl_str_mv |
Finamor, Luciana Peixoto dos Santos [UNIFESP] Martins, Maria Cristina [UNIFESP] Muccioli, Cristina [UNIFESP] Singulem, Daniel [UNIFESP] Lopes, Paulo R. L. [UNIFESP] Belfort, Rubens Junior [UNIFESP] |
dc.subject.por.fl_str_mv |
Telemedicine Ophthalmology Diagnosis Uveitis AIDS Telemedicina Oftalmologia Diagnóstico Uveítes Síndrome de imunodeficiência adquirida |
topic |
Telemedicine Ophthalmology Diagnosis Uveitis AIDS Telemedicina Oftalmologia Diagnóstico Uveítes Síndrome de imunodeficiência adquirida |
description |
PURPOSE: The purpose of this study was to evaluate the efficacy of teleophthalmology as an auxiliary approach for diagnosis of infectious and inflammatory ocular diseases and to study the main problems associated with the conclusion reached by consultation. METHODS: Two hundred and thirty three 35 mm slides (retinography or biomicroscopy photos) were digitalized and stored in a Compact Disc to be later analyzed in a computer monitor by two consultants, specialists in uveitis. The consultants filled out a form and a questionnaire, indicating the diagnosis and probable treatment for the analyzed cases also the main difficulties found to reach a conclusion of the consultation. The Kappa statistic, an assessment of the change-corrected agreement (reproducibility) among consultants, was calculated. Kappa values of > 0.7 indicated excellent agreement; values between 0.4 and 0.7 indicated fair to good agreement and values of < 0.4 indicated poor agreement. RESULTS: Agreement between the consultants and the final diagnosis was of 73.5%. Treatment suggestion or management was not possible in 8% of the cases for consultant A and in 10.4% for consultant B. The higher agreement rate among consultants, relating to the reasons that rendered diagnosis difficult, was found in relation to lack of clinical data and low quality of images. CONCLUSION: Teleophthalmology, through the asynchronous method, was an efficient means for diagnosis of patients with infectious and inflammatory ocular diseases. The main problems affecting the teleophthalmology consultation were lack of detailed clinical data and low quality of the images. |
publishDate |
2005 |
dc.date.none.fl_str_mv |
2005-10-01 2015-06-14T13:31:45Z 2015-06-14T13:31:45Z |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1590/S0104-42302005000500020 Revista da Associação Médica Brasileira. Associação Médica Brasileira, v. 51, n. 5, p. 279-284, 2005. 10.1590/S0104-42302005000500020 S0104-42302005000500020.pdf 0104-4230 S0104-42302005000500020 http://repositorio.unifesp.br/handle/11600/2702 |
url |
http://dx.doi.org/10.1590/S0104-42302005000500020 http://repositorio.unifesp.br/handle/11600/2702 |
identifier_str_mv |
Revista da Associação Médica Brasileira. Associação Médica Brasileira, v. 51, n. 5, p. 279-284, 2005. 10.1590/S0104-42302005000500020 S0104-42302005000500020.pdf 0104-4230 S0104-42302005000500020 |
dc.language.iso.fl_str_mv |
por |
language |
por |
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Revista da Associação Médica Brasileira |
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info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
279-284 application/pdf |
dc.publisher.none.fl_str_mv |
Associação Médica Brasileira |
publisher.none.fl_str_mv |
Associação Médica Brasileira |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
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Repositório Institucional da UNIFESP |
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Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
biblioteca.csp@unifesp.br |
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1824718277254840320 |