Teleoftalmologia como auxílio diagnóstico nas doenças infecciosas e inflamatórias oculares

Detalhes bibliográficos
Autor(a) principal: Finamor, Luciana Peixoto dos Santos [UNIFESP]
Data de Publicação: 2005
Outros Autores: Martins, Maria Cristina [UNIFESP], Muccioli, Cristina [UNIFESP], Singulem, Daniel [UNIFESP], Lopes, Paulo R. L. [UNIFESP], Belfort, Rubens Junior [UNIFESP]
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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spelling 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
dc.relation.none.fl_str_mv Revista da Associação Médica Brasileira
dc.rights.driver.fl_str_mv 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
collection Repositório Institucional da UNIFESP
repository.name.fl_str_mv Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)
repository.mail.fl_str_mv biblioteca.csp@unifesp.br
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