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Title: Investigation of the efficacy of an online diagnostic tool for improving the diagnosis of ocular fundus lesions imaged by Optical Coherence Tomography (OCT)
Author: Grace, Paul
ISNI:       0000 0004 6497 3557
Awarding Body: London South Bank University
Current Institution: London South Bank University
Date of Award: 2017
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Background: Novel ocular imaging technology has proliferated within UK community optometry. Optical Coherence Tomography (OCT) is a pillar of ocular imaging, playing a central role in retinal disease management. As a non-invasive method for diagnosis and follow-up of patients with common retinal conditions such as age-related macular degeneration (AMD) and diabetic macular oedema, OCT is well suited to the primary care setting of community optometry. The novel nature of OCT images presents considerable challenges for community optometrists. AMD prevalence will rise as a consequence of population growth and unprecedented life expectancy and, despite the emergence of novel treatment options, limited clinical capacity threatens access to potentially sight-saving treatment. Limited guidance exists for optometrists using OCT for diagnostic and referral decisions. Objective: To measure the efficacy of a novel internet resource which, if proven to be efficacious, could not only aid in the use of OCT for diagnosis of retinal disease and subsequent patient management but could also play a role in ongoing training of optometrists. Method: An online diagnostic tool (OCTAID) was designed for diagnosis of central retinal lesions using OCT. The effectiveness of OCTAID was evaluated by a randomised controlled trial comparing two groups of practitioners who underwent an online assessment (using clinical vignettes) of their diagnostic and management skills based on OCT images before and after an educational intervention. Participants' answers were validated against experts' classifications (the reference standard). OCTAID was randomly allocated as the educational intervention for one group with the control group receiving an intervention of standard OCT material. Participants: Participants were community optometrists recruited through online optometry forums Setting: Internet based application Results: 53 optometrists (study group) and 65 optometrists (control group) completed the study (n = 118), forming the analysis population. Both groups performed similarly at baseline with no significant difference in mean exam 1 scores (p = 0.212). The primary outcome measure was mean improvement in exam score between the two exam modules. Participants who received OCTAID improved their exam score significantly more than those who received conventional educational materials (p = 0.005). Conclusion: Use of OCTAID is associated with an improvement in the combined skill of OCT scan recognition and subsequent patient management. There is potential for this mode of educational delivery in optometric training. Future work recommendations: With further development, OCTAID could become a collaborative learner-centred model of OCT education allowing optometrists to take responsibility for their own learning within a unique professional community.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Prof.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available