title: Novice Reviewers Retain High Sensitivity and Specificity of Posterior Segment Disease Identification with iWellnessExam™.
abstract: Introduction. Four novices to Spectral Domain Optical Coherence Tomography (SD-OCT) image review were provided a brief lecture on the interpretation of iVue iWellnessExam™ findings (available on iVue® SD-OCT, Optovue, Inc., Fremont, CA). For a cohort of 126 (Confirmed) Normal, 101 (Confirmed) Disease subjects, iWellnessExam™ OD, OS, and OU reports were provided. Each novice independently reviewed and sorted the subjects into one of four categories: normal, retinal disease, optic nerve (ON) disease, and retinal + ON disease. Their accuracy is compared between the novices and with an expert reviewer. Results. Posterior segment disease was properly detected by novices with sensitivities of 90.6%, any disease; 84.3%, retinal disease; 88.0%, ON disease; expert sensitivity: 96.0%, 95.5%, and 90.0%, respectively; specificity: 84.3%, novices; 99.2%, expert. Novice accuracy correlates best with clinical exposure and amount of time spent reviewing each image set. The novices' negative predictive value was 92.0% (i.e., very few false negatives). Conclusions. Novices can be trained to screen for posterior segment disease efficiently and effectively using iWellnessExam™ data, with high sensitivity, while maintaining high specificity. Novice reviewer accuracy covaries with both clinical exposure and time spent per image set. These findings support exploration of training nonophthalmic technicians in a primary medical care setting.
authors.affiliation: Private Practice, Scarsdale, NY 10583, USA; SUNY State College of Optometry, New York, NY 10036, USA; SUNY Eye Institute, Syracuse, NY 13202, USA.
authors.forename: Samantha
authors.identifier: 0000-0002-7904-1547
authors.initials: S
authors.lastname: Slotnick
authors.affiliation: Nova Southeastern University College of Optometry, Fort Lauderdale, FL 33314, USA; University of Incarnate Word Rosenberg School of Optometry, San Antonio, TX 78229, USA.
authors.forename: Catherine
authors.initials: C
authors.lastname: Awad
authors.affiliation: Eye Institute & Laser Center, New York, NY 10065, USA.
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Nath
authors.affiliation: SUNY State College of Optometry, New York, NY 10036, USA; SUNY Eye Institute, Syracuse, NY 13202, USA; Eye Institute & Laser Center, New York, NY 10065, USA.
authors.forename: Jerome
authors.initials: J
authors.lastname: Sherman