Back to Search
Start Over
A Telephone Triage System for Patients Calling with Symptoms of a Posterior Vitreous Detachment.
- Source :
-
Ophthalmology. Retina [Ophthalmol Retina] 2023 Jun; Vol. 7 (6), pp. 516-526. Date of Electronic Publication: 2023 Jan 09. - Publication Year :
- 2023
-
Abstract
- Purpose: The purpose of the study was to develop a simple telephone questionnaire, without physical examination input, that predicts which patients calling with symptoms of a posterior vitreous detachment (PVD) have a retinal tear (RT) or rhegmatogenous retinal detachment (RD).<br />Design: Prospective cohort (quality improvement) study.<br />Participants: All patients with symptoms consistent with a PVD calling a major academic ophthalmology department over a 4-month period in 2020 and who were seen on follow-up within 1.5 months (211 screened and 193 included).<br />Methods: A comprehensive telephone questionnaire assessing for RT/RD risk factors was administered by telephone triage staff to all patients calling with symptoms of flashes, floaters, or curtain/veil in their vision. Multivariable logistic regression was used to determine risk factors most predictive of having an RT/RD during the add-on visit. Risk factor odds ratios were used to develop an RT/RD risk score.<br />Main Outcomes Measures: Development of a clinical risk score for having an RT/RD at the add-on visit after telephone triage.<br />Results: Approximately 55% of patients were previously established in the retina clinic, 26% were new to the department, 19% were previously established in the comprehensive clinic, and 7% had an RT/RD at the add-on visit. Out of 23 questions and 70 prespecified possible answers from the telephone questionnaire, the final clinical risk score for RT/RDs was derived from 7 questions and 15 possible answers. The simplified questionnaire can be administered quickly by telephone operators without any reference to physical examination or the patient's chart. The receive-operator curve for our final multivariable logistic regression and clinical risk score models have an area under the curve of > 0.90. Using a conservative clinical risk score, approximately 50% of all patients without an RT/RD can be safely seen nonurgently. Progressively higher scores can be used to determine relative urgency of an appointment.<br />Conclusions: To our knowledge, this is the first study to predict risk of an RT/RD in a patient calling with symptoms consistent with a PVD without reference to the patient's physical examination or chart. Our clinical risk scoring system can be used to determine urgency of an add-on appointment and increase the number of low-risk patients with symptomatic PVDs who are scheduled routinely.<br />Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.<br /> (Copyright © 2023 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)
Details
- Language :
- English
- ISSN :
- 2468-6530
- Volume :
- 7
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Ophthalmology. Retina
- Publication Type :
- Academic Journal
- Accession number :
- 36634817
- Full Text :
- https://doi.org/10.1016/j.oret.2023.01.003