Novice Reviewers Retain High Sensitivity and Specificity of Posterior Segment Disease Identification with iWellnessExam™

Abstract EN

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.