Fundus Photography vs. Ophthalmoscopy Outcomes in the Emergency Department (FOTO-ED) Phase III: Web-based, In-service Training of Emergency Providers

ABSTRACT

We evaluated a web-based training aimed at improving the review of fundus photography by emergency providers. 587 patients were included, 12.6% with relevant abnormalities. Emergency providers spent 31 minutes (median) training and evaluated 359 patients. Median post-test score improvement was 6 percentage points (IQR: 2–14; p = 0.06). Pre- vs. post-training, the emergency providers reviewed 45% vs. 43% of photographs; correctly identified abnormals in 67% vs. 57% of cases; and correctly identified normals in 80% vs. 84%. The Fundus photography vs. Ophthalmoscopy Trial Outcomes in the Emergency Department studies have demonstrated that emergency providers perform substantially better with fundus photography than direct ophthalmoscopy, but our web-based, in-service training did not result in further improvements at our institution.

KEYWORDS:

• Fundus photography
• training
• telemedicine

Acknowledgments

This study was supported in part by an unrestricted departmental grant (Department of Ophthalmology) from Research to Prevent Blindness, Inc., New York, and by NIH/NEI core grant P30-EY006360 (Department of Ophthalmology).

Dr. Bruce received research support from the NIH/NEI (K23-EY019341) and the Knights Templar Eye Foundation, and received the American Academy of Neurology Practice Research Fellowship.

Dr. Wright received research support from NIH/PHS (KL2-RR025009).

Dr. Biousse received research support from NIH/PHS (UL1-RR025008).

Dr. Newman is a recipient of the Research to Prevent Blindness Lew R. Wasserman Merit Award.

No conflicting relationship exists for any author.

Additional information

Funding

This work was supported by the American Academy of Neurology; Knights Templar Eye Foundation; National Institutes of Health [K23-EY019341, KL2-RR025009, P30-EY006360, UL1-RR025008]; Research to Prevent Blindness.