Developing standards for the development of glaucoma virtual clinics using a modified Delphi approach

Kotecha, Aachal; Longstaff, S; Azuara‐Blanco, Augusto; Kirwan, James; Morgan, James I.; Spencer, Anne Fiona; Foster, Paul J.

doi:10.1136/bjophthalmol-2017-310504

Cited by 26 publications

(18 citation statements)

References 24 publications

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“…The Delphi technique used in this study successfully developed a consensus among the experts contributing through repeated information exchange and feedback ( 28 ). Unlike with the classic Delphi technique, the modified Delphi method used here did not apply the conventional 4 rounds ( 29 – 31 ). The consultation ended after 2 rounds, as the experts had reached a consensus.…”

Section: Discussionmentioning

confidence: 99%

A team approach to applying the International Classification of Functioning, Disability and Health Rehabilitation set in clinical evaluation

Zhang¹,

Zhang²,

Xiang³

et al. 2021

J Rehabil Med

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Objective To develop a team approach to applying the International Classification of Functioning, Disability and Health Rehabilitation Set (ICF-RS) in clinical evaluation. Design A Delphi study. Subjects Experts from rehabilitation institutions in China including physicians, nurses, physiotherapists and occupational therapists. Methods A 2-round Delphi survey and expert panel discussion were used to generate the team approach. Firstly, the candidate types of professionals for team rating were chosen through expert panel discussion. A carefully selected group of participants was then asked to score the suitability of physicians, nurses, or other candidate therapists for each category’s rating, applying the International Classification of Functioning, Disability and Health Rehabilitation Set in clinical evaluation. After initial assignment of category to types of professionals, a second round Delphi survey was conducted to quantify the professionals’ agreement with the category assignments and generate a final team evaluation approach. Results Thirty of the category assignments achieved consensus. The final team evaluation approach assigned 6 categories to physicians to evaluate, 7 categories to nurses, 9 categories to physiotherapists, and 8 to occupational therapists. Conclusion Such a team evaluation approach could facilitate implementation of the ICF-RS in clinical settings and provide a more convenient assessment tool for professionals. LAY ABSTRACT As the Chinese International Classification of Functioning, Disability and Health Rehabilitation Set became widely used in rehabilitation institutions in China, it was found to be timeconsuming and inefficient for a single rater to complete the entire evaluation in a single setting. Team evaluation provides an alternative team approach for busy professionals, especially when used to evaluate patients with complex problems or poor communication ability. The whole set of 30 evaluation categories was divided among a hypothetical team consisting of a physician, a nurse, a physiotherapist and an occupational therapist, with 6 categories assigned to the physician, 7 to the nurse, 9 to the physiotherapist, and 8 to the occupational therapist. Each professional in the team rated categories closely related to their daily work. The team evaluation approach promises to better share the evaluation workload, perhaps improving the accuracy of evaluations and strengthening interdisciplinary collaboration in the clinic.

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Section: Discussionmentioning

confidence: 99%

A team approach to applying the International Classification of Functioning, Disability and Health Rehabilitation set in clinical evaluation

Zhang¹,

Zhang²,

Xiang³

et al. 2021

J Rehabil Med

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“…68 A Delphi survey has also been used to define outcome measures for glaucoma effectiveness trials, 69 to ascertain specifications on screening intervention for open angle glaucoma 70 and to develop standards for glaucoma virtual clinics in the UK. 71 In our study, we aimed to rank expected glaucoma surgery complications according to severity. We achieved a high level of consensus in two rounds with a high response rate (80%), which is a strength of this study.…”

Section: Discussionmentioning

confidence: 99%

“…For example, in a recent literature review on the reporting of hypotony after glaucoma surgery, the authors found that this parameter had been inconsistently defined across 128 studies. 71 They have also concluded that hypotony should be further coded according to clinical significance. In our study, we have described hypotony as either 'early post-operative with no other symptoms', 'persistent low IOP with no other symptoms', 'low IOP and shallow anterior chamber with peripheral iris-corneal touch' or 'hypotony with maculopathy' to reflect the varying grades of severity.…”

Section: Discussionmentioning

confidence: 99%

Reporting Harm in Glaucoma Surgical Trials: Systematic Review and a Consensus-Derived New Classification System

Sii

Barton

Pasquale

et al. 2018

American Journal of Ophthalmology

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“…Digital fundus photographs, copies of the visual field plots, and a summary of the patient record which included case history information, slit lamp findings, intraocular pressure (IOP) and pachymetry readings, and the optometrist's written record of the optic disc assessment, were made available for the consultant to view in a ‘virtual clinic’, similar to that described by Trikha, et al . and Kotecha, et al . following the patient's GRR exam.…”

Section: Methodsmentioning

confidence: 99%

Glaucoma referral refinement in Ireland: managing the sensitivity‐specificity paradox in optometric practice

Barrett

O’Brien

Loughman

2018

Ophthalmic Physiologic Optic

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Of the patients seen within the scheme, 62% did not require referral onward to ophthalmology, thus releasing the significant majority of hospital clinic slots that would previously have been required to examine such patients. The high level of inter-professional decision agreement likely reflects the benefits of pre-scheme apprenticeship style training and ongoing hospital clinic participation by the scheme optometrist. The rate of loss to follow up compares favourably with ophthalmology led, hospital based, glaucoma clinics. Nevertheless, the losses indicate that patient education remains a key priority for future planning.

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Developing standards for the development of glaucoma virtual clinics using a modified Delphi approach

Abstract: Use of a modified Delphi approach has provided consensus agreement for the standards required for the development of virtual clinics to monitor glaucoma in the UK. It is anticipated that this document will be useful as a guide for those implementing this model of service delivery.

Cited by 26 publications

References 24 publications

A team approach to applying the International Classification of Functioning, Disability and Health Rehabilitation set in clinical evaluation

A team approach to applying the International Classification of Functioning, Disability and Health Rehabilitation set in clinical evaluation

Reporting Harm in Glaucoma Surgical Trials: Systematic Review and a Consensus-Derived New Classification System

Glaucoma referral refinement in Ireland: managing the sensitivity‐specificity paradox in optometric practice

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