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Journal of Ophthalmology
Volume 2016, Article ID 1964254, 8 pages
Research Article

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

1Private Practice, Scarsdale, NY 10583, USA
2SUNY State College of Optometry, New York, NY 10036, USA
3SUNY Eye Institute, Syracuse, NY 13202, USA
4Nova Southeastern University College of Optometry, Fort Lauderdale, FL 33314, USA
5University of Incarnate Word Rosenberg School of Optometry, San Antonio, TX 78229, USA
6Eye Institute & Laser Center, New York, NY 10065, USA

Received 30 August 2015; Accepted 2 November 2015

Academic Editor: Ireneusz Grulkowski

Copyright © 2016 Samantha Slotnick et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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.