Quality of Referrals to a Pediatric Ophthalmology Practice in South Western Ontario
Bibliographic record
Abstract
OBJECTIVE: The purpose of this study is to examine the referrals made to a pediatric ophthalmology practice in south Western Ontario. Timing of initiating a referral for children presenting with esotropia and the management offered prior to referral will be examined to identify room for improvement. METHODS: Retrospective chart review of 326 children diagnosed with esotropia with an age of onset <5 years. Data collected included the referring doctor (optometrist or physician), age at onset of the disease, age at referral, clinical characteristics of esotropia at presentation, management, and stereopsis outcome. RESULTS: A total of 326 charts were reviewed; 63.7% were referred by optometrists and 36.2% by physicians. The mean delay in referral for all cases was 24.64 ± 25.5 months for optometrists and 17.82 ± 19.9 months for physicians. Referrals made by an optometrist were significantly more delayed than those made by physicians when tested with the unpaired t-test (p = 0.0136). CONCLUSION: There is a significant delay in referring all subtypes of esotropia. Management offered prior to referral does not seem to be adequate in more than 50% of patients. Pediatric ophthalmologists need to engage a lot more with the local community of referring doctors and optometrists to advocate for improving management prior to the referral as well as suggest the proper timeline for initiating a referral aiming to improve patient's final outcome.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".