Early Experience With Full-scope Shared-care Teleglaucoma in Canada
Bibliographic record
Abstract
PRCIS: Large Canadian full-scope, shared-care teleglaucoma facilitates efficient management and diversion of medically stable patients away from overburdened subspecialty clinics while allowing patients the convenience of shorter travel, shorter wait time, and continuity with one provider. This report shares Care1 protocol, early patient characteristics, and quality data. PURPOSE: This paper describes early experience with Care1, a large full-scope, shared-care teleglaucoma program. Optometrists located in high-demand locations saw patients in-person, acquired clinical history, performed a physical examination, organized diagnostic testing, then uploaded data to a proprietary online platform where they were able to collaborate with participating ophthalmologists to make plans for patient care. MATERIALS AND METHODS: The Care1 database was queried for all patients with a diagnosis of glaucoma or glaucoma suspect seen between February 2016 and March 2017. Clinical characteristics like diagnosis, ocular medication history, best-corrected visual acuity, intraocular pressure, cup-to-disc ratios, optical coherence tomography imaging results, and central corneal thickness were collected. Quality metrics studied included rates of referral to an in-person ophthalmologist and consistency of cup-to-disc assessments between in-person optometrists and remote ophthalmologists. RESULTS: A total of 4070 patients received care at a Care1 teleophthalmology site in 2 provinces for glaucoma assessment from February 2016 to March 2017. The population was 55.1% female, and the average age was 57.8 years. Overall, 97.3% of patients had a best-corrected visual acuity between 20/20 and 20/40 and 3.3% had an intraocular pressure >26. An in-person consultation with an ophthalmologist was recommended for 1.9% of patients. CONCLUSION: Early experience with this full-scope, shared-care teleglaucoma program in Canada indicates it is a convenient, collaborative model of care for glaucoma suspects, and medically stable glaucoma patients.
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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 | 0.003 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.004 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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".