Accessing emergency eye care by therapeutically qualified optometrists: a simulated-patient study in Quebec, Canada
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Bibliographic record
Abstract
Clinical relevance Therapeutically qualified optometrists are important providers of emergency eye care. To provide insight on how to optimise accessibility of a population to emergency care, it is helpful to examine factors which go beyond the scope of practice and number of practitioners in a jurisdiction.Background Therapeutically qualified optometrists play an important role in managing ocular emergencies. This study assesses the accessibility of emergency eye care for a new patient in Quebec and explores associated factors such as geographical region of practices and morbidity of patient symptoms.Methods Cross-sectional study using simulated-patient design. Scripted phone calls were placed to optometry practices, posing as patients seeking emergency care. A random sample of Quebec practices was stratified by region: urban, peri-urban, and rural. Each practice received one call for a simulated conjunctivitis (low morbidity) and one for a simulated retinal break (high morbidity). Outcomes included obtaining an appointment, time-to-appointment and out-of-pocket costs.Results Eighty-nine practices participated: 30 urban, 30 peri-urban and 29 rural. Some 46% of practices granted at least one eye emergency appointment (n = 41) with significant differences between regions: 40% in urban areas, 30% in peri-urban areas and 69% in rural areas (p = 0.008). Overall, median delay to obtain an appointment was 3.7 hours (interquartile range = 1.8–6.3) and median fee was 55 Canadian dollars (interquartile range 50–65). Low-morbidity appointments were granted slightly more often (p = 0.07). Neither time-to-appointment nor fees differed significantly with morbidity or type of region.Conclusion In this simulated-patient study, less than half of optometry practices offered an emergency appointment to new patients in Quebec; more appointments were granted in rural areas and for low morbidity conditions. In a jurisdiction with many therapeutically qualified optometrists across its territory, accessibility to emergency eye care was somewhat limited, with significant geographical differences.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 it