, Volume 4, Issue 4, pp 296-299

Physician recognition of ophthalmoscopic signs of open-angle glaucoma

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Objective:To evaluate a short educational intervention instructing primary care physicians in the recognition of glaucomatous changes of the optic disc.

Design:Comparison of performances on a pretest and a posttest consisting of fundus slides in color.

Setting:Educational conferences at two university-affiliated teaching hospitals and one staff-model bealth maintenance organization.

Subjects:Thirty-six internal medicine residents and ten practicing internists.

Intervention:A 20-minute slide/narration educational program, which covered diagnostic criteria for openangle glaucoma, normal and abnormal optic disc anatomy, and funduscopic signs of open-angle glaucoma.

Measurements and main results:Following the intervention, residents showed improved sensitivity (0.76 to 0.88, p=0.007), specificity (0.65 to 0.88, p<0.001), and accuracy (0.71 to 0.88, p<0.001). Internists showed similar increments in sensitivity, specificity, and accuracy: 0.67 to 0.86 (p=0.01), 0.59 to 0.84 (p=0.01), and 0.63 to 0.85 (p=0.002), respectively.

Conclusion:A brief educational intervention can result in meaningful improvement in physician diagnostic accuracy in recognizing ophthalmoscopic signs of open-angle glaucoma.

Presented in part at the 26th Annual Conference on Research in Medical Education, Washington DC, November 1987, and at Midwest Conference of the Society of General Internal Medicine, Chicago IL, November 1987