Accuracy and Reliability of Telediagnosis Approach for Canine and Feline Ophthalmological Emergencies: A Retrospective Study of 100 Cases.

Abstract

OBJECTIVES: To evaluate the sensitivity of ocular pain detection by email, as well as the concordance between telediagnosis by email and the diagnosis established in consultation for canine or feline ophthalmological emergencies. ANIMALS STUDIED: 65 dogs and 35 cats. PROCEDURES: Retrospective study of 100 ophthalmological emergencies with a contact by email before being examined by a specialized ophthalmology department. Telediagnoses from one European College of Veterinary Ophthalmologists (ECVO) diplomate and three ECVO residents retrospectively derived from the email communications were compared to clinical diagnoses following consultations. Analysis was focused on signs of ocular pain and ocular disease diagnosis. RESULTS: Sensitivity of detecting ocular pain by email was 79%. This sensitivity significantly improved in emails with photographs attached (89%; p&#x2009;<&#x2009;0.01). Inter-operator reproducibility of remote email diagnosis was satisfactory when diagnosis was possible (K&#x2009;=&#x2009;0.82). Concordance between remote email diagnosis and diagnosis made in consultation was satisfactory for the four clinicians for all ocular conditions (K&#x2009;=&#x2009;0.85&#x2009;&#xb1;&#x2009;0.08), but unsatisfactory when restricted to corneal conditions (K&#x2009;=&#x2009;0.66&#x2009;&#xb1;&#x2009;0.16). There was also a significant positive association between excellent photograph quality and diagnostic concordance (p&#x2009;=&#x2009;0.01). CONCLUSIONS: This exploratory study represents the first description of the use of veterinary teleophthalmology for email triage and telediagnosis of canine and feline ophthalmological emergencies. In our study, emails were a reliable tool for detecting ocular pain and giving a diagnostic orientation, especially when photographs were attached.