Novice Reviewers Retain High Sensitivity and Specificity of Posterior Segment Disease Identification with iWellnessExam ™

Introduction. four novices to spectral domain optical coherence tomography (sd-oct) image review were provided a brief lecture on the interpretation of ivue iwellnessexam™ findings (available on ivue® sd-oct,optovue,inc.,fremont,ca). for a cohort of 126 (confirmed) normal,101 (confirmed) disease subjects,iwellnessexam™ od,os,and ou reports were provided. each novice independently reviewed and sorted the subjects into one of four categories: normal,retinal disease,optic nerve (on) disease,and retinal + on disease. their accuracy is compared between the novices and with an expert reviewer. results. posterior segment disease was properly detected by novices with sensitivities of 90. 6%,any disease; 84. 3%,retinal disease; 88. 0%,on disease; expert sensitivity: 96. 0%,95. 5%,and 90. 0%,respectively; specificity: 84. 3%,novices; 99. 2%,expert. novice accuracy correlates best with clinical exposure and amount of time spent reviewing each image set. the novices' negative predictive value was 92. 0% (i. e.,very few false negatives). conclusions. novices can be trained to screen for posterior segment disease efficiently and effectively using iwellnessexam™ data,with high sensitivity,while maintaining high specificity. novice reviewer accuracy covaries with both clinical exposure and time spent per image set. these findings support exploration of training nonophthalmic technicians in a primary medical care setting. © 2016 samantha slotnick et al.