Can we make better use of patients’ time?
Research type
Research Study
Full title
Can we make better use of patients’ time spent in waiting rooms? A feasibility pilot study.
IRAS ID
335811
Contact name
Panagiota Founti
Contact email
Sponsor organisation
Moorfields Eye Hospital NHS Foundation Trust
Duration of Study in the UK
0 years, 9 months, 0 days
Research summary
Summary of Research
The study will investigate whether it is feasible to collect additional data about a patient’s vision directly within the waiting room of an ophthalmology clinic, while the patient awaits their routine clinical appointment.
The study will be conducted in the Glaucoma Virtual Clinic at Moorfields Eye Centre at Bedford Hospital. In this technician-led clinic patients spend on average 1 hour in the waiting area, while waiting to go from one test to another. Such time could potentially be used more efficiently to collect additional data (potentially improving both health outcomes and patient satisfaction). However, the feasibility/practicality of such an approach remains unknown.
We will enrol 150 patients attending the above clinic. All participants will be asked to complete a short questionnaire and a sight test examining their contrast sensitivity (ability to see faint objects). Half (N=75), selected at random, will perform the questionnaire and sight test (“SpotChecks”) using pen-and-paper. The other half (N=75) will perform the questionnaire and sight test using a digital tablet (“Pop Contrast Sensitivity Function - PopCSF)”
In brief: “SpotChecks" is a 3-minute test in which the patient identifies ink spots of progressively decreasing contrast. "PopCSF" is also a 3-minute test, in which the patient presses on the screen to pop bubbles of varying contrast, as in a game. All participants will also be asked at the end to step into an annexe and perform a quick (60-second) reference measure (the "Pelli Robson" letter chart), for comparison with the in-waiting-room measures.
The primary objective is to assess feasibility (how many patients completed the tests and how long it took them to do that). The secondary objective is to assess whether feasibility depends on the way in which the test is administered (pen-and-paper vs digital tablets).
Summary of Results
We managed to reach the recruitment target.
Most participating patients (97.4%) successfully completed their randomly assigned test (Pen-and paper or digital test).
Differences in illuminance, noise, and crowd levels in the waiting room had no significant impact on the results of either the pen-and-paper or digital test (no difference in group-mean scores; all P>0.05).The tests themselves were quick to complete (Mean Testing time: 210-240 seconds per test).
Completion times were unaffected by clinical factors such as visual-field mean deviation, LogMAR acuity or Pelli-Robson score (all P > 0.05).
Age had no impact on the duration of the pen-and-paper test (P = 0.31) but did show a weak correlation with the digital test (rdigital = 0.27, P = 0.020), with older participants taking longer to complete the test.
Test results correlated with the results from the Pelli-Robson reference measure (rpen-and-paper= 0.81, rdigital=0.62), age (rpen-and-paper = -0.58, rdigital =0.37), logMAR visual acuity (rpen-and-paper = -0.42, rdigital =-0.44), and visual field (mean deviation) scores (rpen-and-paper = -0.54, rdigital =0.63).
Study participants reported high acceptability scores for both tests (>80% positive feedback on all questions).Performing these tests in the clinic on a daily basis would cost the clinic £1.96 and £3.89 per patient, for the “digital” and “pen-and-paper” tests, respectively, though these costs could be reduced substantially if the tests could be administered autonomously, without the need for a research nurse.
REC name
West of Scotland REC 1
REC reference
24/WS/0012
Date of REC Opinion
19 Feb 2024
REC opinion
Further Information Favourable Opinion