Too Little Information: Accessibility of Information About Language Services on Hospital Websites.

Hospital websites are an important resource to patients with limited English proficiency (LEP) seeking information about a facility's language assistance services. We sought to identify the types of such services described on hospital websites in a diverse state and compare them by hospital characteristics. Washington State acute care hospital websites were systematically reviewed in February 2018 for translated content and information about language assistance services. Hospital characteristics included annual admissions and revenue, bed size and the proportion of populations with LEP in the hospital's county. Of 93 hospitals, 10.8% provided translated websites. Interpreter services were mentioned on 81.7% of websites; access required navigation through 1-4 English webpages. Larger bed-size, higher revenue, and more admissions were positively associated with providing language services information (p < 0.01), whereas county-level population with LEP was not (p = 0.17). Many hospital websites are not translated or lack easily accessible information about language assistance services and consequently may not be a useful resource to patients with LEP.

Comparison of 1-field, 2-fields, and 3-fields fundus photography for detection and grading of diabetic retinopathy.

AIM: To evaluate the sensitivity and specificity of 1-, 2-, and 3-fields, nonmydriatic (NM), 45° color photography compared with mydriatic ophthalmoscopy for detection of diabetic retinopathy (DR). METHODS: Masked, comparative case series was performed utilizing a group of 128 diabetic patients (256 eyes) with various stages of DR who underwent both 3-fields NM color photography and ophthalmologic examination. In a blinded manner, the same optometrist who read the original 3-fields images for a patient read the 1- and 2-fields photographs on separate dates later. RESULTS: The sensitivity and specificity of digital retinal photography compared with dilated ophthalmoscopy were, respectively: 88% and 76% for 1-field; 94% and 69% for 2-fields; and 100% and 79% for 3-fields. The proportion of agreement between fundus photography reading and exam DR diagnosis were 58% for 1-field, 58% for 2-fields, and 77% for 3-fields. Kappa and Cramer's V statistics for 1-, 2-, and 3-fields were 0.55 and 0.60, 0.52 and 0.57, and 0.72 and 0.74, respectively. Three-fields measurement of DR was most similar to the dilated ophthalmological exam overall and across all DR severity levels. CONCLUSIONS: Compared to 1- and 2-fields fundus photography, 3-fields is superior for detecting vision-threatening DR. One- and 2-fields have reasonable sensitivity for DR screening.