Diabetic retinopathy screening in general practice (A pilot study)

Askew, Deborah A., Schluter, Philip J., Spurling, Geoffrey, Maher, Clare M., Cranstoun, Peter, Kennedy, Craig and Jackson, Claire L. (2009) Diabetic retinopathy screening in general practice (A pilot study). Australian Family Physician, 38 8: 650-656.

Author Askew, Deborah A.
Schluter, Philip J.
Spurling, Geoffrey
Maher, Clare M.
Cranstoun, Peter
Kennedy, Craig
Jackson, Claire L.
Title Diabetic retinopathy screening in general practice (A pilot study)
Formatted title
Diabetic retinopathy screening in general practice (A pilot study)
Journal name Australian Family Physician   Check publisher's open access policy
ISSN 0300-8495
Publication date 2009-08-01
Year available 2009
Sub-type Article (original research)
Open Access Status Not yet assessed
Volume 38
Issue 8
Start page 650
End page 656
Total pages 5
Editor Jenni Parsons
Place of publication Australia
Publisher Royal Australian College of General Practitioners
Language eng
Subject C1
111717 Primary Health Care
920412 Preventive Medicine
Abstract BACKGROUND Early detection and treatment of diabetic retinopathy (DR) can prevent nearly all associated severe vision loss. We investigated the feasibility of DR screening using nonmydriatic cameras in two Australian primary care clinics. METHODS Two general practitioners from Queensland photographed the retinas of patients with type 2 diabetes seen in their clinics during the 9 month study period. The patients were then photographed and assessed by two independent ophthalmologists. The ophthalmologists’ assessments provided the reference standard. General practitioners’ accuracy in determining photograph interpretability and DR diagnostic sensitivity and specificity were measured. The attitudes of GPs about the DR screening were also assessed. RESULTS One hundred and fourteen patient participants provided 219 photographs. Two ophthalmologists read 158 photographs and deemed 61% (97/158) interpretable, but GPs tended to accept more photographs for interpretation. General practitioners’ diagnostic sensitivity and specificity was 87% and 95% respectively. Participating GPs were very positive about expanding their clinical role into DR screening. DISCUSSION General practice based DR screening was feasible and acceptable in the clinics studied, but photograph quality was an issue.
Formatted abstract
Background
Early detection and treatment of diabetic retinopathy (DR) can prevent nearly all associated severe vision loss. We investigated the feasibility of DR screening using nonmydriatic cameras in two Australian primary care clinics.

Methods
Two general practitioners from Queensland photographed the retinas of patients with type 2 diabetes seen in their clinics during the 9 month study period. The patients were then photographed and assessed by two independent ophthalmologists. The ophthalmologists’ assessments provided the reference standard. General practitioners’ accuracy in determining photograph interpretability and DR diagnostic sensitivity and specificity were measured. The attitudes of GPs about the DR screening were also assessed.

Results
One hundred and fourteen patient participants provided 219 photographs. Two ophthalmologists read 158 photographs and deemed 61% (97/158) interpretable, but GPs tended to accept more photographs for interpretation. General practitioners’ diagnostic sensitivity and specificity was 87% and 95% respectively. Participating GPs were very positive about expanding their clinical role into DR screening.

Discussion
General practice based DR screening was feasible and acceptable in
the clinics studied, but photograph quality was an issue.
Keyword diabetes
diabetic retinopathy
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

 
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Created: Mon, 24 Aug 2009, 21:30:56 EST by Vicki Percival on behalf of School of Nursing, Midwifery and Social Work