Diabetic Eye Disease Detection by Primary-Care Physicians

Sb, Baker; Vallbona, Carlos; Jv, Campbell; Mb, Hamill; Goetz, B; Ms, West

doi:10.2337/diacare.13.8.908

Cited by 6 publications

(2 citation statements)

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“…Other studies have observed a similar rate of noncompliance in diabetic populations. [15][16][17][18][19][20][21] Though screening for DR is widely recognized as both good clinical practice and cost-effective health care, a majority of diabetic patients do not comply with examination guidelines for multiple reasons, including the absence of any symptom until the disease is very advanced and ignorance of eye disease in a context of multiple other health problems associated with diabetes. 22 Other factors of an organizational kind, such as difficult access to ophthalmologic resources, represent a major logistic problem partly because the requirements of mass screening through regular ophthalmologic settings largely exceed the medical and financial resources available.…”

Section: The Challengementioning

confidence: 99%

Teleophthalmology screening for diabetic retinopathy through mobile imaging units within Canada

Boucher

Desroches

Garcia-Salinas

et al. 2008

Canadian Journal of Ophthalmology

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Section: The Challengementioning

confidence: 99%

Teleophthalmology screening for diabetic retinopathy through mobile imaging units within Canada

Boucher

Desroches

Garcia-Salinas

et al. 2008

Canadian Journal of Ophthalmology

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“…Many trained optometrists claim to have these skills and cite at least one small study (7). Diabetologists, other MDs, nurses, and technicians can certainly be trained to do so (8,9). There are circumstances where screenings by individuals other than an ophthalmologist can be used.…”

mentioning

confidence: 98%

Financial Implications of Implementing Standards of Care for Diabetic Eye Disease

Rand

1992

Diabetes Care

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This article reviews practical financial issues surrounding the implementation of published standards of care for diabetic patients concerning examination for detection of retinopathy. Issues such as the financial basis of referral patterns and the fear of patient loss are raised. The role of the primary physician in coordinating care is discussed. The strategies of ophthalmic screening at the site of primary care are presented as alternatives to published standards. There is a need for development of low-cost screening for low-risk patient groups. All effective means of detecting retinopathy and implementing sight-saving therapy in a timely manner is cost-effective compared with the cost saved of disability payment alone.

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Screening for diabetic retinopathy: A relative cost‐effectiveness analysis of alternative modalities and strategies

et al. 1992

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Diabetic retinopathy is the most common cause of blindness among adults of working age in the UK. If the disease is detected early effective treatment can be provided and this has resulted in calls for a systematic national screening programme. Using data on the screening of 3423 diabetics collected as part of an experimental programme in three UK centres, the relative cost-effectiveness of various screening options is assessed. The paper utilises direct evidence on a number of single modality screening options, including ophthalmoscopy undertaken by general practitioners or ophthalmic opticians, and non-mydriatic photography. With the objective of increasing the sensitivity of screening and using data collected in the study, options based on two further potential screening strategies are modelled and evaluated: combined screening using both ophthalmoscopy and non-mydriatic photography; and selective screening where high-risk diabetics are directly referred to an ophthalmologist and low-risk cases are either left unscreened or are screened by one of the single or combined modality screening options. Given the objective of early detection, effectiveness is assessed in terms of the sensitivity and specificity of the referral decisions of screening options. Both health service and private resource costs of the various screening options are estimated, the latter in terms of travel and the opportunity cost of time. Cost effectiveness is evaluated in terms of the expected cost per true positive case of diabetic retinopathy referred by the screening options. To narrow the choice between the options, those subject to three-way domination with respect to the three choice variables of sensitivity, specificity and expected cost per true positive are excluded. Amongst the remaining options, the choice is dependent on the trade-off between the higher specifics of unselective single modality screening options and the higher sensitivities and lower expected costs per true positive case detected of combined modality and selective screening options.

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Diabetic Eye Disease Detection by Primary-Care Physicians

Cited by 6 publications

References 0 publications

Teleophthalmology screening for diabetic retinopathy through mobile imaging units within Canada

Teleophthalmology screening for diabetic retinopathy through mobile imaging units within Canada

Financial Implications of Implementing Standards of Care for Diabetic Eye Disease

Screening for diabetic retinopathy: A relative cost‐effectiveness analysis of alternative modalities and strategies

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