Inter‐grader reliability in the Danish screening programme for diabetic retinopathy

Thykjær, Anne Suhr; Andresen, J.; Andersen, Nis; Bek, Toke; Heegaard, Steffen; Hajari, Javad Nouri; Laugesen, Caroline Schmidt; Möller, Sören; Pedersen, Frederik Nørregaard; Kawasaki, Ryo; Højlund, Kurt; Rubin, Katrine Hass; Stokholm, Lonny; Grauslund, Jakob

doi:10.1111/aos.15667

Cited by 5 publications

(2 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The screening in Denmark [ 2 , 42 ] is conducted by private practicing ophthalmologists and hospitals ensuring comprehensive coverage. A recent Danish study [ 62 ] revealed an impressive overall agreement of 93% between inter-grader reliability within the Danish screening program for DR. These results highlight the reliability and consistency of grading outcomes within the Danish screening program for DR.…”

Section: Discussionmentioning

confidence: 99%

Present and future screening programs for diabetic retinopathy: a narrative review

Abou Taha,

Dinesen,

Vergmann

et al. 2024

Int J Retin Vitr

Self Cite

View full text Add to dashboard Cite

Diabetes is a prevalent global concern, with an estimated 12% of the global adult population affected by 2045. Diabetic retinopathy (DR), a sight-threatening complication, has spurred diverse screening approaches worldwide due to advances in DR knowledge, rapid technological developments in retinal imaging and variations in healthcare resources.Many high income countries have fully implemented or are on the verge of completing a national Diabetic Eye Screening Programme (DESP). Although there have been some improvements in DR screening in Africa, Asia, and American countries further progress is needed. In low-income countries, only one out of 29, partially implemented a DESP, while 21 out of 50 lower-middle-income countries have started the DR policy cycle. Among upper-middle-income countries, a third of 59 nations have advanced in DR agenda-setting, with five having a comprehensive national DESP and 11 in the early stages of implementation.Many nations use 2–4 fields fundus images, proven effective with 80–98% sensitivity and 86–100% specificity compared to the traditional seven-field evaluation for DR. A cell phone based screening with a hand held retinal camera presents a potential low-cost alternative as imaging device. While this method in low-resource settings may not entirely match the sensitivity and specificity of seven-field stereoscopic photography, positive outcomes are observed.Individualized DR screening intervals are the standard in many high-resource nations. In countries that lacks a national DESP and resources, screening are more sporadic, i.e. screening intervals are not evidence-based and often less frequently, which can lead to late recognition of treatment required DR.The rising global prevalence of DR poses an economic challenge to nationwide screening programs AI-algorithms have showed high sensitivity and specificity for detection of DR and could provide a promising solution for the future screening burden.In summary, this narrative review enlightens on the epidemiology of DR and the necessity for effective DR screening programs. Worldwide evolution in existing approaches for DR screening has showed promising results but has also revealed limitations. Technological advancements, such as handheld imaging devices, tele ophthalmology and artificial intelligence enhance cost-effectiveness, but also the accessibility of DR screening in countries with low resources or where distance to or a shortage of ophthalmologists exists.

show abstract

Section: Discussionmentioning

confidence: 99%

Present and future screening programs for diabetic retinopathy: a narrative review

Abou Taha,

Dinesen,

Vergmann

et al. 2024

Int J Retin Vitr

Self Cite

View full text Add to dashboard Cite

show abstract

“…The severity of DR is categorized using the International Clinical Diabetic Retinopathy Disease Severity Scale, which consists of five stages: level 0 (no DR), levels 1–3 (mild, moderate, and severe DR, respectively), and level 4 (proliferative DR) ( 13 ). DiaBase has recently been validated with high agreement between graders according to the severity of DR ( 14 ).…”

Section: Methodsmentioning

confidence: 99%

Risk of Diabetic Retinopathy According to Subtype of Type 2 Diabetes

Pedersen,

Stokholm,

Andersen

et al. 2024

Diabetes

View full text Add to dashboard Cite

Type 2 diabetes is a heterogeneous disease that can be subdivided based on beta-cell function and insulin sensitivity. We aimed to investigate the presence, incidence and progression of diabetic retinopathy (DR) according to subtypes of type 2 diabetes. In a national cohort, we identified three subtypes of type 2 diabetes which included classical, hyperinsulinemic and insulinopenic type 2 diabetes based on HOMA2 measurements. From the Danish Registry of Diabetic Retinopathy (DiaBase) we extracted information on level of DR. We used several national health registries to link information on comorbidity, medications and laboratory tests. We found individuals with hyperinsulinemic type 2 diabetes were less likely to have DR at entry date compared to classical type 2 diabetes, whereas individuals with insulinopenic type 2 diabetes were more likely to have DR. In multivariable Cox regression analysis, individuals with hyperinsulinemic type 2 diabetes had a decreased risk of both incidence and progression of DR compared to classical type 2 diabetes. We did not find any clear difference in risk of incident or progression of DR in individuals with insulinopenic compared to classical type 2 diabetes. These findings indicate that subcategorization of type 2 diabetes is important in evaluating the future risk of DR.

show abstract

Risk of 2‐year progression from no diabetic retinopathy to proliferative diabetic retinopathy in accordance with glycaemic regulation in 145 527 persons with diabetes in a national cohort

Grauslund,

Stokholm,

Andersen

et al. 2023

Acta Ophthalmologica

Self Cite

View full text Add to dashboard Cite

show abstract

Inter‐grader reliability in the Danish screening programme for diabetic retinopathy

Cited by 5 publications

References 12 publications

Present and future screening programs for diabetic retinopathy: a narrative review

Present and future screening programs for diabetic retinopathy: a narrative review

Risk of Diabetic Retinopathy According to Subtype of Type 2 Diabetes

Risk of 2‐year progression from no diabetic retinopathy to proliferative diabetic retinopathy in accordance with glycaemic regulation in 145 527 persons with diabetes in a national cohort

Contact Info

Product

Resources

About