Patients’ perspectives on the barriers to referral after telescreening for diabetic retinopathy in communities

Abstract

Significance of this studyWhat is already known about this subject? ► Telemedicine has been applied in diabetic retinopathy (DR) screening. ► High rates of incomplete referral after telescreening for DR, and patients factors or healthcare system factors might contribute to the barriers for accessing the eye care services.What are the new findings?► Referral completion and perceived barriers to the referral were assessed in a large representative sample with vision-threatening DR (VTDR) from the communities after DR telescreening. ► The issue of incomplete referral is serious among the individuals with VTDR, particularly in the elder and low education level population. ► The negativity of knowledge-related and attituderelated factors might be more prominent than logistic barriers in predicting the incomplete referrals.on July 4, 2020 by guest. Protected by copyright.

The Role of Telemedicine, In-Home Testing and Artificial Intelligence to Alleviate an Increasingly Burdened Healthcare System: Diabetic Retinopathy

“…However, some studies noted limited sensitivity and specificity of smartphone examinations and lack of applications dedicated to screening. AI helped in the use of low-quality portable screening devices for high-quality assessments [ 117 ]. Smartphones needed a wide pupil for good-quality images [ 38 , 63 , 73 ]…”

Telemedicine in ophthalmology in view of the emerging COVID-19 outbreak

“…Low referral completion after undergoing DR tele-screening is a drawback that should be noted, one which is not unique to teleophthalmology and which has been noted in face-to-face appointments and for other medical disciplines. In a large study conducted by Zhu et al they found that the phenomenon of limited engagement is particularly common in the elderly and low education level populations and that lack of knowledge and a negative attitude toward telemedicine might be more prominent than logistic barriers in predicting incomplete referral, thus emphasizing the importance of proper education and raising awareness [32]. Similarly, improving patients' perception toward and promoting the use of teleophthalmology through proper education in low-income diabetic US population was also described [33].…”

Disparities Between People with Diabetic Retinopathy and Community Health Service Centers’ Staff in Estimating Satisfaction with Telescreening for Diabetic Eye Diseases

“…Participants diagnosed with vision-threatening diabetic retinopathy (VTDR) after remote retinal image reading were referred to the superior medical institutions for further diagnosis and treatment. People with diabetes were classi ed as management in the CHSCs based on the diagnosis after telescreening and referrals [16,17].…”

“…In addition, most of the known community management guidelines of DR are for high-income countries with high resource allocation, but no standardized management method for community population with DR currently exists in many developing countries including China [14,15]. A comprehensive management system for diabetic eye diseases (abbreviated as "the System" in the following text) has been established through the Shanghai Diabetic Eye Study (SDES) since 2015, which focuses on telescreening, referral, and management [16,17]. The new cooperation mode between CHSCs and superior medical institutions not only meets the eye health care of community people with diabetes but also effectively realizes the early screening, diagnosis, and intervention of DR.…”