Six-year prevalence and incidence of diabetic retinopathy and cost-effectiveness of tele-ophthalmology in Manitoba

Kanjee, Raageen; Dookeran, Ravi I.; Mathen, Mathen K.; Stockl, Frank; Leicht, Richard

doi:10.1016/j.jcjo.2016.05.002

Cited by 31 publications

(13 citation statements)

References 24 publications

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“…In North America & Caribbean, Region 4, there were a total of 3 studies [25][26][27] involving 56,518 people with diabetes examined from 2007, 2011 and 2013 onwards, with periods extending over 4-6 years duration ( Table 3). The overall prevalence of any DR, was 21.9%, NPDR 19.5%, PDR 2.5% and DME at 2.5%.…”

Section: Resultsmentioning

confidence: 99%

IDF Diabetes Atlas: A review of studies utilising retinal photography on the global prevalence of diabetes related retinopathy between 2015 and 2018

Thomas

Halim

Gurudas

et al. 2019

Diabetes Research and Clinical Practice

269

151

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The purpose of this study is to assess the prevalence of diabetic retinopathy (DR) worldwide from articles published since 2015 where the assessment of the presence and severity of DR was based on retinal images. Methods: A total of 4 databases were searched for the MESH terms diabetic retinopathy and prevalence. Of 112 publications 32 studies were included and individual data pooled for analysis. The presence of any DR or diabetic macular edema (DME) was recorded and severity as mild, moderate or severe non-proliferative DR (NPDR), proliferative DR (PDR) and DME and/or clinically significant macular edema (CSME). The level of severity of DR reported refer to persons with diabetes and not individual eyes.

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Section: Resultsmentioning

confidence: 99%

IDF Diabetes Atlas: A review of studies utilising retinal photography on the global prevalence of diabetes related retinopathy between 2015 and 2018

Thomas

Halim

Gurudas

et al. 2019

Diabetes Research and Clinical Practice

269

151

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“…Kanjee et al [25] estimated the costs of a telemedicine program in a Manitoban cohort. They performed a retrospective chart analysis of 4676 patients from the Manitoba Retinal Screening Vision Program.…”

Section: Resultsmentioning

confidence: 99%

“…Currently, there are 170,000 DM patients in Singapore, thus the expected total savings if a teleophthalmology screening program would be implemented is estimated to be $21.6 million (170,000 × $127). Kanjee et al [25] demonstrated a lower cost to the telemedicine program compared to the conventional in-clinic screening in a Canadian cohort. Ben et al [26] presented that systematic teleophthalmology based screening is cost-effective compared to opportunistic ophthalmology-referral based screening in Brazil.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of diabetic retinopathy screening programs using telemedicine: a systematic review

Avidor

Loewenstein

Waisbourd

et al. 2020

Cost Eff Resour Alloc

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Background: Diabetic retinopathy (DR) is a significant global public health and economic burden. DR accounts for approximately 15-17% of all cases of total blindness in the USA and Europe. Telemedicine is a new intervention for DR screening, however, there is not enough evidence to support its cost-effectiveness. The aim of this study is to review the most recent published literature on economic evaluations of telemedicine in DR screening and summarize the evidence on the cost-effectiveness of this technology. Methods:A systematic search of PubMed, Embase and Google Scholar for relevant articles published between January 2010 and January 2020. Studies were included if they met the following criteria: (1) recruited subjects with either type 1, type 2 diabetes (2) evaluated telemedicine technology (3) patients underwent primary screening for DR (4) compared a telemedicine-based intervention with standard care (5) performed an economic evaluation or provided sufficient data for evaluating the cost-effectiveness of the technology used.Results: Of 2238 articles screened, seven studies were included. Four of the studies were conducted in developed countries: The United States, Singapore and two studies in Canada. Three studies were conducted in developing countries: India, Brazil and South Africa. The patient populations in all studies were diabetic patients over the age of 18, previously not screened for DR. All seven studies used a telemedicine program which included capturing a retinal image and subsequently transmitting it to an ocular imaging center to assess the severity of DR. All studies compared telemedicine to a standard screening method for DR, including the option of no screening as standard of care. Although telemedicine requires initial and maintenance costs, it has the potential to provide significant cost savings by increasing patients' working ability, increasing independent living ability, increasing quality of life and reducing travel costs. Conclusions:Diabetic retinopathy telemedicine technology has the potential to provide significant cost savings, especially in low-income populations and rural patients with high transportation costs.

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“…Thus, diabetes education alone is not enough to resolve the gap between urban and rural areas in the DR and DN screening rates. It is necessary to build more medical institutions, to expand community diabetes centers, to combine primary medical care with ophthalmology, and to introduce tele-ophthalmology [ 26 – 28 ].…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic differences among community-dwelling diabetic adults screened for diabetic retinopathy and nephropathy: The 2015 Korean Community Health Survey

Lee

2018

PLoS ONE

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We investigated the association between socioeconomic status (SES) and screening for diabetic retinopathy (DR) and diabetic nephropathy (DN) in community-dwelling diabetics. We analyzed data from 22,134 people with diabetes aged ≥19 years at the time of the nationwide 2015 Korean Community Health Survey. Multiple logistic regression analysis was used to explore the relationship between SES and screening for DR and DN both before and after adjustment for health behaviors, comorbidities, and educational level. Of all diabetic subjects, 33.9% and 38.1% underwent DR and DN screening, respectively. In the fully adjusted model, the extent of the DR and DN screening trended significantly lower as the educational level fell. Monthly household income was positively associated with DR screening, but a lower odds ratio (OR) for DN screening was evident only when the lowest and highest income groups were compared. Compared with managers/professionals, agricultural/forestry/fishery workers (OR 0.81, 95% confidence interval [CI] 0.69–0.96) and mechanical/manual laborers (OR 0.83, 95% CI 0.71–0.97) had lower ORs for DN screening. Residents in rural (compared with urban) areas and widows/widowers (compared with members of couples) were significantly less likely to undergo screening for DR and DN. Similar findings were obtained when the analysis was limited to those who had been educated about diabetes. In conclusion, socioeconomic inequalities were evident in terms of screening for DR and DN in community-dwelling Korean diabetics, regardless of whether they had reported receiving diabetes education. Tailored public health policies (and societal attention) are required to aid the socioeconomically disadvantaged.

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Six-year prevalence and incidence of diabetic retinopathy and cost-effectiveness of tele-ophthalmology in Manitoba

Cited by 31 publications

References 24 publications

IDF Diabetes Atlas: A review of studies utilising retinal photography on the global prevalence of diabetes related retinopathy between 2015 and 2018

IDF Diabetes Atlas: A review of studies utilising retinal photography on the global prevalence of diabetes related retinopathy between 2015 and 2018

Cost-effectiveness of diabetic retinopathy screening programs using telemedicine: a systematic review

Socioeconomic differences among community-dwelling diabetic adults screened for diabetic retinopathy and nephropathy: The 2015 Korean Community Health Survey

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