Neighborhood Deprivation and Adherence to Initial Diabetic Retinopathy Screening.
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ABSTRACT:
SUBMITTER: Yusuf R
PROVIDER: S-EPMC8281953 | biostudies-literature | 2020 May
REPOSITORIES: biostudies-literature
Publications
Neighborhood Deprivation and Adherence to Initial Diabetic Retinopathy Screening.
Yusuf Ramsey R Chen Evan M EM Nwanyanwu Kristen K Richards Bradley B
Ophthalmology. Retina 20200128 5
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Project description:The success of screening programs depends to a large extent on the adherence of the target population, so it is therefore of fundamental importance to develop computer simulation models that make it possible to understand the factors that correlate with this adherence, as well as to identify population groups with low adherence to define public health strategies that promote behavioral change. Our aim is to demonstrate that it is possible to simulate screening adherence behavior using computer simulations. Three versions of an agent-based model are presented using different methods to determine the agent's individual decision to adhere to screening: (a) logistic regression; (b) fuzzy logic components and (c) a combination of the previous. All versions were based on real data from 271,867 calls for diabetic retinopathy screening. The results obtained are statistically very close to the real ones, which allows us to conclude that despite having a high degree of abstraction from the real data, the simulations are very valid and useful as a tool to support decisions in health planning, while evaluating multiple scenarios and accounting for emergent behavior.
| S-EPMC10904866 | biostudies-literature
Project description:Aims/hypothesisThe aim of our study was to identify subgroups of patients attending the Scottish Diabetic Retinopathy Screening (DRS) programme who might safely move from annual to two yearly retinopathy screening.MethodsThis was a retrospective cohort study of screening data from the DRS programme collected between 2005 and 2011 for people aged ≥12 years with type 1 or type 2 diabetes in Scotland. We used hidden Markov models to calculate the probabilities of transitions to referable diabetic retinopathy (referable background or proliferative retinopathy) or referable maculopathy.ResultsThe study included 155,114 individuals with no referable diabetic retinopathy or maculopathy at their first DRS examination and with one or more further DRS examinations. There were 11,275 incident cases of referable diabetic eye disease (9,204 referable maculopathy, 2,071 referable background or proliferative retinopathy). The observed transitions to referable background or proliferative retinopathy were lower for people with no visible retinopathy vs mild background retinopathy at their prior examination (respectively, 1.2% vs 8.1% for type 1 diabetes and 0.6% vs 5.1% for type 2 diabetes). The lowest probability for transitioning to referable background or proliferative retinopathy was among people with two consecutive screens showing no visible retinopathy, where the probability was <0.3% for type 1 and <0.2% for type 2 diabetes at 2 years.Conclusions/interpretationTransition rates to referable diabetic eye disease were lowest among people with type 2 diabetes and two consecutive screens showing no visible retinopathy. If such people had been offered two yearly screening the DRS service would have needed to screen 40% fewer people in 2009.
| S-EPMC3699707 | biostudies-literature
Project description:ObjectivesThe Australian Government funded a nationwide diabetic retinopathy screening programme to improve visual outcomes for people with diabetes. This study examined the benefits and barriers of the programme, image interpretation pathways and assessed the characteristics of people who had their fundus photos graded by a telereading service which was available as a part of the programme.DesignMultimethod: survey and retrospective review of referral forms.SettingTwenty-two primary healthcare facilities from urban, regional, rural and remote areas of Australia, and one telereading service operated by a referral-only eye clinic in metropolitan Sydney, Australia.ParticipantsTwenty-seven primary healthcare workers out of 110 contacted completed a survey, and 145 patient referrals were reviewed.ResultsManifest qualitative content analysis showed that primary healthcare workers reported that the benefits of the screening programme included improved patient outcomes and increased awareness and knowledge of diabetic retinopathy. Barriers related to staffing issues and limited referral pathways. Image grading was performed by a variety of primary healthcare workers, with one responder indicating the utilisation of a diabetic retinopathy reading service. Of the people with fundus photos graded by the reading service, 26.2% were reported to have diabetes. Overall, 12.3% of eyes were diagnosed with diabetic retinopathy. Photo quality was rated as excellent in 46.2% of photos. Referral to an optometrist for diabetic retinopathy was recommended in 4.1% of cases, and to an ophthalmologist in 6.9% of cases.ConclusionsThis nationwide diabetic retinopathy screening programme was perceived to increase access to diabetic retinopathy screening in regional, rural and remote areas of Australia. The telereading service has diagnosed diabetic retinopathy and other ocular pathologies in images it has received. Key barriers, such as access to ophthalmologists and optometrists, must be overcome to improve visual outcomes.
| S-EPMC8375720 | biostudies-literature
Project description: Not available
| S-EPMC6491139 | biostudies-literature
Project description:BACKGROUND:Diabetic retinopathy (DR) is the leading cause of blindness among working-age adults worldwide. Early detection and treatment are necessary to forestall vision loss from DR. METHODS:A working group of ophthalmic and diabetes experts was established to develop a consensus on the key principles of an effective DR screening program. Recommendations are based on analysis of a structured literature review. RESULTS:The recommendations for implementing an effective DR screening program are: (1) Examination methods must be suitable for the screening region, and DR classification/grading systems must be systematic and uniformly applied. Two-field retinal imaging is sufficient for DR screening and is preferable to seven-field imaging, and referable DR should be well defined and reliably identifiable by qualified screening staff; (2) in many countries/regions, screening can and should take place outside the ophthalmology clinic; (3) screening staff should be accredited and show evidence of ongoing training; (4) screening programs should adhere to relevant national quality assurance standards; (5) studies that use uniform definitions of risk to determine optimum risk-based screening intervals are required; (6) technology infrastructure should be in place to ensure that high-quality images can be stored securely to protect patient information; (7) although screening for diabetic macular edema (DME) in conjunction with DR evaluations may have merit, there is currently insufficient evidence to support implementation of programs solely for DME screening. CONCLUSION:Use of these recommendations may yield more effective DR screening programs that reduce the risk of vision loss worldwide.
| S-EPMC7311555 | biostudies-literature
Project description: Not available
| S-EPMC9843336 | biostudies-literature
Project description: Not available
| S-EPMC9652528 | biostudies-literature
Project description:ObjectivesAdherence to routine annual eye evaluations for diabetes is frequently insufficient on a global scale. We evaluated the adherence to annual diabetic retinopathy screening (DRS) and recommended follow-up among Chinese patients with diabetes, and we also identified the associated risk variables.DesignThis was a cross-sectional and longitudinal study.SettingPatients with diabetes were inquired about their completion of DRS within the preceding year. All participants were required to complete the Compliance with Annual Diabetic Eye Exams Survey.ParticipantsParticipants with diabetes who initially sought eye examination from November 2021 to October 2023 at He Eye Specialist Hospital, Shenyang, China.Outcome measuresLogistic regression analyses defined the risk factors associated with poor compliance with the annual DRS and recommended follow-up.ResultsThere were 468 patients registered, with a mean age of 67.42±10.66 years. A total of 308 (65.8%) participants had DRS in the previous year. Rural residents (OR 1.704, 95% CI 1.019 to 2.850, p=0.042), vision-threatening diabetic retinopathy (VTDR) (OR 1.948, 95% CI 1.145 to 3.313, p=0.014), item 7 (over the past 4 weeks, I have felt blue, downhearted or depressed) (OR 0.624, 95% CI 0.401 to 0.971, p=0.037) and item 42 (I receive a reminder from my eye doctor's office when it is time to schedule an exam) (OR 0.618, 95% CI 0.387 to 0.989, p=0.045) were associated with non-adherence to annual DRS. The compliance with DRS improved to 80.9% in the second year after health education and reminders of follow-up. VTDR (OR 3.063, 95% CI 1.852 to 5.066, p<0.01) was found to be the risk factor for poor compliance with scheduled follow-up.ConclusionsAbout one-third of diabetics did not complete annual DRS; that rate decreased to one-fifth after health education and follow-up reminders.
| S-EPMC11906989 | biostudies-literature
Project description:Background/Objectives: Despite the availability of screening services, the rate of diabetic retinopathy (DR) screening continues to be suboptimal in Australia, necessitating improvement. However, improving DR screening rates requires a more comprehensive understanding of the factors influencing adherence to the screening recommendations. This study aimed to explore the factors that influence adherence to DR screening among people with diabetes attending a community screening clinic in Australia. Methods: This qualitative study included purposively patients with diabetes recruited from a nurse-led community screening clinic in Australia. Semi-structured interviews were conducted to explore barriers and enablers impacting patient adherence to DR screening recommendations. The interview data were analyzed thematically using NVivo based on the socio-ecological model, with salience identified by the frequency of the theme. Results: A total of 22 participants completed the interview, including 10 females with a mean age of 60 ± 16.2 years. The interviews identified several factors that improved adherence to DR screening guidelines, including (a) knowledge of the connection between DR and diabetes and the importance of the screening, (b) the care provider's recommendations, and (c) pre-booked appointments and automatic invitations. Beyond these factors, clinic staff interactions, family support, fear of vision loss, flexible clinic hours, and transportation accessibility also facilitate DR screening adherence. Conclusions: The present study identified key multi-level factors influencing adherence to DR screening. While these findings from a single clinic provide valuable insights to inform screening strategies, larger multi-center studies are needed to validate their broader applicability across diverse healthcare settings and populations.
| S-EPMC11767495 | biostudies-literature
Project description: Not available
| S-EPMC9843399 | biostudies-literature