Document Detail

Coverage in screening for diabetic retinopathy according to screening provision: results from a national survey in England and Wales.
MedLine Citation:
PMID:  15008839     Owner:  NLM     Status:  MEDLINE    
AIM: To assess the proportion of people with diabetes screened for retinopathy according to provision of screening services. METHODS: Twenty-five health authorities in England and Wales were sampled after stratification by type of screening provision for diabetic retinopathy. Nine did not have a population-based screening scheme, six had an optometry scheme, six had a camera scheme and four had schemes with more than one method of screening ('mixed schemes'). Within each authority general practices were randomly sampled, 129 in total, and in each the records of a sample of diabetic patients examined. RESULTS: Of the 9200 records examined, 5812 (63.2%) had a record of one or more retinal examinations from any source in the year before the survey. This proportion did not differ significantly according to type of screening provision. The proportion of people with one or more retinal examinations by an 'expert' (defined as ophthalmologist, diabetologist, optometrist or screening scheme) in the last year was 44.7% where there was no screening scheme and 62.2%, 59.4%, and 61.6%, respectively, where optometry, camera and mixed schemes were present. Adjusted relative odds (95% confidence interval) for a retinal examination from any source in the last year compared with areas with no screening schemes were 1.19 (0.73, 1.93), 1.26 (0.80, 1.98), and 1.19 (0.77, 1.84) for camera, optometry and mixed schemes, respectively. Equivalent figures for an expert retinal examination were 2.30 (1.51, 3.49), 1.86 (1.25, 2.78) and 2.13 (1.32, 3.45). Coverage by schemes themselves did not differ according to type of scheme. Highest coverage rates, including examinations by screening schemes, were achieved in those treated with insulin, and the lowest rates found in those treated with diet alone. CONCLUSIONS: Screening schemes have had a small impact on overall retinal examinations, but a higher impact on the coverage of examinations performed by experts.
A Wilson; R Baker; J Thompson; G Grimshaw
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Diabetic medicine : a journal of the British Diabetic Association     Volume:  21     ISSN:  0742-3071     ISO Abbreviation:  Diabet. Med.     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-03-10     Completed Date:  2004-05-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8500858     Medline TA:  Diabet Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  271-8     Citation Subset:  IM    
Department of General Practice and Primary Health Care, University of Leicester, UK.
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MeSH Terms
Diabetes Mellitus / therapy
Diabetic Retinopathy / epidemiology*
England / epidemiology
Family Practice
Health Surveys
Insulin / therapeutic use
Middle Aged
Odds Ratio
Reproducibility of Results
Vision Screening / methods*
Wales / epidemiology
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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