Predicted impact of extending the screening interval for diabetic retinopathy: the Scottish Diabetic Retinopathy Screening programme

Looker, H.C. et al. (2013) Predicted impact of extending the screening interval for diabetic retinopathy: the Scottish Diabetic Retinopathy Screening programme. Diabetologia, 56(8), pp. 1716-1725. (doi:10.1007/s00125-013-2928-7)

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Abstract

<p>Aims/hypothesis The 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.</p> <p>Methods This 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.</p> <p>Results The 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.</p> <p>Conclusions/interpretation Transition 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.</p>

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Lindsay, Dr Robert and Briggs, Professor Andrew and Sattar, Professor Naveed
Authors: Looker, H.C., Nyangoma, S.O., Cromie, D.T., Olson, J.A., Leese, G.P., Philip, S., Black, M.W., Doig, J., Lee, N., Briggs, A., Hothersall, E.J., Morris, A.D., Lindsay, R.S., McKnight, J.A., Pearson, D.W.M., Sattar, N.A., Wild, S.H., McKeigue, P., and Colhoun, H.M.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Health Economics and Health Technology Assessment
College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:Diabetologia
Publisher:Springer-Verlag
ISSN:0012-186X
ISSN (Online):1432-0428
Copyright Holders:Copyright © 2013 The Authors
First Published:First published in Diabetologia 56(8):1716-1725
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
488042Scottish Health Informatics Programme ( SHIP )Ian FordWellcome Trust (WELLCOME)086113/Z/08/ZIHW - ROBERTSON CENTRE