Establishing ongoing quality assurance in a retinal screening programme

Arun, Chankramath S; Young, Davey; Batey, Deborah; Shotton, M; Mitchie, D; Stannard, K; Taylor, Roy

doi:10.1111/j.1464-5491.2006.01865.x

Cited by 16 publications

(15 citation statements)

References 17 publications

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“…The present study observed no progression of retinopathy requiring intervention at any time after the pregnancy in a population of women with considerable greater duration of diabetes. It is unlikely that cases were missed, as the Newcastle screening method has high sensitivity (88%) and specificity (98%), as previously described [21], and because missed cases would be picked up in subsequent years within this single centre study.…”

Section: Discussionsupporting

confidence: 61%

Influence of pregnancy on long-term progression of retinopathy in patients with type 1 diabetes

Arun

Taylor

2008

Diabetologia

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Aims/hypothesis Pregnancy in type 1 diabetic women is associated with risk of worsening of retinopathy. It has been reported that deterioration continues in the months after delivery, but direct data are lacking. It is also unclear what impact pregnancy has on the long-term progression of retinopathy. Methods We studied 59 women with type 1 diabetes who had retinal photographs before pregnancy and yearly for 5 years post pregnancy. These photographs were graded using the EURODIAB retinopathy grading system. Results The mean duration of diabetes was 14.4±8.2 years and mean age at pregnancy was 29.8±5.5 years. Mean HbA 1c was 8.2±2.0% before pregnancy with tighter control during pregnancy itself. This value was high despite efforts to improve take-up of pre-conception care. Mean HbA 1c was 8.6±1.5 during the follow-up period. At baseline, 43 (72.9%) women were free of retinopathy, 15 had nonproliferative retinopathy and one woman had previously had laser therapy. During pregnancy four women required laser therapy. Over the next 5 years none required laser therapy, although retinopathy worsened in 14 women. Tenyear follow-up data were available on 22 women, one of whom required laser therapy 8 years after pregnancy. Baseline retinopathy status was the only independent risk factor which predicted progression of retinopathy. Conclusions/interpretation Pregnancy is not associated with post-partum worsening of retinopathy.

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Section: Discussionsupporting

confidence: 61%

Influence of pregnancy on long-term progression of retinopathy in patients with type 1 diabetes

Arun

Taylor

2008

Diabetologia

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“…2,11 This was satisfactory in the era of Polaroid films. However, by the year 2000, it was possible to use digital images.…”

Section: Quality Assurancementioning

confidence: 96%

“…Our ongoing sensitivity and specificity for detection of sight threatening diabetic retinopathy are currently 93.5% and 97.8%). 11 There is no reason not to incorporate QA into routine screening, but the QA system must be simple and cost effective.…”

Section: State Of the Art Lecturementioning

confidence: 99%

Vision in diabetes

Taylor

2005

Pract Diab Int

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Arnold Bloom was Consultant Physician at the Whittington Hospital, London. His sound clinical common sense was combined with a scintillating wit. In this lecture I shall describe a series of studies which have been conducted in Newcastle over the last 20 years. Retinal screening has now come of age, and the results in terms of decrease in diabetes blindness are clear. Today's digital retinal images allow trained retinal screeners to explain the result of screening to the patient immediately, and help to set appropriate individual targets for the rest of diabetes care.

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“…For example, a U.K. diabetes center re-graded a percentage of images to determine appropriateness of referrals for clinic examination. 156 Other programs have reported outcomes measuring image quality, intragrader reliability, and percentage of grader-generated reports within 48 h of grading images. 157 …”

Section: Appendix 5: Privileging and Credentialingmentioning

confidence: 99%

Telehealth Practice Recommendations for Diabetic Retinopathy, Second Edition

Horton

Bursell

et al. 2011

Telemedicine and e-Health

111

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Ocular telemedicine and telehealth have the potential to decrease vision loss from DR. Planning, execution, and follow-up are key factors for success. Telemedicine is complex, requiring the services of expert teams working collaboratively to provide care matching the quality of conventional clinical settings. Improving access and outcomes, however, makes telemedicine a valuable tool for our diabetic patients. Programs that focus on patient needs, consider available resources, define clear goals, promote informed expectations, appropriately train personnel, and adhere to regulatory and statutory requirements have the highest chance of achieving success.

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Establishing ongoing quality assurance in a retinal screening programme

Abstract: A robust and cost-effective system has been developed to allow monitoring of performance of routine retinal screening which may be extended to meet current national recommendations.

Cited by 16 publications

References 17 publications

Influence of pregnancy on long-term progression of retinopathy in patients with type 1 diabetes

Influence of pregnancy on long-term progression of retinopathy in patients with type 1 diabetes

Vision in diabetes

Telehealth Practice Recommendations for Diabetic Retinopathy, Second Edition

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