title: Improved detection and referral of patients with diabetic retinopathy by primary care physicians. Effectiveness of education.
abstract: We studied the effect of a 4-hour course in recognition and management of diabetic retinopathy on the ability of nonophthalmologist physicians to detect and to appropriately refer patients with sight-threatening diabetic retinopathy. Participants completed a written examination covering case management and performed a total of 340 dilated ophthalmoscopic examinations on selected patients before and 2 weeks following the teaching session. Accuracy of ophthalmoscopy was assessed by comparison with standardized grading of fundus photographs. Scores on the written examination increased from a mean of 49% to 78% correct. The likelihood of failing to detect and appropriately refer patients with proliferative or preproliferative retinopathy decreased from 60% to 15%. Similarly, for patients with maculopathy, the likelihood of failure to detect and to appropriately refer decreased from 83% to 15.6%. These data suggest that education may significantly improve the ability of nonophthalmologists to detect and to appropriately refer patients who are at risk for vision loss.
authors.affiliation: Worthen Center for Eye Care Research, Georgetown University Medical Center, Washington, DC 20007.
authors.forename: C C
authors.initials: CC
authors.lastname: Awh
authors.forename: H P
authors.initials: HP
authors.lastname: Cupples
authors.forename: J C
authors.initials: JC
authors.lastname: Javitt
mesh_terms: D001291:Attitude of Health Personnel; D003930:Diabetic Retinopathy / Q000175:diagnosis*; D004502:Education, Medical, Continuing; D005194:Family Practice / Q000193:education*; D006801:Humans; D009887:Ophthalmoscopy; D010818:Practice Patterns, Physicians'; D012017:Referral and Consultation