Accuracy of screening for diabetic retinopathy by family physicians.
BACKGROUND
We wanted to examine the accuracy of family physicians' screening for diabetic retinopathy using standardized criteria and a nonmydriatic ophthalmoscope.


METHODS
Eleven family physicians assessed 28 standardized patients with diabetes mellitus using the PanOptic ophthalmoscope. Their assessments of whether the patients required referral to an ophthalmologist were compared with the reference standard of retinal diagrams.


RESULTS
The mean sensitivity for the family physicians was 87% (95% confidence interval [CI], 83%-91%) with a specificity of 57% (95% CI, 46%-68%). Overall agreement was moderate, with a mean kappa = .43 (95% CI, 0.39%-0.47%).


CONCLUSIONS
Using standardized criteria and a nonmydriatic ophthalmoscope, family physicians were fairly accurate in screening patients for diabetic retinopathy. Whereas this technique is not sufficiently accurate to replace routine referral for all patients with diabetes, it can be used to improve care for those patients who fail to get routine eye screenings.
Gill
James M
JM
Christiana Care Health Services, 1401 Foulk Rd, Wilmington, DE 19803, USA. jgill@christianacare.org
Cole
David M
DM
Lebowitz
Harry M
HM
Diamond
James J
JJ
D003930:Diabetic Retinopathy / Q000175:diagnosis*; D005194:Family Practice; D006801:Humans; D008403:Mass Screening / Q000379:methods; D009885:Ophthalmology; D019721:Ophthalmoscopes; D009887:Ophthalmoscopy / Q000592:standards*; D015203:Reproducibility of Results