[Evaluation of a screening programme for diabetic retinopathy (DODIA study)].
BACKGROUND
In France, 43% to 63% of diabetics have an annual fundoscopy. Do the new screening tools, coupled with teletransmission of the images, allow for satisfying ophthalmological screening? It is an important matter given the foreseeable reduction in the number of French ophthalmologists in the forthcoming years.


OBJECTIVE
To measure the quality of screening for diabetic retinopathy (DR), in the framework of a network, by the provision of a retinograph by numeric camera (with teletransmission of the images and centralised interpretation), in a screening centre located in town.


METHODS
The study evaluated the quality of screening obtained in two comparable groups of general practitioners, one using the retinograph and the other using the classical method of screening by ophthalmologist. The screening was targeted at diabetics who had not had a fundoscopy in the preceding year, nor had known DR or a treating ophthalmologist (for the retinography group only).


RESULTS
667 patients were sampled in the retinography group (456 included) and 707 in the control group (426 included) between 1/04/02 and 1/11/02; 417 patients were followed until the end of the study in the 2 groups. A screening examination was considered effective if it was performed within the six months following its request, and by the presence of a report in the file of the general practitioner. The percentage of patients thus screened was 74% in the retinography group and 71,5% in the other group (not significant). 16% of diabetics in the retinography group had DR compared with 10% of patients in the control group. The analysis of the level of satisfaction of patients tended to show a preference for the system of screening by fundal photography.


CONCLUSIONS
In the framework of a healthcare network, the availability of a retinograph by numeric camera, with the interpretation of photos by teletransmission of the images, obtained a high level of quality of screening for diabetic retinopathy that was at least as good as that obtained by a healthcare network using the classical ophthalmological screening method.
Aubert
Jean-Pierre
JP
Médecins généralistes, Réseau de santé Paris-Nord. aubert.petrequin@wanadoo.fr
Massin
Pascale
P
Audran
Ghislaine
G
Ben Mehidi
Amina
A
Bernit
Blandine
B
Bouée
Stéphane
S
Bouhassira
Myriam
M
Bourovitch
Jean-Claude
JC
Erginay
Ali
A
Eschwege
Evelyne
E
Jamet
Marina
M
Marre
Michel
M
Nougairède
Michel
M
Tcherny-Lessenot
Stéphanie
S
D000368:Aged; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000453:epidemiology*; D004596:Electroretinography; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D005654:Fundus Oculi; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D017060:Patient Satisfaction; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000379:methods; D013997:Time Factors