title: The incorporation of family physicians in the assessment of diabetic retinopathy by non-mydriatic fundus camera.
abstract: OBJECTIVE
  To evaluate the inclusion of family physicians in screening for diabetic retinopathy.
  
  
  METHODS
  We evaluated by non-mydriatic fundus camera 2779 diabetic patients. The family physicians made an initial evaluation of the fundus and pathological images were sent to a reference ophthalmologist. An audit was taken of all the patients at the end of the study. We analysed the concordance in: diabetic retinopathy, diabetic macular edema, and lesions in the macular area.
  
  
  RESULTS
  Diabetic retinopathy was observed in 226 patients (8.1%) and diabetic macular edema in 40 patients (1.4%). Other retinal pathologies were diagnosed in 291 (11.0%). The sensitivity of the study was 95.2% for diabetic retinopathy, 96.0% for macular lesions and 92.9% for diabetic macular edema. The specificity was above 98% in the three studied variables. Cohen's Kappa coefficient was 0.82 for diabetic retinopathy, 0.81 for diabetic macular edema and 0.96 for macular lesions.
  
  
  CONCLUSIONS
  The inclusion of family physicians in the screening system seems to be effective in the diagnosis of diabetic retinopathy.
authors.affiliation: Department of Ophthalmology, University Hospital Sant Joan, Reus, Tarragona, Spain. promero@grupsagessa.com
authors.forename: Pedro
authors.initials: P
authors.lastname: Romero
authors.forename: Ramon
authors.initials: R
authors.lastname: Sagarra
authors.forename: Jeroni
authors.initials: J
authors.lastname: Ferrer
authors.forename: Juan
authors.initials: J
authors.lastname: Fernández-Ballart
authors.forename: Marc
authors.initials: M
authors.lastname: Baget
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003930:Diabetic Retinopathy / Q000175:diagnosis*; D003952:Diagnostic Imaging / Q000379:methods*; D005260:Female; D005654:Fundus Oculi; D006801:Humans; D008269:Macular Edema; D008297:Male; D008875:Middle Aged; D010781:Photography / Q000379:methods; D010821:Physicians, Family; D012164:Retinal Diseases; D012680:Sensitivity and Specificity