title: Implementation and first-year screening results of an ocular telehealth system for diabetic retinopathy in China.
abstract: BACKGROUND
  To describe implementation and first-year screening results of the first Chinese telehealth system for diabetic retinopathy (DR) - the Beixinjing Community Diabetic Retinopathy Telehealth system (BCDRT).
  
  
  METHODS
  BCDRT implementation was based on the acquisition of adequate digital retinographs, secure digital transmission, storage and retrieval of participants' data and reader-generated medical reports. Local diabetic residents meeting inclusion criteria were enrolled into the BCDRT system beginning in 2009. Participants recommended for further in-person examination with ophthalmologists were followed, and the consistencies in diagnoses between BCDRT and ophthalmologists for DR or macular edema were calculated.
  
  
  RESULTS
  A total of 471 diabetic residents participated in BCDRT screening in 2009. The proportions of total DR, proliferative DR, and diabetic macular edema were 24.42% (115 patients), 2.12% (10 patients) and 6.47% (24 patients), respectively: 56 patients consulted ophthalmologists for further in-person retinal examination with funduscopy after pupil dilation. High rates of consistency between BCDRT screening and ophthalmologists were observed for macular edema (Kappa = 0.81), moderate or severe non-proliferative DR grade (Kappa = 0.92), and other DR grades (Kappa = 1). A total of 456 (96.82%) patients were willing to participate in the next BCDRT screening.
  
  
  CONCLUSIONS
  BCDRT was a reliable and valid system for DR screening, and offers the potential to increase DR annual screening rates in local residents.
authors.affiliation: Department of Ophthalmology, Shanghai First People's Hospital, affiliated Shanghai Jiaotong University, Shanghai 200080, China.
authors.forename: Jinjuan
authors.initials: J
authors.lastname: Peng
authors.forename: Haidong
authors.initials: H
authors.lastname: Zou
authors.forename: Weiwei
authors.initials: W
authors.lastname: Wang
authors.forename: Jiong
authors.initials: J
authors.lastname: Fu
authors.forename: Bingjie
authors.initials: B
authors.lastname: Shen
authors.forename: Xuelin
authors.initials: X
authors.lastname: Bai
authors.forename: Xun
authors.initials: X
authors.lastname: Xu
authors.forename: Xi
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D002681:China; D003151:Community Health Centers; D003930:Diabetic Retinopathy / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006284:Health Plan Implementation; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009887:Ophthalmoscopy / Q000379:methods*; D015203:Reproducibility of Results; D018570:Risk Assessment; D017216:Telemedicine / Q000379:methods*