title: ["Local" or "mobile" screening for diabetic retinopathy in general practice by non-mydriatic digital cameras? about the Diabetes Midi-Pyrénées network activity between 2005 and 2010].
abstract: Fundus photographs using non-mydriatic digital cameras for diabetic retinopathy screening have been studied in France during the past 10 years. Nevertheless, the different screening modalities have not been compared. The main goal of this study was to compare patient recruitment with two different screening modalities, and secondarily to compare diagnostic effectiveness and cost. A retrospective study analyzed data from the Diabetes Midi Pyrenees Network in 2005 and between 2006 and 2010. In 2005, a vehicle with digital camera traveled through a rural department in order to screen diabetic patients whose last fundus examination was performed greater than 1 year previously. Between 2006 and 2010, general practitioners sent their diabetic patients whose last fundus examination was performed greater than 1 year previously to a "local" screening site. In the two cases, fundus photographs were made by trained operator at screening site and analyzed by an ophthalmologist. The "mobile" screening recruited 698 patients, and the "local" screening 345 patients. Patients recruited by "mobile" screening were older than those recruited by "local" screening. They were preferentially men and suffered from diabetes from far longer The diagnostic performance of "local" screening was 26.8%, and it was 28.6% for "mobile" screening (p = 0.47). The cost of screening was higher for "mobile" screening: 116 Euro against 61 Euro for "local" screening. "Mobile" screening could allow more patient recruitment than "local" screening when geographic and demographic constraints are more important.
authors: Département de médecine générale, faculté de médecine de Toulouse-Rangueil, 31062 Toulouse Cedex, France. bismuthpierre@gmail.com
authors: Pierre
authors: P
authors: Bismuth
authors: Michel
authors: M
authors: Bismuth
authors: Julie
authors: J
authors: Dupouy
authors: Marie-Eve
authors: ME
authors: Rougé-Bugat
authors: Jean-Christophe
authors: JC
authors: Poutrain
authors: Brigitte
authors: B
authors: Escourrou
authors: Hélène
authors: H
authors: Hanaire
authors: Stéphane
authors: S
authors: Oustric
mesh_terms: D000368:Aged; D019058:Community Networks; D003930:Diabetic Retinopathy / Q000175:diagnosis* / Q000453:epidemiology; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D005602:France; D058006:General Practice / Q000379:methods*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008403:Mass Screening / Q000295:instrumentation* / Q000379:methods*; D008952:Mobile Health Units / Q000706:statistics & numerical data; D009184:Mydriatics; D009887:Ophthalmoscopy / Q000379:methods; D014741:Video Recording
chemical_list: D009184:Mydriatics