title: A Multi-Center Diabetes Eye Screening Study in Community Settings: Study Design and Methodology.
abstract: OBJECTIVE
  Diabetes is the leading cause of new cases of blindness among adults aged 20-74 years within the United States. The Innovative Network for Sight Research group (INSIGHT) designed the Diabetic Eye Screening Study (DESS) to examine the feasibility and short-term effectiveness of non-mydriatic diabetic retinopathy (DR) screening for adults with diabetes in community-based settings.
  
  
  METHODS
  Study enrollment began in December 2011 at four sites: an internal medicine clinic at a county hospital in Birmingham, Alabama; a Federally-qualified community healthcare center in Miami-Dade County, Florida; a university-affiliated outpatient pharmacy in Philadelphia, Pennsylvania; and a medical home in Winston-Salem, North Carolina. People 18 years or older with previously diagnosed diabetes were offered free DR screening using non-mydriatic retinal photography that was preceded by a brief questionnaire addressing demographic information and previous eye care use. Visual acuity was also measured for each eye. Images were evaluated at a telemedicine reading center by trained evaluators using the National Health System DR grading classification. Participants and their physicians were sent screening report results and telephoned for a follow-up survey 3 months post-screening to determine whether participants had sought follow-up comprehensive eye care and their experiences with the screening process.
  
  
  RESULTS
  Target enrollment at each site was a minimum of 500 persons. Three of the four sites met this enrollment goal.
  
  
  CONCLUSIONS
  The INSIGHT/DESS is intended to establish the feasibility and short-term effectiveness of DR screening using non-mydriatic retinal photography in persons with diabetes who seek services in community-based clinic and pharmacy settings.
authors.affiliation: a Wills Eye Hospital , Thomas Jefferson University , Philadelphia , PA , USA.
authors.forename: Ann P
authors.initials: AP
authors.lastname: Murchison
authors.affiliation: b Dana Center for Preventive Ophthalmology , Johns Hopkins Hospital , Baltimore , MD , USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Friedman
authors.affiliation: b Dana Center for Preventive Ophthalmology , Johns Hopkins Hospital , Baltimore , MD , USA.|c Departments of Epidemiology and Prevention, and Ophthalmology , Wake Forest School of Medicine , Winston-Salem , NC , USA.
authors.forename: Emily W
authors.initials: EW
authors.lastname: Gower
authors.affiliation: a Wills Eye Hospital , Thomas Jefferson University , Philadelphia , PA , USA.
authors.forename: Julia A
authors.initials: JA
authors.lastname: Haller
authors.affiliation: d Department of Public Health Sciences , University of Miami Miller School of Medicine , Miami , FL , USA.
authors.forename: Byron L
authors.initials: BL
authors.lastname: Lam
authors.affiliation: d Department of Public Health Sciences , University of Miami Miller School of Medicine , Miami , FL , USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Lee
authors.affiliation: e Department of Ophthalmology , University of Alabama at Birmingham , Birmingham , AL , USA.|f Department of Epidemiology , University of Alabama at Birmingham , Birmingham , AL , USA.
authors.forename: Gerald
authors.initials: G
authors.lastname: McGwin
authors.affiliation: e Department of Ophthalmology , University of Alabama at Birmingham , Birmingham , AL , USA.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Owsley
authors.affiliation: g Division of Diabetes Translation , Centers for Disease Control and Prevention , Atlanta , GA , USA.
authors.forename: Jinan
authors.initials: J
authors.lastname: Saaddine
authors.lastname: Insight Study Group
mesh_terms: D000328:Adult; D000368:Aged; D003153:Community Health Services / Q000706:statistics & numerical data*; D003920:Diabetes Mellitus; D003930:Diabetic Retinopathy / Q000175:diagnosis* / Q000453:epidemiology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008913:Minority Groups; D018579:Patient Selection; D010781:Photography / Q000295:instrumentation; D011446:Prospective Studies; D012107:Research Design; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D015351:Vision Screening / Q000295:instrumentation / Q000379:methods*; D014792:Visual Acuity / Q000502:physiology
keywords: Diabetes; eye screening; methodology; study design; tele-ophthalmology