Please use this identifier to cite or link to this item: https://scholarbank.nus.edu.sg/handle/10635/109153
Title: Accuracy of diabetic retinopathy screening by trained non-physician graders using non-mydriatic fundus camera
Authors: Bhargava, M.
Cheung, C.Y.-L.
Sabanayagam, C.
Kawasaki, R.
Harper, C.A.
Lamoureux, E.L.
Chow, W.L.
Ee, A.
Hamzah, H.
Ho, M.
Wong, W.
Wong, T.Y. 
Keywords: Diabetic retinopathy
Family physicians
Screening
Single-field digital retinal images
Trained graders
Issue Date: Nov-2012
Citation: Bhargava, M.,Cheung, C.Y.-L.,Sabanayagam, C.,Kawasaki, R.,Harper, C.A.,Lamoureux, E.L.,Chow, W.L.,Ee, A.,Hamzah, H.,Ho, M.,Wong, W.,Wong, T.Y. (2012-11). Accuracy of diabetic retinopathy screening by trained non-physician graders using non-mydriatic fundus camera. Singapore Medical Journal 53 (11) : 715-719. ScholarBank@NUS Repository.
Abstract: Introduction We compared the agreement of diabetic retinopathy (DR) assessment between trained non-physician graders (NPGs) and family physicians (FPs) in a primary healthcare setting. Methods This was a cross-sectional study conducted retrospectively over a period of one month. The participants were diabetic patients from two primary healthcare clinics (polyclinics) in Singapore. Single-field digital retinal images were obtained using a non-mydriatic 45-degree fundus camera. Retinal images were graded for the presence or absence of DR by FPs at the polyclinics and by NPGs at a central ocular grading centre. The FPs' and NPGs' assessments of DR were compared with readings by a single retinal specialist (reference standard). Resu lts A total of 367 diabetic patients (706 eyes) were included in the study. The mean age of the patients was 63 years, and the majority were Chinese (83.8%). For DR assessment, the agreement between NPGs and the retinal specialist was substantial (K{green} = 0.66), while the agreement between FPs and the retinal specialist was only fair (K{green} = 0.40). NPGs' assessment showed higher sensitivity (70% vs. 45%) and comparable specificity (94% vs. 92%) as compared to FPs' assessment. The area under the receiver operating characteristic curve of NPGs' assessment of DR was greater than that of the FPs' (0.82 vs. 0.69, p < 0.001). Conc lusion This study has demonstrated that trained NPGs are able to provide good detection of DR and maculopathy from fundus photographs. Our findings suggest that DR screening by trained NPGs may provide a costeffective alternative to FPs.
Source Title: Singapore Medical Journal
URI: http://scholarbank.nus.edu.sg/handle/10635/109153
ISSN: 00375675
Appears in Collections:Staff Publications

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