Millett Christopher, Dodhia Hiten
Department of Primary Care & Social Medicine, Imperial College Faculty of Medicine, London W6 8RP, UK.
J Med Screen. 2006;13(3):152-5. doi: 10.1258/096914106778440608.
To assess uptake of the diabetes retinopathy screening programme in South East London and examine variation in attendance and screening outcomes.
Cross-sectional study of patients on a centralized disease register invited for retinal screening during 2003. The influence of age, gender, deprivation, region of birth and type of diabetes on screening attendance and outcomes was assessed.
An estimated 46% of residents with known diabetes (9750/21,104) were offered digital retinopathy screening during 2003. In all, 88.9% of patients who were invited for screening attended. Attendance rates were significantly lower in younger patients (< or = 40 years), in those with type 1 diabetes and in patients residing in areas with the highest levels of deprivation. A total of 28.9% of patients had background retinopathy or worse during 2003. Retinopathy was more common in older patients (>40 years) and in individuals with type 1 diabetes after adjusting for other factors. Patients born outside the United Kingdom and the Republic of Ireland were significantly more likely to present with retinopathy.
This study identified considerable inequity in the delivery of a local diabetic retinopathy screening programme. Equity audits should form an integral component of ongoing quality assurance monitoring of retinopathy screening programmes.
评估伦敦东南部糖尿病视网膜病变筛查项目的接受情况，并研究就诊率和筛查结果的差异。
对2003年被邀请进行视网膜筛查的集中疾病登记患者进行横断面研究。评估年龄、性别、贫困程度、出生地和糖尿病类型对筛查就诊率和结果的影响。
2003年，估计有46%的已知糖尿病居民（9750/21104）接受了数字视网膜病变筛查。总共有88.9%被邀请参加筛查的患者前来就诊。年轻患者（≤40岁）、1型糖尿病患者以及居住在贫困程度最高地区的患者就诊率显著较低。2003年，共有28.9%的患者患有轻度视网膜病变或更严重的病变。在调整其他因素后，视网膜病变在老年患者（>40岁）和1型糖尿病患者中更为常见。在英国和爱尔兰共和国以外出生的患者患视网膜病变的可能性明显更高。
本研究发现当地糖尿病视网膜病变筛查项目的实施存在相当大的不公平性。公平性审计应成为视网膜病变筛查项目持续质量保证监测的一个组成部分。
