Vargas-Sánchez Carmen, Maldonado-Valenzuela Juan José, Pérez-Durillo Francisco Tomás, González-Calvo José, Pérez-Milena Alejandro
Centro de Salud de Valdepeñas (Jaén), Servicio Andaluz de Salud, España.
Salud Publica Mex. 2011 May-Jun;53(3):212-9.
To identify the coverage of a diabetic retinopathy screening program in primary health care and to assess agreement between ophthalmologists and family physicians (FP) regarding retinography evaluations of diabetic patients.
Cross-sectional observational study,with a review of diabetic patients' mydriatic retinographies (2007-2008) from three urban primary health centers (PHC)(Jaén-Spain).
A total of 296 retinographies in 2007 and 380 in 2008 (coverage=26% ± 2,4) were reviewed. Pathological retinographies were identified by 181 FPs (27% ± 1,3) and 59 (9% ± 0,3) ophthalmologists.Total agreement was moderate (kappa=0, 408 ± 0,039).Agreement was better in the latter year (0,45 vs 0,34; p < 0,001 test χ²). FP evaluations showed 97% sensitivity, 80% specificity, 33% positive predictive value, 100% negative predictive value, 4, 88 positive likelihood ratio and 0,04 negative likelihood ratio. We find variability in coverage and agreement between PHC.
Mydriatic retinographies performed and evaluated by FPs are useful to retinopathy screening of diabetic patients. Coverage, predictive values and likelihood ratio were better in the latter year, although the interpretation should be homogenized.
