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一项社区环境下的多中心糖尿病眼部筛查研究:研究设计与方法

A Multi-Center Diabetes Eye Screening Study in Community Settings: Study Design and Methodology.

作者信息

Murchison Ann P, Friedman David S, Gower Emily W, Haller Julia A, Lam Byron L, Lee David J, McGwin Gerald, Owsley Cynthia, Saaddine Jinan

机构信息

a Wills Eye Hospital , Thomas Jefferson University , Philadelphia , PA , USA.

b Dana Center for Preventive Ophthalmology , Johns Hopkins Hospital , Baltimore , MD , USA.

出版信息

Ophthalmic Epidemiol. 2016;23(2):109-15. doi: 10.3109/09286586.2015.1099682. Epub 2016 Mar 7.

Abstract

PURPOSE

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.

CONCLUSION

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.

摘要

目的

糖尿病是美国20 - 74岁成年人失明新病例的主要病因。视力研究创新网络小组(INSIGHT)设计了糖尿病眼病筛查研究(DESS),以检验在社区环境中对糖尿病成年人进行非散瞳糖尿病视网膜病变(DR)筛查的可行性和短期有效性。

方法

研究于2011年12月在四个地点开始招募:阿拉巴马州伯明翰一家县医院的内科诊所;佛罗里达州迈阿密 - 戴德县一家符合联邦资格的社区医疗中心;宾夕法尼亚州费城一家大学附属门诊药房;北卡罗来纳州温斯顿 - 塞勒姆的一个家庭医疗中心。为18岁及以上先前被诊断患有糖尿病的人提供免费的非散瞳视网膜摄影DR筛查,在筛查前会有一份简短问卷,询问人口统计学信息和以前的眼部护理使用情况。还对每只眼睛测量视力。图像由经过培训的评估人员在远程医疗阅读中心使用国家卫生系统DR分级分类进行评估。在筛查后3个月,向参与者及其医生发送筛查报告结果,并打电话进行随访调查,以确定参与者是否寻求了后续的全面眼部护理以及他们在筛查过程中的体验。

结果

每个地点的目标招募人数至少为500人。四个地点中有三个达到了这个招募目标。

结论

INSIGHT/DESS旨在确定在社区诊所和药房环境中寻求服务的糖尿病患者中,使用非散瞳视网膜摄影进行DR筛查的可行性和短期有效性。

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