糖尿病性视网膜病变筛查的虚拟读片中心。

Diabetic retinopathy screening using a virtual reading center.

机构信息

Department of Ophthalmology, Kaiser Permanente, 1100 Veterans Blvd, Redwood City, CA, 94063, USA.

Kaiser Permanente Division of Research, 2000 Broadway, Oakland, CA, 94512, USA.

出版信息

Acta Diabetol. 2020 Feb;57(2):183-188. doi: 10.1007/s00592-019-01392-9. Epub 2019 Aug 3.

DOI:10.1007/s00592-019-01392-9

PMID:31377925

Abstract

AIMS

To summarize the effects of centralization of diabetic fundus photograph interpretation into a virtual reading center.

METHODS

In 2016 Kaiser Permanente Northern California, a large, membership-based health plan with an ethnically and racially diverse population, centralized diabetic retinopathy screening into a virtual reading center. Retina screens were based on single field, 45-degree fundus photographs. We compared the accuracy of photography interpretation the year before centralization to the year after using masked reads performed by retina specialists of 1000 randomly selected screens from each time period.

RESULTS

In all, 1902 patient screens with adequate quality images were included in the primary analysis. Images from pre-centralization screens were largely read by ophthalmologists (76.2%), while screens post-centralization were mainly read by optometrists (84.6%). Despite being interpreted by readers with lower levels of professional training, the sensitivity of screening increased from 43.9% (95% CI 38.0-49.8%) to 66.0% (95% CI 60.5-71.4%).

CONCLUSION

A move to a centralized virtual reading center was associated with improved accuracy of diabetic retinopathy screening.

摘要

目的

总结将糖尿病眼底图像解读集中到虚拟读片中心的效果。

方法

2016 年，在一个拥有多样化种族和民族的大型会员制健康计划——北加利福尼亚凯泽永久医疗集团，将糖尿病视网膜病变筛查集中到虚拟读片中心。视网膜筛查基于单视野、45 度眼底照片。我们比较了集中化前一年和集中化后一年通过由视网膜专家进行的 1000 张随机选择的每张图片的掩蔽读取来比较摄影解读的准确性。

结果

共有 1902 例患者的眼底图像质量足够纳入主要分析。集中化前的眼底图像主要由眼科医生（76.2%）解读，而集中化后的眼底图像主要由验光师（84.6%）解读。尽管由专业培训水平较低的读者进行解读，但筛查的敏感性从 43.9%（95%CI 38.0-49.8%）提高到 66.0%（95%CI 60.5-71.4%）。