Accuracy of screening for diabetic retinopathy by family physicians

Abstract

BACKGROUND: We wanted to examine the accuracy of family physicians' screening for diabetic retinopathy using standardized criteria and a nonmydriatic ophthalmoscope. METHODS: Eleven family physicians assessed 28 standardized patients with diabetes mellitus using the PanOptic ophthalmoscope. Their assessments of whether the patients required referral to an ophthalmologist were compared with the reference standard of retinal diagrams. RESULTS: The mean sensitivity for the family physicians was 87% (95% confidence interval [CI], 83%-91%) with a specificity of 57% (95% CI, 46%-68%). Overall agreement was moderate, with a mean κ = .43 (95% CI, 0.39%-0.47%). CONCLUSIONS: Using standardized criteria and a nonmydriatic ophthalmoscope, family physicians were fairly accurate in screening patients for diabetic retinopathy. Whereas this technique is not sufficiently accurate to replace routine referral for all patients with diabetes, it can be used to improve care for those patients who fail to get routine eye screenings.