Improved Detection and Referral of Patients With Diabetic Retinopathy by Primary Care Physicians: Effectiveness of Education

Carl C. Awh, Howard P. Cupples, Jonathan C. Javitt

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

We studied the effect of a 4-hour course in recognition and management of diabetic retinopathy on the ability of nonophthalmologist physicians to detect and to appropriately refer patients with sight-threatening diabetic retinopathy. Participants completed a written examination covering case management and performed a total of 340 dilated ophthalmoscopic examinations on selected patients before and 2 weeks following the teaching session. Accuracy of ophthalmoscopy was assessed by comparison with standardized grading of fundus photographs. Scores on the written examination increased from a mean of 49% to 78% correct. The likelihood of failing to detect and appropriately refer patients with proliferative or preproliferative retinopathy decreased from 60% to 15%. Similarly, for patients with maculopathy, the likelihood of failure to detect and to appropriately refer decreased from 83% to 15.6%. These data suggest that education may significantly improve the ability of nonophthalmologists to detect and to appropriately refer patients who are at risk for vision loss.

Original languageEnglish (US)
Pages (from-to)1405-1408
Number of pages4
JournalArchives of Internal Medicine
Volume151
Issue number7
DOIs
StatePublished - 1991
Externally publishedYes

ASJC Scopus subject areas

  • Internal Medicine

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