Abstract
Abstract: :
Purpose: The purpose of this project was to evaluate national and state trends in the numbers of diabetics reporting annual or biannual dilated examination during the 10 year period 1994–2003 using Behavioral Risk Factor Surveillance Survey data(BRFSS). The BRFSS is a yearly probability sample of the health status of the United States population designed by the Centers for Disease Control and Prevention(CDC) and administered by individual state departments of public health. In addition to a set of core questions, individual states may choose to administer a diabetes specific module. Methods: Raw BRFSS data files were obtained from the CDC. A specific question within the BRFSS diabetes module asks when the last dilated eye examination occurred. Analysis was carried out to produce prevalence estimates of the number of diabetics receiving annual or biannual examination on a state by state basis. National estimates were obtained by aggregating state data. A group of 10 states administered the diabetes module each year, a subanalysis was carried out on this group. Due to the complex sampling schema of the BRFSS all analyses were completed using SUDAAN enabled SAS accounting for weighting, stratification, and primary sampling unit. Results: Based on aggregated state data during the period 1994–2000 the number of diabetics reporting having had a dilated examination within the previous year increased by 1.8%year(p<.0001). During this time frame the mean number of diabetics reporting yearly dilated exam increased from 60.7% to 70.8%. From 2000–2003 there is a plateau in the numbers reporting yearly dilated examination with a small but not statistically significant trend to decreasing prevalence –.6%/year(p<.17). The two year prevalence of examination mirrors closely the one year data with a remarkably stable 12% of the diabetic population reporting dilated examination between one to two years. This was consistent across all years 1994–2003. It does not appear that delaying of examination is a cause of the yearly examination prevalence plateau seen between 2000–2003. Subanalysis of data from the 10 states which have administered the diabetes module each year shows similar results to those seen for aggregated all state data. Conclusions: During the period 1994–2000 the number of diabetics reporting dilated within one year grew dramatically. Since 2000 however, these numbers have plateaued. It does not appear as though delaying examination from one to two years is associated with this trend.
Keywords: diabetic retinopathy • clinical (human) or epidemiologic studies: biostatistics/epidemiology methodology • clinical (human) or epidemiologic studies: prevalence/incidence