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Marta Alonso Plasencia, Lorena Solé González, Rodrigo Abreu González, Pedro Abreu Reyes; Effect of continuing training for general practitioners in a diabetic retinopathy screeening program in Canary Islands. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1555.
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© ARVO (1962-2015); The Authors (2016-present)
In Canary Islands there is a telemedicine Diabetic Retinopathy (DR) screening program based in a one-field, non-mydriatic, 45 degree digital fundus photography whose first reviewers are general practitioners (GP) with knowledges in reading retinographies. Retinographies suspected to be pathological are sent to eye care physicians to designate a diagnosis. We assessed the effectiveness of a continuing training project to those GPs.
Comparative intervention study was conducted. Data was obtained in two six-months periods before and after the training in the same time of the year, from June to November, in 2012 and 2014. Training activity was a paticipative and interactive lesson imparted across Tenerife and Gran Canaria islands. In our area, twelve trainings were held by the same two ophthalmologists. T-test and Chi square were used for the analysis.
A total of 2.584 consecutive diabetics patients were included in the study. In both groups of patients, before and after the training, they present the same epidemiologic characteristics (age, sex and glycemic control measured by A1c hemoglobin) (p>0,05).After training, percentage of pathological patients referred by the GPs has increased from 30.5% to 41.4% , this represents a statistically significant increase (p < 0.05) in the percentage of true positives (TP).Moreover, we found that the number of false positives (FP), pathological images sent by GPs and diagnosed as healthy by the ophthalmologist , has decreased significantly from 56.2% (720 cases) to 48.3% (629 cases), (p < 0.05).However, after training, the percentage of studies submitted with no diagnosis was similar than before, we found 46.6 % and 49.7 % (p = 0.125).
Medical training by a single clinical lesson has improved screening of DR in our telemedicine program as it has led to improve sensitivity by reducing false positives. However, there is still a high percentage of studies submitted with no diagnosis.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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