Diabetic Retinopathy Screening Audit - Trained Non-physician Personnel as Compared with Ophthalmologists

Abstract

This cross-sectional descriptive study was to audit the interpretation of digital retinal images by trained non-physician personnel in the diabetic retinopathy screening project, compared with those by ophthalmologist, and retinal specialist. Digital retinal images of diabetes patients who classified as no diabetic retinopathy by trained non-physician personnel, from the diabetic retinopathy screening in Trang province during August - September 2009 were studied. Five hundred patients were randomly selected. These included a total of 955 normal retinal images. In order to allow ophthalmologist, and retinal specialist to interpret the images, all images were stored on the CD-ROMs and both specialist recorded results in a data record form.

Interpretation difference between the retinal specialist and the trained non-physician personnel accounted for 2.7 percent of the total samples. The retinal specialist graded the images as mild nonproliferative diabetic retinopathy in 26 images from 955 images, while trained non-physician personnel interpreted images as normal.

In conclusion, non-physician personnel who received training and practice on diabetic retinopathy screening can read and interpret the digital retinal images in the screening pro-cess. There was no loss of chance for patients in seeking treatment. However, it is recom-mended that retinal images interpretation needs periodical system evaluation and an audit.