Diabetes Macular Edema, Diabetes Retinopathy
Conditions
Keywords
sensibility, specificity, positive predictive value, negative predictive value, Cost-effectiveness
Brief summary
To evaluate the impact of telemedicine system in rural hospitals for diagnosis and treatment of Diabetes retinopathy and Diabetes macular edema.
Detailed description
Telemedicine system mainly contains a comprehensive eye examination electric-records (E-record), which can transfer the fundus pictures from rural hospitals to professional Graders (golden standard for a diagnose of Diabetes Retinopathy (DR) and Diabetes Macular Edema(DME)). In Zhongshan Ophthalmic Center (ZOC). By this system, the investigators can evaluate the capacity of rural eye doctors about the diagnosis of DR/DME, and give proper suggestions for the treatment and revisit plan.
Interventions
DEVICE90 D
rural doctors exam eye fundus by 90 D
DEVICEfundus camera and grader
taking fundus pictures and graded by graders in ZOC
Sponsors
Orbis
The World Diabetes Foundation
Sun Yat-sen University
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
40 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* age \> 40y, diagnosed (Diabetes Retinopathy) DR,10% normal patients
Exclusion criteria
* unconsciousness, history of diabetic ketoacidosis, cardiac insufficiency, Severe atrioventricular block, hepatic insufficiency , allergic to mydriatic
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Accuracy of trained doctors in diagnosing DR/DME versus photo grading and automated grading | 2 years after the telemedicine begin to use | To compare the sensitivity, specificity and positive and negative predictive value for a diagnosis of DR/DME , a diagnosis of DR/DME requiring treatment, of trained rural doctors and an automated grading system, as compared to trained graders using photographs (the gold standard) |
| cost-effectiveness | 2 years | Cost-effectiveness of three methods of DR screening (trained rural doctors versus telemedicine versus automated grading) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Frequency of comprehensive eye examination taken by rural doctors | 2 years | Frequency with which trained rural doctors continue to implement suggested examinations (IOP, gonioscopy, pupil exam, dilated examination) |
| comprehensive eye examination rate among patients in rural hospitals | 2 years | Frequency with which patients get comprehensive eye examinations in rural hospitals, and its influencing factors. |
| the usage rate of Electric-Record | 2 years | to evaluate the usage rate of E-record by rural doctors when they see patients in the eye clinic, and its influencing factors. |
| Cost-effectiveness of van | 2 years | compare the cost-effectiveness of van for laser treatment to DR/DME patients with the transfer treatment in ZOC |
Countries
China
Outcome results
None listed