Long-term comparative effectiveness of telemedicine to detect diabetic retinopathy

BACKGROUND: Diabetic retinopathy is the leading cause of new cases of blindness in adults aged 20-74. Without treatment, diabetic retinopathy can progress from being asymptomatic in its early stages, to permanent visual impairment in its later stages. It is recommended that diabetics have an eye exam each year to screen for the presence of retinopathy, but less than 50% of those diagnosed with diabetes obtain annual eye exams. This low screening proportion is even worse for minority and rural patients. METHODS: The researchers partnered with two tribal health clinics in Oregon and Kansas to focus on screening for diabetic retinopathy. Participants were randomly assigned to either telemedicine (digital images of the retina were captured in the clinic with a nonmydriatic camera and sent electronically to an eye care provider for evaluation) or traditional surveillance (annual eye exams in an eye care provider's office). Participants also completed two surveys created for this study: The Compliance with Annual Diabetic Eye Exams (CADEES) Survey and a Cost-Effectiveness Survey. RESULTS: Last year baseline results were reported. This year the researchers will report on (1) long-term effectiveness of telemedicine to detect diabetic retinopathy when compared to traditional surveillance methods, (2) health belief factors associated with adherence to annual eye exams, and (3) cost-effectiveness of the telemedicine system from the perspective of the community clinic, the third-party payer, and the patient. CONCLUSION: This data will be presented to policy makers to encourage change in the national and state guidelines regarding the delivery of diabetic eye exams.