Predicted impact of extending the screening interval for diabetic retinopathy: the Scottish Diabetic Retinopathy Screening programme

Scottish Diabetes Research Network (SDRN) Epidemiology Group and the Scottish Diabetic Retinopathy Collaborative; H C Looker; S O Nyangoma; D T Cromie; J A Olson; G P Leese; S Philip; M W Black; J Doig; N Lee; A Briggs; E J Hothersall; Andrew Morris; R S Lindsay; J A McKnight; D W M Pearson; N A Sattar; S H Wild; P McKeigue; H M Colhoun

doi:10.1007/s00125-013-2928-7

Predicted impact of extending the screening interval for diabetic retinopathy: the Scottish Diabetic Retinopathy Screening programme

Scottish Diabetes Research Network (SDRN) Epidemiology Group and the Scottish Diabetic Retinopathy Collaborative, H C Looker, S O Nyangoma, D T Cromie, J A Olson, G P Leese, S Philip, M W Black, J Doig, N Lee, A Briggs, E J Hothersall, Andrew Morris, R S Lindsay, J A McKnight, D W M Pearson, N A Sattar, S H Wild, P McKeigue, H M Colhoun

Research output: Contribution to journal › Article › peer-review

Abstract / Description of output

Aims/hypothesis

The aim of our study was to identify subgroups of patients attending the Scottish Diabetic Retinopathy Screening (DRS) programme who might safely move from annual to two yearly retinopathy screening.
Methods

This was a retrospective cohort study of screening data from the DRS programme collected between 2005 and 2011 for people aged ≥12 years with type 1 or type 2 diabetes in Scotland. We used hidden Markov models to calculate the probabilities of transitions to referable diabetic retinopathy (referable background or proliferative retinopathy) or referable maculopathy.
Results

The study included 155,114 individuals with no referable diabetic retinopathy or maculopathy at their first DRS examination and with one or more further DRS examinations. There were 11,275 incident cases of referable diabetic eye disease (9,204 referable maculopathy, 2,071 referable background or proliferative retinopathy). The observed transitions to referable background or proliferative retinopathy were lower for people with no visible retinopathy vs mild background retinopathy at their prior examination (respectively, 1.2% vs 8.1% for type 1 diabetes and 0.6% vs 5.1% for type 2 diabetes). The lowest probability for transitioning to referable background or proliferative retinopathy was among people with two consecutive screens showing no visible retinopathy, where the probability was <0.3% for type 1 and <0.2% for type 2 diabetes at 2 years.
Conclusions/interpretation

Transition rates to referable diabetic eye disease were lowest among people with type 2 diabetes and two consecutive screens showing no visible retinopathy. If such people had been offered two yearly screening the DRS service would have needed to screen 40% fewer people in 2009.

Original language	English
Pages (from-to)	1716-25
Number of pages	10
Journal	Diabetologia
Volume	56
Issue number	8
DOIs	https://doi.org/10.1007/s00125-013-2928-7
Publication status	Published - Aug 2013

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10.1007/s00125-013-2928-7

Predicted impact of extending the screening interval for diabetic retinopathy
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Scottish Diabetes Research Network (SDRN) Epidemiology Group and the Scottish Diabetic Retinopathy Collaborative, Looker, H. C., Nyangoma, S. O., Cromie, D. T., Olson, J. A., Leese, G. P., Philip, S., Black, M. W., Doig, J., Lee, N., Briggs, A., Hothersall, E. J., Morris, A., Lindsay, R. S., McKnight, J. A., Pearson, D. W. M., Sattar, N. A., Wild, S. H., McKeigue, P., & Colhoun, H. M. (2013). Predicted impact of extending the screening interval for diabetic retinopathy: the Scottish Diabetic Retinopathy Screening programme. Diabetologia, 56(8), 1716-25. https://doi.org/10.1007/s00125-013-2928-7

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title = "Predicted impact of extending the screening interval for diabetic retinopathy: the Scottish Diabetic Retinopathy Screening programme",

abstract = "Aims/hypothesisThe aim of our study was to identify subgroups of patients attending the Scottish Diabetic Retinopathy Screening (DRS) programme who might safely move from annual to two yearly retinopathy screening.MethodsThis was a retrospective cohort study of screening data from the DRS programme collected between 2005 and 2011 for people aged ≥12 years with type 1 or type 2 diabetes in Scotland. We used hidden Markov models to calculate the probabilities of transitions to referable diabetic retinopathy (referable background or proliferative retinopathy) or referable maculopathy.ResultsThe study included 155,114 individuals with no referable diabetic retinopathy or maculopathy at their first DRS examination and with one or more further DRS examinations. There were 11,275 incident cases of referable diabetic eye disease (9,204 referable maculopathy, 2,071 referable background or proliferative retinopathy). The observed transitions to referable background or proliferative retinopathy were lower for people with no visible retinopathy vs mild background retinopathy at their prior examination (respectively, 1.2% vs 8.1% for type 1 diabetes and 0.6% vs 5.1% for type 2 diabetes). The lowest probability for transitioning to referable background or proliferative retinopathy was among people with two consecutive screens showing no visible retinopathy, where the probability was <0.3% for type 1 and <0.2% for type 2 diabetes at 2 years.Conclusions/interpretationTransition rates to referable diabetic eye disease were lowest among people with type 2 diabetes and two consecutive screens showing no visible retinopathy. If such people had been offered two yearly screening the DRS service would have needed to screen 40% fewer people in 2009.",

author = "{Scottish Diabetes Research Network (SDRN) Epidemiology Group and the Scottish Diabetic Retinopathy Collaborative} and Looker, {H C} and Nyangoma, {S O} and Cromie, {D T} and Olson, {J A} and Leese, {G P} and S Philip and Black, {M W} and J Doig and N Lee and A Briggs and Hothersall, {E J} and Andrew Morris and Lindsay, {R S} and McKnight, {J A} and Pearson, {D W M} and Sattar, {N A} and Wild, {S H} and P McKeigue and Colhoun, {H M}",

year = "2013",

month = aug,

doi = "10.1007/s00125-013-2928-7",

language = "English",

volume = "56",

pages = "1716--25",

journal = "Diabetologia",

issn = "0012-186X",

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Scottish Diabetes Research Network (SDRN) Epidemiology Group and the Scottish Diabetic Retinopathy Collaborative, Looker, HC, Nyangoma, SO, Cromie, DT, Olson, JA, Leese, GP, Philip, S, Black, MW, Doig, J, Lee, N, Briggs, A, Hothersall, EJ, Morris, A, Lindsay, RS, McKnight, JA, Pearson, DWM, Sattar, NA, Wild, SH , McKeigue, P & Colhoun, HM 2013, 'Predicted impact of extending the screening interval for diabetic retinopathy: the Scottish Diabetic Retinopathy Screening programme', Diabetologia, vol. 56, no. 8, pp. 1716-25. https://doi.org/10.1007/s00125-013-2928-7

Predicted impact of extending the screening interval for diabetic retinopathy: the Scottish Diabetic Retinopathy Screening programme. / Scottish Diabetes Research Network (SDRN) Epidemiology Group and the Scottish Diabetic Retinopathy Collaborative; Looker, H C; Nyangoma, S O et al.
In: Diabetologia, Vol. 56, No. 8, 08.2013, p. 1716-25.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Predicted impact of extending the screening interval for diabetic retinopathy

T2 - the Scottish Diabetic Retinopathy Screening programme

AU - Scottish Diabetes Research Network (SDRN) Epidemiology Group and the Scottish Diabetic Retinopathy Collaborative

AU - Looker, H C

AU - Nyangoma, S O

AU - Cromie, D T

AU - Olson, J A

AU - Leese, G P

AU - Philip, S

AU - Black, M W

AU - Doig, J

AU - Lee, N

AU - Briggs, A

AU - Hothersall, E J

AU - Morris, Andrew

AU - Lindsay, R S

AU - McKnight, J A

AU - Pearson, D W M

AU - Sattar, N A

AU - Wild, S H

AU - McKeigue, P

AU - Colhoun, H M

PY - 2013/8

Y1 - 2013/8

N2 - Aims/hypothesisThe aim of our study was to identify subgroups of patients attending the Scottish Diabetic Retinopathy Screening (DRS) programme who might safely move from annual to two yearly retinopathy screening.MethodsThis was a retrospective cohort study of screening data from the DRS programme collected between 2005 and 2011 for people aged ≥12 years with type 1 or type 2 diabetes in Scotland. We used hidden Markov models to calculate the probabilities of transitions to referable diabetic retinopathy (referable background or proliferative retinopathy) or referable maculopathy.ResultsThe study included 155,114 individuals with no referable diabetic retinopathy or maculopathy at their first DRS examination and with one or more further DRS examinations. There were 11,275 incident cases of referable diabetic eye disease (9,204 referable maculopathy, 2,071 referable background or proliferative retinopathy). The observed transitions to referable background or proliferative retinopathy were lower for people with no visible retinopathy vs mild background retinopathy at their prior examination (respectively, 1.2% vs 8.1% for type 1 diabetes and 0.6% vs 5.1% for type 2 diabetes). The lowest probability for transitioning to referable background or proliferative retinopathy was among people with two consecutive screens showing no visible retinopathy, where the probability was <0.3% for type 1 and <0.2% for type 2 diabetes at 2 years.Conclusions/interpretationTransition rates to referable diabetic eye disease were lowest among people with type 2 diabetes and two consecutive screens showing no visible retinopathy. If such people had been offered two yearly screening the DRS service would have needed to screen 40% fewer people in 2009.

AB - Aims/hypothesisThe aim of our study was to identify subgroups of patients attending the Scottish Diabetic Retinopathy Screening (DRS) programme who might safely move from annual to two yearly retinopathy screening.MethodsThis was a retrospective cohort study of screening data from the DRS programme collected between 2005 and 2011 for people aged ≥12 years with type 1 or type 2 diabetes in Scotland. We used hidden Markov models to calculate the probabilities of transitions to referable diabetic retinopathy (referable background or proliferative retinopathy) or referable maculopathy.ResultsThe study included 155,114 individuals with no referable diabetic retinopathy or maculopathy at their first DRS examination and with one or more further DRS examinations. There were 11,275 incident cases of referable diabetic eye disease (9,204 referable maculopathy, 2,071 referable background or proliferative retinopathy). The observed transitions to referable background or proliferative retinopathy were lower for people with no visible retinopathy vs mild background retinopathy at their prior examination (respectively, 1.2% vs 8.1% for type 1 diabetes and 0.6% vs 5.1% for type 2 diabetes). The lowest probability for transitioning to referable background or proliferative retinopathy was among people with two consecutive screens showing no visible retinopathy, where the probability was <0.3% for type 1 and <0.2% for type 2 diabetes at 2 years.Conclusions/interpretationTransition rates to referable diabetic eye disease were lowest among people with type 2 diabetes and two consecutive screens showing no visible retinopathy. If such people had been offered two yearly screening the DRS service would have needed to screen 40% fewer people in 2009.

U2 - 10.1007/s00125-013-2928-7

DO - 10.1007/s00125-013-2928-7

M3 - Article

C2 - 23689796

SN - 0012-186X

VL - 56

SP - 1716

EP - 1725

JO - Diabetologia

JF - Diabetologia

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Scottish Diabetes Research Network (SDRN) Epidemiology Group and the Scottish Diabetic Retinopathy Collaborative, Looker HC, Nyangoma SO, Cromie DT, Olson JA, Leese GP et al. Predicted impact of extending the screening interval for diabetic retinopathy: the Scottish Diabetic Retinopathy Screening programme. Diabetologia. 2013 Aug;56(8):1716-25. doi: 10.1007/s00125-013-2928-7

Predicted impact of extending the screening interval for diabetic retinopathy: the Scottish Diabetic Retinopathy Screening programme

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