Modeling a Telemedicine Screening Program for Diabetic Retinopathy in Iran and Implementing a Pilot Project in Tehran Suburb
Purpose. To model a community-based telescreening program for diabetic retinopathy (DR) in Iran and to implement a pilot project at the Iranian Diabetes Society (IDS) branch in a Tehran suburb. Methods. In this mixed model study, a web application called the “Iranian Retinopathy Teleophthalmology Sc...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Journal of Ophthalmology |
| Online Access: | http://dx.doi.org/10.1155/2019/2073679 |
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| author | Sare Safi Hamid Ahmadieh Marzieh Katibeh Mehdi Yaseri Homayoun Nikkhah Saeed Karimi Ramin Nourinia Ali Tivay Mohammad Zareinejad Mohsen Azarmina Alireza Ramezani Siamak Moradian Mohammad Hossein Dehghan Narsis Daftarian Davood Abbasi Afshin Eshghi Fallah Bahareh Kheiri |
| author_facet | Sare Safi Hamid Ahmadieh Marzieh Katibeh Mehdi Yaseri Homayoun Nikkhah Saeed Karimi Ramin Nourinia Ali Tivay Mohammad Zareinejad Mohsen Azarmina Alireza Ramezani Siamak Moradian Mohammad Hossein Dehghan Narsis Daftarian Davood Abbasi Afshin Eshghi Fallah Bahareh Kheiri |
| author_sort | Sare Safi |
| collection | DOAJ |
| description | Purpose. To model a community-based telescreening program for diabetic retinopathy (DR) in Iran and to implement a pilot project at the Iranian Diabetes Society (IDS) branch in a Tehran suburb. Methods. In this mixed model study, a web application called the “Iranian Retinopathy Teleophthalmology Screening (IRTOS)” was launched. The educational course for DR screening was established for general practitioners (GPs). Registered patients in IDS branch were recalled for fundus photography; images were transferred to the reading center via IRTOS to be graded by GPs, and patients were informed about the results via mobile messaging. All images were independently reviewed by a retina specialist as the gold standard. Patients who required further assessment were referred to an eye hospital. Results. Overall, 604 subjects with diabetes were screened; of these, 50% required referral. The sensitivity and specificity for diagnosis of any stage of DR by trained GPs were 82.8% and 86.2%, respectively, in comparison to the gold standard. The corresponding values for detecting any stage of diabetic macular edema (DME) were 63.5% and 96.6%, respectively. Conclusions. Telescreening was an effective method for detecting DR in a Tehran suburb. This screening model demonstrated its capacity for promoting diabetic eye care services at the national level. However, the sensitivity for detecting DME needs to be improved by modifying the referral pathway and promoting the skill of GPs. |
| format | Article |
| id | doaj-art-a0a1f82a1d1a48a5bae7784ea9504565 |
| institution | Kabale University |
| issn | 2090-004X 2090-0058 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Ophthalmology |
| spelling | doaj-art-a0a1f82a1d1a48a5bae7784ea95045652025-02-03T01:10:47ZengWileyJournal of Ophthalmology2090-004X2090-00582019-01-01201910.1155/2019/20736792073679Modeling a Telemedicine Screening Program for Diabetic Retinopathy in Iran and Implementing a Pilot Project in Tehran SuburbSare Safi0Hamid Ahmadieh1Marzieh Katibeh2Mehdi Yaseri3Homayoun Nikkhah4Saeed Karimi5Ramin Nourinia6Ali Tivay7Mohammad Zareinejad8Mohsen Azarmina9Alireza Ramezani10Siamak Moradian11Mohammad Hossein Dehghan12Narsis Daftarian13Davood Abbasi14Afshin Eshghi Fallah15Bahareh Kheiri16Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IranOphthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IranOphthalmic Epidemiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IranOphthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IranOphthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IranOphthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IranOphthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IranNew Technologies Research Center, Amirkabir University of Technology, Tehran, IranNew Technologies Research Center, Amirkabir University of Technology, Tehran, IranOphthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IranOphthalmic Epidemiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IranOphthalmic Epidemiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IranOphthalmic Epidemiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IranOcular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IranIslamshahr Branch, Iranian Diabetes Society, Islamshahr, IranOphthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IranOphthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IranPurpose. To model a community-based telescreening program for diabetic retinopathy (DR) in Iran and to implement a pilot project at the Iranian Diabetes Society (IDS) branch in a Tehran suburb. Methods. In this mixed model study, a web application called the “Iranian Retinopathy Teleophthalmology Screening (IRTOS)” was launched. The educational course for DR screening was established for general practitioners (GPs). Registered patients in IDS branch were recalled for fundus photography; images were transferred to the reading center via IRTOS to be graded by GPs, and patients were informed about the results via mobile messaging. All images were independently reviewed by a retina specialist as the gold standard. Patients who required further assessment were referred to an eye hospital. Results. Overall, 604 subjects with diabetes were screened; of these, 50% required referral. The sensitivity and specificity for diagnosis of any stage of DR by trained GPs were 82.8% and 86.2%, respectively, in comparison to the gold standard. The corresponding values for detecting any stage of diabetic macular edema (DME) were 63.5% and 96.6%, respectively. Conclusions. Telescreening was an effective method for detecting DR in a Tehran suburb. This screening model demonstrated its capacity for promoting diabetic eye care services at the national level. However, the sensitivity for detecting DME needs to be improved by modifying the referral pathway and promoting the skill of GPs.http://dx.doi.org/10.1155/2019/2073679 |
| spellingShingle | Sare Safi Hamid Ahmadieh Marzieh Katibeh Mehdi Yaseri Homayoun Nikkhah Saeed Karimi Ramin Nourinia Ali Tivay Mohammad Zareinejad Mohsen Azarmina Alireza Ramezani Siamak Moradian Mohammad Hossein Dehghan Narsis Daftarian Davood Abbasi Afshin Eshghi Fallah Bahareh Kheiri Modeling a Telemedicine Screening Program for Diabetic Retinopathy in Iran and Implementing a Pilot Project in Tehran Suburb Journal of Ophthalmology |
| title | Modeling a Telemedicine Screening Program for Diabetic Retinopathy in Iran and Implementing a Pilot Project in Tehran Suburb |
| title_full | Modeling a Telemedicine Screening Program for Diabetic Retinopathy in Iran and Implementing a Pilot Project in Tehran Suburb |
| title_fullStr | Modeling a Telemedicine Screening Program for Diabetic Retinopathy in Iran and Implementing a Pilot Project in Tehran Suburb |
| title_full_unstemmed | Modeling a Telemedicine Screening Program for Diabetic Retinopathy in Iran and Implementing a Pilot Project in Tehran Suburb |
| title_short | Modeling a Telemedicine Screening Program for Diabetic Retinopathy in Iran and Implementing a Pilot Project in Tehran Suburb |
| title_sort | modeling a telemedicine screening program for diabetic retinopathy in iran and implementing a pilot project in tehran suburb |
| url | http://dx.doi.org/10.1155/2019/2073679 |
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