Abstract
BACKGROUND We wanted to examine the accuracy of family physicians’ screening for diabetic retinopathy using standardized criteria and a nonmydriatic ophthalmoscope.
METHODS Eleven family physicians assessed 28 standardized patients with diabetes mellitus using the PanOptic ophthalmoscope. Their assessments of whether the patients required referral to an ophthalmologist were compared with the reference standard of retinal diagrams.
RESULTS The mean sensitivity for the family physicians was 87% (95% confidence interval [CI], 83%–91%) with a specificity of 57% (95% CI, 46%–68%). Overall agreement was moderate, with a mean κ = .43 (95% CI, 0.39%–0.47%).
CONCLUSIONS Using standardized criteria and a nonmydriatic ophthalmoscope, family physicians were fairly accurate in screening patients for diabetic retinopathy. Whereas this technique is not sufficiently accurate to replace routine referral for all patients with diabetes, it can be used to improve care for those patients who fail to get routine eye screenings.
- Received for publication December 10, 2002.
- Revision received June 18, 2003.
- Accepted for publication June 23, 2003.
- © 2004 Annals of Family Medicine, Inc.