| Title: | Special Interest Project (SIP): Global Network Diabetic Retinopathy Project SIP 14-022 (Collaborating Center) |
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| Status: | Completed |
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| Topic: | Global Health Network |
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| Funding Source: | Centers for Disease Control and Prevention (CDC) |
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| Funding Period: | 2014-2019 |
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| Study Design: | Implementation and evaluation of a diabetic retinopathy screening program |
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| Purpose: | The Yale-Griffin PRC is a Collaborating Center of the Global and Territorial Health Research Network (Global Network), funded by the CDC Division of Population Health. (https://www.cdc.gov/nccdphp/dph/index.html). The overall goal of the network is to leverage innovative public health approaches from around the world and apply them to address health disparities in chronic disease prevention and health promotion in local communities in the U.S. The purpose of this specific project was to leverage information gained from organizations in India to implement a telemedicine-based retinal screening program for eligible patients in Ansonia CT. |
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| Further Study Details: | The Yale-Griffin PRC received Special Interest Project (SIP) funding from the CDC to develop and implement a primary care-based, telemedicine-based diabetic retinopathy screening program, learning from the successful approaches adopted by organizations in India. In 2015, a team of medical and public health professionals visited these organizations in central and southern India to observe and discuss their organizational structures, business models, use of tele-ophthalmology with patients, and lessons learned in implementing the technology and providing patient care. In 2016, they began implementing a pilot project at a medical clinic operated by Griffin Hospital in Ansonia CT. The project involved utilizing medical assistants and resident physicians to operate an automatic focus retinal camera to clinically screen patients with diabetes for evidence of diabetic retinopathy, with review of the images provided by a consultant ophthalmologist, and referral of patients found to have diabetic retinopathy to a retinal specialist. |
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| Findings: | A total of 275 patients at medical offices in Ansonia, Beacon Falls, Oxford, Shelton and Hamden CT participated in the screenings. They ranged in age from 55.8 to 73.8 years, with a median age of 64.7 years. Participants were primarily Caucasian (81.5%), with the remainder being African-American (11.2%), Asian (3.2%), Hispanic (2.8%), other race (0.4%), or race not specified (0.8%). Among participants, 50 (18.5%) were current smokers, 150 (55.8%) had a known history of diabetes, and 160 (59.0%) had a known history of high blood cholesterol levels. Retinal imaging results showed evidence of diabetic retinopathy in 4 (1.5%) participants, and intra-retinal hemorrhages and micro-aneurysms in 10 (3.7%) participants. |
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| Eligibility: | Adult patients (18 years and older) of local medical practices in the Griffin Hospital service area whose primary care physician had referred them for retinal screening, and who had not already seen an ophthalmologist and were not previously diagnosed with retinal disease, glaucoma, macular degeneration, diabetic retinopathy, or hypertensive retinopathy. |
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| Evaluation: | For patients who agreed to be screened, the study team noted their retinopathy grade to determine the percentage of patients diagnosed with specific levels or retinopathy. They then used the diagnosis of retinopathy as a dichotomous variable and compared it with ethnicity, race, age, and other variables. |
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Yale-Griffin Prevention Research Center
