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Brief ReportBrief Report

Screening for Diabetic Retinopathy with a Nonmydriatic Ultra-Wide-Field Retina Camera by Family Medicine Physicians

Bryan A. Farford, Abhimanyu S. Ahuja, Michael W. Stewart, James M. Naessens and Joshua J. Keith
The Journal of the American Board of Family Medicine January 2021, 34 (1) 231-237; DOI: https://doi.org/10.3122/jabfm.2021.01.200302
Bryan A. Farford
the Department of Family Medicine, Mayo Clinic–Florida, Jacksonville, FL (BAF, JJK); Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL (ASA); Department of Ophthalmology, Mayo Clinic–Florida, Jacksonville, FL (MWS); Health Care Policy and Research, Mayo Clinic–Rochester, Rochester, MN (JMN).
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Abhimanyu S. Ahuja
the Department of Family Medicine, Mayo Clinic–Florida, Jacksonville, FL (BAF, JJK); Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL (ASA); Department of Ophthalmology, Mayo Clinic–Florida, Jacksonville, FL (MWS); Health Care Policy and Research, Mayo Clinic–Rochester, Rochester, MN (JMN).
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Michael W. Stewart
the Department of Family Medicine, Mayo Clinic–Florida, Jacksonville, FL (BAF, JJK); Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL (ASA); Department of Ophthalmology, Mayo Clinic–Florida, Jacksonville, FL (MWS); Health Care Policy and Research, Mayo Clinic–Rochester, Rochester, MN (JMN).
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James M. Naessens
the Department of Family Medicine, Mayo Clinic–Florida, Jacksonville, FL (BAF, JJK); Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL (ASA); Department of Ophthalmology, Mayo Clinic–Florida, Jacksonville, FL (MWS); Health Care Policy and Research, Mayo Clinic–Rochester, Rochester, MN (JMN).
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Joshua J. Keith
the Department of Family Medicine, Mayo Clinic–Florida, Jacksonville, FL (BAF, JJK); Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL (ASA); Department of Ophthalmology, Mayo Clinic–Florida, Jacksonville, FL (MWS); Health Care Policy and Research, Mayo Clinic–Rochester, Rochester, MN (JMN).
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Article Figures & Data

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    Table 1.

    Initial Estimates of Diagnostic Accuracy of Interpretation of Retinal Images of 34 Patients by Family Physicians

    DR FindingPresumed DRNo DRTotalFraction (%)95% CI, %
    Retinal specialist results3—31343/34 (8)(2-24)
    Family physician results1726348/34 (24)(11-41)
    Sensitivity1/3 (33)(1-91)
    Specificity24/31 (77)(59-90)
    PPV1/8 (13)(0-53)
    NPV24/26 (92)(75-99)
    Accuracy25/34 (74)(56-87)
    • DR, diabetic retinopathy; NPV, negative predictive value; PPV, positive predictive value; CI, confidence interval.

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    Table 2.

    Patient Follow-Up Survey

    QuestionNo. of ResponsesN (%)
    Did you find the retinal imaging an easy/efficient way of screening for eye disease as a result of having diabetes?31
     Yes28 (90)
     No1 (3)
     Unknown2 (7)
    If you had to pay for retinal imaging out-of-pocket what is the maximum amount you would be willing to pay?30
     $257 (23)
     $5014 (47)
     $753 (10)
     $1002 (7)
     Unknown4 (13)
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    Appendix Supplementary Table 1.

    Accuracy of phase 1 and phase 2 results by physician

    Phase 1 AccuracyPhase 2 Accuracy
    Family PhysicianFraction (%)95% CIFraction (%)95% CI
    129/30 (97)(83, 99)7/7 (100)(59, 100)
    230/30 (100)(88, 100)5/7 (71)(29, 96)
    330/30 (100)(88, 100)5/7 (71)(29, 96)
    426/30 (87)(69, 96)3/6 (50)(12, 88)
    530/30 (100)(88, 100)5/7 (71)(29, 96)
    Overall145/150 (97)(92, 99)25/34 (74)(56, 87)
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The Journal of the American Board of Family     Medicine: 34 (1)
The Journal of the American Board of Family Medicine
Vol. 34, Issue 1
January/February 2021
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Screening for Diabetic Retinopathy with a Nonmydriatic Ultra-Wide-Field Retina Camera by Family Medicine Physicians
Bryan A. Farford, Abhimanyu S. Ahuja, Michael W. Stewart, James M. Naessens, Joshua J. Keith
The Journal of the American Board of Family Medicine Jan 2021, 34 (1) 231-237; DOI: 10.3122/jabfm.2021.01.200302

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Screening for Diabetic Retinopathy with a Nonmydriatic Ultra-Wide-Field Retina Camera by Family Medicine Physicians
Bryan A. Farford, Abhimanyu S. Ahuja, Michael W. Stewart, James M. Naessens, Joshua J. Keith
The Journal of the American Board of Family Medicine Jan 2021, 34 (1) 231-237; DOI: 10.3122/jabfm.2021.01.200302
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Keywords

  • Blindness
  • Diabetic Retinopathy
  • Diabetes Mellitus
  • Family Medicine
  • Obesity
  • Retina
  • Screening

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