Screening for diabetic retinopathy--comparison of a nurse and a doctor with retinal photography.
Screening for diabetic retinopathy--comparison of a nurse and a doctor with retinal photography.
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糖尿病视网膜病变筛查——护士和医生通过视网膜摄影进行比较。
DOI：
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发表时间：
1987
期刊：
影响因子：
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通讯作者：
J S Yudkin
中科院分区：
文献类型：
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作者：
R. Forrest;Jackson Ca;J S Yudkin
通过与眼底照相比较，评估了由接受过检眼镜检查培训的护士和糖尿病专家进行糖尿病视网膜筛查的有效性。该研究在282名受试者中进行，其中59名患有已知糖尿病，223名参与筛查调查，其中13名患有糖尿病，43名糖耐量受损。糖尿病受试者中视网膜病变的患病率为36.8%，严重视网膜病变的患病率为9.5%，而筛选受试者中视网膜病变的患病率分别为3.5%和0.9%。护士检查诊断视网膜病变的敏感性为50.0% ± CL16.8%，特异性为99.2% ± CL0.9%，而医生检查的敏感性为51.3% ± CL15.7%，特异性为98.7% ± CL1.2%。护士未能像医生一样准确地发现严重的视网膜病变，尽管医生在6例病例中遗漏了5例新生血管。视网膜病变的筛查需要由一个受过比医生更高水平训练的观察者进行检眼镜检查，或者进行非散瞳视网膜摄影。
The efficacy of diabetic retinal screening by a nurse trained in ophthalmoscopy and of a diabetologist was assessed by comparison with fundal photography. The study was performed in 282 subjects, 59 with known diabetes and 223 participating in a screening survey, of whom 13 had diabetes and 43 impaired glucose tolerance. The prevalence of retinopathy in the diabetic subjects was 36.8% and serious retinopathy 9.5% while in the screened subjects it was 3.5% and 0.9% respectively. The characteristics of nurse examination as a test to detect retinopathy was: sensitivity 50.0% +/- CL16.8%, specificity 99.2% +/- CL0.9%, which compared with 51.3% +/- CL15.7% and 98.7% +/- CL1.2% for the doctor. The nurse failed to detect serious retinopathy as accurately as the doctor, although new vessels were missed in 5 of 6 cases by the doctor. Screening for retinopathy requires either ophthalmoscopy by an observer trained to a higher level than is common in doctors, or non-mydriatic retinal photography.