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Establishing ongoing quality assurance in a retinal screening programme

Lookup NU author(s): Dr Chankramath Arun, Dr Kevin Stannard, Professor Roy Taylor


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Aim: To establish a clinically efficient, cost-effective quality assurance programme as part of a routine retinopathy screening service. Methods: The operation of a quality assurance system as part of an ongoing retinal screening service is described. A random selection of 12% of images of all people reported to have retinopathy and of 2% reported to have no retinopathy are re-graded by a consultant ophthalmologist. Entry of the two sets of data into a purpose-designed excel spreadsheet allows automated calculation of sensitivity and specificity. Results: The results of quality assurance from August 2001 to July 2003 are reported. Out of 8351 screening episodes, 498 were re-examined. Of the 62 cases identified by the ophthalmologist as having referable retinopathy, four false negatives for detection were identified. Three of these had been assigned to early re-screening by the retinal screener but were still regarded as false negative by the parameters of the quality assurance system. The sensitivity and specificity for detection of sight-threatening retinopathy were 93.5% (95% CI = 84.3-98.2%) and 97.8% (95% CI = 95.8-98.9%), respectively. Conclusion: A robust and cost-effective system has been developed to allow monitoring of performance of routine retinal screening which may be extended to meet current national recommendations. © 2006 Diabetes.

Publication metadata

Author(s): Arun CS, Young D, Batey D, Shotton M, Mitchie D, Stannard KP, Taylor R

Publication type: Article

Publication status: Published

Journal: Diabetic Medicine

Year: 2006

Volume: 23

Issue: 6

Pages: 629-634

ISSN (print): 0742-3071

ISSN (electronic): 1464-5491

Publisher: Wiley-Blackwell


DOI: 10.1111/j.1464-5491.2006.01865.x


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