Evidence map›Paper›PMID 28840258›Full record

ArticleDiabetologia2017

Individualised variable-interval risk-based screening for sight-threatening diabetic retinopathy: the Liverpool Risk Calculation Engine.

Antonio Eleuteri, Anthony C Fisher, Deborah M Broadbent, Marta García-Fiñana, Christopher P Cheyne, Amu Wang, Irene M Stratton, Mark Gabbay, Daniel Seddon, Simon P Harding and 1 more

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In one paragraph

Article in Diabetologia, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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  20. Cost-effectiveness of biennial screening for diabetes related retinopathy in people with type 1 and type 2 diabetes compared to annual screening.The European journal of health economics : HEPAC : health economics in prevention and care · 2020
    Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Antonio EleuteriDepartment of Medical Physics and Clinical Engineering, Royal Liverpool University Hospital, Liverpool, UK.
Anthony C FisherDepartment of Medical Physics and Clinical Engineering, Royal Liverpool University Hospital, Liverpool, UK.
Deborah M BroadbentDepartment of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, William Henry Duncan Building, 6, West Derby Street, Liverpool, L7 8TX, UK.
Marta García-FiñanaDepartment of Biostatistics, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
Christopher P CheyneDepartment of Biostatistics, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
Amu WangDepartment of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, William Henry Duncan Building, 6, West Derby Street, Liverpool, L7 8TX, UK.
Irene M StrattonGloucestershire Retinal Research Group, Cheltenham General Hospital, Cheltenham, UK.
Mark GabbayDepartment of Health Services Research, University of Liverpool, Liverpool, UK.
Daniel SeddonPublic Health England, Cheshire and Merseyside Screening and Immunisation Team, Liverpool, UK.
Simon P HardingDepartment of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, William Henry Duncan Building, 6, West Derby Street, Liverpool, L7 8TX, UK. s.p.harding@liverpool.ac.uk.
Individualised Screening for Diabetic Retinopathy (ISDR) Study Group

Funding

Department of Health RP-PG-1210-12016Programme Grants for Applied Research RP-PG-1210-12016
6 · The paper itself

Abstract

aims/hypothesisIndividualised variable-interval risk-based screening offers better targeting and improved cost-effectiveness in screening for diabetic retinopathy. We developed a generalisable risk calculation engine (RCE) to assign personalised intervals linked to local population characteristics, and explored differences in assignment compared with current practice.

methodsData from 5 years of photographic screening and primary care for people with diabetes, screen negative at the first of > 1 episode, were combined in a purpose-built near-real-time warehouse. Covariates were selected from a dataset created using mixed qualitative/quantitative methods. Markov modelling predicted progression to screen-positive (referable diabetic retinopathy) against the local cohort history. Retinopathy grade informed baseline risk and multiple imputation dealt with missing data. Acceptable intervals (6, 12, 24 months) and risk threshold (2.5%) were established with patients and professional end users.

resultsData were from 11,806 people with diabetes (46,525 episodes, 388 screen-positive). Covariates with sufficient predictive value were: duration of known disease, HbA CONCLUSIONS/

interpretationThe Liverpool RCE shows sufficient performance for a local introduction into practice before wider implementation, subject to external validation. This approach offers potential enhancements of screening in improved local applicability, targeting and cost-effectiveness.

Indexed as

Blood PressureDiabetic RetinopathyDisease ProgressionGlycated HemoglobinHumansMass ScreeningRisk FactorsTime FactorsGlycated HemoglobinDiabetic retinopathyRisk-based screeningRisk calculation engine

Identifiers

PMID28840258
PMCPMC6448900

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.