Evidence map›Paper›PMID 38481239›Full record

ArticleBMC public health2024

Extending the diabetic retinopathy screening intervals in Singapore: methodology and preliminary findings of a cohort study.

Amudha Aravindhan, Eva K Fenwick, Aurora Wing Dan Chan, Ryan Eyn Kidd Man, Ngiap Chuan Tan, Wei Teen Wong, Wern Fern Soo, Shin Wei Lim, Sabrina Yi-Mei Wee, Charumathi Sabanayagam and 9 more

Open access · goldAbstract read
In one paragraph

Article in BMC public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.6field-weighted citation impact, top 19% of its field
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

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Diabetic retinal disease.Nature reviews. Disease primers · 2025
    Review
  2. Article
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

19 authors at 8 institutions in 4 countries.

Amudha AravindhanSingapore Eye Research Institute and Singapore National Eye Centre, Singapore, Singapore.
Eva K FenwickSingapore Eye Research Institute and Singapore National Eye Centre, Singapore, Singapore.
Aurora Wing Dan ChanSingapore Eye Research Institute and Singapore National Eye Centre, Singapore, Singapore.
Ryan Eyn Kidd ManSingapore Eye Research Institute and Singapore National Eye Centre, Singapore, Singapore.
Ngiap Chuan TanSingHealth Polyclinics, Singapore, Singapore.
Wei Teen WongSingHealth Polyclinics, Singapore, Singapore.
Wern Fern SooSingHealth Polyclinics, Singapore, Singapore.
Shin Wei LimSingHealth Polyclinics, Singapore, Singapore.
Sabrina Yi-Mei WeeSingHealth Polyclinics, Singapore, Singapore.
Charumathi SabanayagamSingapore Eye Research Institute and Singapore National Eye Centre, Singapore, Singapore.
Eric FinkelsteinDuke-NUS Medical School, Singapore, Singapore.
Gavin TanSingapore Eye Research Institute and Singapore National Eye Centre, Singapore, Singapore.
Haslina HamzahSingapore Eye Research Institute and Singapore National Eye Centre, Singapore, Singapore.
Bibhas ChakrabortyDuke-NUS Medical School, Singapore, Singapore.
Sanchalika AcharyyaTan Tock Seng Hospital, Singapore, Singapore.
Tai E ShyongSaw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.
Peter ScanlonGloucestershire Hospitals NHS Foundation Trust, Gloucester, UK.
Tien Yin WongTsinghua University, Beijing, China.
Ecosse L LamoureuxSingapore Eye Research Institute and Singapore National Eye Centre, Singapore, Singapore. ecosse.lamoureux@duke-nus.edu.sg.ORCID 0000-0001-8674-5705
Singapore National Eye Center · SGSingHealth Polyclinics · SGDuke-NUS Medical School · SGGloucestershire Hospitals NHS Foundation Trust · GBNational University of Singapore · SGTan Tock Seng Hospital · SGThe University of Melbourne · AUTsinghua University · CN

Funding

National Medical Research Council NMRC/CIRG/1440/2016
6 · The paper itself

Abstract

backgroundThe Diabetic Retinopathy Extended Screening Study (DRESS) aims to develop and validate a new DR/diabetic macular edema (DME) risk stratification model in patients with Type 2 diabetes (DM) to identify low-risk groups who can be safely assigned to biennial or triennial screening intervals. We describe the study methodology, participants' baseline characteristics, and preliminary DR progression rates at the first annual follow-up.

methodsDRESS is a 3-year ongoing longitudinal study of patients with T2DM and no or mild non-proliferative DR (NPDR, non-referable) who underwent teleophthalmic screening under the Singapore integrated Diabetic Retinopathy Programme (SiDRP) at four SingHealth Polyclinics. Patients with referable DR/DME (> mild NPDR) or ungradable fundus images were excluded. Sociodemographic, lifestyle, medical and clinical information was obtained from medical records and interviewer-administered questionnaires at baseline. These data are extracted from medical records at 12, 24 and 36 months post-enrollment. Baseline descriptive characteristics stratified by DR severity at baseline and rates of progression to referable DR at 12-month follow-up were calculated.

resultsOf 5,840 eligible patients, 78.3% (n = 4,570, median [interquartile range [IQR] age 61.0 [55-67] years; 54.7% male; 68.0% Chinese) completed the baseline assessment. At baseline, 97.4% and 2.6% had none and mild NPDR (worse eye), respectively. Most participants had hypertension (79.2%) and dyslipidemia (92.8%); and almost half were obese (43.4%, BMI ≥ 27.5 kg/m

conclusionsIn our prospective study of patients with T2DM and non-referable DR attending polyclinics, we found extremely low annual DR progression rates. These preliminary results suggest that extending screening intervals beyond 12 months may be viable and safe for most participants, although our 3-year follow up data are needed to substantiate this claim and develop the risk stratification model to identify low-risk patients with T2DM who can be assigned biennial or triennial screening intervals.

Indexed as

Diabetes Mellitus, Type 2Diabetic RetinopathyMacular EdemaCohort StudiesFemaleHumansLongitudinal StudiesMaleMiddle AgedProspective StudiesSingaporeDiabetic macular edemaDiabetic retinopathyRisk stratificationScreening

Identifiers

PMID38481239
PMCPMC10935797
OpenAlexW4392742546

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.