Table 2.

Per-Patient Analyses—Diagnostic Accuracy of Patient Referral Based on Digital Images (with 35-mm Assessments as Reference Standard)

	Mydriatic			Nonmydriatic
Gradersa	A	B	C	A	B	C
At least one eye with ETDRS >35
Sensitivity/specificity	0.62/0.91	0.46/0.95	0.45/1.00	0.71/0.70	0.57/0.83	0.38, 0.96
Area (95% CI for area)b	0.76 (0.71, 0.82)*	0.71 (0.63, 0.78)*	0.73 (0.66, 0.79)*	0.71 (0.65, 0.77)*	0.70 (0.62, 0.78)*	0.67 (0.61, 0.72)*
At least one eye with ETDRS >53
Sensitivity/specificity	0.22/0.88	0.33/0.93	0.50/0.96	0.43/0.67	0.50/0.76	0.71/0.94
Area (95% CI for area)b	0.55 (0.41, 0.70)	0.63 (0.31, 0.96)	0.73 (0.51, 0.95)*	0.55 (0.35, 0.75)	0.63 (0.14, 1.00)	0.83 (0.64, 1.00)*
At least one eye with macular edema
Sensitivity/specificity	0.50/0.89	0.67/0.90	0.71/0.92	0.80/0.65	0.25/0.75	0.78/0.90
Area (95% CI for area)b	0.70 (0.53, 0.86)*	0.78 (0.46, 1.00)	0.82 (0.64, 1.00)*	0.73 (0.59, 0.86)*	0.50 (0.25, 0.75)	0.84 (0.69, 0.98)*
At least one eye with vision-threatening diabetic retionpathy c
Sensitivity/specificity	0.54/.85	0.40/0.90	0.78/0.92	0.73/0.65	0.20/0.40	0.73/0.89
Area (95% CI for area)b	0.70 (0.55, 0.84)*	0.65 (0.41, 0.89)	0.85 (0.70, 0.99)*	0.69 (0.55, 0.83)*	0.47 (0.27, 0.67)	0.81 (0.67, 0.95)*

^aA, nonphysician grader; B, retinal subspecialist; C, retinal fellow.

^bArea under the receiver-operating characteristic curve with 95% confidence interval; an asterisk indicates an area significantly greater than 0.5.

^cDefined as ETDRS ≥53 and/or macular edema in at least one eye.