Skip to main content
PMC home page
The British Journal of Ophthalmology logoLink to The British Journal of Ophthalmology
. 1996 Nov;80(11):945–950. doi: 10.1136/bjo.80.11.945

Simulation of diabetic eye disease to compare screening policies.

R Davies 1, P Sullivan 1, C Canning 1
PMCID: PMC505668  PMID: 8976719

Abstract

AIMS/BACKGROUND: The purpose of the project was to develop a technique for evaluating screening policies in the treatment of insulin dependent diabetic retinopathy. The study was concerned with patients who contracted the disease, aged under 35 years. Simulation was used to describe the progress of a cohort of patients through disease and treatment. METHOD: Data, derived from a literature survey of European and American population and clinic studies, were used to model as closely as possible the development of retinopathy in all its stages, together with the effects of screening and treatment. The model output was validated against published data. RESULTS: The results showed that where screening sensitivities are high, the frequency of screening makes little difference to the years of sight saved, but it does make a difference if screening sensitivities are close to 50%. CONCLUSIONS: Although annual screening is normally desirable, biannual screening could be considered where patient compliance and screening sensitivities are both high.

Full text

PDF

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aldington S. J., Kohner E. M., Meuer S., Klein R., Sjølie A. K. Methodology for retinal photography and assessment of diabetic retinopathy: the EURODIAB IDDM complications study. Diabetologia. 1995 Apr;38(4):437–444. doi: 10.1007/BF00410281. [DOI] [PubMed] [Google Scholar]
  2. Bingley P. J., Gale E. A. Incidence of insulin dependent diabetes in England: a study in the Oxford region, 1985-6. BMJ. 1989 Mar 4;298(6673):558–560. doi: 10.1136/bmj.298.6673.558. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bolger P. G., Davies R. Simulation model for planning renal services in a district health authority. BMJ. 1992 Sep 12;305(6854):605–608. doi: 10.1136/bmj.305.6854.605. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Buxton M. J., Sculpher M. J., Ferguson B. A., Humphreys J. E., Altman J. F., Spiegelhalter D. J., Kirby A. J., Jacob J. S., Bacon H., Dudbridge S. B. Screening for treatable diabetic retinopathy: a comparison of different methods. Diabet Med. 1991 May;8(4):371–377. doi: 10.1111/j.1464-5491.1991.tb01612.x. [DOI] [PubMed] [Google Scholar]
  5. Dorman J. S., Laporte R. E., Kuller L. H., Cruickshanks K. J., Orchard T. J., Wagener D. K., Becker D. J., Cavender D. E., Drash A. L. The Pittsburgh insulin-dependent diabetes mellitus (IDDM) morbidity and mortality study. Mortality results. Diabetes. 1984 Mar;33(3):271–276. doi: 10.2337/diab.33.3.271. [DOI] [PubMed] [Google Scholar]
  6. Fendrick A. M., Javitt J. C., Chiang Y. P. Cost-effectiveness of the screening and treatment of diabetic retinopathy. What are the costs of underutilization? Int J Technol Assess Health Care. 1992 Fall;8(4):694–707. doi: 10.1017/s0266462300002385. [DOI] [PubMed] [Google Scholar]
  7. Gamble D. R. The epidemiology of insulin dependent diabetes with particular reference to the relationship of virus infection to its etiology. Epidemiol Rev. 1980;2:49–70. doi: 10.1093/oxfordjournals.epirev.a036226. [DOI] [PubMed] [Google Scholar]
  8. Javitt J. C., Aiello L. P., Bassi L. J., Chiang Y. P., Canner J. K. Detecting and treating retinopathy in patients with type I diabetes mellitus. Savings associated with improved implementation of current guidelines. American Academy of Ophthalmology. Ophthalmology. 1991 Oct;98(10):1565–1574. [PubMed] [Google Scholar]
  9. Joner G., Patrick S. The mortality of children with type 1 (insulin-dependent) diabetes mellitus in Norway, 1973-1988. Diabetologia. 1991 Jan;34(1):29–32. doi: 10.1007/BF00404021. [DOI] [PubMed] [Google Scholar]
  10. Klein R., Klein B. E., Moss S. E., Davis M. D., DeMets D. L. The Wisconsin epidemiologic study of diabetic retinopathy. II. Prevalence and risk of diabetic retinopathy when age at diagnosis is less than 30 years. Arch Ophthalmol. 1984 Apr;102(4):520–526. doi: 10.1001/archopht.1984.01040030398010. [DOI] [PubMed] [Google Scholar]
  11. Klein R., Klein B. E., Moss S. E., Davis M. D., DeMets D. L. The Wisconsin epidemiologic study of diabetic retinopathy. IV. Diabetic macular edema. Ophthalmology. 1984 Dec;91(12):1464–1474. doi: 10.1016/s0161-6420(84)34102-1. [DOI] [PubMed] [Google Scholar]
  12. Klein R., Moss S. E., Klein B. E., DeMets D. L. Relation of ocular and systemic factors to survival in diabetes. Arch Intern Med. 1989 Feb;149(2):266–272. [PubMed] [Google Scholar]
  13. Modan M., Karp M., Bauman B., Gordon O., Danon Y. L., Laron Z. Mortality in Israeli Jewish patients with type 1 (insulin-dependent) diabetes mellitus diagnosed prior to 18 years of age: a population based study. Diabetologia. 1991 Jul;34(7):515–520. doi: 10.1007/BF00403289. [DOI] [PubMed] [Google Scholar]
  14. Sussman E. J., Tsiaras W. G., Soper K. A. Diagnosis of diabetic eye disease. JAMA. 1982 Jun 18;247(23):3231–3234. [PubMed] [Google Scholar]

Articles from The British Journal of Ophthalmology are provided here courtesy of BMJ Publishing Group

RESOURCES