Evaluation of a screening program for diabetic retinopathy in a primary care setting Dodia (Dépistage ophtalmologique du diabète) study

2005 ◽  
Vol 31 (2) ◽  
pp. 153-162 ◽  
Author(s):  
P Massin ◽  
JP Aubert ◽  
E Eschwege ◽  
A Erginay ◽  
JC Bourovitch ◽  
...  
Keyword(s):  
Primary Care ◽  
Diabetic Retinopathy ◽  
Care Setting ◽  
Primary Care Setting ◽  
Screening Program

Intimate Partner Violence (IPV) Screening and Referral Outcomes among Transgender Patients in a Primary Care Setting

2021 ◽  
pp. 088626052199746
Author(s):  
Kirsten J. H. Das ◽  
Sarah Peitzmeier ◽  
Iman K. Berrahou ◽  
Jennifer Potter
Keyword(s):  
Primary Care ◽  
Intimate Partner Violence ◽  
Gender Identity ◽  
Partner Violence ◽  
Care Setting ◽  
Primary Care Setting ◽  
Screening Program ◽  
Intimate Partner ◽  
Related Services ◽  
Specific Care

Transgender patients are at elevated risk of intimate partner violence (IPV), but national guidelines do not recommend routine screening for this population. This paper explores the feasibility and effectiveness of routine IPV screening of transgender patients in a primary care setting by describing an existing screening program and identifying factors associated with referral and engagement in IPV-related care for transgender patients. An IPV “referral cascade” was created for 1,947 transgender primary care patients at an urban community health center who were screened for IPV between January 1, 2014 to May 31, 2016: (a) Of those screening positive, how many were referred? (b) Of those referred, how many engaged in IPV-specific care within 3 months? Logistic regression identified demographic correlates of referral and engagement. Of the 1,947 transgender patients screened for IPV, 227 screened positive. 110/227 (48.5%) were referred to either internal or external IPV-related services. Of those referred to on-site services, 65/103 (63.1%) had an IPV-related appointment within 3 months of a positive screen. IPV referral was associated with being assigned male at birth (AMAB) versus assigned female at birth (AFAB) (AOR = 2.69, 95% CI 1.52, 4.75) and with nonbinary, rather than binary, gender identity (AOR = 2.07, 95%CI 1.09, 3.73). Engagement in IPV-related services was not associated with any measured demographic characteristics. Similar to published rates for cisgender women, half of transgender patients with positive IPV screens received referrals and two-thirds of those referred engaged in IPV-specific care. These findings support routine IPV screening and referral for transgender patients in primary care settings. Provider training should focus on how to ensure referrals are made for all transgender patients who screen positive for IPV, regardless of gender identity, to ensure the benefits of screening accrue equally for all patients.

Screening for diabetic retinopathy: the first telemedical approach in a primary care setting in France

2004 ◽  
Vol 30 (5) ◽  
pp. 451-457 ◽  
Author(s):  
P Massin ◽  
J-P Aubert ◽  
A Erginay ◽  
JC Bourovitch ◽  
A BenMehidi ◽  
...  
Keyword(s):  
Primary Care ◽  
Diabetic Retinopathy ◽  
Care Setting ◽  
Primary Care Setting

scholarly journals Correction to: Diabetic retinopathy screening in urban primary care setting with a handheld smartphone-based retinal camera

2020 ◽  
Author(s):  
Márcia Silva Queiroz ◽  
Jacira Xavier de Carvalho ◽  
Silvia Ferreira Bortoto ◽  
Mozania Reis de Matos ◽  
Cristiane das Graças Dias Cavalcante ◽  
...  
Keyword(s):  
Primary Care ◽  
Diabetic Retinopathy ◽  
Care Setting ◽  
Primary Care Setting ◽  
Diabetic Retinopathy Screening ◽  
Retinopathy Screening

The Implementation of a Clinical Toolkit and Adolescent Depression Screening Program in Primary Care

2014 ◽  
Vol 53 (14) ◽  
pp. 1336-1344
Author(s):  
Jonathan M. Libby ◽  
Eileen Stuart-Shor ◽  
Almas Patankar
Keyword(s):  
Primary Care ◽  
Adolescent Depression ◽  
Care Setting ◽  
Primary Care Setting ◽  
Screening Program ◽  
Primary Care Providers ◽  
Depression Screening ◽  
Care Providers ◽  
Comfort Levels ◽  
Survey Results

Problem/Background. Adolescent depression is a growing problem for today’s society with only 30% receiving services. Aim and Methods. The aim of this project was to increase identification and treatment of depressed adolescents, and comfort levels of primary care providers with the implementation of a depression-screening program and use of a clinical depression toolkit within a primary care setting. Setting. The setting was a private pediatric practice in central Maine. Results. Over an 8-week period, 266 adolescents were screened. Twelve adolescents (4.5%) received a diagnosis of depression and 11 received treatment within 8 days. Survey results showed a significant increase in providers’ feelings of comfort and accountability. Conclusion. This project demonstrates that it is feasible to implement a depression screening and treatment program in primary care. It demonstrates that primary care providers can increase their comfort and feelings accountability in treating depression in primary care, thus increasing access for this monumental and potential catastrophic problem.

Risk factors for diabetic retinopathy in people with Type 2 diabetes: A case–control study in a UK primary care setting

2016 ◽  
Vol 10 (4) ◽  
pp. 300-308 ◽  
Author(s):  
Elisa Martín-Merino ◽  
Joan Fortuny ◽  
Elena Rivero-Ferrer ◽  
Marcus Lind ◽  
Luis Alberto Garcia-Rodriguez
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Diabetic Retinopathy ◽  
Care Setting ◽  
Primary Care Setting ◽  
Case Control Study ◽  
Case Control ◽  
Control Study

604-P: Automated Diabetic Retinopathy Screening in the Primary Care Setting Improves Compliance with Follow-Up Ophthalmic Care

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 604-P
Author(s):  
JAMES C. LIU ◽  
SHAWN RAMCHAL ◽  
ELLA GIBSON ◽  
JESSICA KUO ◽  
KAUSHAL SOLANKI ◽  
...  
Keyword(s):  
Primary Care ◽  
Diabetic Retinopathy ◽  
Care Setting ◽  
Primary Care Setting ◽  
Diabetic Retinopathy Screening ◽  
Retinopathy Screening

scholarly journals Diagnosing Diabetic Retinopathy With Artificial Intelligence: What Information Should Be Included to Ensure Ethical Informed Consent?

2021 ◽  
Vol 8 ◽  
Author(s):  
Frank Ursin ◽  
Cristian Timmermann ◽  
Marcin Orzechowski ◽  
Florian Steger
Keyword(s):  
Artificial Intelligence ◽  
Primary Care ◽  
Diabetic Retinopathy ◽  
Informed Consent ◽  
Care Setting ◽  
Primary Care Setting ◽  
Information Process ◽  
Novel Technologies ◽  
Ethical Implications ◽  
Aided Diagnosis

Purpose: The method of diagnosing diabetic retinopathy (DR) through artificial intelligence (AI)-based systems has been commercially available since 2018. This introduces new ethical challenges with regard to obtaining informed consent from patients. The purpose of this work is to develop a checklist of items to be disclosed when diagnosing DR with AI systems in a primary care setting.Methods: Two systematic literature searches were conducted in PubMed and Web of Science databases: a narrow search focusing on DR and a broad search on general issues of AI-based diagnosis. An ethics content analysis was conducted inductively to extract two features of included publications: (1) novel information content for AI-aided diagnosis and (2) the ethical justification for its disclosure.Results: The narrow search yielded n = 537 records of which n = 4 met the inclusion criteria. The information process was scarcely addressed for primary care setting. The broad search yielded n = 60 records of which n = 11 were included. In total, eight novel elements were identified to be included in the information process for ethical reasons, all of which stem from the technical specifics of medical AI.Conclusions: Implications for the general practitioner are two-fold: First, doctors need to be better informed about the ethical implications of novel technologies and must understand them to properly inform patients. Second, patient's overconfidence or fears can be countered by communicating the risks, limitations, and potential benefits of diagnostic AI systems. If patients accept and are aware of the limitations of AI-aided diagnosis, they increase their chances of being diagnosed and treated in time.

Improving Access to Diabetic Retinopathy Screening through Telemedicine (Preprint)

2020 ◽  
Author(s):  
Shuja Rayaz ◽  
Tiffany Wandy ◽  
Jenna Brager ◽  
Michael Kiritsy ◽  
Daniel Durand
Keyword(s):  
Primary Care ◽  
Diabetic Retinopathy ◽  
Care Setting ◽  
Vision Loss ◽  
Primary Care Setting ◽  
Adult Population ◽  
Descriptive Study ◽  
Pilot Program ◽  
Diabetic Retinopathy Screening ◽  
Retinopathy Screening

BACKGROUND Screening for diabetic retinopathy is important for the prevention of blindness among the adult population. Currently, patients with diabetes require a referral from their primary care physician to see an ophthalmologist for their annual eye exam, which can be an added inconvenience. As such, there is a need for alternative screening strategies within an outpatient network. The use of a telemedicine platform in a primary care network serves as a novel strategy to increase diabetic retinopathy screening rates. LifeBridge Health operates two Track 1 Accountable Care Organizations with a combined attribution of approximately 28,000 patients. Many value-based care and pay for performance programs use diabetic retinopathy screening rate as a quality measure. In order to provide better access to diabetic retinopathy screening for our patients, three specialized cameras were placed in three primary care practices in October 2017 as part of a pilot program. The online Intelligent Retinal Imaging Systems (IRIS) platform was utilized as a secure data warehouse of images that could be interpreted remotely by an ophthalmologist within the LifeBridge Health network for the diagnosis of diabetic retinopathy or detecting other types of pathology (e.g. macular edema). OBJECTIVE The aim of this retrospective descriptive study was to examine if a telemedicine platform can be used to increase diabetic retinopathy screening rates in the primary care setting. METHODS Three distinct datasets corresponding with three time periods were examined for this study. Pre-post comparison examined screening rates from all practices from January 2018 – December 2018 to those of January 2017 – December 2017. The pilot program dataset examined screening rates in the practices before and after the implementation of the IRIS cameras in October 2017. Aggregate diagnostic data from the IRIS online dashboard from October 2017- December 2019 was also examined to determine the benefit of the IRIS platform since the initial implementation. RESULTS Pre-post comparison screening rates showed mean screening rates of 38.5% and 47.2%, respectively, indicating an 8.7% improvement in screening. The pilot program showed improved screening rates at each outpatient practice with the implementation of the IRIS cameras. Aggregate data since the implementation of the IRIS cameras showed that, of the 1213 patients who were screened, approximately 17.1% (n=207 patients) were diagnosed with diabetic retinopathy and an additional17.7% (n=215 patients) were suspected of having some form of other pathology. 10.1% (n=123 patients) were also suspected to be at risk for imminent vision loss. CONCLUSIONS This retrospective descriptive study suggests that a telemedicine platform can be used to improve diabetic retinopathy screening rates in the primary care setting within a large healthcare system.

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