scholarly journals Diabetic retinopathy: its cost effective and durable therapeutic health strategy in diabetic and pre-diabetic population

2017 ◽  
Author(s):  
Devrajani Bikharam
Keyword(s):  
Diabetic Retinopathy ◽  
Cost Effective ◽  
Health Strategy ◽  
Diabetic Population

Review of Various Tasks Performed in the Preprocessing Phase of a Diabetic Retinopathy Diagnosis System

2020 ◽  
Vol 16 (4) ◽  
pp. 397-426
Author(s):  
Muhammad Nadeem Ashraf ◽  
Muhammad Hussain ◽  
Zulfiqar Habib
Keyword(s):  
Diabetic Retinopathy ◽  
Blood Vessels ◽  
Early Stage ◽  
Spherical Shape ◽  
Cost Effective ◽  
Lesion Detection ◽  
Diabetic Patients ◽  
Cad System ◽  
Non Invasive ◽  
Optic Discs

Diabetic Retinopathy (DR) is a major cause of blindness in diabetic patients. The increasing population of diabetic patients and difficulty to diagnose it at an early stage are limiting the screening capabilities of manual diagnosis by ophthalmologists. Color fundus images are widely used to detect DR lesions due to their comfortable, cost-effective and non-invasive acquisition procedure. Computer Aided Diagnosis (CAD) of DR based on these images can assist ophthalmologists and help in saving many sight years of diabetic patients. In a CAD system, preprocessing is a crucial phase, which significantly affects its performance. Commonly used preprocessing operations are the enhancement of poor contrast, balancing the illumination imbalance due to the spherical shape of a retina, noise reduction, image resizing to support multi-resolution, color normalization, extraction of a field of view (FOV), etc. Also, the presence of blood vessels and optic discs makes the lesion detection more challenging because these two artifacts exhibit specific attributes, which are similar to those of DR lesions. Preprocessing operations can be broadly divided into three categories: 1) fixing the native defects, 2) segmentation of blood vessels, and 3) localization and segmentation of optic discs. This paper presents a review of the state-of-the-art preprocessing techniques related to three categories of operations, highlighting their significant aspects and limitations. The survey is concluded with the most effective preprocessing methods, which have been shown to improve the accuracy and efficiency of the CAD systems.

Yoga in the management of Diabetes Mellitus

2017 ◽  
Vol 2 (2) ◽  
Author(s):  
Sreeharsha N. ◽  
Bargale Sushant Sukumar ◽  
Divyasree C. H.
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Eating Habits ◽  
Cost Effective ◽  
The Body ◽  
Positive Thinking ◽  
The World ◽  
Diabetic Population ◽  
Major Factors ◽  
Excess Glucose

Diabetes mellitus is a chronic metabolic disorder in which the body is unable to make proper utilisation of glucose, resulting in the condition of hyperglycaemia. Excess glucose in the blood ultimately results in high levels of glucose being present in the urine (glycosuria). This increase the urine output, which leads to dehydration and increase thirst. India has the largest diabetic population in the world. Changes in eating habits, increasing weight and decreased physical activity are major factors leading to increased incidence of Diabetes. Lifestyle plays an important role in the development of Diabetes. Yoga offers natural and effective remedies without toxic side-effects, and with benefits that extend far beyond the physical. This system of Yoga is a simple, natural programme involving five main principles: proper exercise, proper breathing, proper relaxation, proper diet and positive thinking and meditation. It is a cost effective lifestyle intervention technique.

Cost-Effectiveness Analysis of Non-Mydriatic Ultrawide- Field Fundus Photography versus Pharmacological Pupil Dilatation in Diabetic Retinopathy Screening Program

2021 ◽  
Vol 104 (5) ◽  
pp. 818-824
Keyword(s):  
Diabetic Retinopathy ◽  
Cost Effectiveness ◽  
Screening Program ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Fundus Photography ◽  
Diabetic Retinopathy Screening ◽  
Effectiveness Analysis ◽  
The Cost ◽  
Retinopathy Screening

Background: Diabetic retinopathy (DR) causes blindness of the population in many countries worldwide. Early detection and treatment of this disease via a DR screening program is the best way to secure the vision. An annual screening program using pharmacological pupil dilatation becomes the standard method. Recently, non-mydriatic ultrawide-field fundus photography (UWF) has been proposed as a choice for DR screening. However, there was no cost-effectiveness study between the standard DR screening and this UWF approach. Objective: To compare the cost-effectiveness between UWF and pharmacological pupil dilatation in terms of hospital and societal perspectives. Materials and Methods: Patients with type 2 diabetes mellitus that visited the ophthalmology clinic at Chulabhorn Hospital for DR screening were randomized using simple randomization method. The patients were interviewed by a trained interviewer for general and economic information. The clinical characteristics of DR and staging were recorded. Direct medical costs, direct non-medical costs, and informal care costs due to DR screening were recorded. Cost analyses were calculated for the hospital and societal perspectives. Results: The present study presented the cost-effectiveness analyses of UWF versus pharmacological pupil dilatation. Cost-effectiveness analysis from the hospital perspective showed the incremental cost-effectiveness ratio (ICER) of UWF to be –13.87. UWF was a cost-effective mean in DR screening in the societal perspective when compared with pharmacologically pupil dilatation with the ICER of 76.46, under the threshold of willingness to pay. Conclusion: The UWF was a cost-effective mean in DR screening. It can reduce screening duration and bypass post-screening blurred vision. The results suggested that UWF could be a viable option for DR screening. Keywords: Diabetic retinopathy, Diabetic retinopathy screening, Non-mydriatic ultrawide-field fundus photography, Cost-effectiveness analysis

Diabetic retinopathy: prevalence and risk factors in a type 2 diabetic population

2021 ◽  
Author(s):  
Eya Safi ◽  
Yosra Htira ◽  
Manel Dridi ◽  
Mehrez Achwak ◽  
Ghofrane Hakiri ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diabetic Retinopathy ◽  
Diabetic Population ◽  
Type 2 Diabetic

OP60 Optimising Risk-Based Screening: The Case Of Diabetic Eye Disease

2018 ◽  
Vol 34 (S1) ◽  
pp. 21-21
Author(s):  
Christopher Sampson ◽  
Marilyn James ◽  
David Whynes ◽  
Antonio Eleuteri ◽  
Simon Harding
Keyword(s):  
Diabetic Retinopathy ◽  
Cost Effectiveness ◽  
Screening Program ◽  
Cost Effective ◽  
Eye Disease ◽  
Risk Calculation ◽  
Diabetic Eye Disease ◽  
The Uk ◽  
The Cost ◽  
Level Of Risk

Introduction:There is growing evidence that many people attending annual screening for diabetic retinopathy in the United Kingdom (UK) are at low risk of developing the disease. This has led to new policy statements. However, the basis on which to establish a risk-based individualized variable-recall screening program has not yet been determined. We present a methodology for using information on an individual's risk factors to improve the allocation of resources within a screening program.Methods:We developed a patient-level state-transition model to evaluate the cost-effectiveness of risk-based screening for diabetic retinopathy in the UK. The model incorporated a recently developed risk calculation engine that predicts an individual's risk of disease onset, and allocated individuals to alternative screening recall periods according to this level of risk. Using the findings, we demonstrate a means of estimating: (i) a threshold level of risk, above which individuals should be invited to screening, and (ii) the optimum screening recall period for an individual, based on the expected cost-effectiveness of screening and treatment.Results:The cost-effectiveness analysis demonstrated that standardized screening (current practice) is the least cost-effective program. Individualized screening can improve outcomes at a reduced cost. We found it feasible – though computationally expensive – to incorporate a risk calculation engine into a decision model in Microsoft Excel. In an optimized screening program, the majority or patients would be invited to attend screening at least two years after a negative screening result.Conclusions:Individualized risk-based screening is likely to be cost-effective in the context of diabetic eye disease in the UK. It is expected that risk calculation engines will be developed in other disease areas in the future, and used to allocate screening and treatment at the individual level. It is important that researchers develop robust methods for combining risk calculation engines into decision analytic models and health technology assessment more broadly.

Strategies of Digital Fundus Photography for Screening Diabetic Retinopathy in a Diabetic Population in Urban China

2012 ◽  
Vol 19 (6) ◽  
pp. 414-419 ◽  
Author(s):  
Jiyuan Ding ◽  
Yanhong Zou ◽  
Ningpu Liu ◽  
Li Jiang ◽  
Xuetao Ren ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Urban China ◽  
Fundus Photography ◽  
Diabetic Population

scholarly journals Saving sight in China and beyond: the Lifeline Express model

2018 ◽  
Vol 3 (4) ◽  
pp. e000766 ◽  
Author(s):  
Ian Yat Hin Wong ◽  
Michael Yuxuan Ni ◽  
Irene Oi Ling Wong ◽  
Nellie Fong ◽  
Gabriel M Leung
Keyword(s):  
Diabetic Retinopathy ◽  
Cataract Surgery ◽  
Large Scale ◽  
Rural China ◽  
Adult Population ◽  
Early Screening ◽  
Diabetic Retinopathy Screening ◽  
Health Strategy ◽  
Patients With Diabetes ◽  
Retinopathy Screening

Cataract and diabetic retinopathy are leading causes of blindness globally. Lifeline Express (LEX) has pioneered the provision of cataract surgery in rural China from custom-built trains and eye centres nationwide. Over the past two decades, LEX has provided free cataract surgery for over 180 000 patients in China. In China, half of the adult population has prediabetes and 113 million adults have diabetes. Recognising the rising threat of diabetic retinopathy, LEX has expanded to providing free diabetic retinopathy screening nationwide by establishing 29 Diabetic Retinopathy Screening Centres across China. Source of referrals included host hospitals, the community and out-reach mobile vans equipped with fundus cameras. Fundi photos taken in the mobile vans were electronically transferred to primary graders. LEX also leveraged the widespread smartphone use to provide electronic medical reports via WeChat, the most popular instant messenger app in China. From April 2014 to December 2016, 34 506 patients with diabetes underwent screening, of which 27.2% (9,396) were identified to have diabetic retinopathy. China’s latest national health strategy (‘Healthy China 2030 Plan’) has championed the ‘prevention first’ principle and early screening of chronic diseases. LEX has accordingly evolved to extend its services to save sight in China—from cataract surgery to diabetic retinopathy screening and most recently outreaching beyond its national borders in a pilot South–South collaboration. With health at the top of the China’s developmental agenda and the country’s growing role in global health—LEX’s large-scale telemedicine-enabled programme could represent a potentially scalable model for nationwide diabetic retinopathy screening elsewhere.

scholarly journals Non-Proliferative Diabetic Retinopathy: is It Cost-Effective to Treat Early?

2014 ◽  
Vol 17 (7) ◽  
pp. A609
Author(s):  
H. Mistry ◽  
P. Auguste ◽  
N. Lois ◽  
N. Waugh
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Cost Effective

scholarly journals The Nonmydriatic Fundus Camera in Diabetic Retinopathy Screening: A Cost-Effective Study with Evaluation for Future Large-Scale Application

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Giuseppe Scarpa ◽  
Francesca Urban ◽  
Stela Vujosevic ◽  
Michele Tessarin ◽  
Giovanni Gallo ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Early Detection ◽  
Large Scale ◽  
Screening Programme ◽  
Cost Effective ◽  
Diabetic Patients ◽  
Local Health Authority ◽  
Local Health ◽  
Fundus Camera ◽  
Diabetic Retinopathy Screening

Aims. The study aimed to present the experience of a screening programme for early detection of diabetic retinopathy (DR) using a nonmydriatic fundus camera, evaluating the feasibility in terms of validity, resources absorption, and future advantages of a potential application, in an Italian local health authority. Methods. Diabetic patients living in the town of Ponzano, Veneto Region (Northern Italy), were invited to be enrolled in the screening programme. The “no prevention strategy” with the inclusion of the estimation of blindness related costs was compared with screening costs in order to evaluate a future extensive and feasible implementation of the procedure, through a budget impact approach. Results. Out of 498 diabetic patients eligible, 80% was enrolled in the screening programme. 115 patients (34%) were referred to an ophthalmologist and 9 cases required prompt treatment for either proliferative DR or macular edema. Based on the pilot data, it emerged that an extensive use of the investigated screening programme, within the Greater Treviso area, could prevent 6 cases of blindness every year, resulting in a saving of €271,543.32 (−13.71%). Conclusions. Fundus images obtained with a nonmydriatic fundus camera could be considered an effective, cost-sparing, and feasible screening tool for the early detection of DR, preventing blindness as a result of diabetes.

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