Accuracy of screening for diabetic retinopathy by family physicians.

BACKGROUND We wanted to examine the accuracy of family physicians’ screening for diabetic retinopathy using standardized criteria and a nonmydriatic ophthalmoscope. METHODS Eleven family physicians assessed 28 standardized patients with diabetes mellitus using the PanOptic ophthalmoscope. Their assessments of whether the patients required referral to an ophthalmologist were compared with the reference standard of retinal diagrams. RESULTS The mean sensitivity for the family physicians was 87% (95% confi dence interval [CI], 83%–91%) with a specifi city of 57% (95% CI, 46%–68%). Overall agreement was moderate, with a mean � = .43 (95% CI, 0.39%– 0.47%). CONCLUSIONS Using standardized criteria and a nonmydriatic ophthalmoscope, family physicians were fairly accurate in screening patients for diabetic retinopathy. Whereas this technique is not suffi ciently accurate to replace routine referral for all patients with diabetes, it can be used to improve care for those patients who fail to get routine eye screenings.