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| Name | Class |
|---|---|
| Orbis | OTHER |
| The World Diabetes Foundation | OTHER |
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To evaluate the impact of telemedicine system in rural hospitals for diagnosis and treatment of Diabetes retinopathy and Diabetes macular edema.
Telemedicine system mainly contains a comprehensive eye examination electric-records (E-record), which can transfer the fundus pictures from rural hospitals to professional Graders (golden standard for a diagnose of Diabetes Retinopathy (DR) and Diabetes Macular Edema(DME)). In Zhongshan Ophthalmic Center (ZOC). By this system, the investigators can evaluate the capacity of rural eye doctors about the diagnosis of DR/DME, and give proper suggestions for the treatment and revisit plan.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| rural doctor | examine patient's fundus by 90D fundus pre-set lens |
| |
| grader | grade fundus pictures in ZOC |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| 90 D | Device | rural doctors exam eye fundus by 90 D |
| |
| fundus camera and grader |
| Measure | Description | Time Frame |
|---|---|---|
| Accuracy of trained doctors in diagnosing DR/DME versus photo grading and automated grading | To compare the sensitivity, specificity and positive and negative predictive value for a diagnosis of DR/DME , a diagnosis of DR/DME requiring treatment, of trained rural doctors and an automated grading system, as compared to trained graders using photographs (the gold standard) | 2 years after the telemedicine begin to use |
| cost-effectiveness | Cost-effectiveness of three methods of DR screening (trained rural doctors versus telemedicine versus automated grading) | 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| Frequency of comprehensive eye examination taken by rural doctors | Frequency with which trained rural doctors continue to implement suggested examinations (IOP, gonioscopy, pupil exam, dilated examination) | 2 years |
| comprehensive eye examination rate among patients in rural hospitals |
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Inclusion Criteria:
Exclusion Criteria:
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age > 40y, diagnosed (Diabetes Retinapathy)DR, 10% normal patients
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| Name | Affiliation | Role |
|---|---|---|
| Nathan Congdong, MD,MPH | Zhongshan Ophthalmic Center, Sun Yat-sen University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Zhongshan Ophthalmic Center, No.54, Xianlienan Road | Guangzhou | Guangdong | 510060 | China |
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| Device |
taking fundus pictures and graded by graders in ZOC |
|
Frequency with which patients get comprehensive eye examinations in rural hospitals, and its influencing factors. |
| 2 years |
| the usage rate of Electric-Record | to evaluate the usage rate of E-record by rural doctors when they see patients in the eye clinic, and its influencing factors. | 2 years |
| Cost-effectiveness of van | compare the cost-effectiveness of van for laser treatment to DR/DME patients with the transfer treatment in ZOC | 2 years |