PMID- 30824420
OWN - NLM
STAT- Publisher
LR  - 20190302
IS  - 1468-2079 (Electronic)
IS  - 0007-1161 (Linking)
DP  - 2019 Mar 1
TI  - Validation of a model for the prediction of retinopathy in persons with type 1
      diabetes.
LID - bjophthalmol-2018-313539 [pii]
LID - 10.1136/bjophthalmol-2018-313539 [doi]
AB  - BACKGROUND/AIM: To validate a previously developed model for prediction of
      diabetic retinopathy (DR) for personalised retinopathy screening in persons with 
      type 1 diabetes. METHODS: Retrospective medical data of persons with type 1
      diabetes treated in an academic hospital setting were used for analysis.
      Sight-threatening retinopathy (STR) was defined as the presence of severe
      non-proliferative DR, proliferative DR or macular oedema. The presence and grade 
      of retinopathy, onset of diabetes, systolic blood pressure, and levels of
      haemoglobin A1c were used to calculate an individual risk estimate and
      personalised screening interval. In persons with STR, the occurrence was compared
      with the calculated date of screening. The model's predictive performance was
      measured using calibration and discrimination techniques. RESULTS: Of the 268
      persons included in our study, 24 (9.0%) developed STR during a mean follow-up of
      4.6 years. All incidences of STR occurred after the calculated screening date. By
      applying the model, the mean calculated screening interval was 30.5 months, which
      is a reduction in screening frequency of 61% compared with annual screening and
      21% compared with biennial screening. The discriminatory ability was good
      (Harrell's C-statistic=0.82, 95% CI 0.74 to 0.90), and calibration showed an
      overestimation of risk in persons who were assigned to a higher risk for STR.
      CONCLUSION: This validation study suggests that a screening programme based on
      the previously developed prediction model is safe and efficient. The use of a
      personalised screening frequency could improve cost-effectiveness of diabetic eye
      care.
CI  - (c) Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and
      permissions. Published by BMJ.
FAU - Schreur, Vivian
AU  - Schreur V
AUID- ORCID: http://orcid.org/0000-0002-2481-7686
AD  - Department of Ophthalmology, Donders Institute for Brain, Cognition and
      Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
      Vivian.Schreur@radboudumc.nl.
FAU - Ng, Heijan
AU  - Ng H
AD  - Department of Ophthalmology, Donders Institute for Brain, Cognition and
      Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
FAU - Nijpels, Giels
AU  - Nijpels G
AD  - Department of General Practice and Elderly Care Medicine, Amsterdam Public Health
      Research Institute, VU Medical Centre, Amsterdam, The Netherlands.
FAU - Stefansson, Einar
AU  - Stefansson E
AD  - Department of Ophthalmology, University of Iceland, Reykjavik, Iceland.
FAU - Tack, Cees J
AU  - Tack CJ
AD  - Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The
      Netherlands.
FAU - Klevering, B Jeroen
AU  - Klevering BJ
AD  - Department of Ophthalmology, Donders Institute for Brain, Cognition and
      Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
FAU - de Jong, Eiko K
AU  - de Jong EK
AD  - Department of Ophthalmology, Donders Institute for Brain, Cognition and
      Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
FAU - Hoyng, Carel B
AU  - Hoyng CB
AD  - Department of Ophthalmology, Donders Institute for Brain, Cognition and
      Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
FAU - Keunen, Jan E E
AU  - Keunen JEE
AD  - Department of Ophthalmology, Donders Institute for Brain, Cognition and
      Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
FAU - van der Heijden, Amber A
AU  - van der Heijden AA
AD  - Department of General Practice and Elderly Care Medicine, Amsterdam Public Health
      Research Institute, VU Medical Centre, Amsterdam, The Netherlands.
LA  - eng
PT  - Journal Article
DEP - 20190301
PL  - England
TA  - Br J Ophthalmol
JT  - The British journal of ophthalmology
JID - 0421041
OTO - NOTNLM
OT  - diagnostic tests
OT  - epidemiology
OT  - investigation
OT  - retina
COIS- Competing interests: None declared.
EDAT- 2019/03/03 06:00
MHDA- 2019/03/03 06:00
CRDT- 2019/03/03 06:00
PHST- 2018/11/09 00:00 [received]
PHST- 2019/01/30 00:00 [revised]
PHST- 2019/02/12 00:00 [accepted]
PHST- 2019/03/03 06:00 [entrez]
PHST- 2019/03/03 06:00 [pubmed]
PHST- 2019/03/03 06:00 [medline]
AID - bjophthalmol-2018-313539 [pii]
AID - 10.1136/bjophthalmol-2018-313539 [doi]
PST - aheadofprint
SO  - Br J Ophthalmol. 2019 Mar 1. pii: bjophthalmol-2018-313539. doi:
      10.1136/bjophthalmol-2018-313539.