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Trained nurse–operated teleophthalmology screening approach as a cost-effective tool for diabetic retinopathy

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Abstract

Introduction

Teleophthalmology for diabetic retinopathy seems to be a cost-effective, accurate, and reliable method for screening for diabetic retinopathy.

Aims

To study the cost-effectiveness of a novel telemedicine-based digital retinal imaging teleophthalmology performed by a locally trained nurse compared to conventional ophthalmologic fundus examination of diabetic patients for early diagnosis of diabetic retinopathy.

Materials and methods

We compared the cost of evaluation of diabetic retinopathy in a total of 3090 patients. These were grouped based on the conventional approach of evaluation (n = 1500) and compared with the teleophthalmology (n = 1590) approach. The diabetic patients were examined through teleophthalmology by a trained nurse using the Forbes 3nethra fundal camera, and these fundal images were transferred by iCloud to a specialized retina center.

Results

In total, 18.2% (n = 562) patients were diagnosed with diabetic retinopathy (DR). Of these, 8.7% had mild non-proliferative diabetic retinopathy (NPDR), 4.8% had moderate NPDR, 3.8% had severe NPDR, and 0.9% had PDR. The total cost of conventional telemedicine-based digital retinal imaging was approximately INR 550 which in contrast was less than half to the total cost of conventional dilated fundus examination by an ophthalmologist (INR 1400).

Conclusion

Our cost analysis indicates that telemedicine-based diabetic retinopathy screening is economical (INR 550 as compared to INR 1400) than conventional retinal examination.

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Authors and Affiliations

  1. North Delhi Diabetes Centre, New Delhi, India

    Shubhaa Chawla, Aastha Chawla & Rajeev Chawla

  2. Lifecare Diabetes Centre, Kirti Nagar, New Delhi, India

    Shalini Jaggi

  3. Eye Q Vision Pvt Limited, Gurugram, Haryana, India

    Deependra Singh

  4. Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, India

    Siddhant Trehan

Authors
  1. Shubhaa Chawla
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  2. Aastha Chawla
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  3. Rajeev Chawla
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  4. Shalini Jaggi
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  5. Deependra Singh
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  6. Siddhant Trehan
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Correspondence to Rajeev Chawla.

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Chawla, S., Chawla, A., Chawla, R. et al. Trained nurse–operated teleophthalmology screening approach as a cost-effective tool for diabetic retinopathy. Int J Diabetes Dev Ctries 42, 747–750 (2022). https://doi.org/10.1007/s13410-021-01037-0

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  • DOI: https://doi.org/10.1007/s13410-021-01037-0

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