Real-world outcomes of a clinical decision support system for diabetic retinopathy in Spain

BMJ Open Ophthalmol. 2022 Mar 28;7(1):e000974. doi: 10.1136/bmjophth-2022-000974. eCollection 2022.

Abstract

Objective: The aim of present study was to evaluate our clinical decision support system (CDSS) for predicting risk of diabetic retinopathy (DR). We selected randomly a real population of patients with type 2 diabetes (T2DM) who were attending our screening programme.

Methods and analysis: The sample size was 602 patients with T2DM randomly selected from those who attended the DR screening programme. The algorithm developed uses nine risk factors: current age, sex, body mass index (BMI), duration and treatment of diabetes mellitus (DM), arterial hypertension, Glicated hemoglobine (HbA1c), urine-albumin ratio and glomerular filtration.

Results: The mean current age of 67.03±10.91, and 272 were male (53.2%), and DM duration was 10.12±6.4 years, 222 had DR (35.8%). The CDSS was employed for 1 year. The prediction algorithm that the CDSS uses included nine risk factors: current age, sex, BMI, DM duration and treatment, arterial hypertension, HbA1c, urine-albumin ratio and glomerular filtration. The area under the curve (AUC) for predicting the presence of any DR achieved a value of 0.9884, the sensitivity of 98.21%, specificity of 99.21%, positive predictive value of 98.65%, negative predictive value of 98.95%, α error of 0.0079 and β error of 0.0179.

Conclusion: Our CDSS for predicting DR was successful when applied to a real population.

Keywords: diagnostic tests/investigation; epidemiology; retina; telemedicine.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Albumins
  • Decision Support Systems, Clinical*
  • Diabetes Mellitus, Type 2* / complications
  • Diabetic Retinopathy* / diagnosis
  • Female
  • Glycated Hemoglobin
  • Humans
  • Hypertension* / diagnosis
  • Male
  • Risk Factors
  • Spain / epidemiology

Substances

  • Albumins
  • Glycated Hemoglobin A