341 lines
125 KiB
Text
341 lines
125 KiB
Text
<!DOCTYPE html>
|
|
<html xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" class="no-js no-jr">
|
|
<head>
|
|
<!-- For pinger, set start time and add meta elements. -->
|
|
<script type="text/javascript">var ncbi_startTime = new Date();</script>
|
|
|
|
<!-- Logger begin -->
|
|
<meta name="ncbi_db" content="books">
|
|
<meta name="ncbi_pdid" content="book-toc">
|
|
<meta name="ncbi_acc" content="NBK607355">
|
|
<meta name="ncbi_domain" content="niceng242er10">
|
|
<meta name="ncbi_report" content="reader">
|
|
<meta name="ncbi_type" content="fulltext">
|
|
<meta name="ncbi_objectid" content="">
|
|
<meta name="ncbi_pcid" content="/NBK607355/?report=reader">
|
|
<meta name="ncbi_pagename" content="Evidence reviews for the effectiveness of different monitoring frequencies - NCBI Bookshelf">
|
|
<meta name="ncbi_bookparttype" content="toc">
|
|
<meta name="ncbi_app" content="bookshelf">
|
|
<!-- Logger end -->
|
|
|
|
<!--component id="Page" label="meta"/-->
|
|
<script type="text/javascript" src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.boots.min.js"> </script><title>Evidence reviews for the effectiveness of different monitoring frequencies - NCBI Bookshelf</title>
|
|
<meta charset="utf-8">
|
|
<meta name="apple-mobile-web-app-capable" content="no">
|
|
<meta name="viewport" content="initial-scale=1,minimum-scale=1,maximum-scale=1,user-scalable=no">
|
|
<meta name="jr-col-layout" content="1">
|
|
<meta name="robots" content="INDEX,FOLLOW,NOARCHIVE,NOIMAGEINDEX">
|
|
<meta name="citation_title" content="Evidence reviews for the effectiveness of different monitoring frequencies">
|
|
<meta name="citation_publisher" content="National Institute for Health and Care Excellence (NICE)">
|
|
<meta name="citation_date" content="2024/08">
|
|
<meta name="citation_pmid" content="39312620">
|
|
<meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK607355/">
|
|
<meta name="citation_keywords" content="Diabetic Retinopathy">
|
|
<meta name="citation_keywords" content="Macular Edema">
|
|
<meta name="citation_keywords" content="Monitoring, Physiologic">
|
|
<meta name="citation_keywords" content="Disease Progression">
|
|
<meta name="citation_keywords" content="Visual Acuity">
|
|
<meta name="citation_keywords" content="Quality of Life">
|
|
<meta name="citation_keywords" content="Treatment Adherence and Compliance">
|
|
<meta name="citation_keywords" content="Treatment Outcome">
|
|
<meta name="citation_keywords" content="Humans">
|
|
<meta name="citation_keywords" content="Review">
|
|
<link rel="schema.DC" href="http://purl.org/DC/elements/1.0/">
|
|
<meta name="DC.Title" content="Evidence reviews for the effectiveness of different monitoring frequencies">
|
|
<meta name="DC.Type" content="Text">
|
|
<meta name="DC.Publisher" content="National Institute for Health and Care Excellence (NICE)">
|
|
<meta name="DC.Date" content="2024/08">
|
|
<meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK607355/">
|
|
<meta name="og:title" content="Evidence reviews for the effectiveness of different monitoring frequencies">
|
|
<meta name="og:type" content="book">
|
|
<meta name="og:url" content="https://www.ncbi.nlm.nih.gov/books/NBK607355/">
|
|
<meta name="og:site_name" content="NCBI Bookshelf">
|
|
<meta name="og:image" content="https://www.ncbi.nlm.nih.gov/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-niceng242er10-lrg.png">
|
|
<meta name="twitter:card" content="summary">
|
|
<meta name="twitter:site" content="@ncbibooks">
|
|
<meta name="bk-non-canon-loc" content="/books/n/niceng242er10/toc/?report=reader">
|
|
<link rel="canonical" href="https://www.ncbi.nlm.nih.gov/books/NBK607355/">
|
|
<link href="https://fonts.googleapis.com/css?family=Archivo+Narrow:400,700,400italic,700italic&subset=latin" rel="stylesheet" type="text/css">
|
|
<link rel="stylesheet" href="/corehtml/pmc/jatsreader/ptpmc_3.22/css/libs.min.css">
|
|
<link rel="stylesheet" href="/corehtml/pmc/jatsreader/ptpmc_3.22/css/jr.min.css">
|
|
<meta name="format-detection" content="telephone=no">
|
|
<link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books.min.css" type="text/css">
|
|
<link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css//books_print.min.css" type="text/css" media="print">
|
|
<link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books_reader.min.css" type="text/css">
|
|
<style type="text/css">p a.figpopup{display:inline !important} .bk_tt {font-family: monospace} .first-line-outdent .bk_ref {display: inline} .body-content h2, .body-content .h2 {border-bottom: 1px solid #97B0C8} .body-content h2.inline {border-bottom: none} a.page-toc-label , .jig-ncbismoothscroll a {text-decoration:none;border:0 !important} .temp-labeled-list .graphic {display:inline-block !important} .temp-labeled-list img{width:100%}</style>
|
|
|
|
<link rel="shortcut icon" href="//www.ncbi.nlm.nih.gov/favicon.ico">
|
|
<meta name="ncbi_phid" content="CE8D55D67D6AC8F10000000000E000BA.m_5">
|
|
<meta name='referrer' content='origin-when-cross-origin'/><link type="text/css" rel="stylesheet" href="//static.pubmed.gov/portal/portal3rc.fcgi/4216699/css/3852956/3849091.css"></head>
|
|
<body>
|
|
<!-- Book content! -->
|
|
|
|
|
|
<div id="jr" data-jr-path="/corehtml/pmc/jatsreader/ptpmc_3.22/"><div class="jr-unsupported"><table class="modal"><tr><td><span class="attn inline-block"></span><br />Your browser does not support the NLM PubReader view.<br />Go to <a href="/pmc/about/pr-browsers/">this page</a> to see a list of supported browsers<br />or return to the <br /><a href="/books/NBK607355/?report=classic">regular view</a>.</td></tr></table></div><div id="jr-ui" class="hidden"><nav id="jr-head"><div class="flexh tb"><div id="jr-tb1"><a id="jr-links-sw" class="hidden" title="Links"><svg xmlns="http://www.w3.org/2000/svg" version="1.1" x="0px" y="0px" viewBox="0 0 70.6 85.3" style="enable-background:new 0 0 70.6 85.3;vertical-align:middle" xml:space="preserve" width="24" height="24">
|
|
<style type="text/css">.st0{fill:#939598;}</style>
|
|
<g>
|
|
<path class="st0" d="M36,0C12.8,2.2-22.4,14.6,19.6,32.5C40.7,41.4-30.6,14,35.9,9.8"></path>
|
|
<path class="st0" d="M34.5,85.3c23.2-2.2,58.4-14.6,16.4-32.5c-21.1-8.9,50.2,18.5-16.3,22.7"></path>
|
|
<path class="st0" d="M34.7,37.1c66.5-4.2-4.8-31.6,16.3-22.7c42.1,17.9,6.9,30.3-16.4,32.5h1.7c-66.2,4.4,4.8,31.6-16.3,22.7 c-42.1-17.9-6.9-30.3,16.4-32.5"></path>
|
|
</g>
|
|
</svg> Books</a></div><div class="jr-rhead f1 flexh"></div><div id="jr-tb2"><a id="jr-bkhelp-sw" class="btn wsprkl hidden" title="Help with NLM PubReader">?</a><a id="jr-help-sw" class="btn wsprkl hidden" title="Settings and typography in NLM PubReader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 512 512" preserveAspectRatio="none"><path d="M462,283.742v-55.485l-29.981-10.662c-11.431-4.065-20.628-12.794-25.274-24.001 c-0.002-0.004-0.004-0.009-0.006-0.013c-4.659-11.235-4.333-23.918,0.889-34.903l13.653-28.724l-39.234-39.234l-28.72,13.652 c-10.979,5.219-23.68,5.546-34.908,0.889c-0.005-0.002-0.01-0.003-0.014-0.005c-11.215-4.65-19.933-13.834-24-25.273L283.741,50 h-55.484l-10.662,29.981c-4.065,11.431-12.794,20.627-24.001,25.274c-0.005,0.002-0.009,0.004-0.014,0.005 c-11.235,4.66-23.919,4.333-34.905-0.889l-28.723-13.653l-39.234,39.234l13.653,28.721c5.219,10.979,5.545,23.681,0.889,34.91 c-0.002,0.004-0.004,0.009-0.006,0.013c-4.649,11.214-13.834,19.931-25.271,23.998L50,228.257v55.485l29.98,10.661 c11.431,4.065,20.627,12.794,25.274,24c0.002,0.005,0.003,0.01,0.005,0.014c4.66,11.236,4.334,23.921-0.888,34.906l-13.654,28.723 l39.234,39.234l28.721-13.652c10.979-5.219,23.681-5.546,34.909-0.889c0.005,0.002,0.01,0.004,0.014,0.006 c11.214,4.649,19.93,13.833,23.998,25.271L228.257,462h55.484l10.595-29.79c4.103-11.538,12.908-20.824,24.216-25.525 c0.005-0.002,0.009-0.004,0.014-0.006c11.127-4.628,23.694-4.311,34.578,0.863l28.902,13.738l39.234-39.234l-13.66-28.737 c-5.214-10.969-5.539-23.659-0.886-34.877c0.002-0.005,0.004-0.009,0.006-0.014c4.654-11.225,13.848-19.949,25.297-24.021 L462,283.742z M256,331.546c-41.724,0-75.548-33.823-75.548-75.546s33.824-75.547,75.548-75.547 c41.723,0,75.546,33.824,75.546,75.547S297.723,331.546,256,331.546z"></path></svg></a><a id="jr-fip-sw" class="btn wsprkl hidden" title="Find"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 550 600" preserveAspectRatio="none"><path fill="none" stroke="#000" stroke-width="36" stroke-linecap="round" style="fill:#FFF" d="m320,350a153,153 0 1,0-2,2l170,170m-91-117 110,110-26,26-110-110"></path></svg></a><a id="jr-cmap-sw" class="btn wsprkl hidden" title="Table of Contents"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M20,20h10v8H20V20zM36,20h44v8H36V20zM20,37.33h10v8H20V37.33zM36,37.33h44v8H36V37.33zM20,54.66h10v8H20V54.66zM36,54.66h44v8H36V54.66zM20,72h10v8 H20V72zM36,72h44v8H36V72z"></path></svg></a></div></div></nav><nav id="jr-dash" class="noselect"><nav id="jr-dash" class="noselect"><div id="jr-pi" class="hidden"><a id="jr-pi-prev" class="hidden" title="Previous page"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M75,30 c-80,60 -80,0 0,60 c-30,-60 -30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Prev</text></svg></a><div class="pginfo">Page <i class="jr-pg-pn">0</i> of <i class="jr-pg-lp">0</i></div><a id="jr-pi-next" class="hidden" title="Next page"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M25,30c80,60 80,0 0,60 c30,-60 30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Next</text></svg></a></div><div id="jr-is-tb"><a id="jr-is-sw" class="btn wsprkl hidden" title="Switch between Figures/Tables strip and Progress bar"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><rect x="10" y="40" width="20" height="20"></rect><rect x="40" y="40" width="20" height="20"></rect><rect x="70" y="40" width="20" height="20"></rect></svg></a></div><nav id="jr-istrip" class="istrip hidden"><a id="jr-is-prev" href="#" class="hidden" title="Previous"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M80,40 60,65 80,90 70,90 50,65 70,40z M50,40 30,65 50,90 40,90 20,65 40,40z"></path><text x="35" y="25" textLength="60" style="font-size:25px">Prev</text></svg></a><a id="jr-is-next" href="#" class="hidden" title="Next"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M20,40 40,65 20,90 30,90 50,65 30,40z M50,40 70,65 50,90 60,90 80,65 60,40z"></path><text x="15" y="25" textLength="60" style="font-size:25px">Next</text></svg></a></nav><nav id="jr-progress"></nav></nav></nav><aside id="jr-links-p" class="hidden flexv"><div class="tb sk-htbar flexh"><div><a class="jr-p-close btn wsprkl">Done</a></div><div class="title-text f1">NCBI Bookshelf</div></div><div class="cnt lol f1"><a href="/books/">Home</a><a href="/books/browse/">Browse All Titles</a><a class="btn share" target="_blank" rel="noopener noreferrer" href="https://www.facebook.com/sharer/sharer.php?u=https://www.ncbi.nlm.nih.gov/books/NBK607355/"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 33 33" style="vertical-align:middle" width="24" height="24" preserveAspectRatio="none"><g><path d="M 17.996,32L 12,32 L 12,16 l-4,0 l0-5.514 l 4-0.002l-0.006-3.248C 11.993,2.737, 13.213,0, 18.512,0l 4.412,0 l0,5.515 l-2.757,0 c-2.063,0-2.163,0.77-2.163,2.209l-0.008,2.76l 4.959,0 l-0.585,5.514L 18,16L 17.996,32z"></path></g></svg> Share on Facebook</a><a class="btn share" target="_blank" rel="noopener noreferrer" href="https://twitter.com/intent/tweet?url=https://www.ncbi.nlm.nih.gov/books/NBK607355/&text=Evidence%20reviews%20for%20the%20effectiveness%20of%20different%20monitoring%20frequencies"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 33 33" style="vertical-align:middle" width="24" height="24"><g><path d="M 32,6.076c-1.177,0.522-2.443,0.875-3.771,1.034c 1.355-0.813, 2.396-2.099, 2.887-3.632 c-1.269,0.752-2.674,1.299-4.169,1.593c-1.198-1.276-2.904-2.073-4.792-2.073c-3.626,0-6.565,2.939-6.565,6.565 c0,0.515, 0.058,1.016, 0.17,1.496c-5.456-0.274-10.294-2.888-13.532-6.86c-0.565,0.97-0.889,2.097-0.889,3.301 c0,2.278, 1.159,4.287, 2.921,5.465c-1.076-0.034-2.088-0.329-2.974-0.821c-0.001,0.027-0.001,0.055-0.001,0.083 c0,3.181, 2.263,5.834, 5.266,6.438c-0.551,0.15-1.131,0.23-1.73,0.23c-0.423,0-0.834-0.041-1.235-0.118 c 0.836,2.608, 3.26,4.506, 6.133,4.559c-2.247,1.761-5.078,2.81-8.154,2.81c-0.53,0-1.052-0.031-1.566-0.092 c 2.905,1.863, 6.356,2.95, 10.064,2.95c 12.076,0, 18.679-10.004, 18.679-18.68c0-0.285-0.006-0.568-0.019-0.849 C 30.007,8.548, 31.12,7.392, 32,6.076z"></path></g></svg> Share on Twitter</a></div></aside><aside id="jr-cmap-p" class="hidden flexv"><div class="tb sk-htbar flexh"><div><a class="jr-p-close btn wsprkl">Done</a></div><div class="title-text f1">In Page Navigation</div></div><div class="cnt lol f1"><a href="/books/n/niceercollect/?report=reader">NICE Evidence Reviews Collection</a><a class="current">Title Information</a></div></aside><aside id="jr-help-p" class="hidden flexv"><div class="tb sk-htbar flexh"><div><a class="jr-p-close btn wsprkl">Done</a></div><div class="title-text f1">Settings</div></div><div class="cnt f1"><div id="jr-typo-p" class="typo"><div><a class="sf btn wsprkl">A-</a><a class="lf btn wsprkl">A+</a></div><div><a class="bcol-auto btn wsprkl"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 200 100" preserveAspectRatio="none"><text x="10" y="70" style="font-size:60px;font-family: Trebuchet MS, ArialMT, Arial, sans-serif" textLength="180">AUTO</text></svg></a><a class="bcol-1 btn wsprkl"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M15,25 85,25zM15,40 85,40zM15,55 85,55zM15,70 85,70z"></path></svg></a><a class="bcol-2 btn wsprkl"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M5,25 45,25z M55,25 95,25zM5,40 45,40z M55,40 95,40zM5,55 45,55z M55,55 95,55zM5,70 45,70z M55,70 95,70z"></path></svg></a></div></div><div class="lol"><a class="" href="/books/NBK607355/?report=classic">Switch to classic view</a><a href="/books/n/niceng242er10/pdf/">PDF (726K)</a><a href="/books/n/niceng242er10/toc/?report=printable">Print View</a></div></div></aside><aside id="jr-bkhelp-p" class="hidden flexv"><div class="tb sk-htbar flexh"><div><a class="jr-p-close btn wsprkl">Done</a></div><div class="title-text f1">Help</div></div><div class="cnt f1 lol"><a id="jr-helpobj-sw" data-path="/corehtml/pmc/jatsreader/ptpmc_3.22/" data-href="/corehtml/pmc/jatsreader/ptpmc_3.22/img/bookshelf/help.xml" href="">Help</a><a href="mailto:info@ncbi.nlm.nih.gov?subject=PubReader%20feedback%20%2F%20NBK607355%20%2F%20sid%3ACE8B5AF87C7FFCB1_0191SID%20%2F%20phid%3ACE8D55D67D6AC8F10000000000E000BA.4">Send us feedback</a><a id="jr-about-sw" data-path="/corehtml/pmc/jatsreader/ptpmc_3.22/" data-href="/corehtml/pmc/jatsreader/ptpmc_3.22/img/bookshelf/about.xml" href="">About PubReader</a></div></aside><aside id="jr-objectbox" class="thidden hidden"><div class="jr-objectbox-close wsprkl">✘</div><div class="jr-objectbox-inner cnt"><div class="jr-objectbox-drawer"></div></div></aside><nav id="jr-pm-left" class="hidden"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 40 800" preserveAspectRatio="none"><text font-stretch="ultra-condensed" x="800" y="-15" text-anchor="end" transform="rotate(90)" font-size="18" letter-spacing=".1em">Previous Page</text></svg></nav><nav id="jr-pm-right" class="hidden"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 40 800" preserveAspectRatio="none"><text font-stretch="ultra-condensed" x="800" y="-15" text-anchor="end" transform="rotate(90)" font-size="18" letter-spacing=".1em">Next Page</text></svg></nav><nav id="jr-fip" class="hidden"><nav id="jr-fip-term-p"><input type="search" placeholder="search this page" id="jr-fip-term" autocorrect="off" autocomplete="off" /><a id="jr-fip-mg" class="wsprkl btn" title="Find"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 550 600" preserveAspectRatio="none"><path fill="none" stroke="#000" stroke-width="36" stroke-linecap="round" style="fill:#FFF" d="m320,350a153,153 0 1,0-2,2l170,170m-91-117 110,110-26,26-110-110"></path></svg></a><a id="jr-fip-done" class="wsprkl btn" title="Dismiss find">✘</a></nav><nav id="jr-fip-info-p"><a id="jr-fip-prev" class="wsprkl btn" title="Jump to previuos match">◀</a><button id="jr-fip-matches">no matches yet</button><a id="jr-fip-next" class="wsprkl btn" title="Jump to next match">▶</a></nav></nav></div><div id="jr-epub-interstitial" class="hidden"></div><div id="jr-content"><article data-type="main"><div class="main-content lit-style"><div class="fm-sec bkr_bottom_sep"><div class="bkr_thumb"><a href="https://www.nice.org.uk" title="National Institute for Health and Care Excellence (NICE)" class="img_link icnblk_img" ref="pagearea=logo&targetsite=external&targetcat=link&targettype=publisher"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-niceng242er10-lrg.png" alt="Cover of Evidence reviews for the effectiveness of different monitoring frequencies" /></a></div><div class="bkr_bib"><h1 id="_NBK607355_"><span itemprop="name">Evidence reviews for the effectiveness of different monitoring frequencies</span></h1><div class="subtitle">Diabetic retinopathy: management and monitoring</div><p><b>Evidence review J</b></p><p><i>NICE Guideline, No. 242</i></p><div class="half_rhythm">London: <a href="https://www.nice.org.uk" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">National Institute for Health and Care Excellence (NICE)</span></a>; <span itemprop="datePublished">2024 Aug</span>.<div class="small">ISBN-13: <span itemprop="isbn">978-1-4731-6438-3</span></div></div><div><a href="/books/about/copyright/">Copyright</a> © NICE 2024.</div></div><div class="bkr_clear"></div></div><div id="niceng242er10.s1"><h2 id="_niceng242er10_s1_">Evidence review for effectiveness of different monitoring frequencies</h2><div id="niceng242er10.s1.1"><h3>1.1. Review question</h3><p>What is the effectiveness of different monitoring frequencies for people with non-proliferative diabetic retinopathy whose care is managed under the hospital eye services but who are not having treatment?</p><p>What is the effectiveness of different monitoring frequencies for people with proliferative diabetic retinopathy or diabetic macular oedema who are receiving treatment or have had previous treatment?</p><div id="niceng242er10.s1.1.1"><h4>1.1.1. Introduction</h4><p>Diabetic retinopathy is a significant cause of vision loss in adults. The risk of the development and progression of non-proliferative retinopathy to macular oedema or vision-threatening proliferative diabetic retinopathy requires timely intervention to improve patient outcomes and reduce the risk of loss of vision.</p><p>Early detection of disease progression can play a significant role in timely treatment. Current recommendations in the <a href="https://www.rcophth.ac.uk/wp-content/uploads/2021/08/2012-SCI-267-Diabetic-Retinopathy-Guidelines-December-2012.pdf" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Royal College of Ophthalmologists guidelines (2012)</a> include 4-6 monthly monitoring for people with moderately severe to very severe non-proliferative retinopathy. The aim of this review was to establish the risks and benefits of different monitoring frequencies to effectively detect potentially vision-threatening changes in:
|
|
<ul><li class="half_rhythm"><div>People with moderate, severe, and very severe non-proliferative diabetic retinopathy without macular oedema, whose care is managed under hospital eye services.</div></li><li class="half_rhythm"><div>People with proliferative diabetic retinopathy or diabetic macular oedema who are receiving treatment or have had previous treatment.</div></li></ul></p><p>The protocols for the evidence reviews are summarised in <a href="/books/NBK607355/table/niceng242er10.tab1/?report=objectonly" target="object" rid-ob="figobniceng242er10tab1">Table 1</a>. Please see full protocols in <a href="#niceng242er10.appa">Appendix A</a>.</p></div><div id="niceng242er10.s1.1.2"><h4>1.1.2. Summary of the protocol</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng242er10tab1"><a href="/books/NBK607355/table/niceng242er10.tab1/?report=objectonly" target="object" title="Table 1" class="img_link icnblk_img" rid-ob="figobniceng242er10tab1"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="niceng242er10.tab1"><a href="/books/NBK607355/table/niceng242er10.tab1/?report=objectonly" target="object" rid-ob="figobniceng242er10tab1">Table 1</a></h4><p class="float-caption no_bottom_margin">PICO for people with non-proliferative diabetic retinopathy. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng242er10tab2"><a href="/books/NBK607355/table/niceng242er10.tab2/?report=objectonly" target="object" title="Table 2" class="img_link icnblk_img" rid-ob="figobniceng242er10tab2"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="niceng242er10.tab2"><a href="/books/NBK607355/table/niceng242er10.tab2/?report=objectonly" target="object" rid-ob="figobniceng242er10tab2">Table 2</a></h4><p class="float-caption no_bottom_margin">PICO for people with proliferative diabetic retinopathy or diabetic macular oedema. </p></div></div></div><div id="niceng242er10.s1.1.3"><h4>1.1.3. Methods and process</h4><p>This evidence review was developed using the methods and process described in <a href="https://www.nice.org.uk/process/pmg20/chapter/introduction" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a> and the <a href="https://www.nice.org.uk/guidance/NG242/history" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">methods document</a> for the diabetic retinopathy guideline.</p><p>Declarations of interest were recorded according to <a href="https://www.nice.org.uk/about/who-we-are/policies-and-procedures" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NICE’s conflicts of interest policy</a>. Methods specific to this review question are described in the review protocol in <a href="#niceng242er10.appa">Appendix A</a>. Additionally:
|
|
<ul><li class="half_rhythm"><div>A modified version of the <a href="https://www.nice.org.uk/about/who-we-are/policies-and-procedures" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NICE economics studies checklist</a> was used to critically appraise modelling studies. Items 1.4, 1.6, 1.7, 2.6, 2.7, 2.8 and 2.9 were removed as they relate to economic aspects which are not applicable to this review.</div></li><li class="half_rhythm"><div>A modified GRADE approach was used to assess the certainty in the evidence from modelling studies. The approach to GRADE for assessing the effectiveness of interventions outlined in the <a href="https://www.nice.org.uk/guidance/NG242/history" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">methods document</a> for the diabetic retinopathy guideline was used, with the exception that evidence from modelling studies was started with a GRADE rating of ‘high’.</div></li></ul></p></div><div id="niceng242er10.s1.1.4"><h4>1.1.4. Effectiveness evidence</h4><div id="niceng242er10.s1.1.4.1"><h5>1.1.4.1. Included studies</h5><p>A single systematic literature search was conducted to cover both review questions. The search included randomised controlled trials (RCTs), comparative observational studies and modelling studies comparing monitoring frequencies. No date limit was applied, and the search yielded 2,686 references. These were screened on title and abstract, with 38 full-text papers ordered as potentially relevant studies.</p><p>Studies were excluded if they did not match the protocol outlined in <a href="#niceng242er10.appa">Appendix A</a>.</p><p>A single paper (<a class="bibr" href="#niceng242er10.ref1" rid="niceng242er10.ref1">DCCT/EDIC Research, 2017</a>) was included after full text screening for the review question on monitoring frequencies for non-proliferative diabetic retinopathy. No studies were included for the review question on monitoring frequencies for proliferative diabetic retinopathy or diabetic macular oedema.</p><p>For the study selection process, please see PRISMA flow diagram in <a href="#niceng242er10.appc">Appendix C</a></p><p>For the full evidence tables and full GRADE profiles for included studies, please see <a href="#niceng242er10.appd">Appendix D</a> and <a href="#niceng242er10.appe">Appendix E</a>.</p></div><div id="niceng242er10.s1.1.4.2"><h5>1.1.4.2. Excluded studies</h5><p>See <a href="#niceng242er10.appi">Appendix I</a> for a list of excluded studies with reasons for exclusion.</p></div></div><div id="niceng242er10.s1.1.5"><h4>1.1.5. Summary of studies included in the effectiveness evidence</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng242er10tab3"><a href="/books/NBK607355/table/niceng242er10.tab3/?report=objectonly" target="object" title="Table 3" class="img_link icnblk_img" rid-ob="figobniceng242er10tab3"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="niceng242er10.tab3"><a href="/books/NBK607355/table/niceng242er10.tab3/?report=objectonly" target="object" rid-ob="figobniceng242er10tab3">Table 3</a></h4><p class="float-caption no_bottom_margin">Studies included in the effectiveness evidence. </p></div></div><p>See <a href="#niceng242er10.appd">Appendix D</a> for full evidence tables.</p></div><div id="niceng242er10.s1.1.6"><h4>1.1.6. Summary of the Effectiveness evidence</h4><div id="niceng242er10.s1.1.6.1"><h5>Probability over a given follow-Up interval of progression from lower levels of retinopathy to higher grade of retinopathy</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng242er10tab4"><a href="/books/NBK607355/table/niceng242er10.tab4/?report=objectonly" target="object" title="Table 4" class="img_link icnblk_img" rid-ob="figobniceng242er10tab4"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="niceng242er10.tab4"><a href="/books/NBK607355/table/niceng242er10.tab4/?report=objectonly" target="object" rid-ob="figobniceng242er10tab4">Table 4</a></h4><p class="float-caption no_bottom_margin">Modelled risk of progression from moderate diabetic retinopathy to proliferative retinopathy or clinically significant macular oedema. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng242er10tab5"><a href="/books/NBK607355/table/niceng242er10.tab5/?report=objectonly" target="object" title="Table 5" class="img_link icnblk_img" rid-ob="figobniceng242er10tab5"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="niceng242er10.tab5"><a href="/books/NBK607355/table/niceng242er10.tab5/?report=objectonly" target="object" rid-ob="figobniceng242er10tab5">Table 5</a></h4><p class="float-caption no_bottom_margin">Modelled risk of progression from severe diabetic retinopathy to proliferative retinopathy or clinically significant macular oedema. </p></div></div><p>See <a href="#niceng242er10.appe">Appendix E</a> for full GRADE tables.</p></div></div><div id="niceng242er10.s1.1.7"><h4>1.1.7. Economic evidence</h4><div id="niceng242er10.s1.1.7.1"><h5>1.1.7.1. Included studies</h5><p>A single search was performed to identify published economic evaluations of relevance to any of the questions in this guideline update (see <a href="#niceng242er10.appb">Appendix B</a>). This search retrieved 672 studies. Based on title and abstract screening, 670 of the studies could confidently be excluded for these questions. Two studies were excluded following the full-text review. No relevant health economic studies were included.</p></div><div id="niceng242er10.s1.1.7.2"><h5>1.1.7.2. Excluded studies</h5><p>See <a href="#niceng242er10.appi">Appendix I</a> for excluded studies and reasons for exclusion.</p><p>See the health economic study selection flow chart presented in <a href="#niceng242er10.appf">Appendix F</a>.</p></div></div><div id="niceng242er10.s1.1.8"><h4>1.1.8. Summary of included economic evidence</h4><p>No relevant health economic studies were identified to be included.</p></div><div id="niceng242er10.s1.1.9"><h4>1.1.9. Economic model</h4><p>Original health economic modelling was not prioritised for this review question.</p></div><div id="niceng242er10.s1.1.10"><h4>1.1.10. Unit costs</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng242er10tab6"><a href="/books/NBK607355/table/niceng242er10.tab6/?report=objectonly" target="object" title="Table 6" class="img_link icnblk_img" rid-ob="figobniceng242er10tab6"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="niceng242er10.tab6"><a href="/books/NBK607355/table/niceng242er10.tab6/?report=objectonly" target="object" rid-ob="figobniceng242er10tab6">Table 6</a></h4><p class="float-caption no_bottom_margin">Unit cost of screening visits. </p></div></div></div><div id="niceng242er10.s1.1.11"><h4>1.1.11. The committee’s discussion and interpretation of the evidence</h4><div id="niceng242er10.s1.1.11.1"><h5>1.1.11.1. The outcomes that matter most</h5><p>The committee agreed that progression to proliferative diabetic retinopathy was an important outcome in people diagnosed with non-proliferative diabetic retinopathy because this can have very serious consequences, including retinal detachment and irreversible and severe vision loss, if not treated. Other outcomes were also considered to be important (progression of diabetic macular oedema, best corrected visual acuity, peripheral vision, adherence, and health related quality of life) but no evidence was found for these outcomes. The committee wanted the data to be separated by subgroups including pregnancy, age, and severity of disease, however the evidence available did not allow for stratification by subgroups.</p></div><div id="niceng242er10.s1.1.11.2"><h5>1.1.11.2. The quality of the evidence</h5><p>Only one study was identified for people with non-proliferative retinopathy that matched the review protocol. The quality of the evidence for the outcomes was low, with the main reasons for downgrading being a lack of information on whether the models adjusted for confounders and the data not allowing for stratification by risk factors.</p><p>The data reported combined progression of proliferative diabetic retinopathy and diabetic macular oedema as one outcome and there was no information on the relative proportions of people with the two outcomes. The committee considered this a major limitation because delaying treatment for proliferative diabetic retinopathy has more serious consequences than delaying treatment for diabetic macular oedema. Delaying treatment for proliferative diabetic retinopathy can result in retinal detachment and irreversible sight loss. Delaying treatment for diabetic macular oedema could also result in sight loss, but this is likely to be less severe and reversible in comparison to sight loss secondary to proliferative diabetic retinopathy.</p><p>The committee were also concerned that the lack of clarity on whether the model was stratified by those who received intensive glycaemic control intervention and those that received no treatment.</p><p>The evidence was downgraded for indirectness as the population in the study was limited to people with type 1 diabetes. However, the committee agreed that they did not expect a large difference in outcomes between people with type 1 and type 2 diabetes.</p><p>No evidence was identified on the effectiveness of different monitoring frequencies for people who are receiving treatment or who have previously received treatment for proliferative diabetic retinopathy or diabetic macular oedema.</p></div><div id="niceng242er10.s1.1.11.3"><h5>1.1.11.3. Imprecision and the clinical importance of effects</h5><p>The evidence identified was modelled based on a large sample, and so the 95% confidence intervals were narrow enough to allow useful comparisons between monitoring frequencies. As noted in the section above, the committee found it difficult to determine what percentage of progression between monitoring visits would be acceptable because of the composite nature of the outcome and the different clinical consequences of progression to proliferative diabetic retinopathy and diabetic macular oedema.</p></div><div id="niceng242er10.s1.1.11.4"><h5>1.1.11.4. Benefits and harms</h5><p>The committee discussed that monitoring is needed to check for disease progression that requires treatment, so that treatment can begin promptly if progression occurs. They also noted that people with diabetic retinopathy and diabetic macular oedema often attend a large number of hospital appointments to manage their diabetes care. They often have other diabetes-related complications that also require hospital visits, and so it is important to make sure that monitoring is not more frequent than necessary to reduce this burden.</p><div id="niceng242er10.s1.1.11.4.1"><h5>People with non-proliferative diabetic retinopathy, proliferative diabetic retinopathy or diabetic macular oedema</h5><p>The committee did not review any evidence that allowed them to clearly differentiate evidence for people under 18 or pregnant people. However, they agreed that the same recommendations should apply to under 18s as to adults. Although the risk of developing diabetic retinopathy is lower in under 18s, if it is identified, it should be monitored in the same way. The committee was aware of existing recommendations on monitoring diabetic retinopathy and the timing of retinal assessments in pregnancy in <a href="https://www.nice.org.uk/guidance/ng3" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NICE’s guideline on diabetes in pregnancy</a>, so they agreed to refer to this guideline.</p></div><div id="niceng242er10.s1.1.11.4.2"><h5>Non-proliferative retinopathy</h5><p>Based on their expertise and the modelling evidence, the committee made different recommendations, depending on severity of disease and risk of progression. The committee made a weaker ‘consider’ recommendation based on the limitations in the evidence that was identified in the quality of the evidence section. However, it should be noted that the choice of consider rather than offer in this recommendation is in relation to the frequency of monitoring, rather than the need for any monitoring at all. It was decided that the recommendations should be separated by people who have moderate non-proliferative retinopathy and those with severe to very severe non-proliferative diabetic retinopathy. People who have moderate non-proliferative diabetic retinopathy can be seen less frequently, with lower risk of progression between appointments, while those who have severe or very severe non-proliferative diabetic retinopathy will need more frequent appointments.</p><p>The committee discussed monitoring every 6–12 months for people with moderate non-proliferative retinopathy who are not being currently treated or have not been previously treated. It was noted that people under hospital eye services who are not receiving treatment occupy a lot of clinic time. It was agreed that progression of disease in this population is relatively slow and the evidence indicates that a 6–12-month window means that people have between 6.6% (6.0%-7.3%) and 12.3% (11.3%-13.5%) chance of progressing to proliferative retinopathy or clinically significant macular oedema between appointments. The committee thought that 6–12 months between appointments is therefore appropriate and should not allow for any major progression of the disease between appointments.</p><p>The committee agreed that people with severe or very severe non-proliferative diabetic retinopathy who are not being currently treated should be seen more frequently, as they are more at risk of progression than those who have moderate non-proliferative retinopathy. They noted that this group have a 14.4% (9.4%-22.0%) chance of progression if they have monitoring appointments every 3 months. It was highlighted that more frequent appointments would further reduce the risk of progression. For instance, appointments every 2 months would mean that someone only had a 10.4% (6.5%-16.0%) chance of progression. However, the committee were concerned that it may not be practical to see all of these patients more frequently than every 3 months. They also discussed how people with diabetic retinopathy have to attend a number of different appointments including these monitoring appointments for their eye disease as well as appointments for other complications associated with their diabetes. As such, very frequent appointments might be unmanageable for some people. Three months was therefore considered an appropriate follow-up time. It was also highlighted that while 3 months is ideal, some people will still not be able to attend appointments this frequently and might instead be at risk of missing appointments, which would have a greater impact on progression than less frequent monitoring. The committee therefore decided that monitoring should take place between 3 and 6 months for this group, giving a maximum risk of 23% (15.8%-32.7%) chance of progression between appointments. This time scale also reflects current practice.</p><p>Due to the limited evidence to inform recommendations on the timing of monitoring, the committee also made a research recommendation on the most effective monitoring frequencies for people with non-proliferative retinopathy who have not started treatment. The ideal study design to inform this research would be a randomised controlled trial comparing outcomes in people monitored at different frequencies. However, such a study would be difficult to carry out because it would need long follow up times and people may need to be allocated to follow up intervals that are longer than current practice. Modelling studies that report data on progression of diabetic retinopathy and diabetic macular oedema would therefore be a feasible alternative. For details of the research recommendation see <a href="#niceng242er10.appj">Appendix J</a>.</p></div><div id="niceng242er10.s1.1.11.4.3"><h5>Proliferative retinopathy and diabetic macular oedema</h5><p>No evidence was found for people who have proliferative diabetic retinopathy or diabetic macular oedema. The committee noted that monitoring during treatment would be determined by the treatment protocol and so did not make recommendations for this area. However, the committee agreed that some guidance would be useful for monitoring frequency after treatment is completed. This was based on their clinical experience that an appropriate monitoring time can vary between individuals depending on their risk factors for progression, and the need to ensure that appointments are not so frequent that there is the risk of non-attendance. After 12 months, they thought the risk of progression was lower and therefore this is an appropriate time to consider discharge back to hospital services.</p><p>The committee agreed that people who have received treatment for proliferative diabetic retinopathy or diabetic macular oedema, whose disease has regressed should be monitored under the care of hospital eye services for 12 months. They discussed how the frequency of monitoring during this time should be individualised depending on the treatment that had been given and on a person’s response to treatment. However, they agreed that some guidance on monitoring frequency after treatment completion is required to improve consistency across the country. Therefore, they agreed that disease regression in people who have received treatment for proliferative diabetic retinopathy should be assessed at 2 to 3 months after treatment has ended. This should be an appropriate time so that any progression following the end of treatment can be identified before it leads to more serious consequences. The committee also agreed that after 12 months, people who have had treatment for proliferative diabetic retinopathy or diabetic macular oedema whose disease has resolved can be discharged back to the diabetic retinopathy annual screening programme. Those that have features that would prompt immediate re-referral to hospital eye services should remain under the care of hospital eye services for monitoring. Based on their clinical knowledge and experience the committee decided that monitoring every 12 months would be appropriate in this case. For those who are eligible to be discharged to the screening programme, the committee highlighted that they should be encouraged to attend both their eye screening appointments and regular appointments with primary care optometrists. This should help identify if further treatment is needed in the future and identify other eye disease that is not covered by the eye screening programme.</p><p>Given the lack of evidence, the committee made a second research recommendation for people with proliferative diabetic retinopathy or diabetic macular oedema who have previously received treatment (see <a href="#niceng242er10.appj">Appendix J</a>). This should enable future guidelines to make more precise recommendations on the most effective monitoring frequencies.</p></div></div><div id="niceng242er10.s1.1.11.5"><h5>1.1.11.5. Cost effectiveness and resource use</h5><p>No relevant economic evaluations were identified which addressed the cost effectiveness of different monitoring frequencies for people with a diagnosis of non-proliferative diabetic retinopathy, proliferative diabetic retinopathy, or diabetic macula oedema. The committee noted that patients with a non-proliferative diabetic retinopathy diagnosis make up a large proportion of those seen within clinic, which led to the research recommendation being made for this population. The committee agreed that the recommendations made to monitor disease progression would not be expected to have a resource impact as they reflect current practice.</p><p>The committee discussed assessing disease regression in people who have received treatment for proliferative retinopathy or diabetic macular oedema would happen within a monitoring visit 2–3 months after treatment has ended. The committee discussed this currently happens within clinical practice and would not expect a resource impact other than improving consistency of practice across the country.</p><p>The committee discussed people with proliferative diabetic retinopathy or diabetic macula oedema whose disease has regressed or resolved after treatment and noted that they should still be monitored for twelve months to ensure any progression of disease is captured early. The committee also agreed that after 12 months people should be discharged back to the diabetic screening programme, however if the persons retina has features that make them ineligible for the screening programme, they should continue to be monitored under the care of hospital eye services every 12 months. This is not expected to be a change in practice, and if implemented consistently may lead to a reduction in monitoring visits as only those whose disease has not improved would continue to be monitored after 12 months. Additionally, any early signs of disease progression would likely be detected and lead to prompt treatment rather than more intensive treatment later when the persons disease has progressed further.</p></div><div id="niceng242er10.s1.1.11.6"><h5>1.1.11.6. Other factors the committee took into account</h5><p>The committee did not review any evidence that allowed them to clearly differentiate and stratify evidence for people 18 and under or pregnant women. However, the committee agreed that the same recommendations should apply to people under 18 as, although risk of developing diabetic retinopathy is lower in this group, if it is identified it should be monitored in the same way. The committee noted that there are existing recommendations on monitoring diabetic retinopathy in pregnancy in the <a href="https://www.nice.org.uk/guidance/ng3/chapter/Recommendations#antenatal-care-for-women-with-diabetes" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NICE’s guideline on diabetes in pregnancy</a>, so they agreed to refer to this guideline.</p><p>The committee were also aware of the recommendations in the <a href="https://www.rcophth.ac.uk/wp-content/uploads/2021/08/2012-SCI-267-Diabetic-Retinopathy-Guidelines-December-2012.pdf" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Royal College of Ophthalmologists guidelines (2012)</a> for 4-6 monthly monitoring for people with moderately severe to very severe non-proliferative retinopathy. The NICE recommendations are broadly in line with those recommendations, although they acknowledge that some people with severe to very severe non-proliferative diabetic retinopathy could benefit from monitoring as often as every 3 months. The committee also thought it was important to highlight that some of the people who are within the recommendation from the Royal College of Ophthalmologists, but who have the least severe disease, may not need to be seen as frequently as every 6 months. For this reason, they thought the additional recommendation for monitoring every 6-12 months for people who have moderate non-proliferative diabetic retinopathy was important.</p></div></div><div id="niceng242er10.s1.1.12"><h4>1.1.12. Recommendations supported by this evidence review</h4><p>This evidence review supports Recommendations 1.4.1 to 1.4.2, 1.5.11 to 1.5.15 and 1.6.13 to 1.6.14 and 1.6.16 and the research recommendations on monitoring frequencies for people with non-proliferative diabetic retinopathy who are not receiving treatment, and for people with proliferative diabetic retinopathy or diabetic macular oedema who have received treatment.</p></div><div id="niceng242er10.s1.1.rl.r1"><h4>1.1.13. References – included studies</h4><ul class="simple-list"><div id="niceng242er10.s1.1.rl.r1.1"><h5>1.1.13.1. Clinical evidence</h5><ul class="simple-list"><li class="half_rhythm"><p><div class="bk_ref" id="niceng242er10.ref1">DCCT/EDIC Research, Group, Nathan, David M, Bebu, Ionut
|
|
et al (2017) Frequency of Evidence-Based Screening for Retinopathy in Type 1 Diabetes. The New England journal of medicine
|
|
376(16): 1507–1516
|
|
[<a href="/pmc/articles/PMC5557280/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5557280</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/28423305" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28423305</span></a>]</div></p></li></ul></div></ul></div></div></div><div id="appendixesappgroup1"><h2 id="_appendixesappgroup1_">Appendices</h2><div id="niceng242er10.appa"><h3>Appendix A. Review protocols</h3><p id="niceng242er10.appa.et1"><a href="/books/NBK607355/bin/niceng242er10-appa-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Review protocol for the most effective monitoring frequencies for people diagnosed with non-proliferative diabetic retinopathy whose care is managed under the hospital eye services but who are not having treatment</a><span class="small"> (PDF, 237K)</span></p><p id="niceng242er10.appa.et2"><a href="/books/NBK607355/bin/niceng242er10-appa-et2.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Review protocol for the most effective monitoring frequencies for people diagnosed with proliferative diabetic retinopathy and diabetic macular oedema that are receiving treatment or who have had previous treatment</a><span class="small"> (PDF, 229K)</span></p></div><div id="niceng242er10.appb"><h3>Appendix B. Literature search strategies</h3><div id="niceng242er10.appb.s1"><h4>Search design and peer review</h4><p>NICE information specialists conducted the literature searches for the evidence review. The searches were run in May 2022. This search report is compliant with the requirements of PRISMA-S.</p><p>The MEDLINE strategy below was quality assured (QA) by a trained NICE information specialist. All translated search strategies were peer reviewed to ensure their accuracy. Both procedures were adapted from the 2016 PRESS Checklist.</p><p>The principal search strategy was developed in MEDLINE (Ovid interface) and adapted, as appropriate, for use in the other sources listed in the protocol, taking into account their size, search functionality and subject coverage.</p></div><div id="niceng242er10.appb.s2"><h4>Review Management</h4><p>The search results were managed in EPPI-Reviewer v5. Duplicates were removed in EPPI-R5 using a two-step process. First, automated deduplication is performed using a high-value algorithm. Second, manual deduplication is used to assess ‘low-probability’ matches. All decisions made for the review can be accessed via the deduplication history.</p></div><div id="niceng242er10.appb.s3"><h4>Limits and restrictions</h4><p>English language limits were applied in adherence to standard NICE practice and the review protocol.</p><p>Limits to exclude, conference abstract or conference paper or "conference review" were applied in adherence to standard NICE practice and the review protocol. The limit to remove animal studies in the searches was the standard NICE practice, which has been adapted from: Dickersin, K., Scherer, R., & Lefebvre, C. (1994). Systematic Reviews: Identifying relevant studies for systematic reviews. BMJ, 309(6964), 1286
|
|
[<a href="/pmc/articles/PMC2541778/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2541778</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/7718048" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7718048</span></a>].</p></div><div id="niceng242er10.appb.s4"><h4>Search filters</h4><p id="niceng242er10.appb.et1"><a href="/books/NBK607355/bin/niceng242er10-appb-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (193K)</span></p></div><div id="niceng242er10.appb.s5"><h4>Limits and restrictions</h4><p>English language limits were applied in adherence to standard NICE practice and the review protocol.</p><p>Limits to exclude, comment or letter or editorial or historical articles or conference abstract or conference paper or "conference review" or letter or case report were applied in adherence to standard NICE practice and the review protocol.</p><p>The limit to remove animal studies in the searches was the standard NICE practice, which has been adapted from: Dickersin, K., Scherer, R., & Lefebvre, C. (1994). Systematic Reviews: Identifying relevant studies for systematic reviews. BMJ, 309(6964), 1286
|
|
[<a href="/pmc/articles/PMC2541778/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2541778</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/7718048" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7718048</span></a>].</p></div><div id="niceng242er10.appb.s6"><h4>Search filters</h4><p id="niceng242er10.appb.et2"><a href="/books/NBK607355/bin/niceng242er10-appb-et2.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (193K)</span></p></div></div><div id="niceng242er10.appc"><h3>Appendix C. Effectiveness evidence study selection</h3><p id="niceng242er10.appc.et1"><a href="/books/NBK607355/bin/niceng242er10-appc-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (103K)</span></p></div><div id="niceng242er10.appd"><h3>Appendix D. Effectiveness evidence</h3><p id="niceng242er10.appd.et1"><a href="/books/NBK607355/bin/niceng242er10-appd-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (162K)</span></p></div><div id="niceng242er10.appe"><h3>Appendix E. GRADE tables</h3><p id="niceng242er10.appe.et1"><a href="/books/NBK607355/bin/niceng242er10-appe-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Modelled risk of progression from moderate diabetic retinopathy to proliferative retinopathy or clinically significant macular oedema</a><span class="small"> (PDF, 171K)</span></p></div><div id="niceng242er10.appf"><h3>Appendix F. Economic evidence study selection</h3><p id="niceng242er10.appf.et1"><a href="/books/NBK607355/bin/niceng242er10-appf-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (101K)</span></p></div><div id="niceng242er10.appg"><h3>Appendix G. Economic evidence tables</h3><p>There are no included studies in this review question.</p></div><div id="niceng242er10.apph"><h3>Appendix H. Health economic model</h3><p>Original health economic modelling was not prioritised for this review question.</p></div><div id="niceng242er10.appi"><h3>Appendix I. Excluded studies</h3><div id="niceng242er10.appi.s1"><h4>Clinical studies</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng242er10appitab1"><a href="/books/NBK607355/table/niceng242er10.appi.tab1/?report=objectonly" target="object" title="Table" class="img_link icnblk_img" rid-ob="figobniceng242er10appitab1"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="niceng242er10.appi.tab1"><a href="/books/NBK607355/table/niceng242er10.appi.tab1/?report=objectonly" target="object" rid-ob="figobniceng242er10appitab1">Table</a></h4><p class="float-caption no_bottom_margin">Study does not contain a relevant intervention. - Does not contain a population of people with DR/DMO</p></div></div></div><div id="niceng242er10.appi.s2"><h4>Economic evidence</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng242er10appitab2"><a href="/books/NBK607355/table/niceng242er10.appi.tab2/?report=objectonly" target="object" title="Table" class="img_link icnblk_img" rid-ob="figobniceng242er10appitab2"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="niceng242er10.appi.tab2"><a href="/books/NBK607355/table/niceng242er10.appi.tab2/?report=objectonly" target="object" rid-ob="figobniceng242er10appitab2">Table</a></h4></div></div></div></div><div id="niceng242er10.appj"><h3>Appendix J. Research Recommendation</h3><div id="niceng242er10.appj.s1"><h4>J.1.1. Research recommendation</h4><p>What is the most effective monitoring frequency for non-proliferative diabetic retinopathy in people who are cared for under hospital eye services and are not receiving treatment?</p></div><div id="niceng242er10.appj.s2"><h4>J.1.2. Why this is important</h4><p>While there are general guidelines for monitoring individuals with this condition, specific evidence-based recommendations are needed for people with non-proliferative diabetic retinopathy who are under the care of hospital eye services and not receiving treatment. Non-proliferative diabetic retinopathy can progress to a more severe stage, such as proliferative diabetic retinopathy, which may require treatment. Regular monitoring can help detect early signs of disease progression and enable timely intervention, reducing the risk of vision loss. Research is therefore needed to ensure that people are monitored at the most effective frequency to ensure they can receive timely treatment.</p></div><div id="niceng242er10.appj.s3"><h4>J.1.3. Rationale for research recommendation</h4><p id="niceng242er10.appj.et1"><a href="/books/NBK607355/bin/niceng242er10-appj-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (129K)</span></p></div><div id="niceng242er10.appj.s4"><h4>J.1.4. Modified PICO table</h4><p id="niceng242er10.appj.et2"><a href="/books/NBK607355/bin/niceng242er10-appj-et2.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (159K)</span></p></div><div id="niceng242er10.appj.s5"><h4>J.1.5. Research recommendation</h4><p>What is the most effective monitoring frequency for proliferative diabetic retinopathy or diabetic macular oedema in people who have received treatment?</p></div><div id="niceng242er10.appj.s6"><h4>J.1.6. Why this is important</h4><p>The monitoring frequency for individuals with proliferative diabetic retinopathy or diabetic macular oedema who have received treatment is an important consideration for managing their condition effectively. The most effective monitoring frequency depends on various factors, including the severity of the condition, the type of treatment received, the stability of the patienťs visual function, and the presence of any additional risk factors. Frequent monitoring is essential to detect any disease progression or recurrence early and initiate timely interventions. Research is therefore needed to ensure that people are monitored at the most effective frequency to ensure they can receive timely treatment.</p></div><div id="niceng242er10.appj.s7"><h4>J.1.7. Rationale for research recommendation</h4><p id="niceng242er10.appj.et3"><a href="/books/NBK607355/bin/niceng242er10-appj-et3.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (149K)</span></p></div><div id="niceng242er10.appj.s8"><h4>J.1.8. Modified PICO table</h4><p id="niceng242er10.appj.et4"><a href="/books/NBK607355/bin/niceng242er10-appj-et4.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (155K)</span></p></div></div></div></div><div class="fm-sec"><div><p>Final</p></div><div><p>Evidence reviews underpinning recommendations 1.4.1, 1.4.2, 1.5.11 to 1.5.15, and 1.6.12 and 1.6.13, and research recommendations 12 and 13 in the NICE guideline</p><p>These evidence reviews were developed by NICE</p></div><div><p><b>Disclaimer</b>: The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.</p><p>Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.</p><p>NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the <a href="http://wales.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Welsh Government</a>, <a href="http://www.scotland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Scottish Government</a>, and <a href="http://www.northernireland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Northern Ireland Executive</a>. All NICE guidance is subject to regular review and may be updated or withdrawn.</p></div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © NICE 2024.</div><div class="small"><span class="label">Bookshelf ID: NBK607355</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/39312620" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">39312620</a></span></div></div><div class="small-screen-prev"></div><div class="small-screen-next"></div></article><article data-type="table-wrap" id="figobniceng242er10tab1"><div id="niceng242er10.tab1" class="table"><h3><span class="label">Table 1</span><span class="title">PICO for people with non-proliferative diabetic retinopathy</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK607355/table/niceng242er10.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng242er10.tab1_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Population</b>
|
|
</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">People with moderate, severe, and very severe non-proliferative diabetic retinopathy, without macular oedema who are not receiving treatment.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Interventions</b>
|
|
</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Increased/decreased monitoring frequency relative to standard monitoring</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Comparator</b>
|
|
</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Standard monitoring frequency (as defined by the study)</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Outcomes</b>
|
|
</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Primary outcomes</b>
|
|
<ul><li class="half_rhythm"><div>Progression to proliferative diabetic retinopathy</div></li><li class="half_rhythm"><div>Progression to macular oedema</div></li></ul>
|
|
</p>
|
|
<p>
|
|
<b>Secondary outcomes</b>
|
|
<ul><li class="half_rhythm"><div>Best corrected visual acuity</div></li><li class="half_rhythm"><div>Peripheral vision, assessed using visual field measurement</div></li><li class="half_rhythm"><div>Quality of life, measured using a validated tool (the overall score as well as mental health domain scores will be reported separately)</div></li><li class="half_rhythm"><div>Adherence (defined as mean percentage of monitoring visits attended)</div></li></ul>
|
|
</p>
|
|
<p>Outcomes will be reported at the latest time point reported by the study.</p>
|
|
</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng242er10tab2"><div id="niceng242er10.tab2" class="table"><h3><span class="label">Table 2</span><span class="title">PICO for people with proliferative diabetic retinopathy or diabetic macular oedema</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK607355/table/niceng242er10.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng242er10.tab2_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Population</b>
|
|
</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">People with proliferative diabetic retinopathy or diabetic macular oedema who are receiving or who have received treatment</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Interventions</b>
|
|
</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Increased/decreased monitoring frequency relative to standard monitoring</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Comparator</b>
|
|
</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Standard monitoring frequency (as defined by the study)</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Outcomes</b>
|
|
</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Primary outcomes</b>
|
|
<ul><li class="half_rhythm"><div>Best corrected visual acuity</div></li></ul>
|
|
</p>
|
|
<p>Population with proliferative diabetic retinopathy:<ul><li class="half_rhythm"><div>Progression to macular oedema</div></li></ul></p>
|
|
<p>Population with macular oedema:<ul><li class="half_rhythm"><div>Recurrence of macular oedema following treatment</div></li><li class="half_rhythm"><div>Progression to macular ischaemia</div></li></ul></p>
|
|
<p>
|
|
<b>Secondary outcomes</b>
|
|
<ul><li class="half_rhythm"><div>Peripheral vision, assessed using visual field measurement</div></li><li class="half_rhythm"><div>Quality of life, measured using a validated tool (the overall score as well as mental health domain scores will be reported separately)</div></li><li class="half_rhythm"><div>Adherence (defined as mean percentage of monitoring visits attended)</div></li></ul>
|
|
</p>
|
|
<p>Population with proliferative diabetic retinopathy:<ul><li class="half_rhythm"><div>progression to diabetic macular ischaemia</div></li><li class="half_rhythm"><div>progression to proliferative diabetic retinopathy in fellow eye</div></li></ul></p>
|
|
<p>Population with diabetic macular oedema:<ul><li class="half_rhythm"><div>progression to diabetic macular oedema in fellow eye</div></li><li class="half_rhythm"><div>progression to proliferative diabetic retinopathy in either eye</div></li></ul></p>
|
|
<p>Outcomes will be reported at the latest time point reported by the study.</p>
|
|
</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng242er10tab3"><div id="niceng242er10.tab3" class="table"><h3><span class="label">Table 3</span><span class="title">Studies included in the effectiveness evidence</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK607355/table/niceng242er10.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng242er10.tab3_lrgtbl__"><table><thead><tr><th id="hd_h_niceng242er10.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Short Title</th><th id="hd_h_niceng242er10.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Title</th><th id="hd_h_niceng242er10.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study characteristics</th><th id="hd_h_niceng242er10.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th></tr></thead><tbody><tr><td headers="hd_h_niceng242er10.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng242er10.ref1" rid="niceng242er10.ref1">DCCT/EDIC Research, 2017</a>
|
|
</p>
|
|
<p>United States and Canada</p>
|
|
</td><td headers="hd_h_niceng242er10.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Frequency of Evidence-Based Screening for Retinopathy in Type 1 Diabetes.</td><td headers="hd_h_niceng242er10.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Study type Modelling study, A longitudinal Markov model</p>
|
|
<p>Study dates from 1983 – 1989</p>
|
|
<p>Sources of funding</p>
|
|
<p>(Funded by the National Institute of Diabetes and Digestive and Kidney Diseases and others; DCCT/EDIC <a href="http://Clinicaltrials.gov" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">ClinicalTrials<wbr style="display:inline-block"></wbr>​.gov</a> numbers, <a href="https://clinicaltrials.gov/ct2/show/NCT00360893" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCT00360893</a> and <a href="https://clinicaltrials.gov/ct2/show/NCT00360815" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCT00360815</a>.)</p>
|
|
<p>The DCCT enrolled 1441 patients with type 1 diabetes who were 13 to 39 years of age.<ul><li class="half_rhythm"><div>The primary prevention cohort (726 patients) had diabetes for 1 to 5 years and no retinopathy detected by means of stereoscopic fundus photography at baseline.</div></li><li class="half_rhythm"><div>The secondary intervention cohort (715 patients) had diabetes for 1 to 15 years and very mild to moderate non-proliferative diabetic retinopathy</div></li></ul></p>
|
|
<p>Duration of follow-up: A maximum of 28.7 years of follow-up (mean, 23.5 years)</p>
|
|
<p>Inclusion criteria</p>
|
|
<p>People with minimal background retinopathy) Duration of IDDM between 1–15 years, Presence of at least one microaneurysm in either eye with or without other diabetes-related lesions, but less retinopathy than that which would characterize either eye as P2 or worse based on central grading of stereo fundus photographs using ETDRS standards, Visual acuity of 45 letters (20/32 Snellen equivalent) or better in both eyes., Less than or equal to 200 mg albumin/24 h on a 4-h urine collection, Basal plasma C-peptide <0.2 pmol/ml and for patients with duration >5 yr, stimulated plasma C-peptide <0.2 pmol/ml.</p>
|
|
<p>Only a subset of this population matches the review protocol (people with moderate, severe, or very severe diabetic retinopathy). However, results were presented separately for progression from moderate and severe retinopathy and so these data were included in the review.</p>
|
|
<p>Exclusion criteria</p>
|
|
<p>The presence of diabetic retinopathy sufficient to categorize either eye as P2 or worse based on central grading of stereo fundus photographs. Eyes with new vessels were classified worse than P2. Eyes without new vessels that met any one of the three criteria listed below were classified as P2. Standard photos referred to below are those of the Modified Airlie House Classification. (a) Soft exudates (SE), venous beading (VB), and intraretinal microvascular abnormalities (IRMA) were each definitely present in at least two of fields 4 through 7. (b) Two of the above three lesions (SE, VB, or IRMA) were present in at least two of fields 4 through 7, and haemorrhages/microaneurysms (HMa) were present in all four fields, equalling or exceeding standard photograph 2A in at least one of them. (c) IRMA were present in all four of these fields and were equal to or exceeded standard photograph 8A in at least two of them.</p>
|
|
</td><td headers="hd_h_niceng242er10.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Study (N = 1441)</p>
|
|
<p>Progression from Lower Levels of Retinopathy (States 1 through 4) to State 5 Retinopathy (Proliferative Diabetic Retinopathy or Clinically Significant Macular Oedema)</p>
|
|
<p>State 3 to State 5 (N = not reported)</p>
|
|
<p>State 3 -corresponds to moderate non-proliferative diabetic retinopathy, State 4 -corresponds to severe non-proliferative diabetic retinopathy State 5 - Corresponded to any of the following: proliferative diabetic retinopathy, clinically significant macular oedema, or previous self-reported treatment with panretinal or focal photocoagulation, intraocular glucocorticoids, or anti-VEGF agents</p>
|
|
<p>State 4 to State 5 (N = not reported)</p>
|
|
<p>State 4 -corresponds to severe non-proliferative diabetic retinopathy State 5 - Corresponded to any of the following: proliferative diabetic retinopathy, clinically significant macular oedema, or previous self-reported treatment with panretinal or focal photocoagulation, intraocular glucocorticoids, or anti-VEGF agents</p>
|
|
<p>Modelled screening Intervals:<ul><li class="half_rhythm"><div>1,2,3,6,9 Months</div></li><li class="half_rhythm"><div>1,2,3,4,5 Years</div></li></ul></p>
|
|
</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng242er10tab4"><div id="niceng242er10.tab4" class="table"><h3><span class="label">Table 4</span><span class="title">Modelled risk of progression from moderate diabetic retinopathy to proliferative retinopathy or clinically significant macular oedema</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK607355/table/niceng242er10.tab4/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng242er10.tab4_lrgtbl__"><table><thead><tr><th id="hd_h_niceng242er10.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">No. of studies</th><th id="hd_h_niceng242er10.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk of progression between monitoring visits in percent (95% CI)</th><th id="hd_h_niceng242er10.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Quality</th><th id="hd_h_niceng242er10.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Interpretation of effects</th></tr></thead><tbody><tr><td headers="hd_h_niceng242er10.tab4_1_1_1_1 hd_h_niceng242er10.tab4_1_1_1_2 hd_h_niceng242er10.tab4_1_1_1_3 hd_h_niceng242er10.tab4_1_1_1_4" colspan="4" rowspan="1" style="text-align:left;vertical-align:top;">Interval of Follow-Up - 1 month</td></tr><tr><td headers="hd_h_niceng242er10.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 study</td><td headers="hd_h_niceng242er10.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1.1 (0–1.3)</td><td headers="hd_h_niceng242er10.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low</td><td headers="hd_h_niceng242er10.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1.1% chance of progressing to proliferative retinopathy or clinically significant macular oedema if the next examination is conducted after a 1-month interval.</td></tr><tr><td headers="hd_h_niceng242er10.tab4_1_1_1_1 hd_h_niceng242er10.tab4_1_1_1_2 hd_h_niceng242er10.tab4_1_1_1_3 hd_h_niceng242er10.tab4_1_1_1_4" colspan="4" rowspan="1" style="text-align:left;vertical-align:top;">Interval of Follow-Up - 2 month</td></tr><tr><td headers="hd_h_niceng242er10.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 study</td><td headers="hd_h_niceng242er10.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2.3 (2.0–2.6)</td><td headers="hd_h_niceng242er10.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low</td><td headers="hd_h_niceng242er10.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2.3% chance of progressing to proliferative retinopathy or clinically significant macular oedema if the next examination is conducted after a 2-month interval.</td></tr><tr><td headers="hd_h_niceng242er10.tab4_1_1_1_1 hd_h_niceng242er10.tab4_1_1_1_2 hd_h_niceng242er10.tab4_1_1_1_3 hd_h_niceng242er10.tab4_1_1_1_4" colspan="4" rowspan="1" style="text-align:left;vertical-align:top;">Interval of Follow-Up - 3 month</td></tr><tr><td headers="hd_h_niceng242er10.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 study</td><td headers="hd_h_niceng242er10.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3.4 (3.1–3.8)</td><td headers="hd_h_niceng242er10.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low</td><td headers="hd_h_niceng242er10.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3.4% chance of progressing to proliferative retinopathy or clinically significant macular oedema if the next examination is conducted after a 3-month interval.</td></tr><tr><td headers="hd_h_niceng242er10.tab4_1_1_1_1 hd_h_niceng242er10.tab4_1_1_1_2 hd_h_niceng242er10.tab4_1_1_1_3 hd_h_niceng242er10.tab4_1_1_1_4" colspan="4" rowspan="1" style="text-align:left;vertical-align:top;">Interval of Follow-Up – 6 months</td></tr><tr><td headers="hd_h_niceng242er10.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 study</td><td headers="hd_h_niceng242er10.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6.6 (6.0–7.3)</td><td headers="hd_h_niceng242er10.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low</td><td headers="hd_h_niceng242er10.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6.6% chance of progressing to proliferative retinopathy or clinically significant macular oedema if the next examination is conducted after 6-month interval.</td></tr><tr><td headers="hd_h_niceng242er10.tab4_1_1_1_1 hd_h_niceng242er10.tab4_1_1_1_2 hd_h_niceng242er10.tab4_1_1_1_3 hd_h_niceng242er10.tab4_1_1_1_4" colspan="4" rowspan="1" style="text-align:left;vertical-align:top;">Interval of Follow-Up - 9 month</td></tr><tr><td headers="hd_h_niceng242er10.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 study</td><td headers="hd_h_niceng242er10.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9.6 (8.8–10.5)</td><td headers="hd_h_niceng242er10.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low</td><td headers="hd_h_niceng242er10.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9.6% chance of progressing to proliferative retinopathy or clinically significant macular oedema if the next examination is conducted after a 9-month interval.</td></tr><tr><td headers="hd_h_niceng242er10.tab4_1_1_1_1 hd_h_niceng242er10.tab4_1_1_1_2 hd_h_niceng242er10.tab4_1_1_1_3 hd_h_niceng242er10.tab4_1_1_1_4" colspan="4" rowspan="1" style="text-align:left;vertical-align:top;">Interval of Follow-Up - 1 Year</td></tr><tr><td headers="hd_h_niceng242er10.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 study</td><td headers="hd_h_niceng242er10.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12.3 (11.3–13.5)</td><td headers="hd_h_niceng242er10.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low</td><td headers="hd_h_niceng242er10.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12.3% chance of progressing to proliferative retinopathy or clinically significant macular oedema if the next examination is conducted after a 1-year interval.</td></tr><tr><td headers="hd_h_niceng242er10.tab4_1_1_1_1 hd_h_niceng242er10.tab4_1_1_1_2 hd_h_niceng242er10.tab4_1_1_1_3 hd_h_niceng242er10.tab4_1_1_1_4" colspan="4" rowspan="1" style="text-align:left;vertical-align:top;">Interval of Follow-Up – 2 Year</td></tr><tr><td headers="hd_h_niceng242er10.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 study</td><td headers="hd_h_niceng242er10.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20.5 (18.9–22.3)</td><td headers="hd_h_niceng242er10.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low</td><td headers="hd_h_niceng242er10.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20.5% chance of progressing to proliferative retinopathy or clinically significant macular oedema if the next examination is conducted after a 2-year interval.</td></tr><tr><td headers="hd_h_niceng242er10.tab4_1_1_1_1 hd_h_niceng242er10.tab4_1_1_1_2 hd_h_niceng242er10.tab4_1_1_1_3 hd_h_niceng242er10.tab4_1_1_1_4" colspan="4" rowspan="1" style="text-align:left;vertical-align:top;">Interval of Follow-Up - 3 Year</td></tr><tr><td headers="hd_h_niceng242er10.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 study</td><td headers="hd_h_niceng242er10.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25.9 (23.9–28.2)</td><td headers="hd_h_niceng242er10.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low</td><td headers="hd_h_niceng242er10.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25.9% chance of progressing to proliferative retinopathy or clinically significant macular oedema if the next examination is conducted after a 3-year interval.</td></tr><tr><td headers="hd_h_niceng242er10.tab4_1_1_1_1 hd_h_niceng242er10.tab4_1_1_1_2 hd_h_niceng242er10.tab4_1_1_1_3 hd_h_niceng242er10.tab4_1_1_1_4" colspan="4" rowspan="1" style="text-align:left;vertical-align:top;">Interval of Follow-Up - 4 Year</td></tr><tr><td headers="hd_h_niceng242er10.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 study</td><td headers="hd_h_niceng242er10.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29.7 (27.6–32.2)</td><td headers="hd_h_niceng242er10.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low</td><td headers="hd_h_niceng242er10.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29.7% chance of progressing to proliferative retinopathy or clinically significant macular oedema if the next examination is conducted after a 4 -year interval.</td></tr><tr><td headers="hd_h_niceng242er10.tab4_1_1_1_1 hd_h_niceng242er10.tab4_1_1_1_2 hd_h_niceng242er10.tab4_1_1_1_3 hd_h_niceng242er10.tab4_1_1_1_4" colspan="4" rowspan="1" style="text-align:left;vertical-align:top;">Interval of Follow-Up - 5 Year</td></tr><tr><td headers="hd_h_niceng242er10.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 study</td><td headers="hd_h_niceng242er10.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32.5 (30.2–35.3)</td><td headers="hd_h_niceng242er10.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low</td><td headers="hd_h_niceng242er10.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32.5% chance of progressing to proliferative retinopathy or clinically significant macular oedema if the next examination is conducted after a 5 -year interval.</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng242er10tab5"><div id="niceng242er10.tab5" class="table"><h3><span class="label">Table 5</span><span class="title">Modelled risk of progression from severe diabetic retinopathy to proliferative retinopathy or clinically significant macular oedema</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK607355/table/niceng242er10.tab5/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng242er10.tab5_lrgtbl__"><table><thead><tr><th id="hd_h_niceng242er10.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">No. of studies</th><th id="hd_h_niceng242er10.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk of progression between monitoring visits in percent (95% CI)</th><th id="hd_h_niceng242er10.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Quality</th><th id="hd_h_niceng242er10.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Interpretation of effect</th></tr></thead><tbody><tr><td headers="hd_h_niceng242er10.tab5_1_1_1_1 hd_h_niceng242er10.tab5_1_1_1_2 hd_h_niceng242er10.tab5_1_1_1_3 hd_h_niceng242er10.tab5_1_1_1_4" colspan="4" rowspan="1" style="text-align:left;vertical-align:top;">Interval of Follow-Up - 1 month</td></tr><tr><td headers="hd_h_niceng242er10.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 study</td><td headers="hd_h_niceng242er10.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5.7 (3.6–8.8)</td><td headers="hd_h_niceng242er10.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low</td><td headers="hd_h_niceng242er10.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5.7% chance of progressing to proliferative retinopathy or clinically significant macular oedema if the next examination is conducted after a 1-month interval.</td></tr><tr><td headers="hd_h_niceng242er10.tab5_1_1_1_1 hd_h_niceng242er10.tab5_1_1_1_2 hd_h_niceng242er10.tab5_1_1_1_3 hd_h_niceng242er10.tab5_1_1_1_4" colspan="4" rowspan="1" style="text-align:left;vertical-align:top;">Interval of Follow-Up - 2 month</td></tr><tr><td headers="hd_h_niceng242er10.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 study</td><td headers="hd_h_niceng242er10.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10.4 (6.5–16.0)</td><td headers="hd_h_niceng242er10.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low</td><td headers="hd_h_niceng242er10.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10.4% chance of progressing to proliferative retinopathy or clinically significant macular oedema if the next examination is conducted after a 2-month interval.</td></tr><tr><td headers="hd_h_niceng242er10.tab5_1_1_1_1 hd_h_niceng242er10.tab5_1_1_1_2 hd_h_niceng242er10.tab5_1_1_1_3 hd_h_niceng242er10.tab5_1_1_1_4" colspan="4" rowspan="1" style="text-align:left;vertical-align:top;">Interval of Follow-Up - 3 month</td></tr><tr><td headers="hd_h_niceng242er10.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 study</td><td headers="hd_h_niceng242er10.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14.4 (9.4–22.0)</td><td headers="hd_h_niceng242er10.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low</td><td headers="hd_h_niceng242er10.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14.4% chance of progressing to proliferative retinopathy or clinically significant macular oedema if the next examination is conducted after a 3-month interval.</td></tr><tr><td headers="hd_h_niceng242er10.tab5_1_1_1_1 hd_h_niceng242er10.tab5_1_1_1_2 hd_h_niceng242er10.tab5_1_1_1_3 hd_h_niceng242er10.tab5_1_1_1_4" colspan="4" rowspan="1" style="text-align:left;vertical-align:top;">Interval of Follow-Up – 6 months</td></tr><tr><td headers="hd_h_niceng242er10.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 study</td><td headers="hd_h_niceng242er10.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23.0 (15.8–32.7)</td><td headers="hd_h_niceng242er10.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low</td><td headers="hd_h_niceng242er10.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23.0% chance of progressing to proliferative retinopathy or clinically significant macular oedema if the next examination is conducted after a 6-month interval.</td></tr><tr><td headers="hd_h_niceng242er10.tab5_1_1_1_1 hd_h_niceng242er10.tab5_1_1_1_2 hd_h_niceng242er10.tab5_1_1_1_3 hd_h_niceng242er10.tab5_1_1_1_4" colspan="4" rowspan="1" style="text-align:left;vertical-align:top;">Interval of Follow-Up - 9 month</td></tr><tr><td headers="hd_h_niceng242er10.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 study</td><td headers="hd_h_niceng242er10.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28.6 (20.9–38.4)</td><td headers="hd_h_niceng242er10.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low</td><td headers="hd_h_niceng242er10.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28.6% chance of progressing to proliferative retinopathy or clinically significant macular oedema if the next examination is conducted after 9-month interval.</td></tr><tr><td headers="hd_h_niceng242er10.tab5_1_1_1_1 hd_h_niceng242er10.tab5_1_1_1_2 hd_h_niceng242er10.tab5_1_1_1_3 hd_h_niceng242er10.tab5_1_1_1_4" colspan="4" rowspan="1" style="text-align:left;vertical-align:top;">Interval of Follow-Up - 1 Year</td></tr><tr><td headers="hd_h_niceng242er10.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 study</td><td headers="hd_h_niceng242er10.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32.5 (23.8–44.2)</td><td headers="hd_h_niceng242er10.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low</td><td headers="hd_h_niceng242er10.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32.5% chance of progressing to proliferative retinopathy or clinically significant macular oedema if the next examination is conducted after 1-year interval.</td></tr><tr><td headers="hd_h_niceng242er10.tab5_1_1_1_1 hd_h_niceng242er10.tab5_1_1_1_2 hd_h_niceng242er10.tab5_1_1_1_3 hd_h_niceng242er10.tab5_1_1_1_4" colspan="4" rowspan="1" style="text-align:left;vertical-align:top;">Interval of Follow-Up – 2 Year</td></tr><tr><td headers="hd_h_niceng242er10.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 study</td><td headers="hd_h_niceng242er10.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41.2 (32.6–50.6)</td><td headers="hd_h_niceng242er10.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low</td><td headers="hd_h_niceng242er10.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41.2% chance of progressing to proliferative retinopathy or clinically significant macular oedema if the next examination is conducted after a 2-year interval.</td></tr><tr><td headers="hd_h_niceng242er10.tab5_1_1_1_1 hd_h_niceng242er10.tab5_1_1_1_2 hd_h_niceng242er10.tab5_1_1_1_3 hd_h_niceng242er10.tab5_1_1_1_4" colspan="4" rowspan="1" style="text-align:left;vertical-align:top;">Interval of Follow-Up - 3 Year</td></tr><tr><td headers="hd_h_niceng242er10.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 study</td><td headers="hd_h_niceng242er10.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">45.9 (38.2–55.7)</td><td headers="hd_h_niceng242er10.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low</td><td headers="hd_h_niceng242er10.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">45.9% chance of progressing to proliferative retinopathy or clinically significant macular oedema if the next examination is conducted after a 3-year interval.</td></tr><tr><td headers="hd_h_niceng242er10.tab5_1_1_1_1 hd_h_niceng242er10.tab5_1_1_1_2 hd_h_niceng242er10.tab5_1_1_1_3 hd_h_niceng242er10.tab5_1_1_1_4" colspan="4" rowspan="1" style="text-align:left;vertical-align:top;">Interval of Follow-Up - 4 Year</td></tr><tr><td headers="hd_h_niceng242er10.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 study</td><td headers="hd_h_niceng242er10.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">49.0 (42.0–58.0)</td><td headers="hd_h_niceng242er10.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low</td><td headers="hd_h_niceng242er10.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">49% chance of progressing to proliferative retinopathy or clinically significant macular oedema if the next examination is conducted after a 4-year interval.</td></tr><tr><td headers="hd_h_niceng242er10.tab5_1_1_1_1 hd_h_niceng242er10.tab5_1_1_1_2 hd_h_niceng242er10.tab5_1_1_1_3 hd_h_niceng242er10.tab5_1_1_1_4" colspan="4" rowspan="1" style="text-align:left;vertical-align:top;">Interval of Follow-Up - 5 Year</td></tr><tr><td headers="hd_h_niceng242er10.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 study</td><td headers="hd_h_niceng242er10.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">51.3 (44.6–60.8)</td><td headers="hd_h_niceng242er10.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Low</td><td headers="hd_h_niceng242er10.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">51.3% chance of progressing to proliferative retinopathy or clinically significant macular oedema if the next examination is conducted after a 5-year interval.</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng242er10tab6"><div id="niceng242er10.tab6" class="table"><h3><span class="label">Table 6</span><span class="title">Unit cost of screening visits</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK607355/table/niceng242er10.tab6/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng242er10.tab6_lrgtbl__"><table><thead><tr><th id="hd_h_niceng242er10.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Resource</th><th id="hd_h_niceng242er10.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Unit cost</th><th id="hd_h_niceng242er10.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Source</th></tr></thead><tbody><tr><td headers="hd_h_niceng242er10.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Diabetic eye screening visit</td><td headers="hd_h_niceng242er10.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">£38.34</td><td headers="hd_h_niceng242er10.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cost of screening within the diabetic eye service. Scanlon et al (2015): £32 (2012/2013 prices) inflated to 2019/2020 prices.</td></tr><tr><td headers="hd_h_niceng242er10.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Monitoring visit during treatment</td><td headers="hd_h_niceng242er10.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">£101.80</td><td headers="hd_h_niceng242er10.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NHS Reference Costs 2019/2020. Consultant led non-admitted face-to-face attendance, follow-up. Code 130 (ophthalmology). Assumption used in <a href="https://www.nice.org.uk/guidance/ta294" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">TA294</a>.</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng242er10appitab1"><div id="niceng242er10.appi.tab1" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK607355/table/niceng242er10.appi.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng242er10.appi.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Title</th><th id="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Reason for exclusion</th></tr></thead><tbody><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Agardh, E, Agardh, C D, Hansson-Lundblad, C
|
|
et al (1996) The importance of early diagnosis of treatable diabetic retinopathy for the four-year visual outcome in older-onset diabetes mellitus. Acta ophthalmologica Scandinavica
|
|
74(2): 166–70
|
|
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/8739684" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8739684</span></a>]
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not contain a relevant intervention</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Agardh, E; Agardh, CD; Hansson-Lundblad, C (1993) The five-year incidence of blindness after introducing a screening programme for early detection of treatable diabetic retinopathy. Diabetic medicine: a journal of the British Diabetic Association
|
|
10(6): 555–9
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/8365093" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8365093</span></a>]
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Does not contain a population of people with Diabetic Retinopathy</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Askew, Deborah A, Crossland, Lisa, Ware, Robert S
|
|
et al (2012) Diabetic retinopathy screening and monitoring of early stage disease in general practice: design and methods. Contemporary clinical trials
|
|
33(5): 969–75
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/22575797" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22575797</span></a>]
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-Study does not contain a relevant intervention</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Bourry, Julien, Courteville, Hugues, Ramdane, Nassima
|
|
et al (2021) Progression of Diabetic Retinopathy and Predictors of Its Development and Progression During Pregnancy in Patients With Type 1 Diabetes: A Report of 499 Pregnancies. Diabetes care
|
|
44(1): 181–187
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/33177172" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33177172</span></a>]
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Does not contain a population of people with DR/DMO</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Broadbent, Deborah M, Wang, Amu, Cheyne, Christopher P
|
|
et al (2021) Safety and cost-effectiveness of individualised screening for diabetic retinopathy: the ISDR open-label, equivalence RCT. Diabetologia
|
|
64(1): 56–69
|
|
[<a href="/pmc/articles/PMC7716929/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7716929</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/33146763" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33146763</span></a>]
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Does not contain a population of people with DR/DMO</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Broadbent, DM, Harding, SP, Garcia-Finana, M
|
|
et al (2020) Safety, efficacy and cost effectiveness of individualised screening for diabetic retinopathy: the individualised screening for diabetic retinopathy (ISDR) single centre, open label, equivalence randomised controlled trial. European journal of ophthalmology
|
|
30(1suppl): 6–7
|
|
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Does not contain a population of people with DR/DMO</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Broadbent, DM, Wang, A, Cheyne, CP
|
|
et al (2019) Individualised screening for diabetic retinopathy: the ISDR study-a randomised controlled trial of safety, efficacy, and cost-effectiveness. Diabetes
|
|
68
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Does not contain a population of people with DR/DMO</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Creuzot-Garcher, C, Malvitte, L, Sicard, A C et al (2010) How to improve screening for diabetic retinopathy: the Burgundy experience. Diabetes & metabolism
|
|
36(2): 114–9
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/20116317" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20116317</span></a>]
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not contain a relevant intervention</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Crossland, L, Askew, D, Ware, R
|
|
et al (2016) Diabetic Retinopathy Screening and Monitoring of Early Stage Disease in Australian General Practice: tackling Preventable Blindness within a Chronic Care Model. Journal of diabetes research
|
|
2016: 8405395
|
|
[<a href="/pmc/articles/PMC4698989/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4698989</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26798655" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26798655</span></a>]
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not contain a relevant intervention</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Datlinger, Felix, Datlinger, Anja, Pollreisz, Andreas
|
|
et al (2022) Intraprocedural OCT monitoring of the immediate treatment response during indocyanine green angiography-guided laser therapy of teleangiectatic capillaries in diabetic macular edema. Scientific reports
|
|
12(1): 2315
|
|
[<a href="/pmc/articles/PMC8831600/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8831600</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/35145156" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35145156</span></a>]
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not contain a relevant intervention</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Gabrielle, Pierre-Henry, Nguyen, Vuong, Bhandari, Sanjeeb
|
|
et al (2022) Initial observation or treatment for diabetic macular oedema with good visual acuity: two-year outcomes comparison in routine clinical practice: data from the Fight Retinal Blindness! Registry. Acta ophthalmologica
|
|
100(3): 285–294
|
|
[<a href="/pmc/articles/PMC9290829/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9290829</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/33196150" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33196150</span></a>]
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study does not contain a relevant intervention</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Garcia-Finana, Marta, Hughes, David M, Cheyne, Christopher P
|
|
et al (2019) Personalized risk-based screening for diabetic retinopathy: A multivariate approach versus the use of stratification rules. Diabetes, obesity & metabolism
|
|
21(3): 560–568 [<a href="/pmc/articles/PMC6492102/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6492102</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30284381" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30284381</span></a>]
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Does not contain a population of people with Diabetic Retinopathy</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Hutchinson, A, McIntosh, A, Peters, J
|
|
et al (2000) Effectiveness of screening and monitoring tests for diabetic retinopathy--a systematic review. Diabetic medicine: a journal of the British Diabetic Association
|
|
17(7): 495–506
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/10972578" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10972578</span></a>]
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not contain a relevant intervention</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
ISRCTN87561257 (2014) Individual risk-based Screening for Diabetic Retinopathy. <a href="https://trialsearch.who.int/Trial2.aspx?TrialID=ISRCTN87561257" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://trialsearch<wbr style="display:inline-block"></wbr>​.who<wbr style="display:inline-block"></wbr>​.int/Trial2.aspx?TrialID<wbr style="display:inline-block"></wbr>​=ISRCTN87561257</a>
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not contain a relevant intervention</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Januszewski, A.S., Velayutham, V., Benitez-Aguirre, P.
|
|
et al (2020) Assessing retinopathy screening frequency in adolescents with type 1 diabetes using Markov model. Diabetologia
|
|
63(suppl1): 37–s38
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Study does not contain a relevant intervention.</p>
|
|
<p>- Does not contain a population of people with DR/DMO</p>
|
|
</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Kawaguchi, Atsushi, Sharafeldin, Noha, Sundaram, Aishwarya
|
|
et al (2018) Tele-Ophthalmology for Age-Related Macular Degeneration and Diabetic Retinopathy Screening: A Systematic Review and Meta-Analysis. Telemedicine journal and e-health: the official journal of the American Telemedicine Association
|
|
24(4): 301–308
|
|
[<a href="/pmc/articles/PMC6916253/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6916253</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/28783458" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28783458</span></a>]
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Study does not contain a relevant intervention.</p>
|
|
<p>- Does not contain a population of people with Diabetic Retinopathy</p>
|
|
</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Khalid, Hagar, Schwartz, Roy, Nicholson, Luke
|
|
et al (2021) Widefield optical coherence tomography angiography for early detection and objective evaluation of proliferative diabetic retinopathy. The British journal of ophthalmology
|
|
105(1): 118–123
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/32193221" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32193221</span></a>]
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not contain a relevant intervention</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Khurana, Rahul N, Hoang, Carol, Khanani, Arshad M
|
|
et al (2021) A Smart Mobile Application to Monitor Visual Function in Diabetic Retinopathy and Age-Related Macular Degeneration: The CLEAR Study. American journal of ophthalmology
|
|
227: 222–230
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/33831342" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33831342</span></a>]
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not contain a relevant intervention</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Kozousek, V, Brown, M G, Cottle, R
|
|
et al (1993) Use of ophthalmologic services by diabetic patients in Nova Scotia. Canadian journal of ophthalmology. Journal canadien d'ophtalmologie
|
|
28(1): 7–10 [<a href="https://pubmed.ncbi.nlm.nih.gov/8439865" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8439865</span></a>]
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Does not contain a population of people with Diabetic Retinopathy</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Li, B, Powell, AM, Hooper, PL
|
|
et al (2015) Prospective evaluation of teleophthalmology in screening and recurrence monitoring of neovascular age-related macular degeneration: a randomized clinical trial. JAMA ophthalmology
|
|
133(3): 276–282
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/25473945" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25473945</span></a>]
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not contain a relevant intervention</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Mehlsen, Jesper, Erlandsen, Mogens, Poulsen, Per Logstrup
|
|
et al (2012) Individualized optimization of the screening interval for diabetic retinopathy: a new model. Acta ophthalmologica
|
|
90(2): 109–14
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/20384605" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20384605</span></a>]
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Not a relevant study design(personalised risk stratification screening study)</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Mellanby, A and Milne, R (1999) Reducing the interval for diabetic retinal screening.
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Not a relevant study design (non-comparative study)</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
NCT01257815 (2010) Ranibizumab Treatment of Diabetic Macular Oedema With Bimonthly Monitoring After a Phase of Initial Treatment. <a href="https://clinicaltrials.gov/show/NCT01257815" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://clinicaltrials.gov/show/NCT01257815</a>
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not contain a relevant intervention</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Pareja-Rios, A, Bonaque-Gonzalez, S, Serrano-Garcia, M
|
|
et al (2017) Tele-ophthalmology for diabetic retinopathy screening: 8 years of experience. Archivos de la Sociedad Espanola de Oftalmologia
|
|
92(2): 63–70
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/27756515" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27756515</span></a>]
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Park, Kyu Hyung, Kim, Yun Young, Jo, Young Joon
|
|
et al (2019) Healthcare Utilization and Treatment Patterns in Diabetic Macular Edema in Korea: a Retrospective Chart Review. Journal of Korean medical science
|
|
34(15): e118
|
|
[<a href="/pmc/articles/PMC6473093/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6473093</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31001935" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31001935</span></a>]
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study does not contain a relevant intervention</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Queiroz, Marcia Silva, de Carvalho, Jacira Xavier, Bortoto, Silvia Ferreira
|
|
et al (2020) Diabetic retinopathy screening in urban primary care setting with a handheld smartphone-based retinal camera. Acta diabetologica
|
|
57(12): 1493–1499
|
|
[<a href="/pmc/articles/PMC7398859/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7398859</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32748176" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32748176</span></a>]
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study does not contain a relevant intervention</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Raman, V, Campbell, F, Holland, P
|
|
et al (2002) Retinopathy screening in children and adolescents with diabetes. Annals of the New York Academy of Sciences
|
|
958: 387–9
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/12021146" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12021146</span></a>]
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Full text paper not available</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Rosati, Renee; Ables, Adrienne Z; Warren, Petra (2017) Improving Diabetic Retinopathy in an Indigent Population. Journal of health care for the poor and underserved
|
|
28(2): 635–642
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/28529214" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28529214</span></a>]
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Data not reported in an extractable format</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Sharif, A.; Jendle, J.; Hellgren, K.-J. (2021) Screening for Diabetic Retinopathy with Extended Intervals, Safe and Without Compromising Adherence: A Retrospective Cohort Study. Diabetes Therapy
|
|
12(1): 223–234
|
|
[<a href="/pmc/articles/PMC7649703/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7649703</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/33165837" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33165837</span></a>]
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Does not contain a population of people with Diabetic Retinopathy</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Singer, D E, Nathan, D M, Fogel, H A
|
|
et al (1992) Screening for diabetic retinopathy. Annals of internal medicine
|
|
116(8): 660–71
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/1546868" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 1546868</span></a>]
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study does not contain a relevant intervention</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Souza, Grazielle Fialho de, Figueira, Renato Minelli, Alkmim, Maria Beatriz
|
|
et al (2020) Teleophthalmology Screening for Diabetic Retinopathy in Brazil: Applicability and Economic Assessment. Telemedicine journal and e-health: the official journal of the American Telemedicine Association
|
|
26(3): 341–346
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/30994411" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30994411</span></a>]
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study does not contain a relevant intervention</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Stone, LG; Grinton, ME; Talks, JS (2021) Delayed follow-up of medical retina patients due to COVID-19: impact on disease activity and visual acuity. Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie [<a href="/pmc/articles/PMC8112469/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8112469</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/33977317" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33977317</span></a>]
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study does not contain a relevant intervention</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Tapp, R.J., Zimmet, P.Z., Harper, C.A.
|
|
et al (2004) Diabetes care in an Australian population: Frequency of screening examinations for eye and foot complications of diabetes. Diabetes Care
|
|
27(3): 688–693
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/14988286" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 14988286</span></a>]
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">people with diabeties but unclear on retinopathy at baseline</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
van der Heijden, Amber A W A, Walraven, Iris, van ť Riet, Esther
|
|
et al (2014) Validation of a model to estimate personalised screening frequency to monitor diabetic retinopathy. Diabetologia
|
|
57(7): 1332–8
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/24763851" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24763851</span></a>]
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-Does not contain a population of people with Diabetic Retinopathy</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Wang, Sophia Y, Andrews, Chris A, Gardner, Thomas W
|
|
et al (2017) Ophthalmic Screening Patterns Among Youths With Diabetes Enrolled in a Large US Managed Care Network. JAMA ophthalmology
|
|
135(5): 432–438
|
|
[<a href="/pmc/articles/PMC5567866/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5567866</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/28334336" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28334336</span></a>]
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Does not contain a population of people with Diabetic Retinopathy</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Wilson, A., Baker, R., Thompson, J.
|
|
et al (2004) Coverage in screening for diabetic retinopathy according to screening provision: Results from a national survey in England and Wales. Diabetic Medicine
|
|
21(3): 271–278
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/15008839" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15008839</span></a>]
|
|
</td><td headers="hd_h_niceng242er10.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Does not contain a population of people with Diabetic Retinopathy</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng242er10appitab2"><div id="niceng242er10.appi.tab2" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK607355/table/niceng242er10.appi.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng242er10.appi.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_niceng242er10.appi.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></th><th id="hd_h_niceng242er10.appi.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Title</th><th id="hd_h_niceng242er10.appi.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Reason for exclusion</th></tr></thead><tbody><tr><td headers="hd_h_niceng242er10.appi.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9536449</td><td headers="hd_h_niceng242er10.appi.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Crijns, H; Casparie, A F; Hendrikse, F; Continuous computer simulation analysis of the cost-effectiveness of screening and treating diabetic retinopathy.; International journal of technology assessment in health care; 1999; vol. 15 (no. 1); 198–206
|
|
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/10407606" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10407606</span></a>]
|
|
</td><td headers="hd_h_niceng242er10.appi.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Does not contain a population of people with Diabetic Retinopathy</td></tr><tr><td headers="hd_h_niceng242er10.appi.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9536429</td><td headers="hd_h_niceng242er10.appi.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Polak, B C P; Crijns, H; Casparie, A F; Niessen, L W; Cost-effectiveness of glycemic control and ophthalmological care in diabetic retinopathy.; Health policy (Amsterdam, Netherlands); 2003; vol. 64 (no. 1); 89–97
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/12644331" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12644331</span></a>]
|
|
</td><td headers="hd_h_niceng242er10.appi.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Does not contain a population of people with Diabetic Retinopathy</td></tr></tbody></table></div></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
|
|
|
|
|
|
|
|
|
|
<!-- Book content -->
|
|
|
|
<script type="text/javascript" src="/portal/portal3rc.fcgi/rlib/js/InstrumentNCBIBaseJS/InstrumentPageStarterJS.js"> </script>
|
|
|
|
|
|
<!-- CE8B5AF87C7FFCB1_0191SID /projects/books/PBooks@9.11 portal106 v4.1.r689238 Tue, Oct 22 2024 16:10:51 -->
|
|
<span id="portal-csrf-token" style="display:none" data-token="CE8B5AF87C7FFCB1_0191SID"></span>
|
|
|
|
<script type="text/javascript" src="//static.pubmed.gov/portal/portal3rc.fcgi/4216699/js/3968615.js" snapshot="books"></script></body>
|
|
</html>
|