Risk stratified screening intervals within diabetic retinopathy screening

Modelling the cost-effectiveness of adopting risk stratified screening intervals within the national diabetic retinopathy screening programme in Scotland

The aim of this study is to access the clinical and cost-effectiveness of adopting risk stratified screening intervals for groups of patients defined by selected clinical and demographic variable routinely available to screening programmes.

With the prevalence of diabetes increasing by ~4% annually in Scotland, costs of screening for diabetic retinopathy are set to rise indefinitely unless efficiency gains can be realised. While the early identification of people at risk of sight loss from diabetic retinopathy is beneficial, many patients currently screened annually in Scotland face a low risk of progression prior to their subsequent screening visit. This project will use longitudinal screening data held by the Scottish Care Information-Diabetes Collaboration to model the risk of developing referable retinopathy by individual level clinical and demographic characteristics. By utilising derived probabilities of progression within a state transition micro-simulation model, we will be able to assess the cost and health impact of adopting longer/shorter screening intervals for different groups of patients.

Outcome and translation

This project will help identify ways in which the national screening programme can be safely reconfigured to meet the growing demand for screening within budget constraints.

HERU researchers involved in this research project: Graham Scotland

External collaborators: H Locker, H Colhoun (University of Dundee); G Leese (NHS Tayside); P McKeigue (University of Edinburgh); J Olson and S Philip (NHS Grampian)

Publications

Scotland, G., Philip, S., McKeigue, P., Leese, G., Olson, J., Looker, H., Colhoun, H. (2015) Modelling the cost-effectiveness of adopting risk stratified screening intervals within the national diabetic retinopathy screening programme in Scotland. Final Report to the CSO.

Scotland, G., McKeigue, P., Philip, S., Leese, G. P., Olson, J. A., Looker, H. C., Colhoun, H. M. and Javanbakht, M. (2016) 'Modelling the cost-effectiveness of adopting risk-stratified approaches to extended screening intervals in the national diabetic retinopathy screening programme in Scotland ', Diabetic Medicine, 33(7), 886-895.

Presentations

Scotland, G., McKeigue, P., Philip, S., Leese, G. P., Olson, J. A., Looker, H. C., Colhoun, H. M. and Javanbakht, M. (2016) 'Modelling the cost-effectiveness of adopting risk-stratified approaches to extended screening intervals in the national diabetic retinopathy screening programme in Scotland' [poster], NHS Research Scotland Conference, Queen Elizabeth University Hospital Campus, Glasgow, 26 October 2016.