Screening for Presence or Absence of Diabetic Retinopathy: A Meta-analysis

Abstract

OBJECTIVES: To examine how mydriasis and the medical qualifications of photographers who take retinal photographs influence the accuracy of screening for diabetic retinopathy (DR). METHODS: Our meta-analysis included studies that measured the sensitivity and specificity of tests designed to detect any DR, sight-threatening DR, or macular edema. Using random-effects logistic regression, we examined the effect of variations in mydriatic status and in medical qualifications of photographers on sensitivity and specificity. RESULTS: Only the category of "any DR" had sufficient consistency in definition, number of studies (n = 20), and number of assessments (n = 40) for meta-analysis. Variations i..