{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T12:33:21Z","timestamp":1790253201140,"version":"4.1.0"},"reference-count":36,"publisher":"American Diabetes Association","issue":"6","license":[{"start":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T00:00:00Z","timestamp":1709856000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"DOI":"10.13039\/100007878","name":"Diabetes Research Center","doi-asserted-by":"publisher","award":["P30DK036836"],"award-info":[{"award-number":["P30DK036836"]}],"id":[{"id":"10.13039\/100007878","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007745","name":"Massachusetts Lions Eye Research Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007745","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,6,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>To assess self-reported awareness of diabetic retinopathy (DR) and concordance of eye examination follow-up compared with findings from concurrent retinal images.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>We conducted a prospective observational 10-year study of 26,876 consecutive patients with diabetes who underwent retinal imaging during an endocrinology visit. Awareness and concordance were evaluated using questionnaires and retinal imaging.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Awareness information and gradable images were available in 25,360 patients (94.3%). Severity of DR by imaging was as follows: no DR (n = 14,317; 56.5%), mild DR (n = 6,805; 26.8%), or vision-threatening DR (vtDR; n = 4,238; 16.7%). In the no, mild, and vtDR groups, 96.7%, 88.5%, and 54.9% of patients, respectively, reported being unaware of any prior DR. When DR was present, reporting no prior DR was associated with shorter diabetes duration, milder DR, last eye examination &amp;gt;1 year before, no dilation, no scheduled appointment, and less specialized provider (all P &amp;lt; 0.001). Among patients with vtDR, 41.2%, 58.1%, and 64.2% did not report being aware of any DR and follow-up was concordant with current DR severity in 66.7%, 41.3%, and 25.4% (P &amp;lt; 0.001) of patients when prior examination was performed by a retinal specialist, nonretinal ophthalmologist, or optometrist (P &amp;lt; 0.001), respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Substantial discrepancies exist between DR presence, patient awareness, and concordance of follow-up across all DR severity levels. These discrepancies are present across all eye care provider types, with the magnitude influenced by provider type. Therefore, patient self-report should not be relied upon to reflect DR status. Modification of medical care and education models may be necessary to enhance retention of ophthalmic knowledge in patients with diabetes and ensure accurate communication between all health care providers.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc23-2282","type":"journal-article","created":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T19:44:26Z","timestamp":1709927066000},"page":"970-977","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":11,"title":["Disparities Between Teleretinal Imaging Findings and Patient-Reported Diabetic Retinopathy Status and Follow-up Eye Care Interval: A 10-Year Prospective Study"],"prefix":"10.2337","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8024-9348","authenticated-orcid":false,"given":"Paolo S.","family":"Silva","sequence":"first","affiliation":[{"name":"1Beetham Eye Institute, Joslin Diabetes Center, Boston, MA"},{"name":"2Department of Ophthalmology, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerry D.","family":"Cavallerano","sequence":"additional","affiliation":[{"name":"1Beetham Eye Institute, Joslin Diabetes Center, Boston, MA"},{"name":"2Department of Ophthalmology, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer K.","family":"Sun","sequence":"additional","affiliation":[{"name":"1Beetham Eye Institute, Joslin Diabetes Center, Boston, MA"},{"name":"2Department of Ophthalmology, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann M.","family":"Tolson","sequence":"additional","affiliation":[{"name":"1Beetham Eye Institute, Joslin Diabetes Center, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorothy","family":"Tolls","sequence":"additional","affiliation":[{"name":"1Beetham Eye Institute, Joslin Diabetes Center, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4735-5717","authenticated-orcid":false,"given":"Martin J.","family":"Abrahamson","sequence":"additional","affiliation":[{"name":"3Adult Diabetes, Joslin Diabetes Center, Boston, MA"},{"name":"4Department of Medicine, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lloyd M.","family":"Aiello","sequence":"additional","affiliation":[{"name":"1Beetham Eye Institute, Joslin Diabetes Center, Boston, MA"},{"name":"2Department of Ophthalmology, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lloyd Paul","family":"Aiello","sequence":"additional","affiliation":[{"name":"1Beetham Eye Institute, Joslin Diabetes Center, Boston, MA"},{"name":"2Department of Ophthalmology, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2024,3,8]]},"reference":[{"key":"2024052018522864200_B1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.diabres.2009.10.007","article-title":"Global estimates of the prevalence of diabetes for 2010 and 2030","volume":"87","author":"Shaw","year":"2010","journal-title":"Diabetes Res Clin Pract"},{"key":"2024052018522864200_B2","doi-asserted-by":"crossref","first-page":"1714","DOI":"10.1001\/jama.1993.03510140074032","article-title":"Ophthalmic examination among adults with diagnosed diabetes mellitus","volume":"270","author":"Brechner","year":"1993","journal-title":"JAMA"},{"key":"2024052018522864200_B3","doi-asserted-by":"crossref","first-page":"1952","DOI":"10.1016\/S0161-6420(03)00817-0","article-title":"Longitudinal rates of annual eye examinations of persons with diabetes and chronic eye diseases","volume":"110","author":"Lee","year":"2003","journal-title":"Ophthalmology"},{"key":"2024052018522864200_B4","doi-asserted-by":"crossref","first-page":"1372","DOI":"10.1016\/j.ophtha.2006.04.018","article-title":"Noncompliance with vision care guidelines in Latinos with type 2 diabetes mellitus: the Los Angeles Latino Eye Study","volume":"113","author":"Paz","year":"2006","journal-title":"Ophthalmology"},{"key":"2024052018522864200_B5","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1136\/bjo.82.4.410","article-title":"Use of eye care services by people with diabetes: the Melbourne Visual Impairment Project","volume":"82","author":"McCarty","year":"1998","journal-title":"Br J Ophthalmol"},{"key":"2024052018522864200_B6","author":"Flaxel"},{"key":"2024052018522864200_B7","doi-asserted-by":"crossref","first-page":"S124","DOI":"10.2337\/dc19-S011","article-title":"11. Microvascular complications and foot care: Standards of Medical Care in Diabetes\u20142019","volume":"42","author":"American Diabetes Association","year":"2019","journal-title":"Diabetes Care"},{"key":"2024052018522864200_B8","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1016\/S0161-6420(00)00600-X","article-title":"Patterns of adherence to diabetes vision care guidelines: baseline findings from the Diabetic Retinopathy Awareness Program","volume":"108","author":"Schoenfeld","year":"2001","journal-title":"Ophthalmology"},{"key":"2024052018522864200_B9","first-page":"1549","article-title":"Self-reported visual impairment among persons with diagnosed diabetes\u2014United States, 1997\u20132010","volume":"60","author":"Centers for Disease Control and Prevention","year":"2011","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2024052018522864200_B10","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.47102\/annals-acadmedsg.V38N12p1048","article-title":"Lack of awareness amongst community patients with diabetes and diabetic retinopathy: the Singapore Malay eye study","volume":"38","author":"Huang","year":"2009","journal-title":"Ann Acad Med Singap"},{"key":"2024052018522864200_B11","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1016\/j.ophtha.2009.03.010","article-title":"Effects of receipt of guideline-recommended care on onset of diabetic retinopathy and its progression","volume":"116","author":"Sloan","year":"2009","journal-title":"Ophthalmology"},{"key":"2024052018522864200_B12","doi-asserted-by":"crossref","first-page":"218","DOI":"10.3109\/08820538.2010.518893","article-title":"Ocular telemedicine for diabetic retinopathy and the Joslin Vision Network","volume":"25","author":"Sanchez","year":"2010","journal-title":"Semin Ophthalmol"},{"key":"2024052018522864200_B13","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/j.jclinepi.2007.11.008","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"61","author":"von Elm","year":"2008","journal-title":"J Clin Epidemiol"},{"key":"2024052018522864200_B14","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1089\/tmj.2020.0006","article-title":"Practice Guidelines for Ocular Telehealth-Diabetic Retinopathy, third edition","volume":"26","author":"Horton","year":"2020","journal-title":"Telemed J E Health"},{"key":"2024052018522864200_B15","doi-asserted-by":"crossref","first-page":"2205","DOI":"10.2337\/dc06-0295","article-title":"The sensitivity and specificity of nonmydriatic digital stereoscopic retinal imaging in detecting diabetic retinopathy","volume":"29","author":"Ahmed","year":"2006","journal-title":"Diabetes Care"},{"key":"2024052018522864200_B16","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1016\/S0161-6420(00)00604-7","article-title":"Stereo nonmydriatic digital-video color retinal imaging compared with Early Treatment Diabetic Retinopathy Study seven standard field 35-mm stereo color photos for determining level of diabetic retinopathy","volume":"108","author":"Bursell","year":"2001","journal-title":"Ophthalmology"},{"key":"2024052018522864200_B17","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1016\/j.ophtha.2016.01.043","article-title":"Identification of diabetic retinopathy and ungradable image rate with ultrawide field imaging in a national teleophthalmology program","volume":"123","author":"Silva","year":"2016","journal-title":"Ophthalmology"},{"key":"2024052018522864200_B18","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1016\/j.ajo.2012.03.019","article-title":"Nonmydriatic ultrawide field retinal imaging compared with dilated standard 7-field 35-mm photography and retinal specialist examination for evaluation of diabetic retinopathy","volume":"154","author":"Silva","year":"2012","journal-title":"Am J Ophthalmol"},{"key":"2024052018522864200_B19","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1093\/oxfordjournals.aje.a114353","article-title":"The validity of a survey question to study diabetic retinopathy","volume":"124","author":"Klein","year":"1986","journal-title":"Am J Epidemiol"},{"key":"2024052018522864200_B20","author":"American Academy of Ophthalmology"},{"key":"2024052018522864200_B21","author":"American Academy of Optometry"},{"key":"2024052018522864200_B22","author":"American Optometric Association"},{"key":"2024052018522864200_B23","author":"New England Ophthalmologic Society"},{"key":"2024052018522864200_B24","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1001\/jamaophthalmol.2013.6046","article-title":"Eye care use among a high-risk diabetic population seen in a public hospital\u2019s clinics","volume":"132","author":"Maclennan","year":"2014","journal-title":"JAMA Ophthalmol"},{"key":"2024052018522864200_B25","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1177\/0145721706297454","article-title":"The Robert Wood Johnson Foundation Diabetes Initiative: demonstration projects emphasizing self-management","volume":"33","author":"Fisher","year":"2007","journal-title":"Diabetes Educ"},{"key":"2024052018522864200_B26","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.amepre.2010.10.017","article-title":"Healthy People 2020 and Education for Health: what are the objectives?","volume":"40","author":"Riegelman","year":"2011","journal-title":"Am J Prev Med"},{"key":"2024052018522864200_B27","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/S0161-6420(90)32612-X","article-title":"Diabetes 2000\u2014closing the gap","volume":"97","author":"Smith","year":"1990","journal-title":"Ophthalmology"},{"key":"2024052018522864200_B28","first-page":"569","article-title":"Healthy People 2010\u2014vision objectives for the nation","volume":"71","author":"Bowyer","year":"2000","journal-title":"Optometry"},{"key":"2024052018522864200_B29","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1001\/jamaophthalmol.2015.1312","article-title":"Assessing the effect of personalized diabetes risk assessments during ophthalmologic visits on glycemic control: a randomized clinical trial","volume":"133","author":"Aiello","year":"2015","journal-title":"JAMA Ophthalmol"},{"key":"2024052018522864200_B30","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.2337\/diacare.14.11.1097","article-title":"Factors determining recall of examination results in diabetic population","volume":"14","author":"Moss","year":"1991","journal-title":"Diabetes Care"},{"key":"2024052018522864200_B31","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1089\/tmj.2019.0239","article-title":"Long-term effect on HbA1c in poorly controlled diabetic patients following nonmydriatic retinal image review at the time of endocrinology visit","volume":"26","author":"Aiello","year":"2020","journal-title":"Telemed J E Health"},{"key":"2024052018522864200_B32","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1089\/tmj.2010.0180","article-title":"Nonmydriatic retinal image review at time of endocrinology visit results in short-term HbA1c reduction in poorly controlled patients with diabetic retinopathy","volume":"17","author":"Salti","year":"2011","journal-title":"Telemed J E Health"},{"key":"2024052018522864200_B33","doi-asserted-by":"crossref","first-page":"1166","DOI":"10.1097\/IAE.0b013e3181cea5c6","article-title":"Adherence to recommendations of the age-related eye disease study in patients with age-related macular degeneration","volume":"30","author":"Hochstetler","year":"2010","journal-title":"Retina"},{"key":"2024052018522864200_B34","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1111\/j.1442-9071.2004.00905.x","article-title":"Utilization of eye care services by Victorians likely to benefit from eye care","volume":"32","author":"Bylsma","year":"2004","journal-title":"Clin Exp Ophthalmol"},{"key":"2024052018522864200_B35","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1097\/MLR.0b013e3180ca95fa","article-title":"Agreement between self-reports and medical records was only fair in a cross-sectional study of performance of annual eye examinations among adults with diabetes in managed care","volume":"45","author":"Beckles","year":"2007","journal-title":"Med Care"},{"key":"2024052018522864200_B36","doi-asserted-by":"crossref","first-page":"933","DOI":"10.2337\/diacare.25.5.933","article-title":"What is the sensitivity and specificity of self-report for retinopathy screening?","volume":"25","author":"Walker","year":"2002","journal-title":"Diabetes Care"}],"container-title":["Diabetes Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/47\/6\/970\/764720\/dc232282.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/47\/6\/970\/764720\/dc232282.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T18:54:55Z","timestamp":1716231295000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/care\/article\/47\/6\/970\/154307\/Disparities-Between-Teleretinal-Imaging-Findings"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,8]]},"references-count":36,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,3,8]]},"published-print":{"date-parts":[[2024,6,1]]}},"URL":"https:\/\/doi.org\/10.2337\/dc23-2282","relation":{},"ISSN":["0149-5992","1935-5548"],"issn-type":[{"value":"0149-5992","type":"print"},{"value":"1935-5548","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,8]]}}}