Ethnic disparities in progression rates for sight-threatening diabetic retinopathy in diabetic eye screening: a population-based retrospective cohort study
Introduction The English Diabetic Eye Screening Programme (DESP) offers people living with diabetes (PLD) annual eye screening. We examined incidence and determinants of sight-threatening diabetic retinopathy (STDR) in a sociodemographically diverse multi-ethnic population.Research design and method...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-11-01
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| Series: | BMJ Open Diabetes Research & Care |
| Online Access: | https://drc.bmj.com/content/11/6/e003683.full |
| _version_ | 1797371398961758208 |
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| author | Yue Wu Sarah Barman Adnan Tufail Aaron Y Lee Sarah A Barman John Anderson Aroon D Hingorani Reecha Sofat Christopher G Owen Alicja R Rudnicka Roshan Welikala Emily Y Chew Abraham Olvera-Barrios Ryan Chambers Louis Bolter Catherine Egan Charlotte Wahlich Frederick L Ferris Lakshmi Chandrasekaran Umar Chaudhry Alasdair N Warwick Jiri Fajtl Paolo Remagnino Royce Shakespeare Kathryn Willis |
| author_facet | Yue Wu Sarah Barman Adnan Tufail Aaron Y Lee Sarah A Barman John Anderson Aroon D Hingorani Reecha Sofat Christopher G Owen Alicja R Rudnicka Roshan Welikala Emily Y Chew Abraham Olvera-Barrios Ryan Chambers Louis Bolter Catherine Egan Charlotte Wahlich Frederick L Ferris Lakshmi Chandrasekaran Umar Chaudhry Alasdair N Warwick Jiri Fajtl Paolo Remagnino Royce Shakespeare Kathryn Willis |
| author_sort | Yue Wu |
| collection | DOAJ |
| description | Introduction The English Diabetic Eye Screening Programme (DESP) offers people living with diabetes (PLD) annual eye screening. We examined incidence and determinants of sight-threatening diabetic retinopathy (STDR) in a sociodemographically diverse multi-ethnic population.Research design and methods North East London DESP cohort data (January 2012 to December 2021) with 137 591 PLD with no retinopathy, or non-STDR at baseline in one/both eyes, were used to calculate STDR incidence rates by sociodemographic factors, diabetes type, and duration. HR from Cox models examined associations with STDR.Results There were 16 388 incident STDR cases over a median of 5.4 years (IQR 2.8–8.2; STDR rate 2.214, 95% CI 2.214 to 2.215 per 100 person-years). People with no retinopathy at baseline had a lower risk of sight-threatening diabetic retinopathy (STDR) compared with those with non-STDR in one eye (HR 3.03, 95% CI 2.91 to 3.15, p<0.001) and both eyes (HR 7.88, 95% CI 7.59 to 8.18, p<0.001). Black and South Asian individuals had higher STDR hazards than white individuals (HR 1.57, 95% CI 1.50 to 1.64 and HR 1.36, 95% CI 1.31 to 1.42, respectively). Additionally, every 5-year increase in age at inclusion was associated with an 8% reduction in STDR hazards (p<0.001).Conclusions Ethnic disparities exist in a health system limited by capacity rather than patient economic circumstances. Diabetic retinopathy at first screen is a strong determinant of STDR development. By using basic demographic characteristics, screening programmes or clinical practices can stratify risk for sight-threatening diabetic retinopathy development. |
| first_indexed | 2024-03-08T18:19:16Z |
| format | Article |
| id | doaj.art-27032c5a1d294b148974bc8a47ccc7e6 |
| institution | Directory Open Access Journal |
| issn | 2052-4897 |
| language | English |
| last_indexed | 2024-03-08T18:19:16Z |
| publishDate | 2023-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Diabetes Research & Care |
| spelling | doaj.art-27032c5a1d294b148974bc8a47ccc7e62023-12-31T02:50:09ZengBMJ Publishing GroupBMJ Open Diabetes Research & Care2052-48972023-11-0111610.1136/bmjdrc-2023-003683Ethnic disparities in progression rates for sight-threatening diabetic retinopathy in diabetic eye screening: a population-based retrospective cohort studyYue Wu0Sarah BarmanAdnan Tufail1Aaron Y Lee2Sarah A Barman3John Anderson4Aroon D Hingorani5Reecha Sofat6Christopher G Owen7Alicja R Rudnicka8Roshan Welikala9Emily Y Chew10Abraham Olvera-Barrios11Ryan Chambers12Louis Bolter13Catherine Egan14Charlotte Wahlich15Frederick L Ferris16Lakshmi Chandrasekaran17Umar ChaudhryAlasdair N Warwick18Jiri Fajtl19Paolo Remagnino20Royce ShakespeareKathryn Willis21Roger and Angie Keralis Johnson Retina Center, Seattle, Washington, USANIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UKDepartment of Ophthalmology, University of Washington, Seattle, Washington, USASchool of Computer Science and Mathematics, Kingston University, London, UKDiabetes and Endocrinolgy, Homerton Healthcare NHS Foundation Trust, London, UKInstitute of Cardiovascular Science, University College London, London, UKDepartment of Pharmacology and Therapeutics, University of Liverpool, Liverpool, UKPopulation Health Research Institute, St George`s University of London, London, UKPopulation Health Research Institute, St. George`s University of London, London, UKSchool of Computer Science and Mathematics, Kingston University London, London, UKDivision of Epidemiology and Clinical Applications, NEI/NIH, Bethesda, Maryland, USANIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UKDiabetes and Endocrinolgy, Homerton Healthcare NHS Foundation Trust, London, UKDiabetes and Endocrinolgy, Homerton Healthcare NHS Foundation Trust, London, UKNIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UKPopulation Health Research Institute, St George`s University of London, London, UKOphthalmic Research Consultants, Charlotte, North Carolina, USAPopulation Health Research Institute, St George`s University of London, London, UKNIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UKSchool of Computer Science and Mathematics, Kingston University London, London, UKDepartment of Computer Science, Durham University, Durham, UKPopulation Health Research Institute, St George`s University of London, London, UKIntroduction The English Diabetic Eye Screening Programme (DESP) offers people living with diabetes (PLD) annual eye screening. We examined incidence and determinants of sight-threatening diabetic retinopathy (STDR) in a sociodemographically diverse multi-ethnic population.Research design and methods North East London DESP cohort data (January 2012 to December 2021) with 137 591 PLD with no retinopathy, or non-STDR at baseline in one/both eyes, were used to calculate STDR incidence rates by sociodemographic factors, diabetes type, and duration. HR from Cox models examined associations with STDR.Results There were 16 388 incident STDR cases over a median of 5.4 years (IQR 2.8–8.2; STDR rate 2.214, 95% CI 2.214 to 2.215 per 100 person-years). People with no retinopathy at baseline had a lower risk of sight-threatening diabetic retinopathy (STDR) compared with those with non-STDR in one eye (HR 3.03, 95% CI 2.91 to 3.15, p<0.001) and both eyes (HR 7.88, 95% CI 7.59 to 8.18, p<0.001). Black and South Asian individuals had higher STDR hazards than white individuals (HR 1.57, 95% CI 1.50 to 1.64 and HR 1.36, 95% CI 1.31 to 1.42, respectively). Additionally, every 5-year increase in age at inclusion was associated with an 8% reduction in STDR hazards (p<0.001).Conclusions Ethnic disparities exist in a health system limited by capacity rather than patient economic circumstances. Diabetic retinopathy at first screen is a strong determinant of STDR development. By using basic demographic characteristics, screening programmes or clinical practices can stratify risk for sight-threatening diabetic retinopathy development.https://drc.bmj.com/content/11/6/e003683.full |
| spellingShingle | Yue Wu Sarah Barman Adnan Tufail Aaron Y Lee Sarah A Barman John Anderson Aroon D Hingorani Reecha Sofat Christopher G Owen Alicja R Rudnicka Roshan Welikala Emily Y Chew Abraham Olvera-Barrios Ryan Chambers Louis Bolter Catherine Egan Charlotte Wahlich Frederick L Ferris Lakshmi Chandrasekaran Umar Chaudhry Alasdair N Warwick Jiri Fajtl Paolo Remagnino Royce Shakespeare Kathryn Willis Ethnic disparities in progression rates for sight-threatening diabetic retinopathy in diabetic eye screening: a population-based retrospective cohort study BMJ Open Diabetes Research & Care |
| title | Ethnic disparities in progression rates for sight-threatening diabetic retinopathy in diabetic eye screening: a population-based retrospective cohort study |
| title_full | Ethnic disparities in progression rates for sight-threatening diabetic retinopathy in diabetic eye screening: a population-based retrospective cohort study |
| title_fullStr | Ethnic disparities in progression rates for sight-threatening diabetic retinopathy in diabetic eye screening: a population-based retrospective cohort study |
| title_full_unstemmed | Ethnic disparities in progression rates for sight-threatening diabetic retinopathy in diabetic eye screening: a population-based retrospective cohort study |
| title_short | Ethnic disparities in progression rates for sight-threatening diabetic retinopathy in diabetic eye screening: a population-based retrospective cohort study |
| title_sort | ethnic disparities in progression rates for sight threatening diabetic retinopathy in diabetic eye screening a population based retrospective cohort study |
| url | https://drc.bmj.com/content/11/6/e003683.full |
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