Benefits of training junior physicians to detect diabetic retinopathy - the Glasgow experience.

The accuracy and appropriateness of 115 consecutive referrals by non-consultant physicians to a specialist Diabetic Retinopathy Clinic were assessed in a retrospective study. The source of the referrals was masked throughout the study. Referrals were classed as `appropriate' or `inappropriate' for patient management, and the referral diagnosis (where specified) was compared with the ophthalmologist's initial assessment. It was graded as `correct', `partly correct' and `incorrect'. Referrals from physicians who had received 40-50 hours of outpatient training in the Diabetic Retinopathy Clinic (group A, n=49)were compared with referrals from doctors without this special instruction (group B, n=66). Referral was deemed 'appropriate' in 32 (65%) of group A referrals, but in only 22 (33%) of group B (χ²=11.54, df=1, P<0.001). Referral diagnosis (when expressed) was graded as `correct' in 28 (67%) of group A referrals compared with only 12 (30%) of group B, being `incorrect' in 10 (25%) of group B referrals and just two (45%) of group A (χ²=12.9, df=2, P< 0.005). Regular fundoscopy with accurate assessment and appropriate action is vital to prevent loss of vision in diabetic patients. Short-term outpatient training in a Diabetic Eye Clinic leads junior physicians to more appropriate referral and more accurate referral diagnosis. [ABSTRACT FROM AUTHOR]