What Is the Sensitivity and Specificity of Self-Report for Retinopathy Screening?

A wide range in screening rates for diabetic retinopathy by dilated ophthalmic examination has been reported in studies over the last decade (1–4). Comparisons of these rates should take into account the measure used to assess the condition (i.e., screened versus unscreened). Examples of measures include self-report by the individual, claims data for the service, or medical record abstraction of the desired information. Because goals for improvement of diabetes care (5) are based on studies using these reported rates, the sources of these data must be considered and described. Self-report by an individual relies on memory, correct discernment of a dilated versus undilated exam, and accurate identification of the screening behavior within the time frame in question. Claims data, on the other hand, can overestimate the rate of dilated exams under the code for a comprehensive ophthalmic examination. Furthermore, depending on the patient’s health care coverage plan, the retinopathy screening may be a service that does not require a separate claim. Finally, abstraction of medical records may be a sensitive measure for a dilated ophthalmic examination; however, its specificity is dependent on a record system that captures and organizes the medical reports for retrieval and evaluation.

A recently published study by Basch et al. (6) reported that a telephone-based health education intervention was associated with a …