Optimisation of health services for sight threatening diabetic retinopathy in the UK

Haider, Sajjad ORCID: https://orcid.org/0000-0001-8111-8577 (2020). Optimisation of health services for sight threatening diabetic retinopathy in the UK. University of Birmingham. Ph.D.

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Abstract

Aims: This research project aimed to investigate the future burden and risk stratification of diabetic retinopathy in the UK.

Methods: The disease burden was calculated through cross-sectional studies, and its future projections through a double exponential smoothing model using primary care Data. The prediction model was designed by a systematic review of the existing models, finalising the predictors list used therein to a shorter list using nominal group technique and evidence evaluation and then a prediction model development and validation in a retrospective cohort study.

Results: There is a trend of increasing prevalence of diabetes and diabetic retinopathy. This trend is highest and accelerating in Sight Threatening Diabetic Retinopathy in patients with type 1 Diabetes Mellitus. The forecast for 2030 is 1.6 million people with diabetic retinopathy and .65 million with Sight Threatening Retinopathy. The systematic review yielded 14 models and 78 predictors. A list of 19 candidate predictors was finalised. The new model has moderately good performance.

Conclusion: Disease burden estimation needs to be carried out periodically to capture changing trends. External validation, clinical benefit and a nomogram are also needed. Newer imaging modalities and artificial intelligence are likely to play a part in future prognostic model research.

Publications:

Haider, S., Sadiq, S.N., Moore, D. et al. Prognostic prediction models for diabetic retinopathy progression: a systematic review. Eye 33, 702–713 (2019). https://doi.org/10.1038/s41433-018-0322-x

Type of Work:	Thesis (Doctorates > Ph.D.)
Award Type:	Doctorates > Ph.D.
Supervisor(s):	Supervisor(s) Email ORCID Nirantharakumar, Krishnarajah UNSPECIFIED UNSPECIFIED Price, Malcolm UNSPECIFIED UNSPECIFIED Moore, David UNSPECIFIED UNSPECIFIED
Licence:	All rights reserved
College/Faculty:	Colleges (2008 onwards) > College of Medical & Dental Sciences
School or Department:	Institute of Applied Health Research
Funders:	None/not applicable
Subjects:	R Medicine > RE Ophthalmology
URI:	http://etheses.bham.ac.uk/id/eprint/10939

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