부산대학교 도서관

Diabetic retinopathy (DR) is the leading cause of blindness for working-age US adults. While comprehensive screening examinations detect most early-stage DR cases, only 50-60% of diabetic patients adhere to the current annual screening guidelines. Recently, teleretinal imaging (TRI) has emerged as an accessible screening tool for patients with limited access. However, there exists no well-established guideline that incorporates TRI-based screening for such patients. We develop a Monte Carlo simulation model to replicate a safety-net system patient population using electronic medical record data from the Harris Health System (Houston, TX) and examine cost and health benefits of various TRI-based screening policies. We conduct sensitivity analysis to study the impact of patient-specific factors including age, A1C level, and screening adherence on screening policy performance. Our findings support TRI-based screening for patients with limited access and highlight the significant role of patient-specific factors in determining cohort-level screening policies.