Randomised Control Trial (Workstream E)

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Why are we doing this research?

All people with diabetes are at risk of developing diabetic retinopathy which could lead to a loss of vision. The risk is different for each person based on factors such as type of diabetes, blood pressure and diabetes control.

Currently in England all people with diabetes are invited for photographic eye screening once a year as part of the National Diabetic Eye Screening Programme. Screening aims to detect eye changes which may soon affect the vision so that the person can be referred to the Hospital Eye Service for close monitoring and treatment. In this way the risk of losing vision can be reduced.

However, there is evidence that not everyone needs to be screened every year because the chances of them developing eye changes are low. Also, there are some people who are at high risk and would benefit from screening more frequently.

As part of a 5 year programme of research, we have developed an electronic tool (Risk Engine) to predict an individual’s likelihood of developing sight-threatening diabetic retinopathy by using information from their previous screening results and their medical records. This means some people may benefit from attending screening more often than once a year while others may not need to attend so often. We have called this approach to screening “personalised risk based screening”.

Nobody has assessed the effect of personalised risk based screening intervals compared to annual screening on participants. We have designed this trial to compare the safety and acceptability of changing from annual screening to personalised risk based screening intervals.