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vi Background 1 Study Rationale 3 Methods 5 Statistical Analysis 14 Results 19 Discussion 30 Conc... more vi Background 1 Study Rationale 3 Methods 5 Statistical Analysis 14 Results 19 Discussion 30 Conclusion 38 References 41 Appendices 44 Appendix A: Inclusion and Exclusion Diagnoses 44 Appendix B: Variable Key 46 Appendix C: Practice Guidelines 50

Telemedicine and e-Health, 2013

Objective: To determine the effectiveness of telemedicine for providing diabetic retinopathy scre... more Objective: To determine the effectiveness of telemedicine for providing diabetic retinopathy screening examinations compared with the effectiveness of traditional surveillance in community health clinics with a high proportion of minorities, including American Indian/Alaska Natives. Subjects and Methods: We conducted a multicenter, randomized controlled trial and assigned diabetic participants to one of two groups: (1) telemedicine with a nonmydriatic camera or (2) traditional surveillance with an eye care provider. For those receiving telemedicine, the criteria for requiring follow-up with an eye care provider were (1) moderate nonproliferative diabetic retinopathy or higher, (2) presence of clinically significant macular edema, or (3) ''unable to grade'' result for diabetic retinopathy or macular edema. Results: The telemedicine group (n = 296) was more likely to receive a diabetic retinopathy screening examination within the first year of enrollment compared with the traditional surveillance group (n = 271) (94% versus 56%, p < 0.001). The overall prevalence of diabetic retinopathy at baseline was 21.4%, and macular edema was present in 1.4% of participants. In the telemedicine group, 20.5% would require further evaluation with an eye care provider, and 86% of these referrals were because of poorquality digital images. Conclusions: Telemedicine using non-mydriatic cameras increased the proportion of participants who obtained diabetic retinopathy screening examinations, and most did not require follow-up with an eye care provider. Telemedicine may be a more effective way to screen patients for diabetic retinopathy and to triage further evaluation with an eye care provider. Methods to decrease poor quality imaging would improve the effectiveness of telemedicine for diabetic retinopathy screening examinations.

Current Opinion in Ophthalmology, 2010

Annals of Internal Medicine, 2011

Background: Screening can detect prostate cancer at earlier, asymptomatic stages, when treatments... more Background: Screening can detect prostate cancer at earlier, asymptomatic stages, when treatments might be more effective.

Electroencephalography and Clinical Neurophysiology, 1974

vi Background 1 Study Rationale 3 Methods 5 Statistical Analysis 14 Results 19 Discussion 30 Conc... more vi Background 1 Study Rationale 3 Methods 5 Statistical Analysis 14 Results 19 Discussion 30 Conclusion 38 References 41 Appendices 44 Appendix A: Inclusion and Exclusion Diagnoses 44 Appendix B: Variable Key 46 Appendix C: Practice Guidelines 50

Telemedicine and e-Health, 2013

Objective: To determine the effectiveness of telemedicine for providing diabetic retinopathy scre... more Objective: To determine the effectiveness of telemedicine for providing diabetic retinopathy screening examinations compared with the effectiveness of traditional surveillance in community health clinics with a high proportion of minorities, including American Indian/Alaska Natives. Subjects and Methods: We conducted a multicenter, randomized controlled trial and assigned diabetic participants to one of two groups: (1) telemedicine with a nonmydriatic camera or (2) traditional surveillance with an eye care provider. For those receiving telemedicine, the criteria for requiring follow-up with an eye care provider were (1) moderate nonproliferative diabetic retinopathy or higher, (2) presence of clinically significant macular edema, or (3) ''unable to grade'' result for diabetic retinopathy or macular edema. Results: The telemedicine group (n = 296) was more likely to receive a diabetic retinopathy screening examination within the first year of enrollment compared with the traditional surveillance group (n = 271) (94% versus 56%, p < 0.001). The overall prevalence of diabetic retinopathy at baseline was 21.4%, and macular edema was present in 1.4% of participants. In the telemedicine group, 20.5% would require further evaluation with an eye care provider, and 86% of these referrals were because of poorquality digital images. Conclusions: Telemedicine using non-mydriatic cameras increased the proportion of participants who obtained diabetic retinopathy screening examinations, and most did not require follow-up with an eye care provider. Telemedicine may be a more effective way to screen patients for diabetic retinopathy and to triage further evaluation with an eye care provider. Methods to decrease poor quality imaging would improve the effectiveness of telemedicine for diabetic retinopathy screening examinations.

Current Opinion in Ophthalmology, 2010

Annals of Internal Medicine, 2011

Background: Screening can detect prostate cancer at earlier, asymptomatic stages, when treatments... more Background: Screening can detect prostate cancer at earlier, asymptomatic stages, when treatments might be more effective.

Electroencephalography and Clinical Neurophysiology, 1974

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