Bonilla Escobar, Francisco Javier
(2024)
Teleophthalmology to Prevent Diabetic Retinopathy: Implementation, Outcomes, and Associated Factors with Lack of Follow-Up in Western Pennsylvania.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
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Image (PNG) (Figure 1.2. Program reading application and resulting system: (A) Within normal limits diabetic retinopathy exam)
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Image (PNG) (Figure 1.2. Program reading application and resulting system: (B) Exam with abnormal results requiring a follow-up visit)
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Image (TIFF) (Figure 1.2. Program reading application and resulting system: (C) Non-gradable images)
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Image (PNG) (Figure 1.3. Geographic distribution of the cameras in the Program)
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Image (PNG) (Figure 1.4. Monthly number of photographs in the Program from August 2008 to December 2020 (n=21,960))
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Image (PNG) (Figure 1.5. Outcomes of the diabetic retinopathy exams (n=21,960) in terms of positive, negative and indeterminate results.)
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Image (PNG) (Figure 1.6. Program rate trends of diagnosis of vision-threatening diabetic retinopathy (VTDR: >moderate non-proliferative and/or macular exudate), age-related macular degeneration (AMD), glaucoma suspicion, and hypertensive retinopathy since 2008 to 2020)
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Image (PNG) (Figure 2.5.1. Percentage of diagnoses in the Point-of-Care Diabetic Retinopathy Examination Program (POCDREP), 2015-2018 (n=7,733))
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Image (JPEG) (Figure 3.5.1. Follow-up Post-Diabetic Retinopathy Examination Over Time, Stratified by One, Two and Three Days from Examination to Patient Contact Adjusted by Variables Used in the Multivariate Combined Model)
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Abstract
This dissertation explores the implementation and outcomes of a teleophthalmology program designed to prevent diabetic retinopathy in Western Pennsylvania, focusing on why some patients do not follow up after screening. By examining asynchronous telemedicine implementations at the University of Pittsburgh and UPMC, the work highlights the significant barriers to routine diabetic retinopathy screenings and subsequent follow-up care. The findings underscore the impact of socioeconomic, clinical, and systemic factors on patient engagement and adherence to follow-up recommendations. Through a detailed analysis of program data and patient characteristics, the research identifies key factors that contribute to patients being lost to follow-up, offering insights into improving patient outcomes in teleophthalmology and diabetic care.
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Details
| Item Type: |
University of Pittsburgh ETD
|
| Status: |
Unpublished |
| Creators/Authors: |
|
| ETD Committee: |
|
| Date: |
19 February 2024 |
| Defense Date: |
14 February 2024 |
| Approval Date: |
16 September 2024 |
| Submission Date: |
12 April 2024 |
| Access Restriction: |
No restriction; Release the ETD for access worldwide immediately. |
| Number of Pages: |
112 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Medicine > Clinical and Translational Science |
| Degree: |
PhD - Doctor of Philosophy |
| Thesis Type: |
Doctoral Dissertation |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
Teleophthalmology, Diabetic Retinopathy, Telemedicine, Patient Follow-Up, Implementation Science, Asynchronous Screening, Health Barriers, Socioeconomic Factors, Clinical Outcomes, Western Pennsylvania |
| Date Deposited: |
16 Sep 2024 19:11 |
| Last Modified: |
16 Sep 2024 19:11 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/46099 |
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