Is arbitration of all abnormal grades valuable in retinopathy grading quality assurance?

Our local diabetic eye screening programme assesses images sets using the English National Grading Protocol. All sets (primary) graded abnormal are quality assurance (secondary) graded ‘blind’. Disagreements are arbitrated. The patient is then either returned to annual screening or referred to an ophthalmology gatekeeper. In October 2010 we stopped arbitrating differences between normal (R0M0) and background diabetic retinopathy (R1M0).

The aim of the audit is to demonstrate whether the arbitration change was safe and cost effective.

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By Laurence Quant