Quantifying Barriers to Diabetic Eye Screening: A Two-Center Study at the University of California

Aryan Ayati; Shadera Azzam; Stella Ko; Claude Bendavid; Michelle Wang; Nicole Bonine; David Tabano; Frank Brodie; Mitul C. Mehta; Vivek A. Rudrapatna

doi:10.2337/dc25-0951

September 9, 2025Diabetes CareOpen Access

Quantifying Barriers to Diabetic Eye Screening: A Two-Center Study at the University of California

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Key Points

To evaluate the diabetic eye disease screening continuum across two academic health centers and identify patient- and provider-level barriers to completion.
Analyzed electronic health records from two academic medical centers to evaluate 8,240 unscreened primary care patients with type 2 diabetes mellitus.
Tracked clinical pathways from referral to diagnosis and treatment while modeling the projected screening rate under an automated referral system.
Applied GPT-4o natural language processing to primary care clinician notes to extract and categorize documented reasons for missed screening exams.
Among 8,240 unscreened patients with type 2 diabetes mellitus, 43% received an eye care referral and only 16% completed screening within 1 year.
Physician referral served as the strongest predictor of adherence, with modeled automated referrals projected to raise completion rates to 22%–34%.
Qualitative analysis of clinician notes revealed that scheduling challenges, logistical issues, medical comorbidities, COVID-19, and personal circumstances were the primary barriers.

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Implication

Retrospective cohort study reveals low completion rates for diabetic eye screening in primary care, indicating that automated referrals alone cannot fully overcome patient barriers.

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Cite This Study

Ayati et al. (2025) studied this question.

synapsesocial.com/papers/6a92268d397d2e5be3b87bc1 https://doi.org/10.2337/dc25-0951

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Quantifying Barriers to Diabetic Eye Screening: A Two-Center Study at the University of California

Key Points

No abstract yet

Implication

Discussion

Cite This Study

Quantifying Barriers to Diabetic Eye Screening: A Two-Center Study at the University of California

Key Points

No abstract yet

Implication

Discussion

Cite This Study

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