ETDRS Diabetic Retinopathy Severity Scale
Standardizes diabetic retinopathy severity grading to guide ophthalmologic management and treatment timing
- Highest activation tier
- Recommended
- How it is scored
- Scored in code; a stated value is compared only from the structured summary or a supplied value
- Scoring type
- classification
- Care settings
- Inpatient, Outpatient
When it activates
Scribeable activates a calculator from the encounter. The ETDRS Diabetic Retinopathy Severity Scale can activate when the transcript or pasted chart context documents any of these:
- Diabetic retinopathy grading
- Diabetic eye exam findings
- Retinopathy severity assessment
- Diabetic fundoscopic findings
- Retinal screening interpretation
A coded diagnosis can also activate it. ICD-10 prefixes carried by the registry: E10.3, E11.3, H35.0.
Inputs the note needs
1 input. Each is resolved from the transcript, the pasted chart context and charted labs; at this calculator’s tier a missing input is never requested, and a missing required input keeps the score out of the draft.
| Input | Type | Unit / options | Guidance |
|---|---|---|---|
| ETDRS severity level: No DR (0), Mild NPDR (1), Moderate NPDR (2), Severe NPDR (3), PDR (4) | exam |
Scoring
No DR (level 0/10): No abnormalities. Mild NPDR (level 1/20-35): Microaneurysms only. Moderate NPDR (level 2/43-47): More than just microaneurysms but less than severe NPDR. Severe NPDR (level 3/53): Any of the 4-2-1 rule (severe hemorrhages in 4 quadrants, venous beading in 2+ quadrants, IRMA in 1+ quadrant) without signs of PDR. PDR (level 4/61-85): Neovascularization or vitreous/preretinal hemorrhage.
Interpretation
No DR: Annual screening. Mild NPDR: Follow-up 9-12 months. Moderate NPDR: Follow-up 6-9 months, optimize glycemic control. Severe NPDR: Follow-up 3-4 months, consider PRP (30% progress to PDR in 1 year without treatment). PDR: Urgent pan-retinal photocoagulation (PRP) or anti-VEGF therapy. Diabetic macular edema (DME) can occur at any severity level and requires anti-VEGF treatment regardless of DR stage.
Evidence
Sources carried in Scribeable's citation registry for this calculator; guideline version: ETDRS 1991.
- Early Treatment Diabetic Retinopathy Study Research Group. Grading diabetic retinopathy from stereoscopic color fundus photographsETDRS (DR Grading) 1991 · 1991 · ETDRS Research Group · Level I · link last verified 2026-03-28
How Scribeable handles it in the note
When an encounter activates the ETDRS Diabetic Retinopathy Severity Scale (its highest tier is recommended), Scribeable does not ask you for missing inputs. The score is computed in code from whatever inputs resolve from the transcript, the pasted chart context or charted labs; a computed value is written into the draft only when every required input already resolves.
The score is computed in code from the resolved inputs, not recalled by the language model. A stated ETDRS Diabetic Retinopathy Severity Scale value is compared against the computed one when the draft's structured summary carries it; a disagreement found there is flagged to the second drafting pass, which is instructed to correct the score and its interpretation, unless Scribeable has supplied the computed value to that pass, in which case the value the draft writes is checked against the supplied one and a detected difference is shown beside the note for you to adjudicate rather than silently rewritten.
Classified as a staging or classification system: activated strictly, because a wrong stage on the wrong patient is a documentation hazard.
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