[1]    Joint Clinical Practice International (JCPI) is a partnership program for medical practitioners and institutions initiated by a group of expertise from Sekwa Institute of Medicine (Beijing, China), University of Wisconsin School of Medicine and Public Health  (Madison WI, USA), University of Oslo (Oslo, Norway), Yuankang Institute of Health Care Research (Guangzhou, China), and International Diabetes Federation West-Pacific Region.

[2]   Mydriatic fundus photography is not recommended for general diabetes care practice, especially for the ethnic groups with high incidence of occludable anterior chamber angle of the eye, such as Asians and Eskimos (Inuit).

[3]  The concept of evaluation on performance: If clinical significant inconsistency between the two readers is detected, and the performance of a reader is judged under the scope, the reader’s work will be stopped. All of the concurrent photographs that the primary reader has read will be send to other readers for re-evaluation. Analysis of the causes of the inconsistency will be performed at the same time.

[4]   The procedure for general diagnostic reading is developed for the ease and accuracy of DR image diagnosis for clinical physicians’ daily clinical practice. A trained clinical physicians may easily finish a reading within a few minutes.

[5]    QASC is a JCPI facility located at Sekwa Institute of Medicine (Beijing, China). In most circumstances, systemic quality control service of general physician readers will be carried out by a regional reference reading center, while the systemic quality control service of all reading centers will be carried out by QASC.