Journal of American Association for Pediatric Ophthalmology and Strabismus
Major ArticleAccuracy of retinopathy of prematurity image-based diagnosis by pediatric ophthalmology fellows: Implications for training
Section snippets
Methods
This research was conducted under the approval of the Columbia University Institutional Review Board and included a waiver of consent for use of de-identified retinal images. Informed consent was obtained from all fellows who participated in the study. All research was performed in compliance with the Health Insurance Portability and Accountability Act of 1996.
Images from consecutive infants whose parents provided informed consent were captured during routine ROP examinations at Columbia
Results
Overall, there were five residency-trained, board-eligible ophthalmologists enrolled in pediatric ophthalmology fellowship programs who met study eligibility criteria and consented to participate. All fellows reported that they had minimal or no ROP screening experience during residency training. All were within the first 6 months (mean, 4.4 months) of their fellowship training at programs where weekly ROP examinations were performed with a faculty member.
Figure 1 reports the distribution of
Discussion
The key finding of this study is that pediatric ophthalmology fellows generally demonstrated high specificity for imaged-based detection of mild levels of ROP but showed lower diagnostic sensitivity for detecting clinically significant levels of disease (ie, type 2 and treatment-requiring ROP). Among fellows in this study, mean sensitivities for detecting type 2 and treatment-requiring ROP were approximately 50%. Fellows in this study had variable diagnostic performance and a general tendency
References (25)
- et al.
Retinopathy of prematurity care: Patterns of care and workforce analysis
J AAPOS
(2008) - et al.
Agreement among pediatric ophthalmologists in diagnosing plus and pre-plus disease in retinopathy of prematurity
J AAPOS
(2008) - et al.
Impact of retinopathy of prematurity screening examination on cardiorespiratory indices: A comparison of indirect ophthalmoscopy and retcam imaging
Ophthalmology
(2006) - et al.
Pain and stress assessment after retinopathy of prematurity screening examination: A comparison study between indirect ophthalmoscopy and digital fundus imaging
Early Hum Dev
(2008) - Ocular Surgery News U.S. Edition 2006. Survey: Physicians being driven away from ROP treatment. Available at:...
Screening examination of premature infants for retinopathy of prematurity
Pediatrics
(2006)- et al.
Annual summary of vital statistics: 2008
Pediatrics
(2011) - et al.
Incidence of retinopathy of prematurity in the United States: 1997 through 2005
Am J Ophthalmol
(2009) - et al.
Accuracy of retinopathy of prematurity diagnosis by retinal fellows
Retina
(2010) - et al.
Telemedical retinopathy of prematurity diagnosis: Accuracy, reliability, and image quality
Arch Ophthalmol
(2007)
Remote image based retinopathy of prematurity diagnosis: A receiver operating characteristic analysis of accuracy
Br J Ophthalmol
A coefficient of agreement for nominal scales
Educ Psychol Meas
Cited by (0)
This study was supported by Grant EY19474 from the National Institutes of Health (MFC), by the St. Giles Foundation (RVPC), and by the Research to Prevent Blindness (JSM, RVPC, DBG, MFC). The sponsors of funding organizations had no role in the design or conduct of this research. The authors have no commercial, proprietary, or financial interest in any of the products or companies described in this article. MFC is an unpaid member of the Scientific Advisory Board for Clarity Medical Systems (Pleasanton, CA).