TY - JOUR
T1 - Accuracy of retinopathy of prematurity image-based diagnosis by pediatric ophthalmology fellows
T2 - Implications for training
AU - Myung, Jane S.
AU - Paul Chan, Robison Vernon
AU - Espiritu, Michael J.
AU - Williams, Steven L.
AU - Granet, David B.
AU - Lee, Thomas C.
AU - Weissgold, David J.
AU - Chiang, Michael F.
N1 - Funding Information:
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).
PY - 2011/12
Y1 - 2011/12
N2 - Purpose: To measure the accuracy of image-based retinopathy of prematurity (ROP) diagnosis by pediatric ophthalmology fellows. Methods: This was a comparative case series of expert versus nonexpert clinicians in image-based ROP diagnosis. An atlas of 804 retinal images was captured from 248 eyes of 67 premature infants with a wide-angle camera (RetCam-II, Clarity Medical Systems, Pleasanton, CA). Images were uploaded to a study website from which an expert pediatric retinal specialist and five pediatric ophthalmology fellows independently provided a diagnosis (no ROP, mild ROP, type 2 ROP, or treatment-requiring ROP) for each eye. Two different retinal specialists experienced in ROP examination served as additional controls. Primary outcome measures were sensitivity and specificity of image-based ROP diagnosis by fellows compared to a reference standard of image-based interpretation by the expert pediatric retinal specialist. Secondary outcome measure was intraphysician reliability. Results: For detection of mild or worse ROP, the mean (range) sensitivity among the five fellows was 0.850 (0.670-0.962) and specificity was 0.919 (0.832-0.964). For detection of type 2 or worse ROP by fellows, mean (range) sensitivity was 0.527 (0.356-0.709) and specificity was 0.938 (0.777-1.000). For detection of treatment-requiring ROP, mean (range) sensitivity was 0.515 (0.267-0.765) and specificity was 0.949 (0.805-1.00). Conclusions: Pediatric ophthalmology fellows in this study demonstrated high diagnostic specificity in image-based ROP diagnosis; however, sensitivity was lower, particularly for clinically significant disease.
AB - Purpose: To measure the accuracy of image-based retinopathy of prematurity (ROP) diagnosis by pediatric ophthalmology fellows. Methods: This was a comparative case series of expert versus nonexpert clinicians in image-based ROP diagnosis. An atlas of 804 retinal images was captured from 248 eyes of 67 premature infants with a wide-angle camera (RetCam-II, Clarity Medical Systems, Pleasanton, CA). Images were uploaded to a study website from which an expert pediatric retinal specialist and five pediatric ophthalmology fellows independently provided a diagnosis (no ROP, mild ROP, type 2 ROP, or treatment-requiring ROP) for each eye. Two different retinal specialists experienced in ROP examination served as additional controls. Primary outcome measures were sensitivity and specificity of image-based ROP diagnosis by fellows compared to a reference standard of image-based interpretation by the expert pediatric retinal specialist. Secondary outcome measure was intraphysician reliability. Results: For detection of mild or worse ROP, the mean (range) sensitivity among the five fellows was 0.850 (0.670-0.962) and specificity was 0.919 (0.832-0.964). For detection of type 2 or worse ROP by fellows, mean (range) sensitivity was 0.527 (0.356-0.709) and specificity was 0.938 (0.777-1.000). For detection of treatment-requiring ROP, mean (range) sensitivity was 0.515 (0.267-0.765) and specificity was 0.949 (0.805-1.00). Conclusions: Pediatric ophthalmology fellows in this study demonstrated high diagnostic specificity in image-based ROP diagnosis; however, sensitivity was lower, particularly for clinically significant disease.
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U2 - 10.1016/j.jaapos.2011.06.011
DO - 10.1016/j.jaapos.2011.06.011
M3 - Article
C2 - 22153403
AN - SCOPUS:83455220586
SN - 1091-8531
VL - 15
SP - 573
EP - 578
JO - Journal of AAPOS
JF - Journal of AAPOS
IS - 6
ER -