TY - JOUR
T1 - Assessment of image-based technology
T2 - impact of referral cutoff on accuracy and reliability of remote retinopathy of prematurity diagnosis.
AU - Chiang, Michael F.
AU - Keenan, Jeremy D.
AU - Du, Yunling E.
AU - Schiff, William
AU - Barile, Gaetano
AU - Li, Joan
AU - Hess, Ditte J.
AU - Johnson, Rose Anne
AU - Flynn, John T.
AU - Starren, Justin
N1 - Copyright:
This record is sourced from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
PY - 2005
Y1 - 2005
N2 - Telemedicine has potential to improve the delivery, quality, and accessibility of ophthalmic care for infants with Retinopathy of Prematurity (ROP). Using a telemedicine screening strategy, three potential diagnostic cutoffs may be used to define disease that warrants ophthalmologic referral: presence of any ROP, presence of moderate ("type-2 prethreshold") ROP, or presence of severe ROP requiring treatment. This study examines the relationship between accuracy and reliability of diagnosis by three masked ophthalmologist graders at each of these diagnostic cutoffs. The sensitivity, specificity, inter-grader reliability, and intra-grader reliability showed significant variation depending on the diagnostic cutoff, with best results at cutoffs of type-2 prethreshold ROP or treatment-requiring ROP. Before the large-scale adoption of telemedicine for image-based screening of diseases such as ROP, standards defining clinically-relevant referral cutoffs must be established, and diagnostic accuracy and reliability at these cutoffs must be characterized.
AB - Telemedicine has potential to improve the delivery, quality, and accessibility of ophthalmic care for infants with Retinopathy of Prematurity (ROP). Using a telemedicine screening strategy, three potential diagnostic cutoffs may be used to define disease that warrants ophthalmologic referral: presence of any ROP, presence of moderate ("type-2 prethreshold") ROP, or presence of severe ROP requiring treatment. This study examines the relationship between accuracy and reliability of diagnosis by three masked ophthalmologist graders at each of these diagnostic cutoffs. The sensitivity, specificity, inter-grader reliability, and intra-grader reliability showed significant variation depending on the diagnostic cutoff, with best results at cutoffs of type-2 prethreshold ROP or treatment-requiring ROP. Before the large-scale adoption of telemedicine for image-based screening of diseases such as ROP, standards defining clinically-relevant referral cutoffs must be established, and diagnostic accuracy and reliability at these cutoffs must be characterized.
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M3 - Article
C2 - 16779015
AN - SCOPUS:33750351049
SN - 1559-4076
SP - 126
EP - 130
JO - AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium
JF - AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium
ER -