Journal article
An international comparison of retinopathy of prematurity grading performance within the Benefits of Oxygen Saturation Targeting II trials.
- Abstract:
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Purpose
To investigate whether the observed international differences in retinopathy of prematurity (ROP) treatment rates within the Benefits of Oxygen Saturation Targeting (BOOST) II trials might have been caused by international variation in ROP disease grading.
Methods
Groups of BOOST II trial ophthalmologists in UK, Australia, and New Zealand (ANZ), and an international reference group (INT) used a web based system to grade a selection of RetCam images of ROP acquired during the BOOST II UK trial. Rates of decisions to treat, plus disease grading, ROP stage grading, ROP zone grading, inter-observer variation within groups and intra-observer variation within groups were measured.
Results
Forty-two eye examinations were graded. UK ophthalmologists diagnosed treatrequiring ROP more frequently than ANZ ophthalmologists, 13.9 (3.49) compared to 9.4 (4.46) eye examinations, P=0.038. UK ophthalmologists diagnosed plus disease more frequently than ANZ ophthalmologists, 14.1 (6.23) compared to 8.5 (3.24) eye examinations, P=0.021. ANZ ophthalmologists diagnosed stage 2 ROP more frequently than UK ophthalmologists, 20.2 (5.8) compared to 12.7 (7.1) eye examinations, P=0.026. There were no other significant differences in the grading of ROP stage or zone. Inter-observer variation was higher within the UK group than within the ANZ group. Intra-observer variation was low in both groups.
Conclusions
We have found evidence of international variation in the diagnosis of treatment-requiring ROP. Improved standardisation of the diagnosis of treatmentrequiring ROP is required. Measures might include improved training in the grading of ROP, using an international approach, and further development of ROP image analysis software.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 160.3KB, Terms of use)
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- Publisher copy:
- 10.1038/eye.2017.150
Authors
- Publisher:
- Nature Publishing Group
- Journal:
- Eye More from this journal
- Publication date:
- 2017-07-01
- Acceptance date:
- 2017-06-21
- DOI:
- EISSN:
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1476-5454
- ISSN:
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0950-222X
- Pmid:
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28752837
- Language:
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English
- Keywords:
- Pubs id:
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pubs:710305
- UUID:
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uuid:32813a8d-e7af-46c1-8192-268f1197fff9
- Local pid:
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pubs:710305
- Source identifiers:
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710305
- Deposit date:
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2017-09-21
Terms of use
- Copyright holder:
- Knight et al
- Copyright date:
- 2017
- Notes:
- © The Author(s) 2017. This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce thematerial. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
- Licence:
- CC Attribution (CC BY)
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