Telemedical diagnosis of retinopathy of prematurity: accuracy of expert versus non-expert graders
Background/aimsTo assess accuracy of telemedical retinopathy of prematurity (ROP) diagnosis by trained non-expert graders compared with expert graders.MethodsEye examinations (n=248) from 67 consecutive infants were captured using wide-angle retinal photography (RetCam-II, Clarity Medical Systems, P...
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Published in | British journal of ophthalmology Vol. 94; no. 3; pp. 351 - 356 |
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Main Authors | , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
BMA House, Tavistock Square, London, WC1H 9JR
BMJ Publishing Group Ltd
01.03.2010
BMJ Publishing Group BMJ Publishing Group LTD |
Subjects | |
Online Access | Get full text |
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Summary: | Background/aimsTo assess accuracy of telemedical retinopathy of prematurity (ROP) diagnosis by trained non-expert graders compared with expert graders.MethodsEye examinations (n=248) from 67 consecutive infants were captured using wide-angle retinal photography (RetCam-II, Clarity Medical Systems, Pleasanton, California, USA). Non-expert graders attended two 1-h training sessions on image-based ROP diagnosis. Using a web-based telemedicine system, 14 non-expert and three expert graders provided a diagnosis for each eye: no ROP, mild ROP, type 2 pre-threshold ROP or treatment-requiring ROP. All diagnoses were compared with a reference standard of dilated indirect ophthalmoscopy by an experienced paediatric ophthalmologist.ResultsFor detection of type 2 or worse ROP, the mean (range) sensitivities and specificities were 0.95 (0.94–0.97) and 0.93 (0.91–0.96) for experts, 0.87 (0.71–0.97) and 0.73 (0.39–0.95) for resident non-experts, and 0.73 (0.41–0.88) and 0.91 (0.84–0.96) for student non-experts, respectively. For detection of treatment-requiring ROP, the mean (range) sensitivities and specificities were 1.00 (1.00–1.00) and 0.93 (0.88–0.96) for experts, 0.88 (0.50–1.00) and 0.84 (0.71–0.98) for resident non-experts, and 0.82 (0.42–1.00) and 0.92 (0.83–0.97) for student non-experts, respectively.ConclusionsMean sensitivity and specificity of trained non-experts were lower than that of experts, although several non-experts had high accuracy. Development of methods for training non-expert graders may help support telemedical ROP evaluation. |
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Bibliography: | href:bjophthalmol-94-351.pdf PMID:19955195 ark:/67375/NVC-MZL6L0SH-W ArticleID:bjo166348 local:bjophthalmol;94/3/351 istex:DDD5661110C48B371AD723B51917CE55A7D69F19 ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Undefined-1 ObjectType-Feature-3 content type line 23 |
ISSN: | 0007-1161 1468-2079 |
DOI: | 10.1136/bjo.2009.166348 |