Development and validation of a new clinical decision support tool to optimize screening for retinopathy of prematurity

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Development and validation of a new clinical decision support tool to optimize screening for retinopathy of prematurity

Pivodic, Aldina, 1978 (author): Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience,Sahlgrenska Academy,Univ Gothenburg, Sweden

Johansson, Helena, 1981 (author): University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för medicin,Institute of Medicine,Australian Catholic University,Australian Catholic Univ, Australia; Univ Gothenburg, Sweden

Smith, Lois E H (author): Harvard Medical School,Harvard Med Sch, MA 02115 USA

Hård, Anna-Lena (author): Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience,Sahlgrenska Academy,Univ Gothenburg, Sweden

Löfqvist, Chatarina, 1964 (author): Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institutionen för vårdvetenskap och hälsa,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience,Institute of Health and Care Sciences,Sahlgrenska Academy,Univ Gothenburg, Sweden

Yoder, Bradley A (author): University of Utah,Univ Utah, UT USA

Hartnett, M Elizabeth (author): University of Utah,Univ Utah, UT USA

Wu, Carolyn (author): Harvard Medical School,Harvard Med Sch, MA 02115 USA

Bründer, Marie-Christine (author): Universitätsmedizin Greifswald,Greifswald University Hospital,University Hospital Greifswald,Univ Med Greifswald, Germany

Lagrèze, Wolf A (author): Albert-Ludwigs-Universität Freiburg,University of Freiburg,Univ Freiburg, Germany

Stahl, Andreas (author): Universitätsmedizin Greifswald,Greifswald University Hospital,University Hospital Greifswald,Univ Med Greifswald, Germany

Al-Hawasi, Abbas (author): Linköpings universitet,Linköping University,Avdelningen för sinnesorgan och kommunikation,Medicinska fakulteten

Larsson, Eva, 1961- (author): Uppsala universitet,Oftalmiatrik,Uppsala University,Uppsala Univ, Sweden

Lundgren, Pia, 1967 (author): Örebro University,Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience,Sahlgrenska Academy,Univ Gothenburg, Sweden; Orebro Univ, Sweden

Gränse, Lotta (author): Lund University,Lunds universitet,Oftalmologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Ophthalmology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital,Lund Univ, Sweden

Sunnqvist, Birgitta (author): Länssjukhuset Ryhov,County Hospital Ryhov,Lanssjukhuset Ryhov, Sweden

Tornqvist, Kristina (author): Lund University,Lunds universitet,Oftalmologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Ophthalmology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital,Lund Univ, Sweden

Wallin, Agneta (author): S:t Eriks Ögonsjukhus,St. Erik Eye Hospital,St Erik Eye Hospital,St Erik Eye Hosp, Sweden

Holmström, Gerd, 1951- (author): Uppsala universitet,Oftalmiatrik,Uppsala University,Uppsala Univ, Sweden

Albertsson-Wikland, Kerstin, 1947 (author): Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för fysiologi,Institute of Neuroscience and Physiology, Department of Physiology,Sahlgrenska Academy,Univ Gothenburg, Sweden

Nilsson, Staffan, 1956 (author): University of Gothenburg,Chalmers University of Technology,Gothenburg University,Göteborgs universitet,Institutionen för matematiska vetenskaper,Institutionen för biomedicin,Department of Mathematical Sciences,Institute of Biomedicine,Chalmers Univ Technol, Sweden; Univ Gothenburg, Sweden

Hellström, Ann, 1959 (author): Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience,Sahlgrenska Academy,Univ Gothenburg, Sweden

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2021-05-12
2022
English.
In: British Journal of Ophthalmology. - : BMJ Publishing Group Ltd. - 0007-1161 .- 1468-2079. ; 106:11, s. 1573-1580

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Journal article (peer-reviewed)

Abstract Subject headings

BACKGROUND/AIMS: Prematurely born infants undergo costly, stressful eye examinations to uncover the small fraction with retinopathy of prematurity (ROP) that needs treatment to prevent blindness. The aim was to develop a prediction tool (DIGIROP-Screen) with 100% sensitivity and high specificity to safely reduce screening of those infants not needing treatment. DIGIROP-Screen was compared with four other ROP models based on longitudinal weights.METHODS: Data, including infants born at 24-30 weeks of gestational age (GA), for DIGIROP-Screen development (DevGroup, N=6991) originate from the Swedish National Registry for ROP. Three international cohorts comprised the external validation groups (ValGroups, N=1241). Multivariable logistic regressions, over postnatal ages (PNAs) 6-14 weeks, were validated. Predictors were birth characteristics, status and age at first diagnosed ROP and essential interactions.RESULTS: ROP treatment was required in 287 (4.1%)/6991 infants in DevGroup and 49 (3.9%)/1241 in ValGroups. To allow 100% sensitivity in DevGroup, specificity at birth was 53.1% and cumulatively 60.5% at PNA 8 weeks. Applying the same cut-offs in ValGroups, specificities were similar (46.3% and 53.5%). One infant with severe malformations in ValGroups was incorrectly classified as not needing screening. For all other infants, at PNA 6-14 weeks, sensitivity was 100%. In other published models, sensitivity ranged from 88.5% to 100% and specificity ranged from 9.6% to 45.2%.CONCLUSIONS: DIGIROP-Screen, a clinical decision support tool using readily available birth and ROP screening data for infants born GA 24-30 weeks, in the European and North American populations tested can safely identify infants not needing ROP screening. DIGIROP-Screen had equal or higher sensitivity and specificity compared with other models. DIGIROP-Screen should be tested in any new cohort for validation and if not validated it can be modified using the same statistical approaches applied to a specific clinical setting.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Oftalmologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Ophthalmology (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Pediatrik (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Pediatrics (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)

Keyword

ROP screening
clinical decision support tool
diagnostic tests/Investigation
neovascularisation
optimized screening
prediction model
preterm
retinopathy of prematurity
Ophtalmology
Oftalmiatrik

Publication and Content Type

ref (subject category)
art (subject category)

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Ophthalmology

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Pediatrics

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Obstetrics Gynae ...

Articles in the publication: British Journal ...

By the university: Uppsala University; Chalmers University of Technology; University of Gothenburg; Lund University; Linköping University

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