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Individual Risk Pre...
Individual Risk Prediction for Sight-Threatening Retinopathy of Prematurity Using Birth Characteristics
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- Pivodic, Aldina, 1978 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi,Institute of Neuroscience and Physiology,Univ Gothenburg, Sahlgrenska Acad, Inst Neurosci & Physiol, Dept Ophthalmol, S-41685 Gothenburg, Sweden;Stat Konsultgrp, Gothenburg, Sweden
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- Hård, Anna Lena (author)
- Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi,Institute of Neuroscience and Physiology,Univ Gothenburg, Sahlgrenska Acad, Inst Neurosci & Physiol, Dept Ophthalmol, S-41685 Gothenburg, Sweden
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- Löfqvist, Chatarina, 1964 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi,Institutionen för vårdvetenskap och hälsa,Institute of Neuroscience and Physiology,Institute of Health and Care Sciences,Univ Gothenburg, Sahlgrenska Acad, Inst Neurosci & Physiol, Dept Ophthalmol, S-41685 Gothenburg, Sweden;Univ Gothenburg, Sahlgrenska Acad, Inst Hlth Care Sci, Gothenburg, Sweden
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- Smith, Lois E.H. (author)
- Children's Hospital Boston,Harvard Med Sch, Boston Childrens Hosp, Dept Ophthalmol, Boston, MA 02115 USA
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- Wu, Carolyn (author)
- Children's Hospital Boston,Harvard Med Sch, Boston Childrens Hosp, Dept Ophthalmol, Boston, MA 02115 USA
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- Bründer, Marie Christine (author)
- Universitätsmedizin Greifswald,Greifswald University Hospital,Univ Med Ctr Greifswald, Dept Ophthalmol, Greifswald, Germany
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- Lagrèze, Wolf A. (author)
- Albert-Ludwigs-Universität Freiburg,University of Freiburg,Univ Freiburg, Eye Ctr, Med Ctr, Fac Med, Freiburg, Germany
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- Stahl, Andreas (author)
- Universitätsmedizin Greifswald,Greifswald University Hospital,Univ Med Ctr Greifswald, Dept Ophthalmol, Greifswald, Germany
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- Holmström, Gerd, 1951- (author)
- Uppsala universitet,Söderberg: Oftalmiatrik
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- 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,Univ Gothenburg, Sahlgrenska Acad, Inst Neurosci & Physiol, Dept Physiol,Unit Endocrinol, Gothenburg, Sweden
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- Johansson, Helena, 1981 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa,Institute of Medicine, School of Public Health and Community Medicine,Australian Catholic Univ, McKillop Hlth Inst, Melbourne, Vic, Australia;Univ Gothenburg, Sahlgrenska Acad, Inst Med, Dept Publ Hlth & Community Med, Gothenburg, Sweden
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- Nilsson, Staffan, 1956 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för matematiska vetenskaper,Institutionen för biomedicin,Department of Mathematical Sciences,Institute of Biomedicine,Chalmers Univ Technol, Math Sci, Gothenburg, Sweden;Univ Gothenburg, Sahlgrenska Acad, Inst Biomed, Gothenburg, Sweden
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- Hellström, Ann, 1959 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi,Institute of Neuroscience and Physiology,Univ Gothenburg, Sahlgrenska Acad, Inst Neurosci & Physiol, Dept Ophthalmol, S-41685 Gothenburg, Sweden
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(creator_code:org_t)
- American Medical Association (AMA), 2020
- 2020
- English.
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In: JAMA Ophthalmology. - : American Medical Association (AMA). - 2168-6165 .- 2168-6173. ; 138:1, s. 21-29
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Abstract
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- Importance: To prevent blindness, repeated infant eye examinations are performed to detect severe retinopathy of prematurity (ROP), yet only a small fraction of those screened need treatment. Early individual risk stratification would improve screening timing and efficiency and potentially reduce the risk of blindness. Objectives: To create and validate an easy-to-use prediction model using only birth characteristics and to describe a continuous hazard function for ROP treatment. Design, Setting, and Participants: In this retrospective cohort study, Swedish National Patient Registry data from infants screened for ROP (born between January 1, 2007, and August 7, 2018) were analyzed with Poisson regression for time-varying data (postnatal age, gestational age [GA], sex, birth weight, and important interactions) to develop an individualized predictive model for ROP treatment (called DIGIROP-Birth [Digital ROP]). The model was validated internally and externally (in US and European cohorts) and compared with 4 published prediction models. Main Outcomes and Measures: The study outcome was ROP treatment. The measures were estimated momentary and cumulative risks, hazard ratios with 95% CIs, area under the receiver operating characteristic curve (hereinafter referred to as AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Results: Among 7609 infants (54.6% boys; mean [SD] GA, 28.1 [2.1] weeks; mean [SD] birth weight, 1119 [353] g), 442 (5.8%) were treated for ROP, including 142 (40.1%) treated of 354 born at less than 24 gestational weeks. Irrespective of GA, the risk for receiving ROP treatment increased during postnatal weeks 8 through 12 and decreased thereafter. Validations of DIGIROP-Birth for 24 to 30 weeks' GA showed high predictive ability for the model overall (AUC, 0.90 [95% CI, 0.89-0.92] for internal validation, 0.94 [95% CI, 0.90-0.98] for temporal validation, 0.87 [95% CI, 0.84-0.89] for US external validation, and 0.90 [95% CI, 0.85-0.95] for European external validation) by calendar periods and by race/ethnicity. The sensitivity, specificity, PPV, and NPV were numerically at least as high as those obtained from CHOP-ROP (Children's Hospital of Philadelphia-ROP), OMA-ROP (Omaha-ROP), WINROP (weight, insulinlike growth factor 1, neonatal, ROP), and CO-ROP (Colorado-ROP), models requiring more complex postnatal data. Conclusions and Relevance: This study validated an individualized prediction model for infants born at 24 to 30 weeks' GA, enabling early risk prediction of ROP treatment based on birth characteristics data. Postnatal age rather than postmenstrual age was a better predictive variable for the temporal risk of ROP treatment. The model is an accessible online application that appears to be generalizable and to have at least as good test statistics as other models requiring longitudinal neonatal data not always readily available to ophthalmologists.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Pediatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Pediatrics (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Allmänmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- General Practice (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)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Oftalmologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Ophthalmology (hsv//eng)
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Pivodic, Aldina, ...
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Hård, Anna Lena
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Löfqvist, Chatar ...
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Smith, Lois E.H.
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Wu, Carolyn
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Bründer, Marie C ...
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Lagrèze, Wolf A.
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Stahl, Andreas
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Holmström, Gerd, ...
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Albertsson-Wikla ...
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Johansson, Helen ...
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Nilsson, Staffan ...
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Hellström, Ann, ...
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- MEDICAL AND HEALTH SCIENCES
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and Clinical Medicin ...
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and Pediatrics
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and General Practice
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Obstetrics Gynae ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Ophthalmology
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JAMA Ophthalmolo ...
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Chalmers University of Technology
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University of Gothenburg
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Uppsala University