Abstract
Background
Algorithms for predicting retinopathy of prematurity (ROP) requiring treatment need to be validated in Indian settings to determine if the burden of screening can be reduced without compromising the sensitivity of existing gestation and weight-based cut offs.
Objective
To evaluate the performance of the available algorithms namely, WINROP (Weight, Insulin-like growth factor I, Neonatal ROP), CHOP-ROP (children’s Hospital of Philadelphia ROP) and ROPScore in predicting type 1 ROP and time from alarm to treatment by each algorithm.
Study design
Ambispective observational.
Setting
Tertiary care neonatal intensive care unit in India.
Participants
Neonates less than 32 weeks or less than 1500 g born between July, 2013 to June, 2019 (N=578), who underwent ROP screening.
Primary outcome
Sensitivity, specificity and time from alarm to treatment by each algorithm.
Results
The sensitivity and specificity of WINROP was 85% and 36%, for CHOP-ROP it was 54% and 71%, and for ROPScore it was 73% and 67%, respectively in detecting type 1 ROP. A total of 50/51 (98%) of neonates with type 1 ROP underwent treatment at median gestation of 9 weeks and median time from alarm to treatment by WINROP, CHOP-ROP and ROPScore was 7, 7 and 3 weeks, respectively.
Conclusion
WINROP, CHOP-ROP and ROPScore were not sensitive enough to replace the gestational age, weight and risk factor-based screening criteria for type 1 ROP.
Keywords: Neonatal intensive care unit, Premature, Sensitivity, Specificity
Footnotes
Ethics clearance
Institutional ethics committee of Post Graduate research (clinical sciences), AIIMS, New Delhi; No. IECPG-280 dated 28 June, 2018.
Contributors
DT: prepared the first draft of the protocol and had the prime responsibility of data collection, data analysis and compilation of results; SM: collected data, cross checked data entry and contributed to the manuscript; AT: conceptualized the study, supervised data entry and provided input in preparation of protocol and final manuscript; MJS: contributed to protocol formation, helped in statistical analysis and contributed to final manuscript; PC: valuable suggestion during protocol formation and provided input to final manuscript; RA: critically reviewed the protocol of the study, ensured timely progress of the study via departmental meetings and provided input to final manuscript; AD: input in protocol of the study and critically reviewed the final manuscript. All the authors in principal agreed to the final manuscript of the study.
Funding
None
Competing interest
None stated.
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