Abstract
BackgroundCurrently used screening criteria for retinopathy of prematurity (ROP) show high sensitivity for predicting treatment-requiring ROP but low specificity; over 90% of examined infants do not develop ROP that requires treatment (type 1 ROP). A novel weight gain-based prediction model was developed by the G-ROP study group to increase the specificity of the screening criteria and keep the number of ophthalmic examinations as low as possible. This retrospective cohort study aimed to externally validate the G-ROP screening criteria in a Swiss cohort.MethodsData from 645 preterm infants in ROP screening at Inselspital Bern between January 2015 and December 2019 were retrospectively retrieved from the screening log and analysed. The G-ROP screening criteria, consisting of 6 trigger parameters, were applied in infants with complete data. To determine the performance of the G-ROP prediction model for treatment-requiring ROP, sensitivity and specificity were calculated.ResultsComplete data were available for 322 infants who were included in the analysis. None of the excluded infants had developed type 1 ROP. By applying the 6 criteria in the G-ROP model, 214 infants were flagged to undergo screening: among these, 14 developed type 1 ROP, 9 developed type 2 ROP, and 43 developed milder stages of ROP. The sensitivity for predicting treatment-requiring ROP was 100% (CI, 0.79–1.00), and the specificity was 41% (CI, 0.35 –0.47). Implementing the novel G-ROP screening criteria would reduce the number of infants entering ROP screening by approximately one third.ConclusionsThe overall prevalence of treatment-requiring ROP was low (2.15%). Previously published performance parameters for the G-ROP algorithm were reproducible in this Swiss cohort. Importantly, all treatment-requiring infants were correctly identified. By using these novel criteria, the burden of screening examinations could be significantly reduced.
Highlights
Used screening criteria for retinopathy of prematurity (ROP) show high sensitivity for predicting treatment-requiring ROP but low specificity; over 90% of examined infants do not develop ROP that requires treatment
One of the most promising algorithms, the G-ROP model, was developed using a large database [10, 11]. It is based on the assessment of 6 trigger criteria: gestational age (GA) less than 28 weeks, birth weight (BW) less than 1051 g, weight gain less than 120 g during 10 to 19 days postnatal age (PNA), weight gain less than 180 g during 20 to 29 days PNA, weight gain less than 170 g during 30 to 39 days PNA, or hydrocephalus
For the infants with a complete data set, the six criteria of the G-ROP prediction model (gestational age (GA) less than 28 weeks, birth weight (BW) less than 1051 g, weight gain less than 120 g during 10 to 19 days PNA, weight gain less than 180 g during 20 to 29 days PNA, weight gain less than 170 g during 30 to 39 days PNA or hydrocephalus) were applied
Summary
Used screening criteria for retinopathy of prematurity (ROP) show high sensitivity for predicting treatment-requiring ROP but low specificity; over 90% of examined infants do not develop ROP that requires treatment (type 1 ROP). A novel weight gain-based prediction model was developed by the G-ROP study group to increase the specificity of the screening criteria and keep the number of ophthalmic examinations as low as possible. This retrospective cohort study aimed to externally validate the G-ROP screening criteria in a Swiss cohort. The G-ROP model has been validated in several populations, [12,13,14] which is crucial since characteristics of premature infants vary depending on their socioeconomic environment [15]
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