The KIDROP model of combining strategies for providing retinopathy of prematurity screening in underserved areas in India using wide-field imaging, tele-medicine, non-physician graders and smart phone reporting.
The KIDROP model of combining strategies for providing retinopathy of prematurity screening in underserved areas in India using wide-field imaging, tele-medicine, non-physician graders and smart phone reporting.
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DOI：
10.4103/0301-4738.126178
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发表时间：
2014-01
影响因子：
3.1
通讯作者：
Bauer N
中科院分区：
文献类型：
--
作者：
Vinekar A;Gilbert C;Dogra M;Kurian M;Shainesh G;Shetty B;Bauer N
报告卡纳塔克邦早产儿视网膜病变互联网辅助诊断 (KIDROP) 计划，使用本地开发的远程 ROP 模型，在服务不足的农村地区进行早产儿视网膜病变 (ROP) 筛查。 KIDROP 目前在印度卡纳塔克邦的三个地区和 81 个新生儿病房提供 ROP 筛查和治疗服务。技术人员接受了使用便携式 Retcam Shuttle（Clarity，美国）的培训，并针对执行间接检眼镜检查的 ROP 专家进行了验证。自主开发的 20 分评分（STAT 评分）根据三向算法对他们成像和决定后续行动的能力进行了分级（I 级至 III 级）。图像还上传到安全的远程 ROP 平台上，并由远程专家通过智能手机（iPhone、Apple）进行访问和报告。对 1601 名婴儿的 6339 次成像进行了分析。三级技术人员同意 94.3% 的专家决策。治疗级别疾病的敏感性、特异性、阳性预测值和阴性预测值分别为95.7、93.2、81.5和98.6。技术人员决定婴儿出院的 kappa 为 0.94 (P < 0.001)。只有 0.4% 的需要治疗的婴儿被遗漏。专家报告 iPhone 与 Retcam 对于需要治疗和轻度 ROP 的 kappa 一致性分别为 0.96 和 0.94 (P < 0.001)。这是第一个也是最大的现实世界项目，雇佣经过认证的非医生来对 ROP 进行分级和报告。 KIDROP 远程 ROP 模型表明，尽管缺乏专家，ROP 服务仍可提供给外展人员，并且可能对具有类似人口统计数据的其他中等收入国家有用。
To report the Karnataka Internet Assisted Diagnosis of Retinopathy of Prematurity (KIDROP) program for retinopathy of prematurity (ROP) screening in underserved rural areas using an indigenously developed tele-ROP model. KIDROP currently provides ROP screening and treatment services in three zones and 81 neonatal units in Karnataka, India. Technicians were trained to use a portable Retcam Shuttle (Clarity, USA) and validated against ROP experts performing indirect ophthalmoscopy. An indigenously developed 20-point score (STAT score) graded their ability (Level I to III) to image and decide follow-up based on a three-way algorithm. Images were also uploaded on a secure tele-ROP platform and accessed and reported by remote experts on their smart phones (iPhone, Apple). 6339 imaging sessions of 1601 infants were analyzed. A level III technician agreed with 94.3% of all expert decisions. The sensitivity, specificity, positive predictive value and negative predictive value for treatment grade disease were 95.7, 93.2, 81.5 and 98.6 respectively. The kappa for technicians to decide discharge of babies was 0.94 (P < 0.001). Only 0.4% of infants needing treatment were missed. The kappa agreement of experts reporting on the iPhone vs Retcam for treatment requiring and mild ROP were 0.96 and 0.94 (P < 0.001) respectively. This is the first and largest real-world program to employ accredited non-physicians to grade and report ROP. The KIDROP tele-ROP model demonstrates that ROP services can be delivered to the outreach despite lack of specialists and may be useful in other middle-income countries with similar demographics.
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影响因子：
--
作者：
Dogra, Mangat R.;Vinekar, Anand;Dutta, Sourab
通讯作者：
Dutta, Sourab
影响因子：
13.7
作者：
Ells, AL;Holmes, JM;Hebert, M
通讯作者：
Hebert, M
影响因子：
--
作者：
Chiang, MF;Keenan, JD;Flynn, JT
通讯作者：
Flynn, JT
影响因子：
8
作者：
Gilbert, C;Fielder, A;Zin, A
通讯作者：
Zin, A
影响因子：
4.1
作者：
Chiang, M. F.;Starren, J.;Flynn, J. T.
通讯作者：
Flynn, J. T.