Accuracy and reliability of remote retinopathy of prematurity diagnosis
Accuracy and reliability of remote retinopathy of prematurity diagnosis
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DOI：
10.1001/archopht.124.3.322
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发表时间：
2006-03-01
影响因子：
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通讯作者：
Flynn, JT
中科院分区：
文献类型：
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作者：
Chiang, MF;Keenan, JD;Flynn, JT
目的：为了确定早产儿视网膜病变（ROP）诊断的准确性和可靠性，使用远程审查的数字图像由3名蒙面眼科医生reader.Methods：一个图集汇编了410视网膜照片从163只眼睛的64个低出生体重儿采用广角数字眼底照相机。所有图像由3名阅片者独立审查，每只眼的诊断分为4个顺序类别之一：无ROP、轻度ROP、2型阈值前ROP或需要治疗的ROP。将结果与经验丰富的儿科眼科医生进行的间接扩张检眼镜检查和巩膜压低的参考标准进行比较。结果：第一位读片者诊断任何ROP的敏感性/特异性为0.845/0.910，第二位读片者为0.816/0.955，第三位读片者为0.864/0.493。第一位读片者诊断ROP的敏感性/特异性为0.850/0.960，第二位读片者为0.850/0.973，第三位读片者为0.900/0.953。当ROP被分类为有序类别时，阅片者间可靠性的总体加权Kappa为0.743。低风险阈值前ROP或更糟的检测intrareader的可靠性为100%for all readers.Conclusion：的准确性，interreader的可靠性，和intrareader的可靠性的远程诊断的临床相关的ROP基于数字成像是实质性的。
Objective: To determine the accuracy and reliability of retinopathy of prematurity (ROP) diagnosis using remote review of digital images by 3 masked ophthalmologist readers.Methods: An atlas was compiled of 410 retinal photographs from 163 eyes of 64 low-birth-weight infants taken using a wide-angle digital fundus camera. All the images were independently reviewed by 3 readers, and the diagnosis in each eye was classified into 1 of 4 ordinal categories: no ROP, mild ROP, type 2 prethreshold ROP, or ROP requiring treatment. Findings were compared with a reference standard of dilated indirect ophthalmoscopy with scleral depression performed by an experienced pediatric ophthalmologist.Results: Sensitivities/specificities of the diagnosis of any ROP were 0.845/0.910 for the first reader, 0.816/0.955 for the second reader, and 0.864/0.493 for the third reader. Sensitivities/specificities of the diagnosis of ROP requiring treatment were 0.850/0.960 for the first reader, 0.850/0.973 for the second reader, and 0.900/0.953 for the third reader. When ROP was classified into ordinal categories, the overall weighted kappa for interreader reliability was 0.743. Intrareader reliability for detection of low-risk pre-threshold ROP or worse was 100% for all readers.Conclusion: The accuracy, interreader reliability, and intrareader reliability of remote diagnosis of clinically relevant ROP based on digital imaging are substantial.