Telemedicine approaches to evaluating acute-phase retinopathy of prematurity: study design.
Telemedicine approaches to evaluating acute-phase retinopathy of prematurity: study design.
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DOI：
10.3109/09286586.2014.926940
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发表时间：
2014-08
影响因子：
1.8
通讯作者：
e-ROP Cooperative Group
中科院分区：
文献类型：
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作者：
Graham E Quinn;e-ROP Cooperative Group
检测威胁视力的早产儿视网膜病变（ROP）依赖于由经验丰富的眼科医生进行的诊断性检查（DE）。另一种选择可能是远程医疗系统，其中读者对高危婴儿的视网膜图像进行分级，以确定ROP的特征，表明需要DE。多中心“评估急性期ROP的远程医疗方法”（e-ROP）研究是一项对2000名出生体重<1251g的婴儿进行的队列研究。每次就诊时，眼科医生进行DEs检查，非医师成像人员获得虹膜和五张视网膜图像，椎间盘分别位于中间、右、左、上和下。图像被上传到一个安全的服务器上，由非医生读者进行评分，以检测附加疾病、3期ROP和/或I区疾病，其中任何一种都表明“推荐ROP （RW-ROP）”。从所有患有RW-ROP的婴儿和随机抽样的没有RW-ROP的婴儿（基于DEs）中选择图像进行分级。将评分与de进行比较，以确定有效性并评估远程医疗系统的可靠性、可行性、安全性和成本效益。e-ROP在美国和加拿大的12个临床中心进行，包括研究总部，费城的数据协调中心和图像阅读中心以及俄克拉荷马城的ROP数据中心。26个成像仪和4个读取器已获得认证。所有的研究数据都是通过安全的网络系统提交的。本研究的设计和结果将有助于开展其他ROP研究或评估其他疾病的远程医疗。
Detecting sight-threatening retinopathy of prematurity (ROP) relies on a diagnostic examination (DE) performed by an experienced ophthalmologist. An alternative may be a telemedicine system where retinal images of at-risk infants are graded by readers to determine features of ROP indicating the need for a DE. The multicenter “Telemedicine Approaches to Evaluating Acute-phase ROP” (e-ROP) Study is a cohort study of 2,000 infants with birth weights <1251g. At each visit, ophthalmologists perform DEs and non-physician imagers obtain iris and five retinal images with the disc positioned in the center, right, left, up anddown. Images are uploaded to a secure server for grading by non-physician readers for the detection of plus disease, stage 3 ROP and/or zone I disease, any of which indicates “referral-warranted ROP (RW-ROP).” Images from all infants with RW-ROP and a random sample of infants without RW-ROP (based on DEs) are selected for grading. Gradings are compared to DEs to determine the validity and evaluate reliability, feasibility, safety, and cost-effectiveness of the telemedicine system. e-ROP is conducted in 12 Clinical Centers in the US and Canada with Study Headquarters, the Data Coordinating Center and the Image Reading Center in Philadelphia and the ROP Data Center in Oklahoma City. 27 Study Center Coordinators, 34 ophthalmologists; 26 imagers, and 4 readers have been certified. All study data are submitted using a secure web-based system. The design and findings of this study will be useful to conduct other ROP studies or evaluate telemedicine for other diseases.