Excellent accuracy of trained neonatal nurses in the detection of referral-warranted retinopathy of prematurity within an established telemedicine screening programme

IF 1.6 4区医学 Q2 PEDIATRICS

Journal of paediatrics and child health Pub Date : 2024-07-21 DOI:10.1111/jpc.16621

Thuan Anh Le Nguyen, Vanessa Raileanu, Bernice Smith, Alison Griffin, Shaheen Shah

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引用次数: 0

Abstract

Aim

To evaluate level of agreement of specialist trained retinopathy of prematurity (ROP) nurses compared with an experienced paediatric ophthalmologist in detection of referral-warranted ROP (RWROP) using wide-field digital retinal imaging.

Methods

This is a prospective, observational, blinded study of neonates in a level III neonatal intensive care unit, from July 2020 to November 2022. Image capture using wide-field digital retinal imaging followed by ROP grading and staging was completed by trained ROP nurses. This was then compared with findings by an experienced paediatric ophthalmologist. The primary outcome was presence of RWROP in either eye.

Results

One hundred and ninety-five neonates (55% male) with a total of 768 screening visits were included. At the initial screen, nurse and ophthalmologist agreed about presence of RWROP for 191 of 195 neonates (98%, kappa = 0.79, P < 0.0001), with 100% sensitivity for RWROP detection. Including all 768 screening episodes, agreement was 98% for RWROP. There was disagreement in 16 screenings (2%) for 11 (6%) neonates. Of the five screenings (0.7%) that the ophthalmologist thought were RWROP and the nurse did not, three were disagreements about whether the zone was posterior zone 2 or zone 1.

Conclusions

We found excellent levels of agreement and add evidence that interpretations by specialist trained nurses could be safely integrated into a ‘hybrid ROP screening system’.

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在一项既定的远程医疗筛查计划中，经过培训的新生儿护士在发现需要转诊的早产儿视网膜病变方面具有极高的准确性。

目的：评估受过专业培训的早产儿视网膜病变（ROP）护士与经验丰富的儿科眼科医生在使用宽视场数字视网膜成像检测转诊需要的早产儿视网膜病变（RWROP）方面的一致程度：这是一项前瞻性、观察性、盲法研究，研究对象是 2020 年 7 月至 2022 年 11 月期间在三级新生儿重症监护病房的新生儿。由经过培训的 ROP 护士使用宽视场数字视网膜成像技术进行图像采集，然后进行 ROP 分级和分期。然后与经验丰富的儿科眼科医生的检查结果进行比较。主要结果是两只眼睛中是否存在 RWROP：共纳入 105 名新生儿（55% 为男性），共进行了 768 次筛查。在初次筛查中，护士和眼科医生对 195 名新生儿中的 191 名（98%，kappa = 0.79，P 结论）是否存在 RWROP 达成一致：我们发现双方的意见高度一致，并进一步证明受过专业培训的护士可以安全地将解释工作整合到 "混合 ROP 筛查系统 "中。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of paediatrics and child health 医学-小儿科

CiteScore

2.90

自引率

5.90%

发文量

487

审稿时长

3-6 weeks

期刊介绍： The Journal of Paediatrics and Child Health publishes original research articles of scientific excellence in paediatrics and child health. Research Articles, Case Reports and Letters to the Editor are published, together with invited Reviews, Annotations, Editorial Comments and manuscripts of educational interest.