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    An international comparison of retinopathy of prematurity grading performance within the Benefits of Oxygen Saturation Targeting II trials

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    Author
    Fleck, BW; Williams, C; Juszczak, E; Cocker, K; Stenson, BJ; Darlow, BA; Dai, S; Gole, GA; Quinn, GE; Wallace, DK; ...
    Date
    2018-01-01
    Source Title
    Eye
    Publisher
    NATURE PUBLISHING GROUP
    University of Melbourne Author/s
    Carden, Susan; Elder, James
    Affiliation
    Paediatrics (RCH)
    Metadata
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    Document Type
    Journal Article
    Citations
    Fleck, B. W., Williams, C., Juszczak, E., Cocker, K., Stenson, B. J., Darlow, B. A., Dai, S., Gole, G. A., Quinn, G. E., Wallace, D. K., Ells, A., Carden, S., Butler, L., Clark, D., Elder, J., Wilson, C., Biswas, S., Shafiq, A., King, A. ,... Fielder, A. R. (2018). An international comparison of retinopathy of prematurity grading performance within the Benefits of Oxygen Saturation Targeting II trials. EYE, 32 (1), pp.74-80. https://doi.org/10.1038/eye.2017.150.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/256652
    DOI
    10.1038/eye.2017.150
    Abstract
    PurposeTo investigate whether the observed international differences in retinopathy of prematurity (ROP) treatment rates within the Benefits of Oxygen Saturation Targeting (BOOST) II trials might have been caused by international variation in ROP disease grading.MethodsGroups of BOOST II trial ophthalmologists in UK, Australia, and New Zealand (ANZ), and an international reference group (INT) used a web based system to grade a selection of RetCam images of ROP acquired during the BOOST II UK trial. Rates of decisions to treat, plus disease grading, ROP stage grading, ROP zone grading, inter-observer variation within groups and intra-observer variation within groups were measured.ResultsForty-two eye examinations were graded. UK ophthalmologists diagnosed treat-requiring ROP more frequently than ANZ ophthalmologists, 13.9 (3.49) compared to 9.4 (4.46) eye examinations, P=0.038. UK ophthalmologists diagnosed plus disease more frequently than ANZ ophthalmologists, 14.1 (6.23) compared to 8.5 (3.24) eye examinations, P=0.021. ANZ ophthalmologists diagnosed stage 2 ROP more frequently than UK ophthalmologists, 20.2 (5.8) compared to 12.7 (7.1) eye examinations, P=0.026. There were no other significant differences in the grading of ROP stage or zone. Inter-observer variation was higher within the UK group than within the ANZ group. Intra-observer variation was low in both groups.ConclusionsWe have found evidence of international variation in the diagnosis of treatment-requiring ROP. Improved standardisation of the diagnosis of treatment-requiring ROP is required. Measures might include improved training in the grading of ROP, using an international approach, and further development of ROP image analysis software.

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