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Reduction in screening for retinopathy of prematurity through risk factor adjusted inclusion criteria.

AbstractAIMS:
To develop a new national screening guideline for retinopathy of prematurity (ROP).
METHODS:
Included were infants of the 2009 prospective ROP inventory in The Netherlands with gestational age (GA) <32 weeks and/or birth weight (BW) <1500 g. Five models were studied, based on GA and BW in combination with no, one or a set of five risk factors for ROP. Risk factors were determined by logistic regression. In MEDLINE and EMBASE, additional risk factors were searched. A precondition was that no infants with severe ROP would be missed. Receiver operating characteristic curves or classical measures were used to determine diagnostic accuracy.
RESULTS:
The model including all infants with severe ROP comprised screening of infants with GA <30 weeks and/or BW <1250 g and a selection of infants with GA 30-32 weeks and/or BW 1250-1500 g, with at least one of the following risk factors: artificial ventilation (AV), sepsis, necrotising enterocolitis (NEC), postnatal glucocorticoids or cardiotonica. This model would not detect 4.8% (95% CI 2.5% to 8.0%) of infants with mild ROP and would reduce infants eligible for screening by 29%.
CONCLUSIONS:
In The Netherlands, screening may be safely reduced using a new guideline based on GA, BW, AV, sepsis, NEC, postnatal glucocorticoids and cardiotonica.
AuthorsA J van Sorge, N E Schalij-Delfos, F T Kerkhoff, L J van Rijn, J L A M van Hillegersberg, I L A van Liempt, P G M Peer, H J Simonsz, J U M Termote
JournalThe British journal of ophthalmology (Br J Ophthalmol) Vol. 97 Issue 9 Pg. 1143-7 (Sep 2013) ISSN: 1468-2079 [Electronic] England
PMID23823079 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Topics
  • Female
  • Humans
  • Incidence
  • Infant, Newborn
  • Infant, Premature
  • Logistic Models
  • Male
  • Mass Screening (organization & administration)
  • Neonatal Screening (methods)
  • Netherlands (epidemiology)
  • Practice Guidelines as Topic
  • Retinopathy of Prematurity (diagnosis, epidemiology)
  • Risk Factors

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