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

BOOST II Retinal Image Digital Analysis (RIDA) Group

Research output: Contribution to journalArticle

11 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)74-80
Number of pages7
JournalEye (Basingstoke)
Volume32
Issue number1
DOIs
StatePublished - Jan 1 2018
Externally publishedYes

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Retinopathy of Prematurity
Oxygen
New Zealand
Observer Variation
Ophthalmologists
Therapeutics
Software

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems

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An international comparison of retinopathy of prematurity grading performance within the Benefits of Oxygen Saturation Targeting II trials. / BOOST II Retinal Image Digital Analysis (RIDA) Group.

In: Eye (Basingstoke), Vol. 32, No. 1, 01.01.2018, p. 74-80.

Research output: Contribution to journalArticle

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title = "An international comparison of retinopathy of prematurity grading performance within the Benefits of Oxygen Saturation Targeting II trials",
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.",
author = "{BOOST II Retinal Image Digital Analysis (RIDA) Group} and Fleck, {B. W.} and C. Williams and E. Juszczak and K. Cocker and Stenson, {B. J.} and Darlow, {B. A.} and S. Dai and Gole, {G. A.} and Quinn, {G. E.} and Wallace, {David K.} and A. Ells and S. Carden and L. Butler and D. Clark and J. Elder and C. Wilson and S. Biswas and A. Shafiq and A. King and P. Brocklehurst and Fielder, {A. R.} and Cottrell, {David G.} and Rasha Altaie and Essex, {Rohan W.} and Lam, {Geoffrey C.} and Michael Forrest and Shaheen Shah and James Smith and Jeremy Smith and Deepa Taranath and Michael O'Keefe",
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AU - BOOST II Retinal Image Digital Analysis (RIDA) Group

AU - Fleck, B. W.

AU - Williams, C.

AU - Juszczak, E.

AU - Cocker, K.

AU - Stenson, B. J.

AU - Darlow, B. A.

AU - Dai, S.

AU - Gole, G. A.

AU - Quinn, G. E.

AU - Wallace, David K.

AU - Ells, A.

AU - Carden, S.

AU - Butler, L.

AU - Clark, D.

AU - Elder, J.

AU - Wilson, C.

AU - Biswas, S.

AU - Shafiq, A.

AU - King, A.

AU - Brocklehurst, P.

AU - Fielder, A. R.

AU - Cottrell, David G.

AU - Altaie, Rasha

AU - Essex, Rohan W.

AU - Lam, Geoffrey C.

AU - Forrest, Michael

AU - Shah, Shaheen

AU - Smith, James

AU - Smith, Jeremy

AU - Taranath, Deepa

AU - O'Keefe, Michael

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N2 - 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.

AB - 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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