Evidence map›Paper›PMID 32759245›Full record

ArticleBMJ open2020

Comparison of wide field imaging by nurses with indirect ophthalmoscopy by ophthalmologists for retinopathy of prematurity: a diagnostic accuracy study.

Sam Ebenezer Athikarisamy, Geoffrey Christopher Lam, Stuart Ross, Shripada Cuddapah Rao, Debbie Chiffings, Karen Simmer, Max K Bulsara, Sanjay Patole

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Observational
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Sam Ebenezer AthikarisamyDepartment of Neonatology, Perth Children's Hospital, Perth, Western Australia, Australia.ORCID 0000-0002-3347-3088
Geoffrey Christopher LamDepartment of Ophthalmology, Perth Children's Hospital, Nedlands, Western Australia, Australia geoffrey.lam@health.wa.gov.au.
Stuart RossDepartment of Ophthalmology, Midland Swan Valley Clinic, Perth, Western Australia, Australia.
Shripada Cuddapah RaoDepartment of Neonatology, Perth Children's Hospital, Perth, Western Australia, Australia.
Debbie ChiffingsDepartment of Neonatology, Perth Children's Hospital, Perth, Western Australia, Australia.
Karen SimmerDepartment of Neonatology, Perth Children's Hospital, Perth, Western Australia, Australia.
Max K BulsaraBiostatistics, Institute for Health Research, University of Notre Dame, Perth, Western Australia, Australia.
Sanjay PatoleDepartment of Neonatology, King Edward Memorial Hospital for Women, Perth, Western Australia, Australia.
The University of Western Australia · AUThe University of Notre Dame Australia · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesRetinopathy of prematurity (ROP) is a vasoproliferative disease of the preterm retina with the potential to cause irreversible blindness. Timely screening and treatment of ROP are critical. Neonatal nurses trained in wide field digital retinal photography (WFDRP) for screening may provide a safe and effective strategy to reduce the burden of ophthalmologists in performing binocular indirect ophthalmoscopy (BIO). The objective of the study was to determine the diagnostic accuracy of WFDRP in the diagnosis of referral warranting ROP (RWROP).

designProspective diagnostic accuracy study.

settingA tertiary neonatal intensive care unit in Perth, Western Australia.

participantsPreterm infants who fulfilled the Australian ROP screening criteria (gestational age (GA) <31 weeks, birth weight (BW) <1250 g).

interventionSets of 5-6 images per eye (index test) were obtained within 24-48 hours prior to or after the BIO (reference standard), and uploaded onto a secured server. A wide field digital camera (RetCam, Natus, Pleasanton, California, USA) was used for imaging. A paediatric ophthalmologist performed the BIO. The ophthalmologists performing BIO versus reporting the images were masked to each other's findings. PRIMARY OUTCOME: The area under the receiver operating characteristic (ROC) curve was used as a measure of accuracy of WFDRP to diagnose RWROP.

resultsA total of 85 infants (mean BW; 973.43 g, mean GA; 29 weeks) underwent a median of two sessions of WFDRP. There were 188 episodes of screening with an average of five images per eye. WFDRP identified RWROP in 7.4% (14/188 sessions) of examinations. In one infant, BIO showed bilateral plus disease and WFDRP did not pick up the plus disease. WFDRP image interpretation had a sensitivity of 80%, specificity of 94.5% for the detection of RWROP. The 'area under the ROC curve' was 88% when adjusted for covariates.

conclusionsWFDRP by neonatal nurses was feasible and effective for diagnosing RWROP in our set up. TRIAL REGISTRATION NUMBER: ACTRN12616001386426.

Indexed as

OphthalmologistsRetinopathy of PrematurityAustraliaChildGestational AgeHumansInfantInfant, NewbornInfant, PrematureNeonatal ScreeningOphthalmoscopyPhotographyProspective StudiesReproducibility of ResultsSensitivity and SpecificityWestern Australiamedical retinaneonatologyophthalmology

Identifiers

PMID32759245
PMCPMC7409991
OpenAlexW3047034969

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.