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Facilitated Versus Self-guided Training of Non-ophthalmologists for Grading Pre-plus and Plus Disease Using Fundus Images for Retinopathy of Prematurity Screening.

Publication ,  Journal Article
Raufi, NN; Morris, CK; Freedman, SF; Wallace, DK; Prakalapakorn, SG
Published in: J Pediatr Ophthalmol Strabismus
May 1, 2016

PURPOSE: Retinopathy of prematurity (ROP) is an important cause of preventable blindness; barriers to screening necessitate novel approaches. Although trained non-ophthalmologists can accurately grade retinal images for ROP, effective training protocols are not established. This study compares the effectiveness of facilitated versus self-guided training of non-ophthalmologists for grading retinal images for pre-plus or plus disease in ROP. METHODS: Forty-eight undergraduate and graduate students were trained to grade retinal images for the presence of pre-plus or plus disease. Students were randomly assigned to one of two training protocols. Both used identical electronic slideshows: one was guided by an in-person facilitator and the other was self-guided. After completing their respective training, students proficient in grading pre-plus and plus disease graded images in a telemedicine screening scenario. Accuracy of grading was compared to the reference standard of clinical examination. RESULTS: Eighty-three percent (40 of 48) of trained students (91% in the facilitated vs 77% in the self-guided group, P = .26) were proficient and qualified to grade the ROP telemedicine screening scenario. Median accuracy for grading normal, pre-plus, or plus disease was 69% (70% in the facilitated vs 68% in the self-guided group, P = .91). When considering the designation of pre-plus or plus disease by graders as a screening test for detecting plus disease (confirmed on clinical examination), the median sensitivity and specificity of all students were 95% and 64%, respectively. CONCLUSIONS: Both facilitated and self-guided teaching protocols yielded similar performance in ROP image grading for pre-plus or plus disease. Self-guided training protocols may be adequate to train non-ophthalmologists to grade retinal images for pre-plus and plus disease with high sensitivity. [J Pediatr Ophthalmol Strabismus. 2016;53(3):179-185.].

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Published In

J Pediatr Ophthalmol Strabismus

DOI

EISSN

1938-2405

Publication Date

May 1, 2016

Volume

53

Issue

3

Start / End Page

179 / 185

Location

United States

Related Subject Headings

  • Telemedicine
  • Sensitivity and Specificity
  • Retinopathy of Prematurity
  • Retinal Vessels
  • Reproducibility of Results
  • Prospective Studies
  • Ophthalmology & Optometry
  • Ophthalmology
  • Infant, Premature
  • Image Interpretation, Computer-Assisted
 

Citation

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ICMJE
MLA
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Raufi, N. N., Morris, C. K., Freedman, S. F., Wallace, D. K., & Prakalapakorn, S. G. (2016). Facilitated Versus Self-guided Training of Non-ophthalmologists for Grading Pre-plus and Plus Disease Using Fundus Images for Retinopathy of Prematurity Screening. J Pediatr Ophthalmol Strabismus, 53(3), 179–185. https://doi.org/10.3928/01913913-20160314-01
Raufi, Nikolas N., Caleb K. Morris, Sharon F. Freedman, David K. Wallace, and S Grace Prakalapakorn. “Facilitated Versus Self-guided Training of Non-ophthalmologists for Grading Pre-plus and Plus Disease Using Fundus Images for Retinopathy of Prematurity Screening.J Pediatr Ophthalmol Strabismus 53, no. 3 (May 1, 2016): 179–85. https://doi.org/10.3928/01913913-20160314-01.
Raufi NN, Morris CK, Freedman SF, Wallace DK, Prakalapakorn SG. Facilitated Versus Self-guided Training of Non-ophthalmologists for Grading Pre-plus and Plus Disease Using Fundus Images for Retinopathy of Prematurity Screening. J Pediatr Ophthalmol Strabismus. 2016 May 1;53(3):179–85.
Raufi, Nikolas N., et al. “Facilitated Versus Self-guided Training of Non-ophthalmologists for Grading Pre-plus and Plus Disease Using Fundus Images for Retinopathy of Prematurity Screening.J Pediatr Ophthalmol Strabismus, vol. 53, no. 3, May 2016, pp. 179–85. Pubmed, doi:10.3928/01913913-20160314-01.
Raufi NN, Morris CK, Freedman SF, Wallace DK, Prakalapakorn SG. Facilitated Versus Self-guided Training of Non-ophthalmologists for Grading Pre-plus and Plus Disease Using Fundus Images for Retinopathy of Prematurity Screening. J Pediatr Ophthalmol Strabismus. 2016 May 1;53(3):179–185.

Published In

J Pediatr Ophthalmol Strabismus

DOI

EISSN

1938-2405

Publication Date

May 1, 2016

Volume

53

Issue

3

Start / End Page

179 / 185

Location

United States

Related Subject Headings

  • Telemedicine
  • Sensitivity and Specificity
  • Retinopathy of Prematurity
  • Retinal Vessels
  • Reproducibility of Results
  • Prospective Studies
  • Ophthalmology & Optometry
  • Ophthalmology
  • Infant, Premature
  • Image Interpretation, Computer-Assisted