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斯坦福大学早产儿视网膜病变诊断网络(SUNDROP):远程医疗筛查的12个月经验

Stanford University Network for Diagnosis of Retinopathy of Prematurity (SUNDROP): 12-month experience with telemedicine screening.

作者信息

Murakami Y, Jain A, Silva R A, Lad E M, Gandhi J, Moshfeghi D M

机构信息

Department of Ophthalmology, Stanford University School of Medicine, Stanford, California 94025, USA.

出版信息

Br J Ophthalmol. 2008 Nov;92(11):1456-60. doi: 10.1136/bjo.2008.138867. Epub 2008 Aug 14.

Abstract

BACKGROUND/AIMS: To report the 1-year experience of the Stanford University Network for Diagnosis of Retinopathy of Prematurity (SUNDROP) telemedicine initiative.

METHODS

Forty-two consecutively enrolled infants who met ROP examination criteria were screened between 1 December 2005 through 30 November 2006 with the RetCam II and evaluated by the SUNDROP reading centre at Stanford University. Nurses obtained five images in each eye. All patients also received a dilated examination by the author within 1 week of discharge from the hospital. Outcomes included referral-warranted disease, need for treatment and anatomical outcomes. Referral-warranted disease was defined as any Early Treatment Retinopathy of Prematurity (ROP) Disease Type 2 or greater, or any plus disease. A retrospective analysis of 84 eyes, 131 unique examinations and 1315 unique images from the SUNDROP archival data is reported here.

RESULTS

In the initial 12-month period, the SUNDROP telemedicine screening initiative had not missed any referral warranted ROP. Calculated sensitivity and specificity was 100% and 95%, respectively. No patient progressed to retinal detachment or other adverse outcomes.

CONCLUSIONS

The SUNDROP telemedicine screening initiative for ROP has proven to have a high degree of sensitivity and specificity for identification of referral warranted disease. These results indicate that telemedicine may improve accessibility of ROP screening.

摘要

背景/目的:报告斯坦福大学早产儿视网膜病变诊断网络(SUNDROP)远程医疗计划的1年经验。

方法

2005年12月1日至2006年11月30日期间,对42名符合ROP检查标准的连续入组婴儿使用RetCam II进行筛查,并由斯坦福大学的SUNDROP阅片中心进行评估。护士为每只眼睛获取5张图像。所有患者在出院后1周内还接受了作者的散瞳检查。结果包括需要转诊的疾病、治疗需求和解剖学结果。需要转诊的疾病定义为任何2型或更严重的早产儿视网膜病变(ROP),或任何附加病变。本文报告了对SUNDROP存档数据中的84只眼、131次独立检查和1315张独立图像的回顾性分析。

结果

在最初的12个月期间,SUNDROP远程医疗筛查计划没有漏诊任何需要转诊的ROP。计算得出的敏感性和特异性分别为100%和95%。没有患者发展为视网膜脱离或其他不良后果。

结论

SUNDROP针对ROP的远程医疗筛查计划已被证明在识别需要转诊的疾病方面具有高度的敏感性和特异性。这些结果表明,远程医疗可能会提高ROP筛查的可及性。

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