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WINROP、CHOP-ROP 和 ROPScore 在检测 1 型早产儿视网膜病变中的诊断准确性。

Diagnostic Accuracy of WINROP, CHOP-ROP and ROPScore in Detecting Type 1 Retinopathy of Prematurity.

机构信息

Division of Neonatology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi.

Division of Neonatology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi. Correspondence to: Dr Anu Thukral, Associate Professor, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029.

出版信息

Indian Pediatr. 2021 Oct 15;58(10):915-921. doi: 10.1007/s13312-021-2321-4. Epub 2021 May 20.

Abstract

BACKGROUND

Algorithms for predicting retinopathy of prematurity (ROP) requiring treatment need to be validated in Indian settings to determine if the burden of screening can be reduced without compromising the sensitivity of existing gestation and weight-based cut offs.

OBJECTIVE

To evaluate the performance of the available algorithms namely, WINROP (Weight, Insulin-like growth factor I, Neonatal ROP), CHOP-ROP (Children's Hospital of Philadelphia ROP) and ROPScore in predicting type 1 ROP and time from alarm to treatment by each algorithm.

STUDY DESIGN

Ambispective observational.

SETTING

Tertiary care neonatal intensive care unit in India.

PARTICIPANTS

Neonates less than 32 weeks or less than 1500 g born between July, 2013 to June, 2019 (N=578), who underwent ROP screening.

PRIMARY OUTCOME

Sensitivity, specificity and time from alarm to treatment by each algorithm.

RESULTS

The sensitivity and specificity of WINROP was 85% and 36%, for CHOP-ROP it was 54% and 71%, and for ROPScore it was 73% and 67%, respectively in detecting type 1 ROP. A total of 50/51 (98%) of neonates with type 1 ROP underwent treatment at median gestation of 9 weeks and median time from alarm to treatment by WINROP, CHOP-ROP and ROPScore was 7, 7 and 3 weeks, respectively.

CONCLUSION

WINROP, CHOP-ROP and ROPScore were not sensitive enough to replace the gestational age, weight and risk factor-based screening criteria for type 1 ROP.

摘要

背景

需要在印度环境中验证预测需要治疗的早产儿视网膜病变(ROP)的算法,以确定是否可以在不影响现有基于胎龄和体重的截止值的敏感性的情况下减少筛查负担。

目的

评估现有的算法,即 WINROP(体重、胰岛素样生长因子 I、新生儿 ROP)、CHOP-ROP(费城儿童医院 ROP)和 ROPScore 在预测 1 型 ROP 和每个算法从警报到治疗的时间方面的表现。

研究设计

前瞻性观察性。

设置

印度的三级保健新生儿重症监护病房。

参与者

2013 年 7 月至 2019 年 6 月期间出生的胎龄小于 32 周或体重小于 1500 克的新生儿(N=578),接受 ROP 筛查。

主要结局

每个算法的敏感性、特异性和从警报到治疗的时间。

结果

WINROP 检测 1 型 ROP 的敏感性和特异性分别为 85%和 36%,CHOP-ROP 分别为 54%和 71%,ROPScore 分别为 73%和 67%。51 例(98%)1 型 ROP 患儿接受治疗,中位胎龄为 9 周,WINROP、CHOP-ROP 和 ROPScore 从警报到治疗的中位时间分别为 7、7 和 3 周。

结论

WINROP、CHOP-ROP 和 ROPScore 对 1 型 ROP 的敏感性不够,无法替代基于胎龄、体重和危险因素的筛查标准。

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本文引用的文献

1
Operational guidelines for ROP in India: A summary.印度早产儿视网膜病变(ROP)临床操作指南:概述。
Indian J Ophthalmol. 2020 Feb;68(Suppl 1):S108-S114. doi: 10.4103/ijo.IJO_1827_19.
10
Evaluation of the WinROP system for identifying retinopathy of prematurity in Czech preterm infants.用于识别捷克早产婴儿早产儿视网膜病变的WinROP系统评估。
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2017 Mar;161(1):111-116. doi: 10.5507/bp.2016.061. Epub 2016 Dec 13.

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