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Evaluation of the WinROP system for identifying retinopathy of prematurity in Czech preterm infants
Juraj Timkovic1,2,3, Martina Pokryvkova4, Katerina Janurova5
1Clinic of Ophthalmology, University Hospital Ostrava, Czech Republic.
Insights
The WinROP system accurately identifies high-risk Retinopathy of Prematurity (ROP) in Czech infants, showing 100% sensitivity. However, it generates many false positives, limiting its use for less severe ROP cases.
Area of Science:
- Neonatology
- Ophthalmology
- Medical Informatics
Background:
- Retinopathy of Prematurity (ROP) is a critical condition in preterm infants requiring accurate risk assessment.
- The WinROP system predicts ROP risk using birth weight and weight changes, but its population-specific performance is unknown.
- Evaluating WinROP in the Czech population is essential for its clinical application.
Purpose of the Study:
- To assess the test characteristics of the WinROP system in Czech preterm infants.
- To determine the sensitivity, specificity, positive predictive value, and negative predictive value of WinROP for ROP prediction.
- To evaluate WinROP's utility in identifying infants at risk for severe ROP.
Main Methods:
- Retrospective analysis of data from 445 preterm infants undergoing ROP screening.
- Comparison of WinROP predictions with regular screening outcomes at University Hospital Ostrava.
- Evaluation of WinROP's performance metrics for high-risk and low-risk ROP.
Main Results:
- WinROP achieved 100% sensitivity and negative predictive value for high-risk ROP (Type 1 or Type 2).
- The system demonstrated lower specificity and positive predictive values, leading to numerous false positives.
- Performance was less reliable for predicting less serious forms of ROP.
Conclusions:
- WinROP is effective in identifying infants unlikely to develop high-risk ROP, potentially reducing screening burdens.
- The system's current limitations include a high false-positive rate, making it unsuitable for predicting less severe ROP.
- WinROP's performance aligns with its intended use for high-risk ROP detection in the Czech preterm infant population.
Aims:
Retinopathy of Prematurity (ROP) is a potentially serious condition that can afflict preterm infants. Timely and correct identification of individuals at risk of developing a serious form of ROP is therefore of paramount importance. WinROP is an online system for predicting ROP based on birth weight and weight increments. However, the results vary significantly for various populations. It has not been evaluated in the Czech population. This study evaluates the test characteristics (specificity, sensitivity, positive and negative predictive values) of the WinROP system in Czech preterm infants.
Methods:
Data on 445 prematurely born infants included in the ROP screening program at the University Hospital Ostrava, Czech Republic, were retrospectively entered into the WinROP system and the outcomes of the WinROP and regular screening were compared.
Results:
All 24 infants who developed high-risk (Type 1 or Type 2) ROP were correctly identified by the system. The sensitivity and negative predictive values for this group were 100%. However, the specificity and positive predictive values were substantially lower, resulting in a large number of false positives. Extending the analysis to low risk ROP, the system did not provide such reliable results.
Conclusions:
The system is a valuable tool for identifying infants who are not likely to develop high-risk ROP and this could help to substantially reduce the number of preterm infants in need of regular ROP screening. It is not suitable for predicting the development of less serious forms of ROP which is however in accordance with the declared aims of the WinROP system.
