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Colorado Retinopathy of Prematurity Screening Algorithm (CO-ROP): a validation study at a tertiary care center
Jason M Huang1, Xihui Lin1, Yu-Guang He1
1Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, Texas.
Insights
The Colorado Retinopathy of Prematurity Screening Algorithm (CO-ROP) reduced infant screenings but missed two cases of type 1 retinopathy of prematurity (ROP). Further algorithm refinement is needed for optimal ROP detection in premature infants.
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Current national screening guidelines for ROP involve a substantial number of infants.
- The Colorado Retinopathy of Prematurity Screening Algorithm (CO-ROP) was developed to optimize screening criteria.
Purpose of the Study:
- To evaluate the diagnostic validity of the CO-ROP algorithm in a real-world clinical setting.
- To assess the CO-ROP algorithm's effectiveness in identifying infants with sight-threatening retinopathy of prematurity.
- To determine if CO-ROP can reduce the number of infants undergoing unnecessary ROP screening.
Main Methods:
- Retrospective analysis of ROP screening data from consecutive newborns at a tertiary referral hospital.
- Application of the CO-ROP algorithm to historical patient data.
- Calculation of sensitivity and specificity for CO-ROP in detecting type 1 and type 2 ROP.
Main Results:
- The CO-ROP model would have reduced the number of infants screened by 34% compared to national criteria.
- CO-ROP demonstrated high sensitivity for detecting type 1 (93.1%) and type 2 (92.7%) ROP.
- However, CO-ROP failed to identify 2 out of 29 infants who developed type 1 ROP.
Conclusions:
- The CO-ROP algorithm shows promise in reducing the number of infants screened for ROP.
- The algorithm's failure to detect all cases of type 1 ROP indicates a need for further modification.
- Refinement of the CO-ROP algorithm is necessary to improve its accuracy and ensure timely ROP detection.
Purpose:
The Colorado Retinopathy of Prematurity Screening Algorithm (CO-ROP) recommends screening for infants meeting the following criteria for retinopathy of prematurity (ROP): gestational age ≤30 weeks, birth weight of ≤1500 g, and net weight gain of ≤650 g between birth and 4 weeks of age. This study was performed to evaluate the validity of CO-ROP in a tertiary referral county hospital.
Methods:
CO-ROP was used to retrospectively analyze the data from consecutive newborns screened for ROP using national screening guidelines at Parkland Hospital, Dallas, Texas, between April 1, 2009, to August 30, 2013. Sensitivities and specificities for identifying ROP were calculated.
Results:
A total of 374 infants were included, of whom 29 (7.8%) developed type 1 ROP and 12 (3.2%) developed type 2 ROP. The CO-ROP model would have decreased number of infants screened by 34% compared to current national screening criteria. CO-ROP had sensitivity of 93.1% (95% CI, 77.2-99.1) and 92.7% (95% CI, 61.5-99.8) for identifying type 1 and type 2 ROP, respectively. Of 29 patients who developed type 1 ROP, 2 were not identified using CO-ROP.
Conclusions:
The CO-ROP model significantly reduced total number screened but failed to detect 2 infants with type 1 ROP, suggesting the need for further modification of the algorithm.
