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Published on: August 6, 2021
Can We Optimize Retinopathy of Prematurity Screening by Combined Risk Score Analysis?
Emma Banwell1, Daniel York2, Sravanthi Vegunta3
1Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT.
Objective:
To evaluate a composite metric incorporating the DIGIROP-Birth (DRB) and Neonatal Research Network Bronchopulmonary Dysplasia Outcome Estimator (NRN-BPD) for predicting severe retinopathy of prematurity requiring treatment (TR-ROP).
Study Design:
This was a retrospective cohort study of 990 infants born prematurely undergoing dilated eye examinations between January 2010 and August 2023. We performed a chart review to assess a primary outcome of TR-ROP and secondary outcome of stage 2 or greater ROP. DRB and 14-day NRN-BPD scores were quantified for each infant, and optimal thresholds for predicting TR-ROP were analyzed using receiver operator characteristic curves. Sensitivity and specificity for TR-ROP were assessed.
Results:
Of the 990 infants, 364 (36.8%) had stage 2 or greater ROP and 68 (6.9%) had TR-ROP. Receiver operator characteristic analysis with (95% CI) showed areas under the curve of 0.867 (0.829-0.906) for DRB and 0.845 (0.809-0.881) for NRN-BPD. Optimal cutoff scores were 1.7 for DRB and 40% for NRN-BPD with respective sensitivities of 97% and 96%. Composite screening for babies meeting either cutoff allowed 100% sensitivity for predicting TR-ROP while decreasing number of infants qualifying for screening from 990 to 562 (43% reduction).
Conclusions:
A composite metric using DigiROP-Birth and NRN-BPD Outcome Estimator scores may allow an early, simple approach to predict TR-ROP with 100% sensitivity yet allow significant reduction in the number of infants requiring screening eye examinations. Additional large validation studies are needed.
