@article {837016,
	title = {Risk Score for Predicting Treatment-Requiring Retinopathy of Prematurity (ROP) in the Telemedicine Approaches to Evaluating Acute-Phase ROP Study.},
	journal = {Ophthalmology},
	volume = {123},
	number = {10},
	year = {2016},
	month = {2016 Oct},
	pages = {2176-82},
	abstract = {PURPOSE: To develop a risk score for predicting treatment-requiring retinopathy of prematurity (TR-ROP) in the Telemedicine Approaches to Evaluating Acute-Phase Retinopathy of Prematurity (e-ROP) study. DESIGN: Second analyses of an observational cohort study. PARTICIPANTS: Infants with birth weight (BW) \&lt;1251 g who had >=1 imaging session by 34 weeks of postmenstrual age (PMA) and >=1 subsequent retinopathy of prematurity (ROP) examination for determining TR-ROP by study-certified ophthalmologists. METHODS: Nonphysician trained readers evaluated wide-field retinal image sets for characteristics of ROP, pre-plus/plus disease, and retinal hemorrhage. Risk score points for predicting TR-ROP were derived from the regression coefficients of significant predictors in a multivariate logistic regression model. MAIN OUTCOME MEASURES: TR-ROP. RESULTS: Eighty-five of 771 infants (11.0\%) developed TR-ROP. In a multivariate model, significant predictors for TR-ROP were gestational age (GA) (odds ratio [OR], 5.7; 95\% confidence interval [CI], 1.7-18.9 for <=25 vs. >=28 weeks), need for respiratory support (OR, 7.0; 95\% CI, 1.3-37.1 for high-frequency oscillatory ventilation vs. no respiratory support), slow weight gain (OR, 2.4; 95\% CI, 1.2-4.6 for weight gain <=12 g/day vs. \&gt;15 g/day), and image findings at the first image session including number of quadrants with pre-plus (OR, 3.8; 95\% CI, 1.5-9.7 for 4 pre-plus quadrants vs. no pre-plus), stage and zone of ROP (OR, 4.7; 95\% CI, 2.1-11.8 for stage 1-2 zone I, OR, 5.9; 95\% CI, 2.1-16.6 for stage 3 zone I vs. no ROP), and presence of blot hemorrhage (OR, 3.1; 95\% CI, 1.4-6.7). Image findings predicted TR-ROP better than GA (area under receiver operating characteristic curve [AUC]\&nbsp;= 0.82 vs. 0.75, P\&nbsp;= 0.03). The risk of TR-ROP steadily increased with higher risk score and predicted TR-ROP well (AUC\&nbsp;= 0.88; 95\% CI, 0.85-0.92). Risk score >=3 points for predicting TR-ROP had a sensitivity of 98.8\%, specificity of 40.1\%, and positive and negative predictive values of 17.0\% and 99.6\%, respectively. CONCLUSIONS: Image characteristics at 34 PMA weeks or earlier independently predict TR-ROP. If externally validated in other infants, risk score, calculated from image findings, GA, weight gain, and respiratory support, enables early identification of infants in need of increased surveillance for TR-ROP.},
	issn = {1549-4713},
	doi = {10.1016/j.ophtha.2016.06.037},
	author = {Ying, Gui-Shuang and Vanderveen, Deborah and Daniel, Ebenezer and Quinn, Graham E and Baumritter, Agnieshka and Telemedicine Approaches to Evaluating Acute-Phase Retinopathy of Prematurity Cooperative Group}
}
