OBJECTIVE: To develop an efficient clinical prediction model that includes postnatal weight gain to identify infants at risk of developing severe retinopathy of prematurity (ROP). Under current birth weight (BW) and gestational age (GA) screening criteria, <5% of infants examined in countries with advanced neonatal care require treatment. PATIENTS AND METHODS: This study was a secondary analysis of prospective data from the Premature Infants in Need of Transfusion Study, which enrolled 451 infants with a BW <; 1000 g at 10 centers. There were 367 infants who remained after excluding deaths (82) and missing weights (2). Multivariate logistic regression was used to predict severe ROP (stage 3 or treatment). RESULTS: Median BW was 800 g (445-995). There were 67 (18.3%) infants who had severe ROP. The model included GA, BW, and daily weight gain rate. Run weekly, an alarm that indicated need for eye examinations occurred when the predicted probability of severe ROP was >0.085. This identified 66 of 67 severe ROP infants (sensitivity of 99% [95% confidence interval: 94%-100%]), and all 33 infants requiring treatment. Median alarm-to-outcome time was 10.8 weeks (range: 1.9-17.6). There were 110 (30%) infants who had no alarm. Nomograms were developed to determine risk of severe ROP by BW, GA, and postnatal weight gain. CONCLUSION: In a high-risk cohort, a BW-GA-weight-gain model could have reduced the need for examinations by 30%, while still identifying all infants requiring laser surgery. Additional studies are required to determine whether including larger-BW, lower-risk infants would reduce examinations further and to validate the prediction model and nomograms before clinical use.
RCT Entities:
OBJECTIVE: To develop an efficient clinical prediction model that includes postnatal weight gain to identify infants at risk of developing severe retinopathy of prematurity (ROP). Under current birth weight (BW) and gestational age (GA) screening criteria, <5% of infants examined in countries with advanced neonatal care require treatment. PATIENTS AND METHODS: This study was a secondary analysis of prospective data from the Premature Infants in Need of Transfusion Study, which enrolled 451 infants with a BW < 1000 g at 10 centers. There were 367 infants who remained after excluding deaths (82) and missing weights (2). Multivariate logistic regression was used to predict severe ROP (stage 3 or treatment). RESULTS: Median BW was 800 g (445-995). There were 67 (18.3%) infants who had severe ROP. The model included GA, BW, and daily weight gain rate. Run weekly, an alarm that indicated need for eye examinations occurred when the predicted probability of severe ROP was >0.085. This identified 66 of 67 severe ROP infants (sensitivity of 99% [95% confidence interval: 94%-100%]), and all 33 infants requiring treatment. Median alarm-to-outcome time was 10.8 weeks (range: 1.9-17.6). There were 110 (30%) infants who had no alarm. Nomograms were developed to determine risk of severe ROP by BW, GA, and postnatal weight gain. CONCLUSION: In a high-risk cohort, a BW-GA-weight-gain model could have reduced the need for examinations by 30%, while still identifying all infants requiring laser surgery. Additional studies are required to determine whether including larger-BW, lower-risk infants would reduce examinations further and to validate the prediction model and nomograms before clinical use.
Authors: Marco Colleoni; Vincenzo Bagnardi; Nicole Rotmensz; Giuseppe Viale; Mauro Mastropasqua; Paolo Veronesi; Anna Cardillo; Rosalba Torrisi; Alberto Luini; Aron Goldhirsch Journal: Eur J Cancer Date: 2010-05-13 Impact factor: 9.162
Authors: L E Smith; W Shen; C Perruzzi; S Soker; F Kinose; X Xu; G Robinson; S Driver; J Bischoff; B Zhang; J M Schaeffer; D R Senger Journal: Nat Med Date: 1999-12 Impact factor: 53.440
Authors: A Hellstrom; C Perruzzi; M Ju; E Engstrom; A L Hard; J L Liu; K Albertsson-Wikland; B Carlsson; A Niklasson; L Sjodell; D LeRoith; D R Senger; L E Smith Journal: Proc Natl Acad Sci U S A Date: 2001-05-01 Impact factor: 11.205
Authors: Ann Hellström; Eva Engström; Anna-Lena Hård; Kerstin Albertsson-Wikland; Björn Carlsson; Aimon Niklasson; Chatarina Löfqvist; Elisabeth Svensson; Sture Holm; Uwe Ewald; Gerd Holmström; Lois E H Smith Journal: Pediatrics Date: 2003-11 Impact factor: 7.124
Authors: Ilias Cagiannos; Pierre Karakiewicz; James A Eastham; Makato Ohori; Farhang Rabbani; Claudia Gerigk; Victor Reuter; Markus Graefen; Peter G Hammerer; Andreas Erbersdobler; Hartwig Huland; Patrick Kupelian; Eric Klein; David I Quinn; Susan M Henshall; John J Grygiel; Robert L Sutherland; Phillip D Stricker; Christopher G Morash; Peter T Scardino; Michael W Kattan Journal: J Urol Date: 2003-11 Impact factor: 7.450
Authors: Emily A McCourt; Gui-Shuang Ying; Anne M Lynch; Alan G Palestine; Brandie D Wagner; Erica Wymore; Lauren A Tomlinson; Gil Binenbaum Journal: JAMA Ophthalmol Date: 2018-04-01 Impact factor: 7.389