Assessment of a Tele-education System to Enhance Retinopathy of Prematurity Training by International Ophthalmologists-in-Training in Mexico

Berrones-Medina, David; Swan, Ryan; Ryan, Michaël; Yap, Vivien; Port, Alexander; Patel, Samir N.; MacKeen, Leslie; Wu, Wei‐Chi; Anzures, Rachelle; Ventura, Camila V.; Chiang, Michael F.; Ostmo, Susan; Sönmez, Kemal; Kim, Sang Jin; Campbell, J. Peter; Chan, Robison Vernon Paul; Jonas, Karyn; Orlin, Anton; Horowitz, Jason; Coki, Osode; Eccles, Cheryl-Ann; Sarna, Leora; Berrocal, Audina M.; Negron, Catherin I.; Denser, Kimberly; Cumming, Kristi; Osentoski, Tammy; Check, Tammy; Zajechowski, Mary; Lee, Thomas; Kruger, Evan; McGovern, Kathryn; Simmons, Charles F.; Murthy, Raghu; Galvis, Sharon; Rotter, Jerome I.; Chen, Ida; Li, Xiaohui; Taylor, Kent D.; Roll, Kaye; Kalpathy–Cramer, Jayashree; Erdoğmuş, Deni̇z; Ionnidis, Stratis; Martinez-Castellanos, María A.; Salinas-Longoria, Samantha; Romero, Rafael; Arriola, Andrea; Olguin-Manríquez, Francisco; Meraz-Gutiérrez, Miroslava; Dulanto-Reinoso, Carlos M.; Montero-Mendoza, Cristina

doi:10.1016/j.ophtha.2017.02.014

Cited by 31 publications

(21 citation statements)

References 37 publications

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“…19 Among children, educational programs can effectively increase the diagnostic accuracy of retinopathy of prematurity. 20 In the elderly Korean population, lifetime use of eye care was influenced by educational level. 21 A study in India also demonstrated that educational intervention may increase the use of eye care by targeting the rural population.…”

Section: Discussionmentioning

confidence: 99%

Association of Socioeconomics With Prevalence of Visual Impairment and Blindness

et al. 2017

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IMPORTANCE Vision loss is the third most common impairment worldwide. Although cost-effective interventions are available for preventing or curing most causes of vision loss, availability of these interventions varies considerably between countries and districts. Knowledge of the association between vision loss and socioeconomic factors is informative for public health planning. OBJECTIVES To explore correlations of the prevalence of visual impairment with socioeconomic factors at country levels and to model and estimate a socioeconomic-adjusted disease burden based on these data. DESIGN, SETTING, AND PARTICIPANTS In this cross-sectional study, the following data were collected from 190 countries and territories: the age-standardized prevalence of moderate to severe visual impairment (MSVI) and blindness from January 1 to December 31, 2010, across countries, human development index (HDI), gross domestic product (GDP) per capita, total health expenditure, total health expenditure as percentage of GDP (total health expenditure/GDP), public health expenditure as percentage of total health expenditure (public/total health expenditure), and out-of-pocket expenditure as percentage of total health expenditure (out-of-pocket/total health expenditure). Countries were divided into 4 levels (low, medium, high, and very high) by HDI. Data analysis was conducted from September 1, 2016, to July 1, 2017. MAIN OUTCOMES AND MEASURES The correlations between prevalence data and socioeconomic indices were assessed. RESULTS A strong negative association between prevalence rates of MSVI and blindness and socioeconomic level of development was observed. The mean (SD) age-standardized prevalence of MSVI decreased from 4.38% (1.32%) in low-HDI regions to 1.51% (1.00%) in very-high-HDI regions (P < .001). The national HDI level was attributable to 56.3% of global variation in prevalence rates of MSVI and 67.1% of global variation in prevalence rates of blindness. Higher prevalence rates were also associated with lower total health expenditure per capita, total health expenditure/GDP (β = −0.236 [95% CI, −0.315 to −0.157] for prevalence of MSVI; β = −0.071 [95% CI, −0.100 to −0.042] for prevalence of blindness), public/total health expenditure (β = −0.041 [95% CI, −0.052 to −0.031] for prevalence of MSVI; β = −0.014 [95% CI, −0.018 to −0.010] for prevalence of blindness), and higher percentage of out-of-pocket/total health expenditure (β = 0.044 [95% CI, 0.032-0.055] for prevalence of MSVI; β = 0.013 [95% CI, 0.009-0.017] for prevalence of blindness). Countries with increased burden of visual impairment and blindness can be easily identified by the results of the linear models. Socioeconomic factors could explain 69.4% of the global variations in prevalence of MSVI and 76.3% of the global variations in prevalence of blindness. CONCLUSIONS AND RELEVANCE Burden of visual impairment and socioeconomic indicators were closely associated and may help to identify countries requiring greater attention to these issues. The regression modeling desc...

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Section: Discussionmentioning

confidence: 99%

Association of Socioeconomics With Prevalence of Visual Impairment and Blindness

et al. 2017

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“…Although this is a potentially reasonable model for universal newborn eye screening, it has been demonstrated that for ROP screening, diagnostic accuracy for ROP is affected by the experience of the image grader. [7][8][9][10][11] Therefore, it would be important to understand, in a well performed prospective study, the ability of physician and non-physician graders to accurately and reliably identify disease that requires referral in a universal newborn eye screening program. Indeed, three out of four pilot studies on universal newborn eye screening have been performed as expanded versions of ongoing ROP telemedicine programs.…”

Section: What Is the Significance Of Retinal Hemorrhages In Newborns?mentioning

confidence: 99%

Universal newborn eye screening: an effective strategy to improve ocular health?

Chee

Chan

2017

Eye

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“…This education system has been studied in two separate populations: 31 ophthalmology residents among 5 residency programs in the United States and 1 residency program in Canada and 58 ophthalmology residents and fellows from 1 program in Mexico. 53,54 Both studies found that the system was effective in improving diagnostic accuracy of ROP by ophthalmologists-in-training. Although this program has limitations, such as not tracking common errors made by trainees and not including examples of stage 4 or stage 5 ROP, the authors feel that improvements can be made and that this platform has potential to be used in a widespread manner to standardize evaluation of ROP images for both physician and nonphysician graders.…”

Section: Guidelines For Reading Centersmentioning

confidence: 99%

Telemedicine for Retinopathy of Prematurity

Brady

D'Amico

Campbell

2020

Telemedicine and e-Health

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Background: Retinopathy of prematurity (ROP) is a disease of the retinal vasculature that remains a leading cause of childhood blindness worldwide despite improvements in the systemic care of premature newborns. Screening for ROP is effective and cost-effective, but in many areas, access to skilled examiners to conduct dilated examinations is poor. Remote screening with retinal photography is an alternative strategy that may allow for improved ROP care. Methods: The current literature was reviewed to find clinical trials and expert consensus documents on the state-of-the-art of telemedicine for ROP. Results: Several studies have confirmed the utility of telemedicine for ROP. In addition, several clinical studies have reported favorable long-term results. Many investigators have reinforced the need for detailed protocols on image acquisition and image interpretation. Conclusions: Telemedicine for ROP appears to be a viable alternative to live ophthalmoscopic examinations in many circumstances. Standardization and documentation afforded by telemedicine may provide additional benefits to providers and their patients. With continued improvements in image quality and affordability of imaging systems as well as improved automated image interpretation tools anticipated in the near future, telemedicine for ROP is expected to play an expanding role for a uniquely vulnerable patient population.

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Assessment of a Tele-education System to Enhance Retinopathy of Prematurity Training by International Ophthalmologists-in-Training in Mexico

Abstract: A tele-education system for ROP education was effective in improving the diagnostic accuracy of ROP by ophthalmologists-in-training in Mexico. This system has the potential to increase competency in ROP diagnosis and management for ophthalmologists-in-training from middle-income nations.

Cited by 31 publications

References 37 publications

Association of Socioeconomics With Prevalence of Visual Impairment and Blindness

Association of Socioeconomics With Prevalence of Visual Impairment and Blindness

Universal newborn eye screening: an effective strategy to improve ocular health?

Telemedicine for Retinopathy of Prematurity

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