Validation of WINROP for detecting retinopathy of prematurity in a North American cohort of preterm infants

Jung, Jennifer; Wagner, Brandie D.; McCourt, Emily A.; Palestine, Alan G.; Cerda, Ashlee M.; Cao, Jennifer H.; Enzenauer, Robert W.; Singh, Jasleen; Braverman, Rebecca; Wymore, Erica; Lynch, Anne M.

doi:10.1016/j.jaapos.2017.05.004

Cited by 28 publications

(22 citation statements)

References 24 publications

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“…NTproBNP and NTproBNP-based scores share the problem of limited generalizability with proportional weight gain (20,21) or risk factor-based models (22,24). In contrast to the expectations underlying this multinational endeavor, the results of this study do not allow for a change in current clinical practice in infants o30 weeks.…”

Section: Discussionmentioning

confidence: 70%

“…Although immaturity and oxygen exposure are pivotal for the development of ROP, the risk of severe ROP is further increased by poor postnatal growth. This link is thought to be mediated by low levels of insulin-like growth factor 1 and serves as a base for ROP prediction models such as WINROP (20) or CHOPROP (21). Furthermore, severe ROP is more common in infants with conditions that increase myocardial pressure or volume load, such as sepsis (22,23), blood transfusions (23,24), pulmonary hypertension treated with inhaled nitric oxide (25), patent ductus arteriosus (23), or inotrope use (22,(26)(27)(28)(29).…”

Section: Discussionmentioning

confidence: 99%

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N-terminal B-type natriuretic peptide urinary concentrations and retinopathy of prematurity

et al. 2017

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BackgroundTo validate the findings of a single-center pilot study showing elevated urinary N-terminal B-type natriuretic peptide (NTproBNP) concentrations in preterm infants subsequently developing severe retinopathy of prematurity (ROP) in a multicenter setting across eight European and Middle East countries.MethodsProspective observational study in 967 preterm infants <30 weeks' gestational age assessing the capacity of urinary NTproBNP on days of life (DOLs) 14 and 28 to predict ROP requiring treatment.ResultsUrinary NTproBNP concentrations were markedly elevated in infants who developed ROP requiring treatment (n=94) compared with survivors without ROP treatment (n=837), at both time points (median (interquartile range) DOL14: 8,950 (1,925-23,783) vs. 3,083 (1,193-17,393) vs. 816 (290-3,078) pg/ml, P<0.001) and DOL28 (2,203 (611-4,063) vs. 1,671 (254-11,340) vs. 408 (162-1,126) pg/ml, P<0.001). C-statistic of NTproBNP for treated ROP or death was 0.731 (95% confidence interval 0.654-0.774) for DOL14 and 0.683 (0.622-0.745) for DOL28 (P<0.001). Threshold scores were calculated, potentially enabling around 20% of infants with low NTproBNP scores never to be screened with ophthalmoscopy.ConclusionThere is a strong association between early urinary NTproBNP and subsequent ROP development, which can be used to further refine subgroups of patients with high or low risk of severe ROP.

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 99%

N-terminal B-type natriuretic peptide urinary concentrations and retinopathy of prematurity

et al. 2017

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“…Table 4 summarizes the results of 12 countries of both high-and moderate-/low-income status who have participated in the WINROP study, including our study. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Overall, WINROP has been reported to have good efficacy as a screening tool. However, the sensitivity of WINROP varies among countries.…”

Section: Discussionmentioning

confidence: 99%

“…The study outcome has been described in numerous countries. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] In Asia, it has been reported in China, Korea, Taiwan, India and Japan. 6,7,11,15,16 Based on a PubMed search, no similar reports are available from the South East Asia region, especially in a developing country.…”

Section: Introductionmentioning

confidence: 99%

<p>Efficacy of WINROP as a Screening Tool for Retinopathy of Prematurity in the East Coast of Malaysia</p>

Lim¹,

Oo²,

Tai³

et al. 2020

OPTH

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Purpose: To evaluate the efficacy of the "weight, insulin-like growth factor 1, neonatal retinopathy of prematurity" (WINROP) algorithm in predicting retinopathy of prematurity (ROP) requiring treatment in Malaysia. Participants: This was a retrospective study involving premature infants with gestational age less than 32 weeks treated from September 2016 to March 2019 in Hospital Universiti Sains Malaysia. Clinical diagnosis was made based on Early Treatment Retinopathy of Prematurity study. Participants' weekly weight gain since birth was entered in the website (http://winrop.com), along with date of birth, gestational age and final clinical examination outcome. WINROP software signals an alarm if an infant is at high risk of developing ROP requiring treatment during weight data entry. By using the alarm status, the sensitivity and specificity of this algorithm for predicting ROP requiring treatment were obtained. Results: Ninety-two infants were included in this study. An alarm was detected in 67 infants (72.8%). There were a total of 53 infants (54.6%) with no ROP, 15 (16.3%) of whom developed stage 1 ROP, 10 (10.8%) who developed stage 2 ROP and 14 infants (15.2%) who developed stage 3 ROP. In our study, WINROP sensitivity was 95.2% and specificity was 33.8%. Conclusion: WINROP is recommended as an initial screening tool for premature infants at risk of developing treatment-requiring ROP in Malaysia. It may help to alert clinicians managing severely ill infants when clinical examinations are less possible.

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“…Although telemedicine and digital photography have improved access in some areas, costs, training expertise and other practicalities restrict universal screening . This and the physical discomfort and instability caused to the infant , and distressing nature of the examination to the family, mean that noninvasive markers of ROP development have been sought, and algorithms generated to attempt to maximise the performance of features associated with ROP development to accurately predict this . To date, no ‘ideal’ biomarkers of ROP have been identified and sufficiently tested, but urinary B‐type natriuretic peptide (BNP) shows promise .…”

Section: Introductionmentioning

confidence: 99%

Retinopathy of prematurity screening at ≥30 weeks: urinary NTpro‐BNP performance

et al. 2018

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Validation of WINROP for detecting retinopathy of prematurity in a North American cohort of preterm infants

Cited by 28 publications

References 24 publications

N-terminal B-type natriuretic peptide urinary concentrations and retinopathy of prematurity

N-terminal B-type natriuretic peptide urinary concentrations and retinopathy of prematurity

<p>Efficacy of WINROP as a Screening Tool for Retinopathy of Prematurity in the East Coast of Malaysia</p>

Retinopathy of prematurity screening at ≥30 weeks: urinary NTpro‐BNP performance

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