{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T14:25:53Z","timestamp":1782915953632,"version":"3.54.5"},"reference-count":31,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2020,8,5]],"date-time":"2020-08-05T00:00:00Z","timestamp":1596585600000},"content-version":"unspecified","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,6,19]]},"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Retinopathy of prematurity (ROP) is a vasoproliferative disease of the preterm retina with the potential to cause irreversible blindness. Timely screening and treatment of ROP are critical. Neonatal nurses trained in wide field digital retinal photography (WFDRP) for screening may provide a safe and effective strategy to reduce the burden of ophthalmologists in performing binocular indirect ophthalmoscopy (BIO). The objective of the study was to determine the diagnostic accuracy of WFDRP in the diagnosis of referral warranting ROP (RWROP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective diagnostic accuracy study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A tertiary neonatal intensive care unit in Perth, Western Australia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Preterm infants who fulfilled the Australian ROP screening criteria (gestational age (GA) &lt;31 weeks, birth weight (BW) &lt;1250 g).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>Sets of 5\u20136 images per eye (index test) were obtained within 24\u201348 hours prior to or after the BIO (reference standard), and uploaded onto a secured server. A wide field digital camera (RetCam, Natus, Pleasanton, California, USA) was used for imaging. A paediatric ophthalmologist performed the BIO. The ophthalmologists performing BIO versus reporting the images were masked to each other\u2019s findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome<\/jats:title>\n                    <jats:p>The area under the receiver operating characteristic (ROC) curve was used as a measure of accuracy of WFDRP to diagnose RWROP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 85 infants (mean BW; 973.43 g, mean GA; 29 weeks) underwent a median of two sessions of WFDRP. There were 188 episodes of screening with an average of five images per eye. WFDRP identified RWROP in 7.4% (14\/188 sessions) of examinations. In one infant, BIO showed bilateral plus disease and WFDRP did not pick up the plus disease. WFDRP image interpretation had a sensitivity of 80%, specificity of 94.5% for the detection of RWROP. The \u2018area under the ROC curve\u2019 was 88% when adjusted for covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>WFDRP by neonatal nurses was feasible and effective for diagnosing RWROP in our set up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>ACTRN12616001386426.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-036483","type":"journal-article","created":{"date-parts":[[2020,8,6]],"date-time":"2020-08-06T01:45:27Z","timestamp":1596678327000},"page":"e036483","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Comparison of wide field imaging by nurses with indirect ophthalmoscopy by ophthalmologists for retinopathy of prematurity: a diagnostic accuracy study"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3347-3088","authenticated-orcid":false,"given":"Sam Ebenezer","family":"Athikarisamy","sequence":"first","affiliation":[{"name":"Department of Neonatology, Perth Children\u2019s Hospital, Perth, Western Australia, Australia"},{"name":"Department of Neonatology, King Edward Memorial Hospital for Women, Perth, Western Australia, Australia"},{"name":"Centre for Neonatal Research and Education, School of Medicine, University of Western Australia, Perth, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey Christopher","family":"Lam","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Perth Children\u2019s Hospital, Nedlands, Western Australia, Australia"},{"name":"Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart","family":"Ross","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Midland Swan Valley Clinic, Perth, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shripada Cuddapah","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Perth Children\u2019s Hospital, Perth, Western Australia, Australia"},{"name":"Department of Neonatology, King Edward Memorial Hospital for Women, Perth, Western Australia, Australia"},{"name":"Centre for Neonatal Research and Education, School of Medicine, University of Western Australia, Perth, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debbie","family":"Chiffings","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Perth Children\u2019s Hospital, Perth, Western Australia, Australia"},{"name":"Department of Neonatology, King Edward Memorial Hospital for Women, Perth, Western Australia, Australia"},{"name":"Centre for Neonatal Research and Education, School of Medicine, University of Western Australia, Perth, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Simmer","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Perth Children\u2019s Hospital, Perth, Western Australia, Australia"},{"name":"Department of Neonatology, King Edward Memorial Hospital for Women, Perth, Western Australia, Australia"},{"name":"Centre for Neonatal Research and Education, School of Medicine, University of Western Australia, Perth, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max K","family":"Bulsara","sequence":"additional","affiliation":[{"name":"Biostatistics, Institute for Health Research, University of Notre Dame, Perth, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Patole","sequence":"additional","affiliation":[{"name":"Department of Neonatology, King Edward Memorial Hospital for Women, Perth, Western Australia, Australia"},{"name":"Centre for Neonatal Research and Education, School of Medicine, University of Western Australia, Perth, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,8,5]]},"reference":[{"key":"2025120618455016000_10.8.e036483.1","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1038\/pr.2013.205","article-title":"Preterm-associated visual impairment and estimates of retinopathy of prematurity at regional and global levels for 2010","volume":"74 Suppl 1","author":"Blencowe","year":"2013","journal-title":"Pediatr 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