P Score: A Reference Image-Based Clinical Grading Scale for Vascular Change in Retinopathy of Prematurity

作者：Gil Binenbaum, Gil Binenbaum, Andreas Stahl, Aaron S. Coyner, Jocelyn He, Gui‐Shuang Ying, Susan Ostmo, R V Paul Chan, Cynthia Toth, Anand Vinekar, J. Peter Campbell, Michael F. Chiang, Graham E. Quinn, Alistair R. Fielder, Susan Ostmo, R V Paul Chan, Audina Berrocal, Gil Binenbaum, Gil Binenbaum, Michael Blair, J. Peter Campbell, Antonio Capone, Yi Chen, Shuan Dai, Anna Ells, Brian W. Fleck, William V. Good, M. Elizabeth Hartnett, G Holmström, Shunji Kusaka, Andrés Kychenthal, Domenico Lepore, Birgit Lorenz, María Ana Martinez-Castellanos, Sengul Ozdek, Dupe Ademola-Popoola, James D. Reynolds, Parag K. Shah, Michael Shapiro, Andreas Stahl, Cynthia Toth, Anand Vinekar, Linda Visser, David K. Wallace, Wei-Chi Wu, Peiquan Zhao, Andrea Zin, Baran Fr, Gerard Barry, Audina Berrocal, Amit Bhatt, Gil Binenbaum, Gil Binenbaum, Michael Blair, J. Peter Campbell, Shuan Dai, BRADLEY DAVITT, Alejandra de Alba Campomanes, Amgad Eldib, Alistair R. Fielder, Brian W. Fleck, Brooke Geddie, Kathryn Haider, M. Elizabeth Hartnett, G Holmström, Anne Jensen, Monica Khitri, Shunji Kusaka, María Ana Martinez-Castellanos, Susan Ostmo, Dupe Ademola-Popoola, Matthew Pihlblad, Graham E. Quinn, Michael Repka, Shira Robbins, Sarah Hilkert Rodriguez, Parag K. Shah, Andreas Stahl · 发表于：Ophthalmology · 年份：2024 · DOI：10.1016/j.ophtha.2024.05.019 · 被引用次数：16 · 研究领域：Retinopathy of Prematurity Studies、Retinal Imaging and Analysis、Child Abuse and Related Trauma

PURPOSE: The International Classification of Retinopathy of Prematurity, Third Edition (ICROP3), acknowledged that plus-like retinopathy of prematurity (ROP) vascular changes occurs along a spectrum. Historically, clinician-experts demonstrate variable agreement for plus diagnosis. We developed a 9-photograph reference image set for grading plus-like changes and compared intergrader agreement of the set with standard grading with no plus, preplus, and plus disease. DESIGN: Retinal photographic grading and expert consensus opinion. PARTICIPANTS: The development set included 34 international ICROP3 committee members. The validation set included 30 ophthalmologists with ROP expertise (15 ICROP3 committee members and 15 non-ICROP3 members) METHODS: Nine ROP fundus images (P1 through P9) representing increasing degrees of zone I vascular tortuosity and dilation, based on the 34 ICROP3 committee members' gradings and consensus image reviews, were used to establish standard photographs for the plus (P) score. Study participants graded 150 fundus photographs 2 ways, separated by a 1-week washout period: (1) no plus, preplus, or plus disease and (2) choosing the closest P score image. MAIN OUTCOME MEASURES: Intergrader agreement measured by intraclass correlation coefficient. RESULTS: Intergrader agreement was higher using the P score (intraclass correlation coefficient, 0.75; 95% confidence interval, 0.71-0.79) than no plus, preplus, or plus disease (intraclass correlation coefficien...