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Retinopathy of prematurity care: patterns of care and workforce analysis.

ABSTRACT: To describe the workforce that provides retinopathy of prematurity (ROP) care.We surveyed a random sample of ophthalmologists' offices by telephone (n = 1504) and then sent a mail survey to those who were reported to provide care to infants (n = 486). Workforce estimates were based on the total number of ophthalmologists in the United States.Thirty percent of ophthalmologists were reported to care for children younger than 1 year of age; 11% of all ophthalmologists examine for (1815; 95% confidence interval [95% CI] 1340-2379) and 6% treat ROP (983, 95% CI 649-1421). ROP examinations are provided by an equal number who have completed fellowship training in pediatric ophthalmology and strabismus (254, 95% CI 182-327) as have not completed any fellowship training (236, 95% CI 163-345). Ophthalmologists with fellowship training in any subspecialty provide 86% of the ROP examinations, with those trained in pediatric ophthalmology providing 50% overall. Some (9%) of the ophthalmologists who examine for ROP, regardless of whether or not they completed a fellowship (p = 0.22), report that their training did not adequately prepare them to do so. In contrast to examinations, most treatment is provided by ophthalmologists who are fellowship trained in retina and vitreous diseases.ROP care is offered by ophthalmologists with different training backgrounds. Future work is needed to understand the relationship between the availability of ophthalmologists and ROP care delivery and the role of new modes of care delivery such as telemedicine.

SUBMITTER: Kemper AR

PROVIDER: S-EPMC2566307 | biostudies-literature | 2008 Aug

REPOSITORIES: biostudies-literature

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Retinopathy of prematurity care: patterns of care and workforce analysis.

Kemper Alex R AR Freedman Sharon F SF Wallace David K DK

Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus 20080425 4

<h4>Purpose</h4>To describe the workforce that provides retinopathy of prematurity (ROP) care.<h4>Methods</h4>We surveyed a random sample of ophthalmologists' offices by telephone (n = 1504) and then sent a mail survey to those who were reported to provide care to infants (n = 486). Workforce estimates were based on the total number of ophthalmologists in the United States.<h4>Results</h4>Thirty percent of ophthalmologists were reported to care for children younger than 1 year of age; 11% of all ...[more]

PMID: 18440256

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Project description:ImportanceThe current guidelines for retinopathy of prematurity (ROP) detection programs in the United States include a range of birth weights (BWs) and gestational ages and likely require examinations of many premature infants who are at low risk for developing serious retinopathy.ObjectiveTo determine the incidence, onset, and early course of ROP in what to our knowledge is the largest cohort to date that is representative of infants who are undergoing ROP screening.Design, setting, and participantsThis secondary analysis of data from the Postnatal Growth and Retinopathy of Prematurity (G-ROP) retrospective cohort study was conducted in 29 hospitals in the United States and Canada between January 2006 and December 2011 and included 7483 infants who underwent serial ROP examinations.Main outcomes and measuresMost severe ROP in either eye, classified as no ROP, mild ROP, type 2 ROP, or type 1 ROP (per Early Treatment for ROP Study criteria). Onset at postmenstrual age for zone I disease and stage of ROP, plus disease, and treatment.ResultsThis study included 7483 infants with a mean (SD) BW of 1099 (259) g and a mean (SD) gestational age of 28 (3) weeks who underwent ROP examinations. Of these, 3224 infants (43.1%) developed ROP, 459 (6.1%) developed type 1 and 472 (6.3%) type 2 ROP, 514 (6.9%) underwent treatment in 1 or both eyes, and 147 (2%) had zone I disease. Additionally, 98.1% of type 1 or 2 ROP cases occurred in infants with a BW of less than 1251 g. Only about half of the eyes (49.4%) were vascularized into zone III by 37 weeks postmenstrual age.Conclusions and relevanceThese findings add to our knowledge of ROP screening as they include all eligible infants, not just high-risk infants as in previous studies. More than 40% of at-risk premature infants develop some stage of ROP, and most retinopathy regresses without treatment. However, approximately 12.5% develop severe ROP, which occurs almost exclusively among infants with a BW of less than 1251 g.

Dataset Information

Retinopathy of prematurity care: patterns of care and workforce analysis.

Publications

Retinopathy of prematurity care: patterns of care and workforce analysis.

Similar Datasets

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