TY - JOUR
T1 - Assessment of a Tele-education System to Enhance Retinopathy of Prematurity Training by International Ophthalmologists-in-Training in Mexico
AU - on behalf of the
AU - GEN-ROP
AU - and the
AU - i-ROP Research Consortium
AU - GEN-ROP
AU - and the
AU - i-ROP Research Consortium
AU - and the
AU - i-ROP Research Consortium
AU - i-ROP Research Consortium
AU - Patel, Samir N.
AU - Martinez-Castellanos, Maria Ana
AU - Berrones-Medina, David
AU - Swan, Ryan
AU - Ryan, Michael C.
AU - Jonas, Karyn E.
AU - Ostmo, Susan
AU - Campbell, J. Peter
AU - Chiang, Michael F.
AU - Chan, R. V.Paul
AU - Chan, R. V.Paul
AU - Jonas, Karyn E.
AU - Chiang, Michael F.
AU - Ostmo, Susan
AU - Campbell, J. Peter
AU - Yap, Vivien
AU - Port, Alexander D.
AU - Patel, Samir N.
AU - Mackeen, Leslie D.
AU - Martinez-Castellanos, Maria Ana
AU - Salinas-Longoria, Samantha
AU - Romero, Rafael
AU - Arriola, Andrea
AU - Wu, Wei Chi
AU - Ang Sam Anzures, Rachelle Go
AU - Ventura, Camila V.
AU - Chiang, Michael F.
AU - Ostmo, Susan
AU - Sonmez, Kemal
AU - Kim, Sang Jin
AU - Campbell, J. Peter
AU - Chan, R. V.Paul
AU - Jonas, Karyn
AU - Orlin, Anton
AU - Horowitz, Jason
AU - Coki, Osode
AU - Eccles, Cheryl Ann
AU - Sarna, Leora
AU - Berrocal, Audina
AU - Negron, Catherin
AU - Denser, Kimberly
AU - Cumming, Kristi
AU - Osentoski, Tammy
AU - Check, Tammy
AU - Zajechowski, Mary
AU - Lee, Thomas
AU - Kruger, Evan
AU - McGovern, Kathryn
AU - Simmons, Charles
AU - Kalpathy-Cramer, Jayashree
N1 - Publisher Copyright:
© 2017 American Academy of Ophthalmology
PY - 2017/7
Y1 - 2017/7
N2 - Purpose To evaluate a tele-education system developed to improve diagnostic competency in retinopathy of prematurity (ROP) by ophthalmologists-in-training in Mexico. Design Prospective, randomized cohort study. Participants Fifty-eight ophthalmology residents and fellows from a training program in Mexico consented to participate. Twenty-nine of 58 trainees (50%) were randomized to the educational intervention (pretest, ROP tutorial, ROP educational chapters, and posttest), and 29 of 58 trainees (50%) were randomized to a control group (pretest and posttest only). Methods A secure web-based educational system was created using clinical cases (20 pretest, 20 posttest, and 25 training chapter–based) developed from a repository of over 2500 unique image sets of ROP. For each image set used, a reference standard ROP diagnosis was established by combining the clinical diagnosis by indirect ophthalmoscope examination and image-based diagnosis by multiple experts. Trainees were presented with image-based clinical cases of ROP during a pretest, posttest, and training chapters. Main Outcome Measures The accuracy of ROP diagnosis (e.g., plus disease, zone, stage, category) was determined using sensitivity and specificity calculations from the pretest and posttest results of the educational intervention group versus control group. The unweighted kappa statistic was used to analyze the intragrader agreement for ROP diagnosis by the ophthalmologists-in-training during the pretest and posttest for both groups. Results Trainees completing the tele-education system had statistically significant improvements (P < 0.01) in the accuracy of ROP diagnosis for plus disease, zone, stage, category, and aggressive posterior ROP (AP-ROP). Compared with the control group, trainees who completed the ROP tele-education system performed better on the posttest for accurately diagnosing plus disease (67% vs. 48%; P = 0.04) and the presence of ROP (96% vs. 91%; P < 0.01). The specificity for diagnosing AP-ROP (94% vs. 78%; P < 0.01), type 2 ROP or worse (92% vs. 84%; P = 0.04), and ROP requiring treatment (89% vs. 79%; P < 0.01) was better for the trainees completing the tele-education system compared with the control group. Intragrader agreement improved for identification of plus disease, zone, stage, and category of ROP after completion of the educational intervention. Conclusions 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.
AB - Purpose To evaluate a tele-education system developed to improve diagnostic competency in retinopathy of prematurity (ROP) by ophthalmologists-in-training in Mexico. Design Prospective, randomized cohort study. Participants Fifty-eight ophthalmology residents and fellows from a training program in Mexico consented to participate. Twenty-nine of 58 trainees (50%) were randomized to the educational intervention (pretest, ROP tutorial, ROP educational chapters, and posttest), and 29 of 58 trainees (50%) were randomized to a control group (pretest and posttest only). Methods A secure web-based educational system was created using clinical cases (20 pretest, 20 posttest, and 25 training chapter–based) developed from a repository of over 2500 unique image sets of ROP. For each image set used, a reference standard ROP diagnosis was established by combining the clinical diagnosis by indirect ophthalmoscope examination and image-based diagnosis by multiple experts. Trainees were presented with image-based clinical cases of ROP during a pretest, posttest, and training chapters. Main Outcome Measures The accuracy of ROP diagnosis (e.g., plus disease, zone, stage, category) was determined using sensitivity and specificity calculations from the pretest and posttest results of the educational intervention group versus control group. The unweighted kappa statistic was used to analyze the intragrader agreement for ROP diagnosis by the ophthalmologists-in-training during the pretest and posttest for both groups. Results Trainees completing the tele-education system had statistically significant improvements (P < 0.01) in the accuracy of ROP diagnosis for plus disease, zone, stage, category, and aggressive posterior ROP (AP-ROP). Compared with the control group, trainees who completed the ROP tele-education system performed better on the posttest for accurately diagnosing plus disease (67% vs. 48%; P = 0.04) and the presence of ROP (96% vs. 91%; P < 0.01). The specificity for diagnosing AP-ROP (94% vs. 78%; P < 0.01), type 2 ROP or worse (92% vs. 84%; P = 0.04), and ROP requiring treatment (89% vs. 79%; P < 0.01) was better for the trainees completing the tele-education system compared with the control group. Intragrader agreement improved for identification of plus disease, zone, stage, and category of ROP after completion of the educational intervention. Conclusions 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.
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U2 - 10.1016/j.ophtha.2017.02.014
DO - 10.1016/j.ophtha.2017.02.014
M3 - Article
C2 - 28385303
AN - SCOPUS:85017359321
SN - 0161-6420
VL - 124
SP - 953
EP - 961
JO - Ophthalmology
JF - Ophthalmology
IS - 7
ER -