Speed of Telemedicine vs Ophthalmoscopy for Retinopathy of Prematurity Diagnosis

Grace M. Richter, Grace Sun, Thomas C. Lee, R. V Paul Chan, John T. Flynn, Justin Starren, Michael Chiang

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Purpose: To compare the speed of retinopathy of prematurity (ROP) diagnosis using standard indirect ophthalmoscopy with that of telemedicine. Design: Prospective, comparative study. Methods: Three study examiners (2 pediatric retinal specialists [R.V.P.C., T.C.L.] and 1 pediatric ophthalmologist [M.F.C.]) conducted ROP diagnosis via standard indirect ophthalmoscopy and telemedicine. Each examiner performed: 1) standard ophthalmoscopy on 72 to 150 consecutive infants at his respective institution and 2) telemedical diagnosis on 125 consecutive deidentified retinal image sets from infants from an at-risk population. Time for ophthalmoscopic diagnosis was measured in 2 ways: 1) time spent by the examiner at the infant's bedside and 2) mean total time commitment per infant. Time for telemedicine diagnosis was recorded by computer time stamps in the web-based system. For each examiner, nonparametric statistical analysis (Mann-Whitney U test) was used to compare the distribution of times for examination by ophthalmoscopy vs telemedicine. Results: Mean (± standard deviation [SD]) times for ophthalmoscopic diagnosis ranged from 4.17 (± 1.34) minutes to 6.63 (± 2.28) minutes per infant. Mean (± SD) times for telemedicine diagnosis ranged from 1.02 (± 0.27) minutes to 1.75 (± 0.80) minutes per infant. Telemedicine was significantly faster than ophthalmoscopy (P <.0001). The total time commitment by ophthalmologists performing bedside ophthalmoscopy for ROP diagnosis, including travel and communication with families and hospital staff, was 10.08 (± 2.53) minutes to 14.42 (± 2.64) minutes per infant. Conclusions: The ophthalmologist time requirement for telemedical ROP diagnosis is significantly less than that for ophthalmoscopic diagnosis. Additional time requirements associated with bedside ROP diagnosis increased this disparity. Telemedicine has potential to alleviate the time commitment for ophthalmologists who manage ROP.

Original languageEnglish (US)
JournalAmerican Journal of Ophthalmology
Volume148
Issue number1
DOIs
StatePublished - Jul 2009
Externally publishedYes

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Ophthalmoscopy
Retinopathy of Prematurity
Telemedicine
Pediatrics
Nonparametric Statistics

ASJC Scopus subject areas

  • Ophthalmology

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Speed of Telemedicine vs Ophthalmoscopy for Retinopathy of Prematurity Diagnosis. / Richter, Grace M.; Sun, Grace; Lee, Thomas C.; Chan, R. V Paul; Flynn, John T.; Starren, Justin; Chiang, Michael.

In: American Journal of Ophthalmology, Vol. 148, No. 1, 07.2009.

Research output: Contribution to journalArticle

Richter, Grace M. ; Sun, Grace ; Lee, Thomas C. ; Chan, R. V Paul ; Flynn, John T. ; Starren, Justin ; Chiang, Michael. / Speed of Telemedicine vs Ophthalmoscopy for Retinopathy of Prematurity Diagnosis. In: American Journal of Ophthalmology. 2009 ; Vol. 148, No. 1.
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abstract = "Purpose: To compare the speed of retinopathy of prematurity (ROP) diagnosis using standard indirect ophthalmoscopy with that of telemedicine. Design: Prospective, comparative study. Methods: Three study examiners (2 pediatric retinal specialists [R.V.P.C., T.C.L.] and 1 pediatric ophthalmologist [M.F.C.]) conducted ROP diagnosis via standard indirect ophthalmoscopy and telemedicine. Each examiner performed: 1) standard ophthalmoscopy on 72 to 150 consecutive infants at his respective institution and 2) telemedical diagnosis on 125 consecutive deidentified retinal image sets from infants from an at-risk population. Time for ophthalmoscopic diagnosis was measured in 2 ways: 1) time spent by the examiner at the infant's bedside and 2) mean total time commitment per infant. Time for telemedicine diagnosis was recorded by computer time stamps in the web-based system. For each examiner, nonparametric statistical analysis (Mann-Whitney U test) was used to compare the distribution of times for examination by ophthalmoscopy vs telemedicine. Results: Mean (± standard deviation [SD]) times for ophthalmoscopic diagnosis ranged from 4.17 (± 1.34) minutes to 6.63 (± 2.28) minutes per infant. Mean (± SD) times for telemedicine diagnosis ranged from 1.02 (± 0.27) minutes to 1.75 (± 0.80) minutes per infant. Telemedicine was significantly faster than ophthalmoscopy (P <.0001). The total time commitment by ophthalmologists performing bedside ophthalmoscopy for ROP diagnosis, including travel and communication with families and hospital staff, was 10.08 (± 2.53) minutes to 14.42 (± 2.64) minutes per infant. Conclusions: The ophthalmologist time requirement for telemedical ROP diagnosis is significantly less than that for ophthalmoscopic diagnosis. Additional time requirements associated with bedside ROP diagnosis increased this disparity. Telemedicine has potential to alleviate the time commitment for ophthalmologists who manage ROP.",
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