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 F. Chiang

doi:10.1016/j.ajo.2009.02.002

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 F. Chiang^*

^*Corresponding author for this work

Preventive Medicine

Research output: Contribution to journal › Article › peer-review

43 Scopus citations

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 language	English (US)
Pages (from-to)	136-142.e2
Journal	American journal of ophthalmology
Volume	148
Issue number	1
DOIs	https://doi.org/10.1016/j.ajo.2009.02.002
State	Published - Jul 2009

ASJC Scopus subject areas

Ophthalmology

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@article{98665c74ffc6474290e2b300e1bf6ccd,

title = "Speed of Telemedicine vs Ophthalmoscopy for Retinopathy of Prematurity Diagnosis",

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.",

author = "Richter, {Grace M.} and Grace Sun and Lee, {Thomas C.} and Chan, {R. V Paul} and Flynn, {John T.} and Justin Starren and Chiang, {Michael F.}",

note = "Funding Information: This study was supported by a Career Development Award from Research to Prevent Blindness Inc, New York, New York (Dr Chiang); Grant No. EY13972 (Dr Chiang) from the National Eye Institute, National Institutes of Health, Bethesda, Maryland; the St Giles Foundation, New York, New York (Dr Chan); and the T. J. Martell Foundation, Santa Monica, California (Dr Lee). Dr Chiang is an unpaid member of the Scientific Advisory Board for Clarity Medical Systems, Pleasanton, California. The authors indicate no financial conflict of interest. Involved in conception and design of study (G.M.R., G.S., T.C.L., R.V.P.C., J.T.F., J.S., M.F.C.); analysis and interpretation of data (G.M.R., M.F.C.); writing the article (G.M.R., M.F.C.); critical revision of the article (G.S., T.C.L., R.V.P.C., J.T.F., J.S.); final approval of the article (G.M.R., G.S., T.C.L., R.V.P.C., J.T.F., J.S., M.F.C.); data collection (G.S., T.C.L., R.V.P.C., M.F.C.); provision of materials, patients, or resources (G.S., T.C.L., R.V.P.C., J.T.F., J.S., M.F.C.); statistical expertise (G.M.R., R.V.P.C., M.F.C.); obtaining funding (M.F.C.); literature search (G.M.R., M.F.C.); and administrative, technical, or logistic support (G.S., R.V.P.C., T.C.L., J.T.F., J.S., M.F.C.). This study was approved by the Institutional Review Boards at Columbia University Medical Center, Weill Medical College of Cornell University, and Childrens Hospital Los Angeles. ",

year = "2009",

month = jul,

doi = "10.1016/j.ajo.2009.02.002",

language = "English (US)",

volume = "148",

pages = "136--142.e2",

journal = "American journal of ophthalmology",

issn = "0002-9394",

publisher = "Elsevier Inc.",

number = "1",

}

TY - JOUR

T1 - Speed of Telemedicine vs Ophthalmoscopy for Retinopathy of Prematurity Diagnosis

AU - Richter, Grace M.

AU - Sun, Grace

AU - Lee, Thomas C.

AU - Chan, R. V Paul

AU - Flynn, John T.

AU - Starren, Justin

AU - Chiang, Michael F.

N1 - Funding Information: This study was supported by a Career Development Award from Research to Prevent Blindness Inc, New York, New York (Dr Chiang); Grant No. EY13972 (Dr Chiang) from the National Eye Institute, National Institutes of Health, Bethesda, Maryland; the St Giles Foundation, New York, New York (Dr Chan); and the T. J. Martell Foundation, Santa Monica, California (Dr Lee). Dr Chiang is an unpaid member of the Scientific Advisory Board for Clarity Medical Systems, Pleasanton, California. The authors indicate no financial conflict of interest. Involved in conception and design of study (G.M.R., G.S., T.C.L., R.V.P.C., J.T.F., J.S., M.F.C.); analysis and interpretation of data (G.M.R., M.F.C.); writing the article (G.M.R., M.F.C.); critical revision of the article (G.S., T.C.L., R.V.P.C., J.T.F., J.S.); final approval of the article (G.M.R., G.S., T.C.L., R.V.P.C., J.T.F., J.S., M.F.C.); data collection (G.S., T.C.L., R.V.P.C., M.F.C.); provision of materials, patients, or resources (G.S., T.C.L., R.V.P.C., J.T.F., J.S., M.F.C.); statistical expertise (G.M.R., R.V.P.C., M.F.C.); obtaining funding (M.F.C.); literature search (G.M.R., M.F.C.); and administrative, technical, or logistic support (G.S., R.V.P.C., T.C.L., J.T.F., J.S., M.F.C.). This study was approved by the Institutional Review Boards at Columbia University Medical Center, Weill Medical College of Cornell University, and Childrens Hospital Los Angeles.

PY - 2009/7

Y1 - 2009/7

N2 - 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.

AB - 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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Speed of Telemedicine vs Ophthalmoscopy for Retinopathy of Prematurity Diagnosis

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