Precision Risk Model Using Quantitative Assessment of Vascular Severity in Telemedicine-Based Screening

Is incorporation of vascular severity, either via artificial intelligence or clinician assessment, associated with improved short-term prediction of treatment-requiring retinopathy of prematurity (TR-ROP) and reduced examination burden?In this diagnostic study including 2103 infants from 2 large multicenter datasets, adding vascular severity improved model discrimination compared with gestational and postmenstrual age alone. At a decision threshold ensuring 100% sensitivity, simulated implementation reduced examinations by 28% in a training, validation, and internal subset cohort and 39% in the validation cohort without missed TR-ROP; substituting clinical assessment preserved strong performance.Results of this study suggest that dynamic visit-specific risk prediction using VSS or clinician assessment may enable safer more efficient ROP screening.

Corresponding Author: J. Peter Campbell, MD, MPH, Oregon Health campbelp@ohsu.edu).

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