학술논문
Retinopathy of prematurity in English neonatal units: a national population-based analysis using NHS operational data
Document Type
Academic Journal
Author
Wong, Hilary S; Santhakumaran, Shalini; Statnikov, Yevgeniy; Gray, Daniel; Watkinson, Michael; Modi, Neena; Kadalraja, R; Kefas, J; Srinnel, S; Ramesh, C; Rackham, O; Brearey, S; Thirumurugan, A; Losa, I; McBride, T; Zipitis, C; Amegavie, L; Moise, J; Zipitis, C; Yadan, M; Maddock, N; Moise, J; Edi-Osagie, N; Heal, C; Birch, J; Al-Zidgali, F; Hasib, A; Kisat, H; Soe, A; Long, D; Fedee, J; Lama, M; Gupta, R; Rawlingson de Boer, RC; Rao, P; Blake, K; Bhaduri, AK; Halahakoon, C; Deshpande Mohite, A; Tewary, KK; Palmer, K; Gallagher, A; Nycyk, J; Simmons, P; Morgen, I; Underhill, HC; Mahesh Babu, R N; Dalton, S; Dixon, H; James, M; Jayalal, V; Dyke, M; Babiker, S; Soe, T; Rubin, S; Ogilvy-Stuart, A; Evans, I; Wickham, T; van Someren, V; Watkin, S; Blumberg, R; Sharief, N; Aladangady, N; Sharma, B; Sullivan, C; Alsford, L; Sharma, B; Khan, A; Hamdan, S; Ahmed, JS; Foo, A; Talekar, R; Adiotomre, P; Gibson, A; Thomas, M; Mathur, R; Cruwys, M; Mannix, P; Ariff, H; Garbasa, M; Lal, M; Bosman, D; Fenton, A; Bolton, AR; Abu-Harb, M; Verber, I; Olivier, J; Larson, J; Cherinet, Y; Munyard, P; Osbourne, N; Raman, M; Watts, T; Hannam, S; Walter, S; Kuna, J; Chang, YL; Shephard, R; Lindo, D; Calvert, S; Wigfield, R; Wylie, P; Misra, I; Shettihalli, N; Khashu, M; Hall, M; Groves, C; de Halpert, P; Schapira, D; Kinsey, S; Butterworth, S; Garg, A; Whitehead, G; Sanghavi, R; Whincup, G; Khader, K; Mallik, A; Amess, P; Godden, C; Reynolds, P; Brannan, N; Noble, V; Rao, AS; Wardle, S; Ratnayaka, M; Holman, J; Zengeya, S; Jones, S; Wach, R; Tooley, J; Mann, RJ; Eaton, M; Babirecki, M; Seal, S; Schwartz, K; Gibson, D; Jampala, C; Pairaudeau, P; Miall, L; Shyamannr, K; Qunib, M
Source
Archives of Disease in Childhood: Fetal and Neonatal Edition. May 01, 2014 99(3):F196-F202
Subject
Language
English
ISSN
1359-2998
Abstract
OBJECTIVES: To report on retinopathy of prematurity (ROP) screening compliance against a national guideline, factors associated with non-compliance and effect on ROP treatment. DESIGN: National cohort study using operational NHS data from the National Neonatal Research Database (NNRD) for the period 2009–2011. SETTING: 161 (94%) neonatal units in England. POPULATION: Infants born below 32 weeks’ gestation and/or with a birth weight below 1501 g. MAIN OUTCOME MEASURES: ROP screening status (‘on-time’, ‘early’, ‘late’, ‘unknown’) and associated infant and neonatal unit characteristics, ROP treatment. RESULTS: The proportion of infants screened on-time increased over the study period (p<0.001). Of 19 821 eligible infants, 7602 (38.4%) were recorded to have received ROP screening in accordance with the national guideline; 7474 (37.8%) received screening outside the recommended time period; data were missing for 4745 (16.7%) infants. For 16 411 infants in neonatal care during the recommended screening period, late screening was significantly associated with lower gestational age (relative risk ratio (RRR) (95% credible interval) for late versus on-time screening 0.83 (0.80 to 0.86) for each increased week of gestation) and care in a neonatal unit providing less than 500 days of intensive care per annum (2.48 (0.99 to 4.99)). Infants screened late were almost 40% more likely to receive ROP treatment (OR (95% CI) 1.36 (1.05 to 1.76)). CONCLUSIONS: Understanding organisational differences between neonatal units may help improve ROP screening. Patient-level electronic NHS clinical data offer opportunity for future rapid, low cost, population-based evaluations but require improved data entry.