Workforce Shortage for Retinopathy of Prematurity Care and Emerging Role of Telehealth and Artificial Intelligence

Barrero-Castillero, Alejandra; Corwin, Brian K.; VanderVeen, Deborah K.; Wang, Jason C

doi:10.1016/j.pcl.2020.04.012

Cited by 22 publications

(19 citation statements)

References 42 publications

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“…Although it remains reassuring that we found a relatively high rate of complete retinal vascularization and there were no significant socioeconomic risk factors associated with this, there are growing concerns over an ROP care workforce shortage, with respect to screening examinations, treatment, and follow-up examinations. 15 This is especially salient given that many ophthalmologists feel inadequately compensated for ROP follow-up care, and there is inconsistent coverage of liability insurance. 16 Although expanding care for these patients in a cost-effective manner is difficult, recent innovations in technologies, such as artificial intelligence and teleretinal screening, have shown promise.…”

Section: Discussionmentioning

confidence: 99%

A Multicenter Study of Retinopathy of Prematurity Follow-Up Adherence

Mahmud

Karmouta

Strawbridge

et al. 2023

Retina

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Purpose: Characterize clinical and socioeconomic factors that impact follow-up to complete retinal vascularization and subsequent pediatric ophthalmology follow-up in neonates with retinopathy of prematurity. Methods: Medical records of 402 neonates diagnosed with retinopathy of prematurity from neonatal intensive care units at the University of California, Los Angeles Mattel Children's Hospital and the University of California, Los Angeles Santa Monica Hospital, both academic medical centers, and the Harbor-University of California, Los Angeles Medical Center, a safety-net county hospital, were reviewed. Primary study outcomes were the rate of follow-up to complete retinal vascularization and adequate pediatric ophthalmology follow-up. Secondary outcome was the rate of nonretinal ocular comorbidity. Results: In whole-cohort analysis, 93.6% of neonates were followed to complete retinal vascularization, and 53.5% had adequate pediatric ophthalmology follow-up. Public insurance was associated with lower rates of pediatric ophthalmology follow-up (Odds ratio 0.66, 95% confidence interval 0.45–0.98, P = 0.04). Participants screened at the academic medical center had lower rates of pediatric ophthalmology follow-up compared with the safety-net county hospital (50.7% vs. 63.5%, P = 0.034). In subgroup analysis, academic medical center participants with public insurance were less likely to have pediatric ophthalmology follow-up than safety-net county hospital participants with public insurance (36.5% vs. 63.8%, P < 0.001) or those with private insurance at the academic medical center (36.5% vs. 59.2%, P< 0.001). Conclusion: This study identified high follow-up rates to complete retinal vascularization, lower pediatric ophthalmology follow-up rates, and nonretinal ocular comorbidity at all hospitals. Insurance status relative to hospital type was identified as a risk factor for loss to follow-up. This demonstrates a need to further study health care disparities in retinopathy of prematurity infants.

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Section: Discussionmentioning

confidence: 99%

A Multicenter Study of Retinopathy of Prematurity Follow-Up Adherence

Mahmud

Karmouta

Strawbridge

et al. 2023

Retina

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“…According to the severity of the lesion, it was divided into five stages: stage 1, dividing line stage; stage 2, critical stage; stage 3, increment stage; stage 4, subpanretinal detachment stage; and stage 5, panretinal detachment stage ( Gensure et al, 2020 ). For treatment, stage 1 and stage 2 can disappear naturally, so they should be observed closely ( Scruggs et al, 2020 ); stage 3 should be treated with condensation or photocoagulation to prevent neovascularization ( Barrero-Castillero et al, 2020 ); and stage 4 and stage 5 can be treated with a vitrectomy to remove proliferated fibrovascular tissue. Photocoagulation was performed simultaneously ( Morya et al, 2022 ).…”

Section: Application Of Artificial Intelligence In Retinal Vascular D...mentioning

confidence: 99%

Research progress on diagnosing retinal vascular diseases based on artificial intelligence and fundus images

Liu

et al. 2023

Front. Cell Dev. Biol.

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As the only blood vessels that can directly be seen in the whole body, pathological changes in retinal vessels are related to the metabolic state of the whole body and many systems, which seriously affect the vision and quality of life of patients. Timely diagnosis and treatment are key to improving vision prognosis. In recent years, with the rapid development of artificial intelligence, the application of artificial intelligence in ophthalmology has become increasingly extensive and in-depth, especially in the field of retinal vascular diseases. Research study results based on artificial intelligence and fundus images are remarkable and provides a great possibility for early diagnosis and treatment. This paper reviews the recent research progress on artificial intelligence in retinal vascular diseases (including diabetic retinopathy, hypertensive retinopathy, retinal vein occlusion, retinopathy of prematurity, and age-related macular degeneration). The limitations and challenges of the research process are also discussed.

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“…Multiple opportunities exist for health services research in pediatric GI TH, with examples drawn from other areas of health care. These include cost‐effectiveness analyses (87), geographic or other variations in access to TH (88), use of TH to expand access to subspecialists (89), and workforce gaps that could be filled by TH (90). Opportunities for TH research, advocacy, QI, and education are summarized in Table 2.…”

Section: The Future Of Telehealthmentioning

confidence: 99%

North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Position Statement for Telehealth

Franciosi

Berg

Rosen

et al. 2023

Journal of Pediatric Gastroenterology &Amp; Nutrition

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Telehealth (TH) broadly encompasses remote activities of clinical care (telemedicine), provider and patient education, and general health services. The use of synchronous video for TH first occurred in 1964 and then catapulted to the forefront in 2020 during the coronavirus disease 2019 public health emergency. Due to the sudden need for increased TH utilization by nearly all health care providers at that time, TH became essential to clinical practice. However, its sustainable future is unclear in part given that best practices for TH in pediatric gastroenterology (GI), hepatology, and nutrition remain undefined and non-standardized. Key areas for review include historical perspective, general and subspeciality usage, health care disparities, quality of care and the provider-patient interaction, logistics and operations, licensure and liability, reimbursement and insurance coverage, research and quality improvement (QI) priorities, and future use of TH in pediatric GI with a call for advocacy. This position paper from the Telehealth Special Interest Group of North American Society of Gastroenterology, Hepatology and Nutrition provides recommendations for pediatric GI-focused TH best practices, reviews areas for research and QI growth, and presents advocacy opportunities.

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Workforce Shortage for Retinopathy of Prematurity Care and Emerging Role of Telehealth and Artificial Intelligence

Cited by 22 publications

References 42 publications

A Multicenter Study of Retinopathy of Prematurity Follow-Up Adherence

A Multicenter Study of Retinopathy of Prematurity Follow-Up Adherence

Research progress on diagnosing retinal vascular diseases based on artificial intelligence and fundus images

North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Position Statement for Telehealth

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