Training and Certification of Retinal Image Readers in the Telemedicine Approaches to evaluating acute-phase Retinopathy of Prematurity (e-ROP) Study

Abstract

Purpose: To describe training and certification process for grading retinopathy of prematurity (ROP) digital images by non-physician Trained Readers (TR) in the Telemedicine Approaches to evaluating acute-phase Retinopathy of Prematurity (e-ROP) Study

Methods: <br /> Four TRs without any previous experience of ROP image grading were trained through didactic lectures on pathophysiology and morphology of ROP, its classification, screening, diagnosis and treatment by the Study Chair, followed by the training of image grading by 3 ROP expert readers using standard RetCam training image sets from other studies for identifying ROP stage, zone, and plus disease. TRs practiced independent grading of the training images, reviewed and discussed discrepancies in their grading with a consensus grading in multiple training sessions with expert readers. TRs then undertook a certification test by independently grading 15 new images sets, and received certification when >85% agreement with the consensus grading was achieved

Results: Four TRs underwent rigorous training in ROP grading and successfully completed the certification. The agreement of their grading with consensus grading was high, with 100% agreement for plus disease, 93% agreement for Zone 1 ROP, at least 93% agreement for ROP stage 3 or higher, and at least 93% agreement for RW-ROP. During the e-ROP study, 3 trained non-physician readers successfully completed the grading of 7756 e-ROP image sets

Conclusions: Non-physician readers with no previous knowledge of ROP can be successfully trained and certified for grading retinal images in telemedicine of ROP