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Retinopathy of prematurity in English neonatal units: a national population-based analysis using NHS operational data.

Wong, HS, Santhakumaran, S, Statnikov, Y, Gray, D, Watkinson, M, Modi, N and UK Neonatal Collaborative, (2014) Retinopathy of prematurity in English neonatal units: a national population-based analysis using NHS operational data. Arch Dis Child Fetal Neonatal Ed, 99 (3). F196-F202.

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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.

Item Type: Article
Authors :
Wong, HS
Santhakumaran, S
Statnikov, Y
Gray, D
Watkinson, M
Modi, N
UK Neonatal Collaborative,
Date : May 2014
DOI : 10.1136/archdischild-2013-304508
Uncontrolled Keywords : Electronic health records, Practice guidelines, Preterm infants, Retinopathy of prematurity, Vision screening, Bayes Theorem, Cohort Studies, England, Female, Gestational Age, Guideline Adherence, Humans, Infant, Newborn, Infant, Premature, Infant, Premature, Diseases, Intensive Care Units, Neonatal, Male, Neonatal Screening, Odds Ratio, Practice Guidelines as Topic, Retinopathy of Prematurity, State Medicine, Time Factors
Related URLs :
Depositing User : Symplectic Elements
Date Deposited : 17 May 2017 10:13
Last Modified : 17 May 2017 10:13

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