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Validation of the East London Retinopathy of Prematurity algorithm to detect treatment-warranted retinopathy of prematurity: a cohort study
  1. Sonia Moorthy1,
  2. Gillian G W Adams1,
  3. Graham Smith2,
  4. Susmito Biswas3,
  5. Waleed Aliyan4,
  6. Roshni Bhudia5,
  7. Aamir Saiyed6,
  8. Shad Husain7
  1. 1Paediatric Ophthalmology and Strabismus, Moorfields Eye Hospital City Road Campus, London, UK
  2. 2Data Analytics, Omnivide, Sydney, New South Wales, Australia
  3. 3Paediatric Ophthalmology, Manchester Royal Eye Hospital, Manchester, UK
  4. 4Paediatric Ophthalmology, Manchester University NHS Foundation Trust, Manchester, UK
  5. 5Primary Care and Public Health, Imperial College London, London, UK
  6. 6Emergency Department, Cardiff and Vale University Health Board, Cardiff, UK
  7. 7Neonatology, Homerton University Hospital Neonatal Unit, London, UK
  1. Correspondence to Dr Sonia Moorthy, Moorfields Eye Hospital City Road Campus, London, UK; sonia.moorthy{at}


Aim To validate the East London Retinopathy of Prematurity algorithm (EL-ROP) in a cohort of infants at risk of developing retinopathy of prematurity (ROP).

Methods The EL-ROP algorithm was applied retrospectively to routinely collected data from two tertiary neonatal units in England on infants eligible for ROP screening. The EL-ROP recommendation, to screen or not, was compared with the development of treatment-warranted ROP (TW-ROP) for each infant. The main outcome measures were (1) EL-ROP’s sensitivity for predicting the future development of TW-ROP and (2) potential to reduce ROP screening examinations.

Results Data from 568 infants were included in the trial. The median (IQR) birth weight (g) was 875 (704 – 1103) and gestational age (weeks) was 27.0 (25.4 – 29.0). Maternal ethnicity was black (33%) and non-black (67%). 58(10%) developed TW-ROP and in every case this was predicted by the EL-ROP algorithm. It’s sensitivity was 100% (95% CI 94-100%) specificity: 44% (95% CI 39-48%) positive predictive value: 17% (95%CI 16-18%), negative predictive value: 100%.

Conclusions EL-ROP has been validated in a cohort of infants from two tertiary neonatal units in England. Further validation is required before its clinical usefulness can be assessed.

  • Retina

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  • Correction notice This article has been updated since it was first published. The article was unintentionally processed as an editorial when it should have been Clinical science. The article type has been changed and an abstract inserted.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.