One of the interesting applications for pediatric telemedicine is ophthalmology, where specialists are spread thin or don’t exist at all in many communities. Similar to teleradiology, non-physicians could be used to screen images to spot potential anomalies that need more urgent attention. A study by Dr. Graham E. Quinn, professor of ophthalmology at the Children’s Hospital of Philadelphia, evaluated telemedicine to screen for an eye disease that affects premature infants globally and can cause blindness in some cases, according to an article on the NIH website.
Quinn served as the lead investigator for the study, which was published in JAMA Ophthalmology. It included 1,257 premature infants born an average of 13 weeks early.
The condition is retinopathy of prematurity — a condition that affects infants born 10 or more weeks premature. Although there is a tendency for there to be some form of ROP in premature infants, only about 5 to 8 percent of cases become severe enough to require treatment, the article said. Blood vessels in the retina grow abnormally, and that can lead to scarring and detachment of the retina. The treatment destroys the abnormal blood vessels with lasers or freezes them through a technique called cryoablation. The American Academy of Ophthalmology recommends routine screening for all babies who are born at gestational age 30 weeks or younger or who weigh less than 3.3 pounds at birth, according to the article.
When Investment Rhymes with Canada
Canada has a proud history of achievement in the areas of science and technology, and the field of biomanufacturing and life sciences is no exception.
Here’s a description of the study, funded by the National Eye Institute — a division of the National Institutes of Health:
“The telemedicine strategy consisted of electronically sending photos of babies’ eyes to a distant image-reading center for evaluation. Staff at the image-reading center, trained to recognize signs of severe ROP, identified whether infants should be referred to an ophthalmologist for evaluation and potential treatment. The study tested how accurately the telemedicine approach reproduced the conclusions of ophthalmologists who examined the babies onsite.”
The study found that telemedicine offers a useful way to detect ROP earlier and provide an alternative to families who don’t want their infants to be relocated to nurseries at larger hospitals, albeit with more resources. Telemedicine helped identify 43 percent of advanced ROP cases before they were detected by an ophthalmologist who usually diagnosed them two weeks later.
In a random sample of photos from 200 infants, half had referral-warranted ROP and half did not. Physicians correctly identified about 86 percent of referral-warranted ROP cases, but the non-physicians were accurate 91 percent of the time. Although physicians correctly identified about 57 percent of babies without referral warranted ROP, non-physicians were correct 73 percent of the time.
Health Benefit Consultants, Share Your Expert Insights in Our Survey
Share some of the trends you are seeing among your clients across healthcare, including chronic conditions, behavioral health, healthcare navigation, and more.
Given that 450,000 infants are born prematurely each year, and that the survival rate is rising for these infants in middle-income countries, there’s a need to develop more efficient ways of screening infants without spreading ophthalmologists too thin.
