ABSTRAK
Latar Belakang: Banyaknya jumlah kasus ROP yang terlambat dirujuk ke RSCM-Kirana menunjukkan bahwa penanganan ROP di Indonesia masihmerupakan tantangan. Keterlambatan diagnosis ROP yang ditemukan di RSCM tersebut dapat disebabkan oleh terbatasnya dokter mata ahli retina dan pediatric ophthalmologist (PO) dan kurangnya pengetahuan dokter mata umum dalammendiagnosis ROP. Pengetahuan dan keterampilan mendiagnosis ROPmerupakan salah satu mata ajar dalam program pendidikan dokter spesialis matadi FKUI. Data mengenai seberapa baik pengetahuan PPDS tersebut dalammendiagnosis ROP belum tersedia. Tujuan: Mengevaluasi kemampuan PPDS mata dalam mendiagnosis ROPberdasarkan pembacaan hasil foto wide field digital retinal imaging (WFDRI)bayi prematur. Metode: Sebanyak 25 set foto WFDRI dibaca dan diinterpretasi oleh 15 subjekPPDS mata, dan digolongkan ke dalam 4 klasifikasi: tidak ada ROP, ROP ringan,ROP tipe 2, dan ROP yang memerlukan terapi. Pembacaan oleh subjek tersebutdihitung nilai kesesuaiannya (Kappa) terhadap pembacaan oleh 3 konsultan POsebagai referensi, kemudian ditentukan tingkat kesesuaian berdasarkanpenggolongan nilai Kappa. Tingkat kesesuaian yang diharapkan adalah ?sangatbaik?, khusus untuk penentuan ROP perlu terapi, nilai Kappa yang diharapkanadalah 1,00. Hasil: Dalam penentuan adanya ROP, seluruh subjek memiliki tingkat kesesuaian?sangat baik? (Kappa 1,00); dalam penentuan ROP ringan atau lebih berat, hanya1 dari 15 subjek memiliki tingkat kesesuaian ?sangat baik?, 9 subjek memilikikesesuaian ?baik?, dan 5 subjek memiliki kesesuian ?sedang? (Kappa 0,65+0,15);dalam penentuan ROP tipe 2 atau lebih berat, 10 dari 15 subjek memiliki tingkatkesesuaian ?sangat baik?, 3 subjek memiliki kesesuaian ?baik?, dan 2 subjekmemiliki kesesuaian ?sedang? (Kappa 0,45-1,00); dalam penentuan ROP yangmemerlukan terapi, hanya 7 dari 15 subjek yang memiliki nilai Kappa 1,00,namun 12 dari 15 subjek memiliki tingkat kesesuaian ?sangat baik?, dan 3 subjekmemiliki kesesuaian ?baik? (Kappa 0,75-1,00). Dalam penentuan zona danstadium, hanya sebagian kecil subjek yang memiliki tingkat kesesuaian ?sangatbaik? (Kappa 0,35-0,81 dan 0,32-0,91); sedangkan dalam penentuan plus disease,hanya 6 dari 15 subjek yang memiliki nilai Kappa 1,00. Kesimpulan: Kemampuan PPDS mata dalam mendiagosis ROP belumseluruhnya mencapai target yang diharapkan. ABSTRACT
Background: Numerous late-stage ROP cases that referred to CiptoMangunkusumo Hospital (Kirana) showed us that ROP management in Indonesiais still a challenge. The delayed management might be caused by limited numberof vitreoretinal specialist or pediatric ophthalmologist, and inadequate diagnosticknowledge of ROP of the general ophthalmologists. In condition of limitednumber of vitreoretinal and pediatric ophthalmologists, the generalophthalmologists are suggested to be taking part in ROP screening program. InFKUI, ROP screening has been a part of residency training program, however,there was no available data of ROP diagnostic knowledge of the residents. Purpose: To measure agreement of image-based ROP diagnosis betweenophthalmology residents and pediatric ophthalmologist. Methods: Twenty-five sets of retinal photographs of premature infants wereinterpreted by 15 ophthalmology residents and pediatric ophthalmologists, andclassified into 4 categories: no ROP, mild ROP, type 2 ROP, and treatmentrequiringROP.Agreementsaremeasuredfordiagnosisclassification,stage,zone,andplus disease detection. Level of agreement was measured based on Kappavalue of each subjects. The expected level of agreement for each category was?very good agreement?. For treatment-requiring ROP and plus disease, theexpected Kappa value was 1.00. Results: For detection of no ROP, agreement of all subjects was ?very good?(Kappa 1,00); for detection of mild or worse ROP, only 1 of 15 subjects has ?verygood agreement?, 9 of 15 subjects have ?good agreement?, and 5 subjects have?moderate agreement? (Kappa 0,65+0,15); for detection of type 2 or worse ROP,10 of 15 subjects have ?very good agreement?, 3 subjects have ?good agreement?,and 2 subjects have ?moderate agreement? (Kappa 0,45-1,00); for detection ofrequiring-therapy ROP, only 7 of 15 subjects that have Kappa value of 1.00,however, 12 of 15 subjects have ?very good agreement?, and only 3 subjects have?good agreement? (Kappa 0,75-1,00). For detection of stage and zone of ROP,only a little number of subjects have ?very good agreement? (Kappa 0.35-0.81,and 0.32-0.91, respectively); and for plus disease detection, only 6 of 15 subjectshave Kappa value of 1.00. Conclusion: Agreement of image-based ROP diagnosis between ophthalmologyresidents and pediatric ophthalmologist has not achieved the expected target yet. ;Background: Numerous late-stage ROP cases that referred to CiptoMangunkusumo Hospital (Kirana) showed us that ROP management in Indonesiais still a challenge. The delayed management might be caused by limited numberof vitreoretinal specialist or pediatric ophthalmologist, and inadequate diagnosticknowledge of ROP of the general ophthalmologists. In condition of limitednumber of vitreoretinal and pediatric ophthalmologists, the generalophthalmologists are suggested to be taking part in ROP screening program. InFKUI, ROP screening has been a part of residency training program, however,there was no available data of ROP diagnostic knowledge of the residents. Purpose: To measure agreement of image-based ROP diagnosis betweenophthalmology residents and pediatric ophthalmologist. Methods: Twenty-five sets of retinal photographs of premature infants wereinterpreted by 15 ophthalmology residents and pediatric ophthalmologists, andclassified into 4 categories: no ROP, mild ROP, type 2 ROP, and treatmentrequiringROP.Agreementsaremeasuredfordiagnosisclassification,stage,zone,andplus disease detection. Level of agreement was measured based on Kappavalue of each subjects. The expected level of agreement for each category was?very good agreement?. For treatment-requiring ROP and plus disease, theexpected Kappa value was 1.00. Results: For detection of no ROP, agreement of all subjects was ?very good?(Kappa 1,00); for detection of mild or worse ROP, only 1 of 15 subjects has ?verygood agreement?, 9 of 15 subjects have ?good agreement?, and 5 subjects have?moderate agreement? (Kappa 0,65+0,15); for detection of type 2 or worse ROP,10 of 15 subjects have ?very good agreement?, 3 subjects have ?good agreement?,and 2 subjects have ?moderate agreement? (Kappa 0,45-1,00); for detection ofrequiring-therapy ROP, only 7 of 15 subjects that have Kappa value of 1.00,however, 12 of 15 subjects have ?very good agreement?, and only 3 subjects have?good agreement? (Kappa 0,75-1,00). For detection of stage and zone of ROP,only a little number of subjects have ?very good agreement? (Kappa 0.35-0.81,and 0.32-0.91, respectively); and for plus disease detection, only 6 of 15 subjectshave Kappa value of 1.00. Conclusion: Agreement of image-based ROP diagnosis between ophthalmologyresidents and pediatric ophthalmologist has not achieved the expected target yet. ;Background: Numerous late-stage ROP cases that referred to CiptoMangunkusumo Hospital (Kirana) showed us that ROP management in Indonesiais still a challenge. The delayed management might be caused by limited numberof vitreoretinal specialist or pediatric ophthalmologist, and inadequate diagnosticknowledge of ROP of the general ophthalmologists. In condition of limitednumber of vitreoretinal and pediatric ophthalmologists, the generalophthalmologists are suggested to be taking part in ROP screening program. InFKUI, ROP screening has been a part of residency training program, however,there was no available data of ROP diagnostic knowledge of the residents. Purpose: To measure agreement of image-based ROP diagnosis betweenophthalmology residents and pediatric ophthalmologist. Methods: Twenty-five sets of retinal photographs of premature infants wereinterpreted by 15 ophthalmology residents and pediatric ophthalmologists, andclassified into 4 categories: no ROP, mild ROP, type 2 ROP, and treatmentrequiringROP.Agreementsaremeasuredfordiagnosisclassification,stage,zone,andplus disease detection. Level of agreement was measured based on Kappavalue of each subjects. The expected level of agreement for each category was?very good agreement?. For treatment-requiring ROP and plus disease, theexpected Kappa value was 1.00. Results: For detection of no ROP, agreement of all subjects was ?very good?(Kappa 1,00); for detection of mild or worse ROP, only 1 of 15 subjects has ?verygood agreement?, 9 of 15 subjects have ?good agreement?, and 5 subjects have?moderate agreement? (Kappa 0,65+0,15); for detection of type 2 or worse ROP,10 of 15 subjects have ?very good agreement?, 3 subjects have ?good agreement?,and 2 subjects have ?moderate agreement? (Kappa 0,45-1,00); for detection ofrequiring-therapy ROP, only 7 of 15 subjects that have Kappa value of 1.00,however, 12 of 15 subjects have ?very good agreement?, and only 3 subjects have?good agreement? (Kappa 0,75-1,00). For detection of stage and zone of ROP,only a little number of subjects have ?very good agreement? (Kappa 0.35-0.81,and 0.32-0.91, respectively); and for plus disease detection, only 6 of 15 subjectshave Kappa value of 1.00. Conclusion: Agreement of image-based ROP diagnosis between ophthalmologyresidents and pediatric ophthalmologist has not achieved the expected target yet. |
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