Diagnostic error rates for ROP detection by trainee ophthalmologist in middle-income countries
Reviewed by Fiona Rowe

The purpose of this study was to describe errors in ROP diagnosis made by ophthalmologists-in-training from programmes in middle-income countries including Brazil, the Philippines and Mexico who participated in a tele-education programme. Trainees were tested on 20 cases from a repository of 2500 web-based cases. They were asked to input their diagnosis in accordance with the international standardised ROP classification system. For all categories of ROP, diagnostic error rates (percentage of incorrect diagnosis) was 50% (3567/7066 responses) across all countries. This ranged from 32–45% across the three countries and 74–79% for type 2 ROP. Diagnostic error rate was 64% for year 1 trainees, 52% for year 2, and 46% for year 3 – significant differences. Reasons for misdiagnosis included incorrectly identifying plus disease, and over diagnosis of type 2 ROP. High rates may be due to insufficient training on classifying different types. Educators may consider changes in curricula and aid in efforts to standardise ROP training. The authors propose a web-based education programme would be beneficial for ROP examiners worldwide.

Characterisation of error in retinopathy of prematurity diagnosis by ophthalmologists-in-training in middle-income countries.
Patel SN, Al-Khaled T, Kang KB et al.
JOURNAL OF PEDIATRIC OPHTHALMOLOGY AND STRABISMUS
2023;60:344–52.