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William V. Good, MD; Earl A. Palmer, MD; Robert J. Hardy, PhD

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

We are concerned that the article by Chiang and colleagues¹ and accompanying editorial by Phelps² could lead to mismanagement and inappropriate care for infants with retinopathy of prematurity (ROP). Based on their study, Chiang and colleagues concluded: "Interexpert agreement of plus disease diagnosis is imperfect. This may have important implications for clinical ROP management, continued refinement of the international ROP classification system, development of computer-based diagnostic algorithms, and implementation of ROP telemedicine systems."^1(p875) These comments imply more than the words stipulate. We believe that many readers will interpret this conclusion to mean that the diagnosis of plus disease is so faulty that it is useless in the management of ROP.

The conclusions drawn by Chiang et al are inappropriate for the design of their study. Selected wide-angle photographs were sent to experts for their review. Noticing considerable disagreement . . . [Full Text of this Article]

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Interexpert Agreement of Plus Disease Diagnosis in Retinopathy of Prematurity
Michael F. Chiang, Lei Jiang, Rony Gelman, Yunling E. Du, and John T. Flynn
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