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Dale L. Phelps, MD

Arch Ophthalmol. 2007;125(7):963-964.

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

Chiang and colleagues¹ collected valuable, reliable data on between-examiner variations in the diagnosis of plus disease in retinopathy of prematurity (ROP). They found no "gold standard" in the traditional meaning of an accurate, diagnostic "truth." Twenty-two experts had moderately high disagreement on the diagnosis of plus and pre-plus disease on 34 high-quality, wide-angle fundus photographs. This was disappointing because plus disease is the key defining characteristic in the decision to treat ROP with peripheral ablative surgery. They conclude that the disagreement has important implications for the clinical management, classification, and development of computer-based diagnostic algorithms and telemedicine systems.¹

This poses a dilemma for the ROP community and an important point. These results force us to confront plus disease as a continuum from clearly absent to severe rather than as the dichotomous "present/absent." The International Committee on Classification of ROP formally acknowledged this problem by adding a . . . [Full Text of this Article]

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RELATED ARTICLE

Interexpert Agreement of Plus Disease Diagnosis in Retinopathy of Prematurity
Michael F. Chiang, Lei Jiang, Rony Gelman, Yunling E. Du, and John T. Flynn
Arch Ophthalmol. 2007;125(7):875-880.
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