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Evaluation of the economic impact of modified screening criteria for retinopathy of prematurity from the Postnatal Growth and ROP (G-ROP) study

Journal of Perinatology volume 40, pages 1100–1108 (2020)Cite this article

Subjects

Abstract

Importance

The Postnatal Growth and Retinopathy of Prematurity (G-ROP) Study showed that the addition of postnatal weight gain to birth weight and gestational age detects similar numbers of infants with ROP, but requires examination of fewer infants.

Objective

To determine the incremental cost-effectiveness of screening with G-ROP compared with conventional screening.

Design, setting and participants

We built a microsimulation model of a 1-year US birth cohort <32 weeks gestation, using data from the G-ROP study. We obtained resource utilization estimates from the G-ROP dataset and from secondary sources, and test characteristics from the G-ROP cohort.

Results

Among 78,281 infants nationally, screening with G-ROP detected ~25 additional infants with Type 1 ROP. This was accomplished with 36,233 fewer examinations, in 14,073 fewer infants, with annual cost savings of approximately US$2,931,980 through hospital discharge.

Conclusions

Screening with G-ROP reduced costs while increasing the detection of ROP compared with current screening guidelines.

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Fig. 1
Fig. 2: Differences in mean costs and effects between conventional screening and G-ROP screening cohorts for the base case (discharge), cost per case of Type 1 ROP detected.

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Funding

This study was supported by the National Institutes of Health grant R01EY021137, and the Richard Shafritz Endowed Chair in Ophthalmology Research at the Children’s Hospital of Philadelphia.

G-ROP Study Group

Gil Binenbaum6, Lauren A. Tomlinson6, Trang B. Duros6, Anh Nguyen6, Gui-shuang Ying7, Maureen G. Maguire7,41, Mary Brightwell-Arnold7, James Shaffer7, Yinxi Yu7, Maria Blanco7, Trina Brown7, Christopher P. Helker7, Amy Hutchinson8, Carrie Young8, Emily McCourt9, Anne Lynch9, Jennifer Cathcart9, Ashlee Cerda9, Levi Bonnell9, Tamara Thevarajah9, Gerard P. Barry10, Marilyn Fisher10, Maria V. Battaglia10, Alex M. Drach10, Kevin Hughes10, Nachammai Chinnakaruppan11, Andrew Meyer11, Christina Gogal11, Cynthia Beitler11, Lauri Centolanza11, Keith T. Moyer11, Mary Sobotor11, Pamela Donohue12, Michael X. Repka12, Jennifer A. Shepard12, Megan Doherty12, James D. Reynolds13, Erin Connelly13, Edward Cheeseman14, Kinsey Shirer14, Carol Bradham14, Allison McAlpine14, Sudeep Sunthankar14, Javaneh Abbasian15, Janet Lim15, Michael Yang16, Patricia Cobb16, Elizabeth L. Alfano16, David Rogers17, Rachel E. Reem17, Amanda Schreckengost17, Rae R. Fellows17, Kaitlyn Loh17, Madeline A. McGregor17, Thabit Mustafa17, Ivy Dean17, Rachel Miller17, Tess Russell17, Rebecca Stattler17, Sara Maletic17, Theran Jake Selph17, David Young18, Andrea Siu18, Michele Kanemori18, George Kingston18, Megan Geloneck19, Robert Feldman19, Ted Baker19, Laura Baker19, Ephrem Melese19, Kathryn Haider20, Jingyun Wang20, Elizabeth Hynes20, Edward F. Bell21, Alina V. Dumitrescu21, Jonathan M. Klein21, Gretchen A. Cress21, Avanthi S. Ajjarapu21, Kristine Berge21, Eric Boeshart21, Morgan Dorsey21, Bethany M. Funk21, Grace Hach21, Claire L. Johnson21, Kevin Kurian21, Emily Miller21, Angela C. Platt21, Christine Law22, Andrew Gissing22, Leila Khazaeni23, Jennifer Dunbar23, Kelley Hawkins23, Sharon Lee23, Lily Sung23, Carly Leggitt23, Aparna Ramasubramanian24, Rahul Bhola24, Michelle Bottorff24, Neviana Dimova24, Rachel Keith24, Laura Thomas24, Jill Anderson25, Raymond G. Areaux Jr.25, Ann Marie Holleschau25, Jordan Gross25, Andrea Kramer25, David Morrison26, Sean Donahue26, Carsyn Saige Wilkins26, Neva Fukuda26, Sandy Owings26, Scott Ruark26, R. Michael Siatkowski27, Faizah Bhatti27, Vanessa Bergman27, Karen Corff27, Kari Harkey27, Amy Manfredo27, Ashley Helmbrecht27, Shrenik Talsania27, Terri Whisenhunt27, Donny Suh28, Ann Anderson Berry28, Denise Lynes28, Kelly C. Erikson28, Gil Binenbaum29, Soraya Abbasi29, Haresh Kirpalani29, Graham E. Quinn29, Lindsay Dawson29, Lauren A. Tomlinson29, Christin Sylvester30, Kanwal Nischal30, Lauren Runkel30, Wendy S. Chen31, Deidrya Jackson31, Bradley Davitt32, Dawn Govreau32, Linda Breuer32, September Noonan32, Robert Hoffman33, Joanna Beachy33, Kelliann Farnsworth33, Katie Jo Farnsworth33, Deborah Harrison33, Ashlie Bernhisel33, Bonnie Carlstrom33, Alejandra G. de Alba Campomanes34, Yizhuo Bastea-Forte34, Lucia Rivera Sanchez34, Jacquelyn Kemmer34, Alexandra Neiman34, Sarah Sitati-Ng’Anda34, Kristina Tarczy-Hornoch35, Francine Baran35, Lauren Eaton35, Nasrin Najm-Tehrani36, Tanya Grossi36, Maram Isaac36, Robin Knighton36, Monica Ralli Khitri37, Madeline Del Signore37, Cynthia Dembofsky38, Andrew Meyer38, Karen Flaherty38, Tracey Harris38, Jamie Heeneke38, Dorothy Hendricks39, Christopher M. Fecarotta39, Alicia Olivant Fisher39, Mark Paullin39, John A. F. Zupancic40, Alejandra de Alba Campomanes41, Edward F. Bell41, Gil Binenbaum41, Pamela Donohue41, David Morrison41, Graham E. Quinn41, Michael X. Repka41, David L. Rogers41, Lauren A. Tomlinson41, Michael Yang41, Gui-shuang Ying41

Author information

Authors and Affiliations

  1. Division of Newborn Medicine, Harvard Medical School, Boston, MA, USA

    John A. F. Zupancic

  2. Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA, USA

    John A. F. Zupancic

  3. Scheie Eye Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    Gui-shuang Ying & Gil Binenbaum

  4. University of California, San Francisco, CA, USA

    Alejandra de Alba Campomanes

  5. The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Lauren A. Tomlinson & Gil Binenbaum

  6. Office of Study Chair, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Gil Binenbaum, Lauren A. Tomlinson, Trang B. Duros & Anh Nguyen

  7. Data Coordinating Center—University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA

    Gui-shuang Ying, Maureen G. Maguire, Mary Brightwell-Arnold, James Shaffer, Yinxi Yu, Maria Blanco, Trina Brown & Christopher P. Helker

  8. Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA

    Amy Hutchinson & Carrie Young

  9. University of Colorado Hospital, Children’s Hospital Colorado, University of Colorado Denver, Denver, CO, USA

    Emily McCourt, Anne Lynch, Jennifer Cathcart, Ashlee Cerda, Levi Bonnell & Tamara Thevarajah

  10. Albany Medical College, Albany, NY, USA

    Gerard P. Barry, Marilyn Fisher, Maria V. Battaglia, Alex M. Drach & Kevin Hughes

  11. Lehigh Valley Hospital, Allentown, PA, USA

    Nachammai Chinnakaruppan, Andrew Meyer, Christina Gogal, Cynthia Beitler, Lauri Centolanza, Keith T. Moyer & Mary Sobotor

  12. Johns Hopkins Hospital, Johns Hopkins University, Baltimore, MD, USA

    Pamela Donohue, Michael X. Repka, Jennifer A. Shepard & Megan Doherty

  13. Women & Children’s Hospital of Buffalo, University at Buffalo, Buffalo, NY, USA

    James D. Reynolds & Erin Connelly

  14. Medical University of South Carolina, Charleston, SC, USA

    Edward Cheeseman, Kinsey Shirer, Carol Bradham, Allison McAlpine & Sudeep Sunthankar

  15. University of Illinois at Chicago, Chicago, IL, USA

    Javaneh Abbasian & Janet Lim

  16. Cincinnati Children’s Hospital Medical Center, Good Samaritan Hospital, and University of Cincinnati Medical Center, Cincinnati, OH, USA

    Michael Yang, Patricia Cobb & Elizabeth L. Alfano

  17. Nationwide Children’s Hospital, Riverside Methodist Hospital, Grant Medical Center, Doctors Hospital, Nationwide Children’s Hospital, Columbus, OH, USA

    David Rogers, Rachel E. Reem, Amanda Schreckengost, Rae R. Fellows, Kaitlyn Loh, Madeline A. McGregor, Thabit Mustafa, Ivy Dean, Rachel Miller, Tess Russell, Rebecca Stattler, Sara Maletic & Theran Jake Selph

  18. Kapi’olani Medical Center for Women and Children, Honolulu, HI, USA

    David Young, Andrea Siu, Michele Kanemori & George Kingston

  19. Children’s Memorial Hermann Hospital, University of Texas at Houston, Houston, TX, USA

    Megan Geloneck, Robert Feldman, Ted Baker, Laura Baker & Ephrem Melese

  20. Riley Hospital for Children at Indiana University Health, Indiana University, Indianapolis, IN, USA

    Kathryn Haider, Jingyun Wang & Elizabeth Hynes

  21. University of Iowa Stead Family Children’s Hospital, University of Iowa, Iowa City, IA, USA

    Edward F. Bell, Alina V. Dumitrescu, Jonathan M. Klein, Gretchen A. Cress, Avanthi S. Ajjarapu, Kristine Berge, Eric Boeshart, Morgan Dorsey, Bethany M. Funk, Grace Hach, Claire L. Johnson, Kevin Kurian, Emily Miller & Angela C. Platt

  22. Kingston Health Sciences Center, Queen’s University, Kingston, ON, Canada

    Christine Law & Andrew Gissing

  23. Loma Linda University Children’s Hospital, Loma Linda University, Loma Linda, CA, USA

    Leila Khazaeni, Jennifer Dunbar, Kelley Hawkins, Sharon Lee, Lily Sung & Carly Leggitt

  24. Norton Children’s Hospital, University of Louisville, Louisville, KY, USA

    Aparna Ramasubramanian, Rahul Bhola, Michelle Bottorff, Neviana Dimova, Rachel Keith & Laura Thomas

  25. Masonic Children’s Hospital, formerly University of Minnesota—Amplatz Children’s Hospital, University of Minnesota, Minneapolis, MN, USA

    Jill Anderson, Raymond G. Areaux Jr., Ann Marie Holleschau, Jordan Gross & Andrea Kramer

  26. Vanderbilt Eye Institute and Vanderbilt University Medical Center, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TN, USA

    David Morrison, Sean Donahue, Carsyn Saige Wilkins, Neva Fukuda, Sandy Owings & Scott Ruark

  27. The Children’s Hospital at OU Medical Center/The University of Oklahoma Health Sciences Center, University of Oklahoma, Oklahoma City, OK, USA

    R. Michael Siatkowski, Faizah Bhatti, Vanessa Bergman, Karen Corff, Kari Harkey, Amy Manfredo, Ashley Helmbrecht, Shrenik Talsania & Terri Whisenhunt

  28. Nebraska Medicine, University of Nebraska, Omaha, NE, USA

    Donny Suh, Ann Anderson Berry, Denise Lynes & Kelly C. Erikson

  29. The Children’s Hospital of Philadelphia, Hospital of the University of Pennsylvania, Pennsylvania Hospital, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Gil Binenbaum, Soraya Abbasi, Haresh Kirpalani, Graham E. Quinn, Lindsay Dawson & Lauren A. Tomlinson

  30. Children’s Hospital of Pittsburgh, Magee Women Hospital of UPMC, University of Pittsburgh, Pittsburgh, PA, USA

    Christin Sylvester, Kanwal Nischal & Lauren Runkel

  31. Women and Infants Hospital of Rhode Island, Rhode Island Hospital, Providence, RI, USA

    Wendy S. Chen & Deidrya Jackson

  32. Cardinal Glennon Children’s Hospital, Saint Louis University, St. Louis, MO, USA

    Bradley Davitt, Dawn Govreau, Linda Breuer & September Noonan

  33. Primary Children’s Hospital and University of Utah Hospital, University of Utah, Salt Lake City, UT, USA

    Robert Hoffman, Joanna Beachy, Kelliann Farnsworth, Katie Jo Farnsworth, Deborah Harrison, Ashlie Bernhisel & Bonnie Carlstrom

  34. UCSF Benioff Children’s Hospital and Zuckerberg San Francisco General Hospital, formerly San Francisco General Hospital, University of California San Francisco, San Francisco, CA, USA

    Alejandra G. de Alba Campomanes, Yizhuo Bastea-Forte, Lucia Rivera Sanchez, Jacquelyn Kemmer, Alexandra Neiman & Sarah Sitati-Ng’Anda

  35. Seattle Children’s Hospital, and University of Washington Medical Center, Seattle, WA, USA

    Kristina Tarczy-Hornoch, Francine Baran & Lauren Eaton

  36. Sick Kids, The Hospital for Sick Children, Toronto, ON, Canada

    Nasrin Najm-Tehrani, Tanya Grossi, Maram Isaac & Robin Knighton

  37. Harbor-UCLA Medical Center, Los Angeles Biomedical Research Institute, Torrance, CA, USA

    Monica Ralli Khitri & Madeline Del Signore

  38. Crozer Chester Medical Center, Delaware County Memorial Hospital, Crozer-Chester Medical Center, Upland, PA, USA

    Cynthia Dembofsky, Andrew Meyer, Karen Flaherty, Tracey Harris & Jamie Heeneke

  39. Nemours/Alfred I duPont Hospital for Children, Wilmington, DE, USA

    Dorothy Hendricks, Christopher M. Fecarotta, Alicia Olivant Fisher & Mark Paullin

  40. Cost-Effectiveness Component, Beth Israel Deaconess Medical Center, Boston, MA, USA

    John A. F. Zupancic

  41. Executive/Editorial Committee, Boston, MA, USA

    Maureen G. Maguire, Alejandra de Alba Campomanes, Edward F. Bell, Gil Binenbaum, Pamela Donohue, David Morrison, Graham E. Quinn, Michael X. Repka, David L. Rogers, Lauren A. Tomlinson, Michael Yang & Gui-shuang Ying

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  1. John A. F. Zupancic
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  2. Gui-shuang Ying
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  3. Alejandra de Alba Campomanes
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  4. Lauren A. Tomlinson
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  5. Gil Binenbaum
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Consortia

on behalf of the G-ROP Study Group

  • Gil Binenbaum
  • , Lauren A. Tomlinson
  • , Trang B. Duros
  • , Anh Nguyen
  • , Gui-shuang Ying
  • , Maureen G. Maguire
  • , Mary Brightwell-Arnold
  • , James Shaffer
  • , Yinxi Yu
  • , Maria Blanco
  • , Trina Brown
  • , Christopher P. Helker
  • , Amy Hutchinson
  • , Carrie Young
  • , Emily McCourt
  • , Anne Lynch
  • , Jennifer Cathcart
  • , Ashlee Cerda
  • , Levi Bonnell
  • , Tamara Thevarajah
  • , Gerard P. Barry
  • , Marilyn Fisher
  • , Maria V. Battaglia
  • , Alex M. Drach
  • , Kevin Hughes
  • , Nachammai Chinnakaruppan
  • , Andrew Meyer
  • , Christina Gogal
  • , Cynthia Beitler
  • , Lauri Centolanza
  • , Keith T. Moyer
  • , Mary Sobotor
  • , Pamela Donohue
  • , Michael X. Repka
  • , Jennifer A. Shepard
  • , Megan Doherty
  • , James D. Reynolds
  • , Erin Connelly
  • , Edward Cheeseman
  • , Kinsey Shirer
  • , Carol Bradham
  • , Allison McAlpine
  • , Sudeep Sunthankar
  • , Javaneh Abbasian
  • , Janet Lim
  • , Michael Yang
  • , Patricia Cobb
  • , Elizabeth L. Alfano
  • , David Rogers
  • , Rachel E. Reem
  • , Amanda Schreckengost
  • , Rae R. Fellows
  • , Kaitlyn Loh
  • , Madeline A. McGregor
  • , Thabit Mustafa
  • , Ivy Dean
  • , Rachel Miller
  • , Tess Russell
  • , Rebecca Stattler
  • , Sara Maletic
  • , Theran Jake Selph
  • , David Young
  • , Andrea Siu
  • , Michele Kanemori
  • , George Kingston
  • , Megan Geloneck
  • , Robert Feldman
  • , Ted Baker
  • , Laura Baker
  • , Ephrem Melese
  • , Kathryn Haider
  • , Jingyun Wang
  • , Elizabeth Hynes
  • , Edward F. Bell
  • , Alina V. Dumitrescu
  • , Jonathan M. Klein
  • , Gretchen A. Cress
  • , Avanthi S. Ajjarapu
  • , Kristine Berge
  • , Eric Boeshart
  • , Morgan Dorsey
  • , Bethany M. Funk
  • , Grace Hach
  • , Claire L. Johnson
  • , Kevin Kurian
  • , Emily Miller
  • , Angela C. Platt
  • , Christine Law
  • , Andrew Gissing
  • , Leila Khazaeni
  • , Jennifer Dunbar
  • , Kelley Hawkins
  • , Sharon Lee
  • , Lily Sung
  • , Carly Leggitt
  • , Aparna Ramasubramanian
  • , Rahul Bhola
  • , Michelle Bottorff
  • , Neviana Dimova
  • , Rachel Keith
  • , Laura Thomas
  • , Jill Anderson
  • , Raymond G. Areaux Jr.
  • , Ann Marie Holleschau
  • , Jordan Gross
  • , Andrea Kramer
  • , David Morrison
  • , Sean Donahue
  • , Carsyn Saige Wilkins
  • , Neva Fukuda
  • , Sandy Owings
  • , Scott Ruark
  • , R. Michael Siatkowski
  • , Faizah Bhatti
  • , Vanessa Bergman
  • , Karen Corff
  • , Kari Harkey
  • , Amy Manfredo
  • , Ashley Helmbrecht
  • , Shrenik Talsania
  • , Terri Whisenhunt
  • , Donny Suh
  • , Ann Anderson Berry
  • , Denise Lynes
  • , Kelly C. Erikson
  • , Gil Binenbaum
  • , Soraya Abbasi
  • , Haresh Kirpalani
  • , Graham E. Quinn
  • , Lindsay Dawson
  • , Lauren A. Tomlinson
  • , Christin Sylvester
  • , Kanwal Nischal
  • , Lauren Runkel
  • , Wendy S. Chen
  • , Deidrya Jackson
  • , Bradley Davitt
  • , Dawn Govreau
  • , Linda Breuer
  • , September Noonan
  • , Robert Hoffman
  • , Joanna Beachy
  • , Kelliann Farnsworth
  • , Katie Jo Farnsworth
  • , Deborah Harrison
  • , Ashlie Bernhisel
  • , Bonnie Carlstrom
  • , Alejandra G. de Alba Campomanes
  • , Yizhuo Bastea-Forte
  • , Lucia Rivera Sanchez
  • , Jacquelyn Kemmer
  • , Alexandra Neiman
  • , Sarah Sitati-Ng’Anda
  • , Kristina Tarczy-Hornoch
  • , Francine Baran
  • , Lauren Eaton
  • , Nasrin Najm-Tehrani
  • , Tanya Grossi
  • , Maram Isaac
  • , Robin Knighton
  • , Monica Ralli Khitri
  • , Madeline Del Signore
  • , Cynthia Dembofsky
  • , Andrew Meyer
  • , Karen Flaherty
  • , Tracey Harris
  • , Jamie Heeneke
  • , Dorothy Hendricks
  • , Christopher M. Fecarotta
  • , Alicia Olivant Fisher
  • , Mark Paullin
  • , John A. F. Zupancic
  • , Alejandra de Alba Campomanes
  • , Edward F. Bell
  • , Gil Binenbaum
  • , Pamela Donohue
  • , David Morrison
  • , Graham E. Quinn
  • , Michael X. Repka
  • , David L. Rogers
  • , Lauren A. Tomlinson
  • , Michael Yang
  •  & Gui-shuang Ying

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Correspondence to John A. F. Zupancic.

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Zupancic, J.A.F., Ying, Gs., de Alba Campomanes, A. et al. Evaluation of the economic impact of modified screening criteria for retinopathy of prematurity from the Postnatal Growth and ROP (G-ROP) study. J Perinatol 40, 1100–1108 (2020). https://doi.org/10.1038/s41372-020-0605-5

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