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.Influencing the Global Retinopathy Screening Agenda: An Analysis.
Retinopathy of prematurity (ROP) screening guidelines are an essential component of neonatal care worldwide. A lack of local guidelines has contributed to an increase in ROP-related blindness in low-income settings. Over the last decade, the “ROP Workgroup” sponsored by the World Health Organization (WHO) has been developed and disseminated multiple ROP guidelines. A critical evaluation of the WHO’s ROP guidelines is undertaken here, and recommendations are made for tailoring these to various contexts. The consensus-based clinical practice guidelines were reviewed and evaluated for adherence to the following criteria: 1) whether the guideline provided valid support for evidence-based practices; 2) if consensus was achieved on the basis of the evidence-based practice, the guideline should have been recommended by the expert panel; and 3) no recommendations or recommendations of conditional clinical practice should be made by an expert panel. Recommendations and feedback were based on the expert panel’s review of the available evidence and the clinical applicability of the guideline. A total of 89 recommendations were made in the form of advice, recommendations, and conditional recommendations. Although the WHO ROP guidelines provide a comprehensive assessment of ROP screening programs, there are clinical and contextual limitations that should be considered when translating the available guidelines into practice. Future research should explore, document, and validate the individual components of the ROP screening cascade in low-income contexts./***************************************************************************
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