BMJ Open Ophthalmology (Dec 2023)

Improved screening of retinopathy of prematurity (ROP): development of a target product profile (TPP) for resource-limited settings

  • Clare E Gilbert,
  • Andrea Zin,
  • Cindy McWhorter,
  • Pukhraj Rishi,
  • Chinyere Ezeaka,
  • Aeesha N J Malik,
  • Dupe S Ademola-Popoola,
  • Odirichi Andrew,
  • Julio A Urrets-Zavalia,
  • Anand Vinekar,
  • Rebecca P Kirby,
  • Kara M Palamountain,
  • Afsar Dastjani Farahani,
  • Alex Pennos,
  • Antonio Castilla Bombín,
  • Ashish N Holani,
  • Elizabeth Asma,
  • Dharma Irugalbandara,
  • Sarah Sitati,
  • Sriharanathan Poopalaratnam,
  • Emeka Ikediugwu,
  • Francis Mutangana,
  • Gilbert Batieka Bonsaana,
  • Guillermo Andres Monteoliva,
  • J Peter Campbell,
  • K Chandrasekhar,
  • Lindsay Hampton-Hampejskova,
  • Nigel Bolster,
  • Nilva Simeren BuenoDeMores,
  • Oluwatimilehin Abayomi,
  • Rilwan Chiroma Muhammad,
  • Roberto Yee,
  • R V Paul Chan

DOI
https://doi.org/10.1136/bmjophth-2022-001197
Journal volume & issue
Vol. 8, no. 1

Abstract

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Background As more preterm infants survive, complications of preterm birth, including retinopathy of prematurity (ROP), become more prevalent. ROP rates and blindness from ROP are higher in low-income and middle-income countries, where exposure to risk factors can be higher and where detection and treatment of ROP are under-resourced or non-existent. Access to low-cost imaging devices would improve remote screening capabilities for ROP.Methods Target product profiles (TPPs) are developed early in the medical device development process to define the setting, target user and range of product requirements. A Delphi-like process, consisting of an online survey and consensus meeting, was used to develop a TPP for an ROP imaging device, collecting feedback on a proposed set of 64 product requirements.Results Thirty-six stakeholders from 17 countries provided feedback: clinicians (72%), product developers (14%), technicians (6%) and other (8%). Thirty-six per cent reported not currently screening for ROP, with cited barriers including cost (44%), no training (17%) and poor image quality (16%). Among those screening (n=23), 48% use more than one device, with the most common being an indirect ophthalmoscope (87%), followed by RetCam (26%) and smartphone with image capture (26%). Consensus was reached on 53 (83%) product requirements. The 11 remaining were discussed at the consensus meeting, and all but two achieved consensus.Conclusions This TPP process was novel in that it successfully brought together diverse stakeholders to reach consensus on the product requirements for an ROP imaging devices. The resulting TPP provides a framework from which innovators can develop prototypes.