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Children unable to perform screening tests in vision in preschoolers study: proportion with ocular conditions and impact on measures of test accuracy.

Abstract：

PURPOSE:To examine the relative prevalence of ocular conditions among children who are unable to perform preschool vision screening tests and the impact on measures of screening test performance. METHODS:Trained nurse and lay screeners each administered a Lea Symbols visual acuity (VA) test (Good-Lite, Inc., Steamwood, IL), Stereo Smile II test (Stereo Optical, Inc., Chicago, IL), and Retinomax Autorefractor (Right Manufacturing, Virginia Beach, VA), and SureSight Vision Screener (Welch Allyn, Inc., Skaneateles Falls, NY) examinations to 1475 children who later received a comprehensive eye examination to identify amblyopia, strabismus, significant refractive error, and unexplained reduced VA. The outcomes of the examination for children for whom screeners were unable to obtain results (Unables) were compared to the outcomes of children who passed and children who failed each screening test. When estimating sensitivity, specificity, and positive and negative predictive values (PPV and NPV), Unables were classified as either screening failures or screening passers. RESULTS:Less than 2% of children were classified as Unables for each test. The percentage with an ocular condition was at least two times higher for Unables than for screening passers for six of the eight modes of screening (P < 0.05). Considering Unables as screening failures, rather than screening passers, increased the estimate of sensitivity by 1% to 3% (depending on test) and decreased the estimate of specificity by 0% to 2%; PPV decreased by 0% to 4% for most tests, whereas NPV increased by <1%. CONCLUSIONS:Preschool children who are unable to perform VIP screening tests are more likely to have vision disorders than are children who pass the tests. Because < or =2% of children were unable to do each test, referring these children for an eye examination had little impact on the PPV and NPV of the tests, as administered in VIP.

journal_name

Invest Ophthalmol Vis Sci

journal_title

Investigative ophthalmology & visual science

authors

Maguire MG,Vision in Preschoolers Study Group.

doi

10.1167/iovs.06-0384

subject

Has Abstract

pub_date

2007-01-01 00:00:00

pages

83-7

issue

eissn

0146-0404

issn

1552-5783

pii

48/1/83

journal_volume

pub_type

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Children unable to perform screening tests in vision in preschoolers study: proportion with ocular conditions and impact on measures of test accuracy.