Vision Screening Assessment (VISA) tool: diagnostic accuracy validation of a novel screening tool in detecting visual impairment among stroke survivors
Vision Screening Assessment (VISA) tool: diagnostic accuracy validation of a novel screening tool in detecting visual impairment among stroke survivors
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DOI：
10.1136/bmjopen-2019-033639
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发表时间：
2020-01-01
期刊：
影响因子：
2.9
通讯作者：
Burnside, Girvan
中科院分区：
文献类型：
--
作者：
Rowe, Fiona J.;Hepworth, Lauren;Burnside, Girvan
目的中风幸存者视力问题的筛查没有标准化。未被发现或识别不佳的视觉问题可能会导致中风幸存者的需求未得到满足。我们报告了一个新的视力障碍筛查评估（VISA）工具，旨在用于中风团队，以提高识别中风survivor.Methods视力障碍，我们进行了前瞻性的病例队列比较研究，在四个中心，以验证VISA工具对专家参考视力评估的验证。VISA有印刷版或应用程序（药品和保健产品监管机构批准）;两组使用相同。VISA和综合参考视力评估都测量了病史、视力、眼睛对准、眼球运动、视野和视觉注意力不集中。主要结果的措施是存在或不存在的视力importance.Results二百二十一中风幸存者进行了筛选。专家参考视力评估由经验丰富的矫正师进行。201名卒中幸存者完全完成了筛查和参考视力评估。101名中风幸存者完成了VISA打印; 100名完成了VISA应用程序。VISA指纹的敏感性和特异性分别为97.67%和66.67%。总体一致性显著; K=0.648。VISA应用程序的敏感性和特异性分别为88.31%和86.96%。总体一致性显著; K=0.690。最低的协议被发现筛选眼动和近视acuity.Conclusions这项验证研究表明，可接受的VISA筛选潜在的视力障碍中风幸存者。灵敏度和特异性都很高，表明这种筛查工具的准确性。VISA有印刷版或应用程序版，可在多种行程设置中进行灵活应用。
Purpose Screening for visual problems in stroke survivors is not standardised. Visual problems that remain undetected or poorly identified can create unmet needs for stroke survivors. We report the validation of a new Vision Impairment Screening Assessment (VISA) tool intended for use by the stroke team to improve identification of visual impairment in stroke survivors.Methods We conducted a prospective case cohort comparative study in four centres to validate the VISA tool against a specialist reference vision assessment. VISA is available in print or as an app (Medicines and Healthcare products Regulatory Agency regulatory approved); these were used equally for two groups. Both VISA and the comprehensive reference vision assessment measured case history, visual acuity, eye alignment, eye movements, visual field and visual inattention. The primary outcome measure was the presence or absence of visual impairment.Results Two hundred and twenty-one stroke survivors were screened. Specialist reference vision assessment was by experienced orthoptists. Full completion of screening and reference vision assessment was achieved for 201 stroke survivors. VISA print was completed for 101 stroke survivors; VISA app was completed for 100. Sensitivity and specificity of VISA print was 97.67% and 66.67%, respectively. Overall agreement was substantial; K=0.648. Sensitivity and specificity of VISA app was 88.31% and 86.96%, respectively. Overall agreement was substantial; K=0.690. Lowest agreement was found for screening of eye movement and near visual acuity.Conclusions This validation study indicates acceptability of VISA for screening of potential visual impairment in stroke survivors. Sensitivity and specificity were high indicating the accuracy of this screening tool. VISA is available in print or as an app allowing versatile uptake across multiple stroke settings.