A new computer-based pediatric vision-screening test.
A new computer-based pediatric vision-screening test.
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DOI：
10.1016/j.jaapos.2015.01.011
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发表时间：
2015-04
期刊：
影响因子：
--
通讯作者：
Holmes JM
中科院分区：
文献类型：
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作者：
Yamada T;Hatt SR;Leske DA;Moke PS;Parrucci NL;Reese JJ;Ruben JB;Holmes JM
我们开发并验证了 Jaeb 视力筛查仪 (JVAS)，这是一种针对儿童的计算机化视力筛查程序，采用快速、针对年龄的标准化算法在医疗之家进行视力筛查，可免费下载。共有 175 名年龄在 3 岁至 <8 岁（中位数为 6 岁）的儿童在进行全面眼科检查（金标准）之前接受了 JVAS 筛查。 JVAS 提供了 2 个大型单环绕视标（20/100 和 20/80），然后在预定的、特定年龄的正常阈值下提供 5 个视标。黄金标准检查失败是根据最近发布的转诊标准和发布的年龄视力标准来确定的。我们评估了 JVAS 检测视力下降、弱视和弱视危险因素的敏感性和特异性。评估的 JVAS 通过/失败范例无法识别 4 中的 3、5 中的 3 和 5 中的 4 种适合年龄的视标表现。 JVAS 的筛选可测试性很高，为 100%。 JVAS 的敏感性范围为 88% 至 91%，特异性范围为 73% 至 86%，阳性预测值范围为 66% 至 79%，阴性预测值范围为 92% 至 93%（范围反映了不同的通过/失败范式）。新的 JVAS 提供了一种有效且实用的方法，可以使用任何基于 Windows 的计算机来筛查 3 至 7 岁的儿童。向儿科医生和学校系统免费提供 JVAS 将使目前分散的基于视力的筛查实践标准化。
We developed and validated the Jaeb Visual Acuity Screener (JVAS), a computerized visual acuity-based screening program for children that employs a rapid, age-specific, standardized algorithm for vision screening in the medical home that is available for download at no cost. A total of 175 children aged 3 to <8 (median, 6) years were screened with the JVAS before undergoing a complete eye examination (gold standard). The JVAS presented 2 large single surround optotypes (20/100 and 20/80) and then 5 optotypes at a predetermined, age-specific normal threshold. Failure on the gold standard examination was determined using recently published referral criteria and published visual acuity norms for age. We evaluated the sensitivity and specificity of the JVAS for detecting reduced visual acuity, amblyopia, and amblyopia risk factors. JVAS pass/fail paradigms evaluated were inability to identify 3 of 4, 3 of 5, and 4 of 5 age-appropriate optotype presentations. Screening testability for the JVAS was high, at 100%. Sensitivity of the JVAS ranged from 88% to 91%, and specificity from 73% to 86%, with positive predictive value ranging from 66% to 79% and negative predictive value from 92% to 93% (ranges reflect different pass/fail paradigms). The new JVAS provides an effective and practical method for screening 3- to 7-year-olds using any Windows-based computer. Providing the JVAS free-of-charge to pediatricians and school systems would standardize currently fragmented visual acuity-based screening practices.