A STATISTICAL-ANALYSIS OF MODIFIED CLINICAL TECHNIQUE VISION SCREENING OF PRESCHOOLERS BY OPTOMETRY STUDENTS

被引:15
作者
MARSHTOOTLE, WL
CORLISS, DA
ALVAREZ, SL
CLORE, KA
DAUM, KM
GORDON, A
HOUSTON, G
PERRY, FF
SWANSON, MW
机构
[1] Departments of Optometry and Physiological Optics, School of Optometry, Civitan International Research Center Sparks Clinics, University of Alabama at Birmingham, Birmingham, AL
[2] Department of Physiological Optics, School of Optometry, University of Alabama at Birmingham, Birmingham, AL
[3] Brookwood Hospital, Birmingham, AL
[4] School of Optometry, University of Alabama at Birmingham, Birmingham, AL
[5] Veteran's Administration Hospital of Birmingham, AL
关键词
CHILD; PRESCHOOL; VISION SCREENING;
D O I
10.1097/00006324-199410000-00001
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
Fourth year optometry students screened 745 preschoolers using a slightly altered Modified Clinical Technique (MCT) under the supervision of a faculty doctor. Children who failed the MCT were randomly selected and then matched by age, sex, and ethnic origin to children who had passed the screening battery. The 61 screening failures and 45 matched controls were later given full eye examinations with cycloplegia by University of Alabama at Birmingham faculty doctors who were unaware of the screening results. The positive predictive value (PPV) (0.52) and negative predictive value (NPV) (0.78) of the MCT were calculated directly from the 2x2 contingency table crossing screening results and a standard diagnosis. Sensitivity [0.50, k(1,0)=0.29], specificity [0.79, k(0,0)=0.30], efficiency [0.70, k(0.5,0)=0.29] of the MCT, and the prevalence (0.30) of children failing the standard diagnosis were estimated using statistics appropriate to the prospective sampling design. The reproducibility of the diagnosis, estimated by analyzing multiple, independent diagnoses of each study child by seven doctors was moderate (kappa(D) 0.58). Statistics summarizing the agreement between the MCT and the diagnosis by the individual study doctor are similar to those obtained with comparison to the standard diagnosis. The characteristics of the MCT may be generalized only to similar populations that are screened by clinicians with similar experience, using the same tests.
引用
收藏
页码:593 / 603
页数:11
相关论文
共 24 条
[1]  
Angi M.R., Pucci V., Forattini F., Formentin P.A., Results of photorefractometric screening for amblyogenic defects in children age 20 months, Behav Brain Res, 49, pp. 91-97, (1992)
[2]  
Neumann E., Friedman Z., Abel-Peleg B., Prevention of strabismic amblyopia of early onset with special reference to the optimal age for screening, J Pediatr Ophthalmol Strab, 24, pp. 106-110, (1987)
[3]  
Ml E., Reinecke R.D., Simons K., Preschool vision screening for amblyopia and strabismus. Programs, methods, guidelines, 1923, Surv Ophthalmol, 28, pp. 145-163, (1983)
[4]  
Wasserman R.C., Croft C.A., Brotherton S.E., Preschool vision screening in pediatric practice: A study from the pediatric research in office settings (PROS) network, Pediatrics, 89, pp. 834-838, (1992)
[5]  
Ingram R.M., Refraction as a basis for screening children for squint and amblyopia, Br J Ophthalmol, 61, pp. 8-15, (1977)
[6]  
Campbell L.R., Charney E., Factors associated with delay in diagnosis of childhood amblyopia, Pediatrics, 87, pp. 178-185, (1991)
[7]  
Epelbaum M., Mllleret C., Bulsseret P., Dufier J.L., The sensitive period for strabismic amblyopia in humans, Ophthalmology (Rochester), 100, pp. 323-327, (1993)
[8]  
Oliver M., Neumann R., Chaimovitch Y., Gotesman N., Shim-Shoni M., Compliance and results of treatment for amblyopia in children more than 8 years old, Am J Ophthalmol, 102, pp. 340-345, (1986)
[9]  
Blum H.L., Peters H.B., Bettman J.W., Vision Screening for Elementary Schools: The Orinda Study, Berkeley: University of California Press, (1959)
[10]  
Simons K., Visual acuity norms in young children, Surv Ophthalmol, 28, pp. 84-92, (1983)