Validation of Peek Acuity application in pediatric screening programs in Paraguay  

作　　者：Bryce de Venecia Yasmin Bradfield Ralph Moiler Trane Alicia Bareiro Miguel Scalamogna 

机构地区：[1]Department of Ophthalmology and Visual Sciences, University of Wisconsin Madison, Madison 53792, Wisconsin, USA [2]Fundacion Vision, Calle Ingavi y Coronel Cazal Departamento,San Lorenzo 2300, Central, Paraguay

出　　处：《International Journal of Ophthalmology(English edition)》2018年第8期1384-1389,共6页国际眼科杂志（英文版）

基　　金：Supported by the Dan and Ellie Albert Student Vision Research Award;Doolittle Professorship Fund;Research to Prevent Blindness, Inc.;Combat Blindness International;Fundación Visión

摘　　要：AIM： To validate the Peek Acuity mobile phone application in pediatric populations and compare its utility, both economic and diagnostic, against conventional screening methods using a pediatric ophthalmologist examination as the gold standard.METHODS： A cohort of 393 subjects from Fernando de la Mora, Paraguay（ages 6-16 y） were enrolled in the study. Subjects were randomly assigned a starting screening modality among： Peek Acuity, a single line of tumbling E optotypes set at 20/40, and Spot Vision Screener. Once completing the first screening modality, the subjects completed the two remaining techniques. Referral criteria were established based on the most current American Association of Pediatric Ophthalmology and Strabismus（AAPOS） recommendations： 20/40 for Peek Acuity and the tumbling E, and refractive error detection for the Spot Vision Screener. Subjects that failed to achieve the cutoff for any of the three screening techniques or subjects that passed the screening but were randomly selected to perform a comprehensive eye exam to determine the false negative rate, were evaluated by a pediatric ophthalmologist. This evaluation was considered the gold standard, and included vision assessment by a Snellen chart, strabismus evaluation, and cycloplegic refraction with dilated fundoscopy.RESULTS： We obtained 48% sensitivity, 83% specificity, 43% positive predictive value, and 86% negative predictive value for Peek Acuity＇s ability to refer compared to evaluation by a pediatric ophthalmologist, failing to achieve a desired sensitivity for implementation. Peek Acuity trended to overestimate the subject＇s visual acuity, providing a higher visual acuity that would not indicate referral for a comprehensive eye examination. However, its high specificity accurately predicted a significant number of children who did not need further evaluation. When comparing the three screening methods, no single screening modality outperformed the others. Peek Acuity represented a technology that was economicallyAIM： To validate the Peek Acuity mobile phone application in pediatric populations and compare its utility, both economic and diagnostic, against conventional screening methods using a pediatric ophthalmologist examination as the gold standard.METHODS： A cohort of 393 subjects from Fernando de la Mora, Paraguay（ages 6-16 y） were enrolled in the study. Subjects were randomly assigned a starting screening modality among： Peek Acuity, a single line of tumbling E optotypes set at 20/40, and Spot Vision Screener. Once completing the first screening modality, the subjects completed the two remaining techniques. Referral criteria were established based on the most current American Association of Pediatric Ophthalmology and Strabismus（AAPOS） recommendations： 20/40 for Peek Acuity and the tumbling E, and refractive error detection for the Spot Vision Screener. Subjects that failed to achieve the cutoff for any of the three screening techniques or subjects that passed the screening but were randomly selected to perform a comprehensive eye exam to determine the false negative rate, were evaluated by a pediatric ophthalmologist. This evaluation was considered the gold standard, and included vision assessment by a Snellen chart, strabismus evaluation, and cycloplegic refraction with dilated fundoscopy.RESULTS： We obtained 48% sensitivity, 83% specificity, 43% positive predictive value, and 86% negative predictive value for Peek Acuity＇s ability to refer compared to evaluation by a pediatric ophthalmologist, failing to achieve a desired sensitivity for implementation. Peek Acuity trended to overestimate the subject＇s visual acuity, providing a higher visual acuity that would not indicate referral for a comprehensive eye examination. However, its high specificity accurately predicted a significant number of children who did not need further evaluation. When comparing the three screening methods, no single screening modality outperformed the others. Peek Acuity represented a technology that was economically

关 键 词：pediatric ophthalmology validation study SCREENING mobile phone application 

分 类 号：TF3[冶金工程—冶金机械及自动化]