Abstract
Purpose: :
To compare the sensitivity and specificity of the Welch Allyn SureSight (SS) in MKVSS to data previously obtained from the Vision in Preschoolers Study Group (VIP) for detecting targeted vision disorders in kindergarten children.
Methods: :
457 Boston Public Schools (BPS) kindergarten students were screened by paraprofessional screeners using the SS or the mandated Massachusetts protocol (MA) [MassVAT Lea Symbols and Random Dot E] in typical screening environments within BPS. All children who did not meet the SS or MA pass criteria along with a matched number who had passed were referred for an eye exam by pediatric optometrists. The exam was the gold standard for identifying targeted conditions as defined previously by VIP for refractive error, amblyopia, and strabismus. The primary outcome measures were the sensitivity and specificity of the MKVSS SS screening for detecting targeted vision disorders compared to previously published VIP SS data.
Results: :
131 children were referred after their vision screening, a total of 154 were consented and received the eye exam (76 who had passed and 78 who had failed).MKVSS SS sensitivity was .64 with .92 specificity. As previously reported, VIP sensitivities were as follows: Eyecare Practitioners (.63), Nurses (.64), Lay Screeners (.61), with specificities set at .90.
Conclusions: :
The data obtained in MPVSS compare very closely with that previously published by VIP, even with different subject ages (3-5 years in VIP, 5-6 years in MKVSS). All three categories of screeners in VIP were trained, certified, and monitored throughout data collection to ensure compliance with all study protocols. MKVSS screeners were trained in the procedures, but were not monitored closely during data collection. Thus, their performance more closely approximates that of personnel who typically carry out vision screening in community based school settings, in comparison to VIP personnel operating under strict study protocols and with younger children. In spite of these differences in the screening environment, the results are virtually identical to that published in VIP. The automated SureSight thus provides a screening tool capable of use under field conditions that is equivalent to that of more highly trained personnel.
Keywords: screening for ambylopia and strabismus • hyperopia • refraction