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S. Salim, K. H. Fung, M. E. Smith, A. Aldridge, P. A. Netland; Assessment of the Student Sight Savers Project (SSSP) Methods for Glaucoma Screening. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5469.
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The purpose of this study was to assess various methods used for glaucoma screening in the Student Sight Savers Project (SSSP) Program, which has screened approximately 41,000 individuals for glaucoma in the US.
This was a prospective, case-control study (total N=70). Patients with primary open-angle glaucoma (N=35) were age-matched (within 10 years) and sex-matched with control individuals with no evidence of glaucoma (N=35). Positive screening criteria included a family history of glaucoma, intraocular pressure (IOP) > 21 mm Hg by non-contact (air puff) tonometry, and ≥ 3 abnormal points on frequency doubling perimetry (FDP). The primary outcome measures were sensitivity, specificity, and positive predictive power of the individual tests and the overall screening method.
The sensitivity and specificity values were 48.6% and 68.6% for family history of glaucoma, 26.5% and 71.4% for IOP, and 74.2% and 97.1% for FDP. When analyzing the overall screening criteria, the sensitivity increased to 88.6% with reduction in specificity to 54.3%. The positive predictive power (PPP) was low for the overall screening criteria (14.8%) and highest for FDP as an individual test (37.0%). Medical student education and community awareness aspects of the program were not assessed.
Of different methods used in the SSSP Program, FDP was the best single screening test, demonstrating high specificity and moderate sensitivity. Use of multiple screening criteria resulted in slightly increased sensitivity over FDP, but decreased specificity.
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