June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Evaluation of measurement properties of an online nurse-assisted eye-screening tool for home healthcare patients
Author Affiliations & Notes
  • Ruth M A van Nispen
    Ophthalmology, Amsterdam UMC Locatie VUmc, Amsterdam, Noord-Holland, Netherlands
  • Ellen Elsman
    Ophthalmology, Amsterdam UMC Locatie VUmc, Amsterdam, Noord-Holland, Netherlands
  • Olivia Lee
    Ophthalmology, Amsterdam UMC Locatie VUmc, Amsterdam, Noord-Holland, Netherlands
  • Robert Wisse
    Ophthalmology, Universitair Medisch Centrum Utrecht, Utrecht, Utrecht, Netherlands
  • Jan Keunen
    Ophthalmology, Radboud UMC, Nijmegen, Netherlands
  • Ger van Rens
    Ophthalmology, Amsterdam UMC Locatie VUmc, Amsterdam, Noord-Holland, Netherlands
  • Hilde Petronella Adriana van der Aa
    Ophthalmology, Amsterdam UMC Locatie VUmc, Amsterdam, Noord-Holland, Netherlands
    Lighthouse Guild, New York, New York, United States
  • Footnotes
    Commercial Relationships   Ruth van Nispen None; Ellen Elsman None; Olivia Lee None; Robert Wisse Easee B.V., Code E (Employment); Jan Keunen None; Ger van Rens None; Hilde van der Aa None
  • Footnotes
    Support  The Netherlands Organisation for Health Research and Development: ZonMw Vroege Opsporing (grant # 555004202)
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 4219 – A0147. doi:
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      Ruth M A van Nispen, Ellen Elsman, Olivia Lee, Robert Wisse, Jan Keunen, Ger van Rens, Hilde Petronella Adriana van der Aa; Evaluation of measurement properties of an online nurse-assisted eye-screening tool for home healthcare patients. Invest. Ophthalmol. Vis. Sci. 2022;63(7):4219 – A0147.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Reliability and agreement of an online nurse-assisted eye-screening tool versus manifest tests was investigated in a home healthcare setting.

Methods : Near and distance visual acuity and macular function (Amsler) was tested in patients (mean age 83 years, range 65-97) from home healthcare organizations in the Netherlands. The online Conformité Européenne (CE)-marked eye-screening tool (Easee B.V.) was administered by nurses at the participants’ homes using a tablet or laptop and a smartphone as a remote control. Manifest tests were administered within two weeks by a researcher. Bland-Altman’s limits of agreement were computed, comparing online and manifest tests. Reliability was analyzed with intraclass correlation coefficients (ICC) and (weighted) kappa. Non-inferiority was set at a difference of less than ±0.15 logMAR.

Results : Forty patients (80 eyes) were included. Between the eye-screening tool and manifest test the following mean differences were found: distance visual acuity 0.02 logMAR, near visual acuity measured with tumbling-E optotypes 0.07 logMAR and 0.03 logMAR with the triangle-circle optotypes. For distance visual acuity 75% of the individual data points were within the non-inferiority threshold. For near visual acuity, 53% and 55% were within the non-inferiority threshold for the tumbling-E and triangle-circle optotypes, respectively. Good reliability between the tests was found for distance visual acuity (ICC=0.78), and moderate for the near visual acuity tests (ICC=0.74 and ICC=0.67) and for detecting macular problems (kappa=0.48).

Conclusions : Nurse-assisted eye-screening seems promising with this online tool in an elderly home healthcare population. Agreement and reliability of the tool was satisfactory. As a next step, acceptability of the tool by the various stakeholders and also cost-effectiveness of eye-screening in home healthcare will be investigated to confirm public support.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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