Sensitivity and Specificity of Preschool Vision Screening in Iran
Background: To determine the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the National Vision Screening Program for 7 yr old children in Iran. Methods: In this cross-sectional study, eight cities in Iran were selected through multistage cluster s...
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Format: | Article |
Language: | English |
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Tehran University of Medical Sciences
2017-02-01
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Series: | Iranian Journal of Public Health |
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Online Access: | https://ijph.tums.ac.ir/index.php/ijph/article/view/9050 |
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author | Hassan HASHEMI Abbasali YEKTA Ebrahim JAFARZADEHPUR Hadi OSTADIMOGHADDAM Amir ASHARLOUS Payam NABOVATI Mehdi KHABAZKHOOB |
author_facet | Hassan HASHEMI Abbasali YEKTA Ebrahim JAFARZADEHPUR Hadi OSTADIMOGHADDAM Amir ASHARLOUS Payam NABOVATI Mehdi KHABAZKHOOB |
author_sort | Hassan HASHEMI |
collection | DOAJ |
description | Background: To determine the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the National Vision Screening Program for 7 yr old children in Iran.
Methods: In this cross-sectional study, eight cities in Iran were selected through multistage cluster sampling. Selected cities were Sari, Birjand, Ardabil, Mashhad, Bandar Abbas, Dezful, Yazd, and Arak, in Iran in 2013. Totally, 4614 schoolchildren were selected, 4106 of which participated in the study. An optometrist at the school site conducted all vision tests. Results were compared against those recorded on each child’s health card. Those with an uncorrected visual acuity worse than 20/25 in at least one eye screened positive for a vision problem.
Results: 8.49% [95% confidence interval, 7.65 to 9.39] of the examinees had a vision problem. The sensitivity rate of the school entry screening was 38.15% (95% CI, 33.01 to 43.50) and the specificity rate was 93.11 (95%CI 92.25 to 93.90). The positive and negative predictive values were 33.93 (29.24 to 38.88) and 94.19 (93.39 to 94.93), respectively. Sensitivity and specificity rates did not significantly differ between boys and girls. For the uncorrected visual acuity tested by public health care workers compared to optometrists, the area under the ROC surface was 0.741 (P<0.001). The best-associated criterion was an uncorrected visual acuity more than 0.05 LogMAR with 67.3% sensitivity and 74.7% specificity.
Conclusion: The validity of the school entry vision screening by health workers is low. To reduce false negative rates, some supplementary examinations such as refraction and near visual acuity measurements as well as further training of screeners should be considered. |
first_indexed | 2024-04-11T14:44:38Z |
format | Article |
id | doaj.art-17eeba9309104b8285cb3e16b1c59a93 |
institution | Directory Open Access Journal |
issn | 2251-6085 2251-6093 |
language | English |
last_indexed | 2024-04-11T14:44:38Z |
publishDate | 2017-02-01 |
publisher | Tehran University of Medical Sciences |
record_format | Article |
series | Iranian Journal of Public Health |
spelling | doaj.art-17eeba9309104b8285cb3e16b1c59a932022-12-22T04:17:40ZengTehran University of Medical SciencesIranian Journal of Public Health2251-60852251-60932017-02-01462Sensitivity and Specificity of Preschool Vision Screening in IranHassan HASHEMI0Abbasali YEKTA1Ebrahim JAFARZADEHPUR2Hadi OSTADIMOGHADDAM3Amir ASHARLOUS4Payam NABOVATI5Mehdi KHABAZKHOOB6Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, IranDept. of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, IranDept. of Optometry, Iran University of Medical Sciences, Tehran, Iran AND Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, IranRefractive Errors Research Center, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, IranNoor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran AND Refractive Errors Research Center, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, IranDept. of Optometry, Iran University of Medical Sciences, Tehran, Iran AND Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, IranDept. of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IranBackground: To determine the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the National Vision Screening Program for 7 yr old children in Iran. Methods: In this cross-sectional study, eight cities in Iran were selected through multistage cluster sampling. Selected cities were Sari, Birjand, Ardabil, Mashhad, Bandar Abbas, Dezful, Yazd, and Arak, in Iran in 2013. Totally, 4614 schoolchildren were selected, 4106 of which participated in the study. An optometrist at the school site conducted all vision tests. Results were compared against those recorded on each child’s health card. Those with an uncorrected visual acuity worse than 20/25 in at least one eye screened positive for a vision problem. Results: 8.49% [95% confidence interval, 7.65 to 9.39] of the examinees had a vision problem. The sensitivity rate of the school entry screening was 38.15% (95% CI, 33.01 to 43.50) and the specificity rate was 93.11 (95%CI 92.25 to 93.90). The positive and negative predictive values were 33.93 (29.24 to 38.88) and 94.19 (93.39 to 94.93), respectively. Sensitivity and specificity rates did not significantly differ between boys and girls. For the uncorrected visual acuity tested by public health care workers compared to optometrists, the area under the ROC surface was 0.741 (P<0.001). The best-associated criterion was an uncorrected visual acuity more than 0.05 LogMAR with 67.3% sensitivity and 74.7% specificity. Conclusion: The validity of the school entry vision screening by health workers is low. To reduce false negative rates, some supplementary examinations such as refraction and near visual acuity measurements as well as further training of screeners should be considered.https://ijph.tums.ac.ir/index.php/ijph/article/view/9050Vision screeningAmblyopiaSchoolchildrenSensitivitySpecificityIran |
spellingShingle | Hassan HASHEMI Abbasali YEKTA Ebrahim JAFARZADEHPUR Hadi OSTADIMOGHADDAM Amir ASHARLOUS Payam NABOVATI Mehdi KHABAZKHOOB Sensitivity and Specificity of Preschool Vision Screening in Iran Iranian Journal of Public Health Vision screening Amblyopia Schoolchildren Sensitivity Specificity Iran |
title | Sensitivity and Specificity of Preschool Vision Screening in Iran |
title_full | Sensitivity and Specificity of Preschool Vision Screening in Iran |
title_fullStr | Sensitivity and Specificity of Preschool Vision Screening in Iran |
title_full_unstemmed | Sensitivity and Specificity of Preschool Vision Screening in Iran |
title_short | Sensitivity and Specificity of Preschool Vision Screening in Iran |
title_sort | sensitivity and specificity of preschool vision screening in iran |
topic | Vision screening Amblyopia Schoolchildren Sensitivity Specificity Iran |
url | https://ijph.tums.ac.ir/index.php/ijph/article/view/9050 |
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