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Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews.

Diagnostic accuracy of vision screening tests for the detection of amblyopia and its risk factors: a systematic review

Review published: 2009.

Bibliographic details: Schmucker C, Grosselfinger R, Riemsma R, Antes G, Lange S, Lagreze W, Kleijnen J.  Diagnostic accuracy of vision screening tests for the detection of amblyopia and its risk factors: a systematic review. Graefe's Archive for Clinical and Experimental Ophthalmology 2009; 247(11): 1441-1454. [PubMed: 19669781]

Quality assessment

This well-conducted review concluded that diagnostic test accuracy of preschool vision screening tests could only be sufficiently investigated after establishing age-related values that defined amblyopia, refractive errors and binocular disorders. This conclusion is likely to be reliable. Full critical summary

Abstract

AIM: This systematic review evaluates the diagnostic accuracy of preschool vision screening tests for the detection of amblyopia and its risk factors.

METHODS: The literature searches were conducted in nine bibliographic databases. No limitation to a specific study design, year of publication or language was applied. Studies were included if they compared a vision screening test with a reference test (gold standard) in children from the general population. In addition, the studies had to provide sufficient data to calculate diagnostic accuracy (sensitivity and specificity). Full-text articles were assessed for studies that satisfied the inclusion criteria using the "Quality of Diagnostic Accuracy Studies (QUADAS)" checklist.

RESULTS: Two studies with a longitudinal design and 25 cross-sectional studies met the inclusion criteria. One of the longitudinal studies compared a screening programme in children between 1 and 2 years of age with a re-examination at the age of 8. The sensitivity for the screening programme was 86% (range: 64-97%) and the specificity 99% (range: 98-99%). The second longitudinal study compared screening examinations at 8, 12, 18, 25 and 31 months, with a re-examination at the age of 37 months. In this study, the sensitivity of the screening examination increased with age, while the specificity remained unchanged. The cross-sectional studies evaluated different screening settings, visual acuity tests, auto- or photorefractors and stereo tests. A large variety of reference tests, differing criteria for defining amblyopia and its risk factors and methodological limitations of the studies prevented a valid data interpretation.

CONCLUSION: Diagnostic test accuracy of preschool vision screening tests can only be sufficiently investigated after establishing age-related values defining amblyopia, refractive errors and binocular disorders. To address these questions, we recommend a controlled longitudinal study design.

CRD has determined that this article meets the DARE scientific quality criteria for a systematic review.

Copyright © 2014 University of York.

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