Smeeth L, Iliffe S
Epidemiology Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK, WC1E 7HT.
Cochrane Database Syst Rev. 2000(2):CD001054. doi: 10.1002/14651858.CD001054.
While the aims of multicomponent screening of older people are broad, any benefit arising from the inclusion of a vision component in the assessment will necessarily be dependent on improved vision.
The objective of this review is to assess the effects on vision of mass screening of older people for visual impairment.
We searched the Cochrane Eye and Vision Group specialised register, the Cochrane Controlled Trials Register - Central, MEDLINE, EMBASE, SciSearch and reference lists of relevant trial reports and review articles. We contacted investigators to identify additional published and unpublished trials. The most recent searches were conducted in April 1998.
We included randomised trials of visual or multicomponent screening for vision impairment in people aged 65 or over in a community setting.
Both reviewers independently extracted data and assessed trial quality.
Visual outcome data were available for 3494 people in five trials of multicomponent assessment. Length of follow up ranged from two to four years. All the trials used self-reported measures for visual impairment, both as screening tools and as outcome measures. In four of the trials people reporting visual problems were referred to either the eye services or to a physician. In one trial people reporting visual problems received information about resources in the community designed to assist those with poor vision. The proportions of participants in the intervention and control groups who reported visual problems at the time of outcome assessment were 0.26 and 0.23 respectively (relative risk for visual impairment 1.03, 95% confidence interval 0.92 to 1.15).
REVIEWER'S CONCLUSIONS: There is no evidence that community-based screening of asymptomatic older people results in improvements in vision.
尽管对老年人进行多组分筛查的目标广泛，但评估中纳入视力组分所带来的任何益处必然依赖于视力的改善。
本综述的目的是评估对老年人进行视力损害大规模筛查对视力的影响。
我们检索了Cochrane眼科和视力组专业注册库、Cochrane对照试验注册库 - 中枢库、MEDLINE、EMBASE、SciSearch以及相关试验报告和综述文章的参考文献列表。我们联系了研究人员以识别其他已发表和未发表的试验。最近一次检索于1998年4月进行。
我们纳入了在社区环境中对65岁及以上人群进行视力或多组分视力损害筛查的随机试验。
两位综述作者独立提取数据并评估试验质量。
在五项多组分评估试验中，有3494人的视力结局数据可用。随访时间为2至4年。所有试验均使用自我报告的视力损害测量方法，既作为筛查工具，也作为结局测量指标。在四项试验中，报告有视力问题的人被转介至眼科服务机构或医生处。在一项试验中，报告有视力问题的人获得了有关社区中旨在帮助视力不佳者的资源的信息。在结局评估时，干预组和对照组中报告有视力问题的参与者比例分别为0.26和0.23（视力损害的相对风险为1.03，95%置信区间为0.92至1.15）。
没有证据表明对无症状老年人进行社区筛查能改善视力。
