儿科医生联合Plusoptix筛查的预测价值：屈光和双眼视轴矫正的影响
Predictive value from pediatrician plusoptix screening: impact of refraction and binocular alignment.
作者信息
Arnold Robert W, Tulip Daniel, McArthur Erin, Shen Janet, Tappel John, Arnold Laura E, Winkle Elizabeth, Armitage M Diane
出版信息
Binocul Vis Strabolog Q Simms Romano. 2012;27(4):227-32.
BACKGROUND
The positive predictive value (PPV) of conventional preschool acuity screening is about 50% whereas previous Polaroid photoscreening with experienced interpretation can achieve PPV greater than 85%. The Plusoptix photoscreener has immediate computer interpretation and a CPT code available to pediatricians.
METHODS
Two Plusoptix SO9 were used in two pediatric group practices with previously validated refractive criteria and new manufacturer's binocular alignment criteria. CPT billing was monitored. Referred patients had prior gold-standard AAPOS examinations.
RESULTS
12% of 675 photoscreened preschoolers were referred. Of the 39 with AAPOS gold-standard exams, the PPV from strabismus referrals was 17%, while 26 of 27 refractive referrals had true amblyopia risk factors (PPV 96%). Screening CPT code 99174 reimbursement rose from zero to half of insurers in 15 months.
CONCLUSION
Plusoptix photoscreening is valid after adjusting the binocular alignment criteria. Such photoscreening should be employed by pediatric practices to detect and ultimately to reduce amblyopia vision impairment in children.
背景
传统的学龄前视力筛查的阳性预测值（PPV）约为50%，而之前经验丰富的宝丽来照片筛查的PPV可超过85%。Plusoptix视力筛查仪具有即时电脑解读功能，并且有儿科医生可用的现行程序编码（CPT）。
方法
在两个儿科门诊使用两台Plusoptix SO9视力筛查仪，采用先前验证的屈光标准和新的制造商双眼对齐标准。监测CPT计费情况。转诊患者之前接受过金标准的美国小儿眼科与斜视学会（AAPOS）检查。
结果
675名接受照片筛查的学龄前儿童中有12%被转诊。在接受AAPOS金标准检查的39名儿童中，斜视转诊的PPV为17%，而27名屈光转诊儿童中有26名存在真正的弱视危险因素（PPV为96%）。筛查CPT编码99174的报销在15个月内从零增长到一半的保险公司。
结论
调整双眼对齐标准后，Plusoptix视力筛查是有效的。儿科门诊应采用这种视力筛查来检测并最终减少儿童弱视视力损害。
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