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基于仪器的幼儿视力筛查在初级保健中的实施

Primary Care Implementation of Instrument-Based Vision Screening for Young Children.

作者信息

Vernacchio Louis, Trudell Emily K, Nigrosh Jason, Focht Glenn

机构信息

1 Pediatric Physicians' Organization at Children's, Brookline, MA, USA.

2 Boston Children's Hospital, MA, USA.

出版信息

Clin Pediatr (Phila). 2018 Aug;57(9):1020-1026. doi: 10.1177/0009922817738342. Epub 2017 Nov 1.

Abstract

Vision screening for young children can detect conditions that may lead to amblyopia and vision loss if left untreated. Portable vision screening devices with high levels of precision are now available, but their effectiveness in busy primary care settings is unknown. We analyzed the effect of deploying instrument screening devices (SPOT Vision Screener, Welch-Allyn) in 19 pediatric practices. At baseline, using chart-based screening, 65.3% of 3- to 5-year-old children completed screening. A significant increase was observed starting 3 weeks after delivery of devices, and a stable level was reached 12 weeks after implementation, with 86.5% of children completing vision screening ( P = .007 by interrupted time series analysis). Improvement was greatest among 3-year-olds (44.0%-79.8%) but was also seen among 4-year-olds (70.9%-88.4%) and 5-year-olds (80.3%-90.8%). The deployment of vision screening devices in primary care practices substantially improved completed screening among preschool-aged children.

摘要

对幼儿进行视力筛查可以检测出一些疾病,如果不加以治疗,这些疾病可能会导致弱视和视力丧失。现在已有高精度的便携式视力筛查设备,但它们在繁忙的基层医疗环境中的有效性尚不清楚。我们分析了在19家儿科诊所部署仪器筛查设备(SPOT视力筛查仪,Welch-Allyn)的效果。在基线时,使用基于图表的筛查方法,65.3%的3至5岁儿童完成了筛查。在设备交付3周后观察到显著增加,并在实施12周后达到稳定水平,86.5%的儿童完成了视力筛查(通过中断时间序列分析,P = 0.007)。3岁儿童的改善最为显著(从44.0%提高到79.8%),但4岁儿童(从70.9%提高到88.4%)和5岁儿童(从80.3%提高到90.8%)也有改善。在基层医疗诊所部署视力筛查设备显著提高了学龄前儿童的筛查完成率。

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