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智能手机照片筛查在儿科实践中的阳性预测值。

The Positive Predictive Value of Smartphone Photoscreening in Pediatric Practices.

作者信息

Arnold Robert W, Arnold Andrew W, Hunt-Smith Taryn T, Grendahl Robin L, Winkle R Kevin

出版信息

J Pediatr Ophthalmol Strabismus. 2018 Nov 19;55(6):393-396. doi: 10.3928/01913913-20180710-01. Epub 2018 Aug 29.

Abstract

PURPOSE

To compare smartphone photoscreening with other commercial objective screeners for amblyopia screening for young children.

METHODS

Ten pediatricians in four practices employed Nokia 1020 smartphones (Espoo, Finland) with single-axis Gobiquity software (Scottsdale, AZ) during well-child visits. Outcomes of confirmatory pediatric ophthalmology examinations were prospectively compared using American Association for Pediatric Ophthalmology and Strabismus uniform standards.

RESULTS

Five percent of 6,310 in-office screenings were referred: 25% for high anisometropia, 31% for hyperopia, and 15% for myopia. The positive predictive value (PPV) in 217 follow-up examinations was 68% (95% confidence interval: 62% to 74%) by 2013 age-stratified standards and 77% (confidence interval: 71% to 83%) by 2003 American Association for Pediatric Ophthalmology and Strabismus standards. The follow-up rate was 65%.

CONCLUSIONS

Smartphone photoscreening had PPV comparable with other commercial objective screeners. Simple, valid photoscreeners should help pediatricians achieve widespread compliance with screening guidelines to reduce the burden of pediatric amblyopia vision impairment. [J Pediatr Ophthalmol Strabismus. 2018;55(6):393-396.].

摘要

目的

比较智能手机照片筛查与其他商用客观筛查工具在幼儿弱视筛查中的效果。

方法

四家诊所的十位儿科医生在儿童健康检查期间使用配备单轴Gobiquity软件(美国亚利桑那州斯科茨代尔)的诺基亚1020智能手机(芬兰埃斯波)。采用美国小儿眼科与斜视协会统一标准,前瞻性比较确诊的小儿眼科检查结果。

结果

在6310例门诊筛查中,5%的儿童被转诊:25%因高度屈光参差,31%因远视,15%因近视。按照2013年年龄分层标准,217例后续检查中的阳性预测值(PPV)为68%(95%置信区间:62%至74%);按照2003年美国小儿眼科与斜视协会标准,阳性预测值为77%(置信区间:71%至83%)。随访率为65%。

结论

智能手机照片筛查的阳性预测值与其他商用客观筛查工具相当。简单、有效的照片筛查工具应有助于儿科医生广泛遵守筛查指南,以减轻小儿弱视视力损害的负担。[《小儿眼科与斜视杂志》。2018;55(6):393 - 396。]

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