Department of Ophthalmology and Visual Sciences, Yale School of Medicine, New Haven, Connecticut.
JAMA Ophthalmol. 2021 Mar 1;139(3):344-347. doi: 10.1001/jamaophthalmol.2020.6177.
The coronavirus disease 2019 pandemic illustrates the increasingly important role of telemedicine as a method of clinician-patient interaction. However, electronic applications (apps) for the testing of ophthalmology vital signs, such as visual acuity, can be published and used without any verification of accuracy, validity, or reliability.
To reassess the accuracy of visual acuity-testing apps and assess their viability for telehealth.
DESIGN, SETTING, AND PARTICIPANTS: The US Apple App Store was queried for apps for visual acuity testing. Anticipated optotype size for various visual acuity lines were calculated and compared against the actual measured optotype size on 4 different Apple hardware devices. No human participants were part of this study.
Mean (SD) errors were calculated per device and across multiple devices.
On iPhones, 10 apps met inclusion criteria, with mean errors ranging from 0.2% to 109.9%. On the iPads, 9 apps met inclusion criteria, with mean errors ranging from 0.2% to 398.1%. Six apps met criteria and worked on both iPhone and iPad, with mean errors from 0.2% to 249.5%. Of the 6 apps that worked across devices, the top 3 most accurate apps were Visual Acuity Charts (mean [SD] error, 0.2% [0.0%]), Kay iSight Test Professional (mean [SD] error, 3.5% [0.7%]), and Smart Optometry (mean [SD] error, 15.9% [4.3%]). None of the apps tested were ideal for telemedicine, because some apps displayed accurate optotype size, while others displayed the same letters on separate devices; no apps exhibited both characteristics.
Both Visual Acuity Charts and Kay iSight Test Professional had low mean (SD) errors and functionality across all tested devices, but no apps were suitable for telemedicine. This suggests that new and/or improved visual acuity-testing apps are necessary for optimal telemedicine use.
2019 年冠状病毒病大流行说明了远程医疗作为临床医生与患者互动的一种方法的作用日益重要。然而，用于测试眼科生命体征（如视力）的电子应用程序（应用程序）可以在未经准确性、有效性或可靠性验证的情况下发布和使用。
重新评估视力测试应用程序的准确性，并评估其在远程医疗中的可行性。
设计、设置和参与者：查询美国苹果应用商店中用于视力测试的应用程序。计算了各种视力线的预期视标大小，并与 4 种不同的苹果硬件设备上实际测量的视标大小进行了比较。本研究没有人类参与者。
根据设备和多个设备计算平均（SD）误差。
在 iPhone 上，有 10 个应用程序符合纳入标准，平均误差范围为 0.2%至 109.9%。在 iPad 上，有 9 个应用程序符合纳入标准，平均误差范围为 0.2%至 398.1%。有 6 个应用程序符合标准，可在 iPhone 和 iPad 上使用，平均误差为 0.2%至 249.5%。在跨设备工作的 6 个应用程序中，前 3 个最准确的应用程序是 Visual Acuity Charts（平均[SD]误差，0.2%[0.0%]）、Kay iSight Test Professional（平均[SD]误差，3.5%[0.7%]）和 Smart Optometry（平均[SD]误差，15.9%[4.3%]）。没有一个测试的应用程序适合远程医疗，因为一些应用程序显示准确的视标大小，而其他应用程序在不同的设备上显示相同的字母；没有应用程序同时具有这两个特征。
Visual Acuity Charts 和 Kay iSight Test Professional 在所有测试设备上的平均（SD）误差和功能都较低，但没有应用程序适合远程医疗。这表明需要新的和/或改进的视力测试应用程序，以实现最佳的远程医疗使用。
