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Visual Impairment Screening Assessment (VISA) tool: pilot validation
OBJECTIVE: To report and evaluate a new Vision Impairment Screening Assessment (VISA) tool intended for use by the stroke team to improve identification of visual impairment in stroke survivors. DESIGN: Prospective case cohort comparative study. SETTING: Stroke units at two secondary care hospitals...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855179/ https://www.ncbi.nlm.nih.gov/pubmed/29511021 http://dx.doi.org/10.1136/bmjopen-2017-020562 |
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author | Rowe, Fiona J Hepworth, Lauren R Hanna, Kerry L Howard, Claire |
author_facet | Rowe, Fiona J Hepworth, Lauren R Hanna, Kerry L Howard, Claire |
author_sort | Rowe, Fiona J |
collection | PubMed |
description | OBJECTIVE: To report and evaluate a new Vision Impairment Screening Assessment (VISA) tool intended for use by the stroke team to improve identification of visual impairment in stroke survivors. DESIGN: Prospective case cohort comparative study. SETTING: Stroke units at two secondary care hospitals and one tertiary centre. PARTICIPANTS: 116 stroke survivors were screened, 62 by naïve and 54 by non-naïve screeners. MAIN OUTCOME MEASURES: Both the VISA screening tool and the comprehensive specialist vision assessment measured case history, visual acuity, eye alignment, eye movements, visual field and visual inattention. RESULTS: Full completion of VISA tool and specialist vision assessment was achieved for 89 stroke survivors. Missing data for one or more sections typically related to patient’s inability to complete the assessment. Sensitivity and specificity of the VISA screening tool were 90.24% and 85.29%, respectively; the positive and negative predictive values were 93.67% and 78.36%, respectively. Overall agreement was significant; k=0.736. Lowest agreement was found for screening of eye movement and visual inattention deficits. CONCLUSIONS: This early validation of the VISA screening tool shows promise in improving detection accuracy for clinicians involved in stroke care who are not specialists in vision problems and lack formal eye training, with potential to lead to more prompt referral with fewer false positives and negatives. Pilot validation indicates acceptability of the VISA tool for screening of visual impairment in stroke survivors. Sensitivity and specificity were high indicating the potential accuracy of the VISA tool for screening purposes. Results of this study have guided the revision of the VISA screening tool ahead of full clinical validation. |
format | Online Article Text |
id | pubmed-5855179 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-58551792018-03-19 Visual Impairment Screening Assessment (VISA) tool: pilot validation Rowe, Fiona J Hepworth, Lauren R Hanna, Kerry L Howard, Claire BMJ Open Ophthalmology OBJECTIVE: To report and evaluate a new Vision Impairment Screening Assessment (VISA) tool intended for use by the stroke team to improve identification of visual impairment in stroke survivors. DESIGN: Prospective case cohort comparative study. SETTING: Stroke units at two secondary care hospitals and one tertiary centre. PARTICIPANTS: 116 stroke survivors were screened, 62 by naïve and 54 by non-naïve screeners. MAIN OUTCOME MEASURES: Both the VISA screening tool and the comprehensive specialist vision assessment measured case history, visual acuity, eye alignment, eye movements, visual field and visual inattention. RESULTS: Full completion of VISA tool and specialist vision assessment was achieved for 89 stroke survivors. Missing data for one or more sections typically related to patient’s inability to complete the assessment. Sensitivity and specificity of the VISA screening tool were 90.24% and 85.29%, respectively; the positive and negative predictive values were 93.67% and 78.36%, respectively. Overall agreement was significant; k=0.736. Lowest agreement was found for screening of eye movement and visual inattention deficits. CONCLUSIONS: This early validation of the VISA screening tool shows promise in improving detection accuracy for clinicians involved in stroke care who are not specialists in vision problems and lack formal eye training, with potential to lead to more prompt referral with fewer false positives and negatives. Pilot validation indicates acceptability of the VISA tool for screening of visual impairment in stroke survivors. Sensitivity and specificity were high indicating the potential accuracy of the VISA tool for screening purposes. Results of this study have guided the revision of the VISA screening tool ahead of full clinical validation. BMJ Publishing Group 2018-03-06 /pmc/articles/PMC5855179/ /pubmed/29511021 http://dx.doi.org/10.1136/bmjopen-2017-020562 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/ |
spellingShingle | Ophthalmology Rowe, Fiona J Hepworth, Lauren R Hanna, Kerry L Howard, Claire Visual Impairment Screening Assessment (VISA) tool: pilot validation |
title | Visual Impairment Screening Assessment (VISA) tool: pilot validation |
title_full | Visual Impairment Screening Assessment (VISA) tool: pilot validation |
title_fullStr | Visual Impairment Screening Assessment (VISA) tool: pilot validation |
title_full_unstemmed | Visual Impairment Screening Assessment (VISA) tool: pilot validation |
title_short | Visual Impairment Screening Assessment (VISA) tool: pilot validation |
title_sort | visual impairment screening assessment (visa) tool: pilot validation |
topic | Ophthalmology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855179/ https://www.ncbi.nlm.nih.gov/pubmed/29511021 http://dx.doi.org/10.1136/bmjopen-2017-020562 |
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