PMID- 29105728
OWN - NLM
STAT- MEDLINE
DCOM- 20180105
LR  - 20230508
IS  - 1469-493X (Electronic)
IS  - 1361-6137 (Linking)
VI  - 11
IP  - 11
DP  - 2017 Nov 6
TI  - Tests for detecting strabismus in children aged 1 to 6 years in the community.
PG  - CD011221
LID - 10.1002/14651858.CD011221.pub2 [doi]
LID - CD011221
AB  - BACKGROUND: Strabismus (misalignment of the eyes) is a risk factor for impaired 
      visual development both of visual acuity and of stereopsis. Detection of 
      strabismus in the community by non-expert examiners may be performed using a 
      number of different index tests that include direct measures of misalignment 
      (corneal or fundus reflex tests), or indirect measures such as stereopsis and 
      visual acuity. The reference test to detect strabismus by trained professionals 
      is the cover‒uncover test. OBJECTIVES: To assess and compare the accuracy of 
      tests, alone or in combination, for detection of strabismus in children aged 1 to 
      6 years, in a community setting by non-expert screeners or primary care 
      professionals to inform healthcare commissioners setting up childhood screening 
      programmes.Secondary objectives were to investigate sources of heterogeneity of 
      diagnostic accuracy. SEARCH METHODS: We searched the Cochrane Central Register of 
      Controlled Trials (CENTRAL; 2016, Issue 12) (which contains the Cochrane Eyes and 
      Vision Trials Register) in the Cochrane Library, the Health Technology Assessment 
      Database (HTAD) in the Cochrane Library (2016, Issue 4), MEDLINE Ovid (1946 to 5 
      January 2017), Embase Ovid (1947 to 5 January 2017), CINAHL (January 1937 to 5 
      January 2017), Web of Science Conference Proceedings Citation Index-Science 
      (CPCI-S) (January 1990 to 5 January 2017), BIOSIS Previews (January 1969 to 5 
      January 2017), MEDION (to 18 August 2014), the Aggressive Research Intelligence 
      Facility database (ARIF) (to 5 January 2017), the ISRCTN registry 
      (www.isrctn.com/editAdvancedSearch); searched 5 January 2017, ClinicalTrials.gov 
      (www.clinicaltrials.gov); searched 5 January 2017 and the World Health 
      Organization (WHO) International Clinical Trials Registry Platform (ICTRP) 
      (www.who.int/ictrp/search/en); searched 5 January 2017. We did not use any date 
      or language restrictions in the electronic searches for trials. In addition, 
      orthoptic journals and conference proceedings without electronic listings were 
      searched. SELECTION CRITERIA: All prospective or retrospective population-based 
      test accuracy studies of consecutive participants were included. Studies compared 
      a single or combination of index tests with the reference test. Only those 
      studies with sufficient data for analysis were included specifically to calculate 
      sensitivity and specificity and determine diagnostic accuracy.Participants were 
      aged 1 to 6 years. Studies reporting participants outside this range were 
      included if subgroup data were available.Permitted settings included 
      population-based vision screening programmes or opportunistic screening 
      programmes, such as those performed in schools. DATA COLLECTION AND ANALYSIS: We 
      used standard methodological procedures expected by Cochrane. In brief, two 
      review authors independently assessed titles and abstracts for eligibility and 
      extracted the data, with a third senior author resolving any disagreement. We 
      analysed data primarily for specificity and sensitivity. MAIN RESULTS: One study 
      from a total of 1236 papers, abstracts and trials was eligible for inclusion with 
      a total number of participants of 335 of which 271 completed both the screening 
      test and the gold standard test. The screening test using an automated 
      photoscreener had a sensitivity of 0.46 (95% confidence interval (CI) 0.19 to 
      0.75) and specificity of 0.97 (CI 0.94 to 0.99). The overall number affected by 
      strabismus was low at 13 (4.8%). AUTHORS' CONCLUSIONS: There is very limited data 
      in the literature to ascertain the accuracy of tests for detecting strabismus in 
      the community as performed by non-expert screeners. A large prospective study to 
      compare methods would be required to determine which tests have the greatest 
      accuracy.
FAU - Hull, Sarah
AU  - Hull S
AD  - NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust 
      and UCL Institute of Ophthalmology, 162 City Road, London, UK, EC1V 2PD.
FAU - Tailor, Vijay
AU  - Tailor V
FAU - Balduzzi, Sara
AU  - Balduzzi S
FAU - Rahi, Jugnoo
AU  - Rahi J
FAU - Schmucker, Christine
AU  - Schmucker C
FAU - Virgili, Gianni
AU  - Virgili G
FAU - Dahlmann-Noor, Annegret
AU  - Dahlmann-Noor A
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
DEP - 20171106
PL  - England
TA  - Cochrane Database Syst Rev
JT  - The Cochrane database of systematic reviews
JID - 100909747
SB  - IM
UOF - doi: 10.1002/14651858.CD011221
MH  - Blinking
MH  - Child
MH  - Child, Preschool
MH  - Depth Perception
MH  - Fundus Oculi
MH  - Humans
MH  - Infant
MH  - Prospective Studies
MH  - Retrospective Studies
MH  - Sensitivity and Specificity
MH  - Strabismus/*diagnosis
MH  - Vision Screening/*methods
MH  - Visual Acuity
PMC - PMC6486041
COIS- The authors have no interests to declare.
EDAT- 2017/11/07 06:00
MHDA- 2018/01/06 06:00
PMCR- 2018/11/06
CRDT- 2017/11/07 06:00
PHST- 2017/11/07 06:00 [pubmed]
PHST- 2018/01/06 06:00 [medline]
PHST- 2017/11/07 06:00 [entrez]
PHST- 2018/11/06 00:00 [pmc-release]
AID - CD011221.pub2 [pii]
AID - 10.1002/14651858.CD011221.pub2 [doi]
PST - epublish
SO  - Cochrane Database Syst Rev. 2017 Nov 6;11(11):CD011221. doi: 
      10.1002/14651858.CD011221.pub2.