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Detection of visual field defects by opticians - with Damato Multifixation Campimetry Online
摘要： Purpose: To study Damato Multifixation Campimetry Online (DMCO), an inexpensive online visual field test, used for screening at optician shops in Denmark. Methods: This was an evaluation of a diagnostic test and customers were included if minimum 50 years old, with a visual acuity of minimum 0.5 and with less myopia than 6 D. Standard equipment was a computer, a wireless mouse and a computer monitor. We used the 'DMCO STANDARD 4,5' algorithm for screening. DMCO results were electronically transmitted to the authors. Customers with a positive DMCO test received an eye examination including the reference standard Humphrey Visual Field Analyzer 30–2 SITA Fast test. A subset of control participants with a negative DMCO test received the same examination in order to estimate the number of false and true negatives. DMCO specificity and sensitivity were estimated according to five reference standards with 95% confidence intervals. Results: The population comprised 627 individuals, 381 women and 246 men, from 13 optician shops. Mean age was 62 years (SD 7.4). DMCO was positive in 32 individuals and 27 individuals were classified as 'true positives' with diagnoses such as glaucoma, cataract and neurological visual field defects. Of the 595 individuals with a negative DMCO test, 110 were examined and nine individuals were classified as 'false negatives' according to diagnoses. Depending on reference the specificity was 97–99% and sensitivity was 14–69%. Conclusion: Screening with DMCO demonstrated high specificity, whereas sensitivity was unsatisfactory. Future studies with enough power to estimate the true sensitivity is needed.
关键词： Humphrey Field Analyzer,glaucoma,screening test,Damato Multifixation Campimetry Online,specificity,opticians/optometrists
更新于2025-09-23 15:23:52
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Can standard deviation of overnight pulse oximetry be used to screen childhood obstructive sleep apnea
摘要： Objectives: Pulse oximetry (PO) has been frequently used as an alternative test to polysomnography (PSG) in children. We conducted this study to determine which statistical parameters obtained from overnight PO monitoring would be most suitable and to evaluate its diagnostic performance. Methods: We prospectively recruited children with snoring referred for PSG. Subjects were monitored with PO while performing PSG. Eight statistical parameters of SpO2 data were analyzed to identify which had the best diagnostic performance as assessed by the area under the receiver-operating characteristic curve (AUC). To validate this parameter (which was found to be the standard deviation, SD) in a larger population, we retrospectively extracted raw data of SpO2 from our previous PSG records, calculated the SD of each patient, and assessed its AUC. Results: A total of 166 children were recruited in the first phase. SD of SpO2 was found to have the largest AUC. In the second phase, raw data of 457 patients were extracted. SD of SpO2 correlated well with the apnea/hypopnea index (AHI) (r=0.6, P<0.001). For diagnosis of moderate to severe obstructive sleep apnea (OSA) (AHI ≥5 events/h), AUC was 0.74. SD of SpO2 ≥1.06 representing mean + 2SD of normal to mild OSA (AHI <5) provided 97% specificity and 92% positive predictive value. The positive likelihood ratio was 11. Conclusion: Calculating the SD of SpO2, which quantifies the amount of dispersion of SpO2 values, is a useful initial investigation in childhood OSA. An SD ≥1.06 can predict moderate to severe OSA with confidence. This parameter is simple, practical, and readily accessible.
关键词： Adenotonsillectomy,Screening test,Children,Obstructive sleep apnea,Polysomnography
更新于2025-09-23 15:22:29