Accuracy and reliability of self-administered visual acuity tests: Systematic review of pragmatic trials
Remote self-administered visual acuity (VA) tests have the potential to allow patients and non-specialists to assess vision without eye health professional input. Validation in pragmatic trials is necessary to demonstrate the accuracy and reliability of tests in relevant settings to justify deployme...
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| description | Remote self-administered visual acuity (VA) tests have the potential to allow patients and non-specialists to assess vision without eye health professional input. Validation in pragmatic trials is necessary to demonstrate the accuracy and reliability of tests in relevant settings to justify deployment. Here, published pragmatic trials of these tests were synthesised to summarise the effectiveness of available options and appraise the quality of their supporting evidence.
A systematic review was undertaken in accordance with a preregistered protocol (CRD42022385045). The Cochrane Library, Embase, MEDLINE, and Scopus were searched. Screening was conducted according to the following criteria: (1) English language; (2) primary research article; (3) visual acuity test conducted out of eye clinic; (4) no clinical administration of remote test; (5) accuracy or reliability of remote test analysed. There were no restrictions on trial participants. Quality assessment was conducted with QUADAS-2.
Of 1227 identified reports, 10 studies were ultimately included. One study was at high risk of bias and two studies exhibited concerning features of bias; all studies were applicable. Three trials-of DigiVis, iSight Professional, and Peek Acuity-from two studies suggested that accuracy of the remote tests is comparable to clinical assessment. All other trials exhibited inferior accuracy, including conflicting results from a pooled study of iSight Professional and Peek Acuity. Two studies evaluated test-retest agreement-one trial provided evidence that DigiVis is as reliable as clinical assessment. The three most accurate tests required access to digital devices. Reporting was inconsistent and often incomplete, particularly with regards to describing methods and conducting statistical analysis.
Remote self-administered VA tests appear promising, but further pragmatic trials are indicated to justify deployment in carefully defined contexts to facilitate patient or non-specialist led assessment. Deployment could augment teleophthalmology, non-specialist eye assessment, pre-consultation triage, and autonomous long-term monitoring of vision. |
| doi_str_mv | 10.1371/journal.pone.0281847 |
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A systematic review was undertaken in accordance with a preregistered protocol (CRD42022385045). The Cochrane Library, Embase, MEDLINE, and Scopus were searched. Screening was conducted according to the following criteria: (1) English language; (2) primary research article; (3) visual acuity test conducted out of eye clinic; (4) no clinical administration of remote test; (5) accuracy or reliability of remote test analysed. There were no restrictions on trial participants. Quality assessment was conducted with QUADAS-2.
Of 1227 identified reports, 10 studies were ultimately included. One study was at high risk of bias and two studies exhibited concerning features of bias; all studies were applicable. Three trials-of DigiVis, iSight Professional, and Peek Acuity-from two studies suggested that accuracy of the remote tests is comparable to clinical assessment. All other trials exhibited inferior accuracy, including conflicting results from a pooled study of iSight Professional and Peek Acuity. Two studies evaluated test-retest agreement-one trial provided evidence that DigiVis is as reliable as clinical assessment. The three most accurate tests required access to digital devices. Reporting was inconsistent and often incomplete, particularly with regards to describing methods and conducting statistical analysis.
Remote self-administered VA tests appear promising, but further pragmatic trials are indicated to justify deployment in carefully defined contexts to facilitate patient or non-specialist led assessment. Deployment could augment teleophthalmology, non-specialist eye assessment, pre-consultation triage, and autonomous long-term monitoring of vision.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0281847</identifier><identifier>PMID: 37347757</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Accuracy ; Acuity ; Agreements ; Analysis ; Bias ; Biology and Life Sciences ; Clinical trials ; Computer and Information Sciences ; Design ; Diabetes ; Diabetic retinopathy ; Engineering and Technology ; Evidence (Law) ; Eye ; Eye (anatomy) ; Health risks ; Humans ; Medical examination ; Medical personnel ; Medical research ; Medicine and Health Sciences ; Medicine, Experimental ; Ophthalmology ; Patients ; Pediatrics ; People and places ; Quality assessment ; Quality control ; Reliability ; Reproducibility of Results ; Social Sciences ; Statistical analysis ; Statistical methods ; Systematic review ; Telemedicine ; Vision ; Visual Acuity</subject><ispartof>PloS one, 2023-06, Vol.18 (6), p.e0281847-e0281847</ispartof><rights>Copyright: © 2023 Thirunavukarasu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2023 Public Library of Science</rights><rights>2023 Thirunavukarasu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 Thirunavukarasu et al 2023 Thirunavukarasu et al</rights><rights>2023 Thirunavukarasu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c693t-da7bc4996af6ecb89934fb957dd4c40aa53d8a25c8d12f3996839333b92ba04b3</citedby><cites>FETCH-LOGICAL-c693t-da7bc4996af6ecb89934fb957dd4c40aa53d8a25c8d12f3996839333b92ba04b3</cites><orcidid>0000-0002-8464-5708 ; 0000-0001-8968-4768</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10286971/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10286971/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37347757$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Grzybowski, Andrzej</contributor><creatorcontrib>Thirunavukarasu, Arun James</creatorcontrib><creatorcontrib>Hassan, Refaat</creatorcontrib><creatorcontrib>Limonard, Aaron</creatorcontrib><creatorcontrib>Savant, Shalom Vitreous</creatorcontrib><title>Accuracy and reliability of self-administered visual acuity tests: Systematic review of pragmatic trials</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Remote self-administered visual acuity (VA) tests have the potential to allow patients and non-specialists to assess vision without eye health professional input. Validation in pragmatic trials is necessary to demonstrate the accuracy and reliability of tests in relevant settings to justify deployment. Here, published pragmatic trials of these tests were synthesised to summarise the effectiveness of available options and appraise the quality of their supporting evidence.
A systematic review was undertaken in accordance with a preregistered protocol (CRD42022385045). The Cochrane Library, Embase, MEDLINE, and Scopus were searched. Screening was conducted according to the following criteria: (1) English language; (2) primary research article; (3) visual acuity test conducted out of eye clinic; (4) no clinical administration of remote test; (5) accuracy or reliability of remote test analysed. There were no restrictions on trial participants. Quality assessment was conducted with QUADAS-2.
Of 1227 identified reports, 10 studies were ultimately included. One study was at high risk of bias and two studies exhibited concerning features of bias; all studies were applicable. Three trials-of DigiVis, iSight Professional, and Peek Acuity-from two studies suggested that accuracy of the remote tests is comparable to clinical assessment. All other trials exhibited inferior accuracy, including conflicting results from a pooled study of iSight Professional and Peek Acuity. Two studies evaluated test-retest agreement-one trial provided evidence that DigiVis is as reliable as clinical assessment. The three most accurate tests required access to digital devices. Reporting was inconsistent and often incomplete, particularly with regards to describing methods and conducting statistical analysis.
Remote self-administered VA tests appear promising, but further pragmatic trials are indicated to justify deployment in carefully defined contexts to facilitate patient or non-specialist led assessment. 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trials</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2023-06-22</date><risdate>2023</risdate><volume>18</volume><issue>6</issue><spage>e0281847</spage><epage>e0281847</epage><pages>e0281847-e0281847</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Remote self-administered visual acuity (VA) tests have the potential to allow patients and non-specialists to assess vision without eye health professional input. Validation in pragmatic trials is necessary to demonstrate the accuracy and reliability of tests in relevant settings to justify deployment. Here, published pragmatic trials of these tests were synthesised to summarise the effectiveness of available options and appraise the quality of their supporting evidence.
A systematic review was undertaken in accordance with a preregistered protocol (CRD42022385045). The Cochrane Library, Embase, MEDLINE, and Scopus were searched. Screening was conducted according to the following criteria: (1) English language; (2) primary research article; (3) visual acuity test conducted out of eye clinic; (4) no clinical administration of remote test; (5) accuracy or reliability of remote test analysed. There were no restrictions on trial participants. Quality assessment was conducted with QUADAS-2.
Of 1227 identified reports, 10 studies were ultimately included. One study was at high risk of bias and two studies exhibited concerning features of bias; all studies were applicable. Three trials-of DigiVis, iSight Professional, and Peek Acuity-from two studies suggested that accuracy of the remote tests is comparable to clinical assessment. All other trials exhibited inferior accuracy, including conflicting results from a pooled study of iSight Professional and Peek Acuity. Two studies evaluated test-retest agreement-one trial provided evidence that DigiVis is as reliable as clinical assessment. The three most accurate tests required access to digital devices. Reporting was inconsistent and often incomplete, particularly with regards to describing methods and conducting statistical analysis.
Remote self-administered VA tests appear promising, but further pragmatic trials are indicated to justify deployment in carefully defined contexts to facilitate patient or non-specialist led assessment. Deployment could augment teleophthalmology, non-specialist eye assessment, pre-consultation triage, and autonomous long-term monitoring of vision.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>37347757</pmid><doi>10.1371/journal.pone.0281847</doi><tpages>e0281847</tpages><orcidid>https://orcid.org/0000-0002-8464-5708</orcidid><orcidid>https://orcid.org/0000-0001-8968-4768</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | PloS one, 2023-06, Vol.18 (6), p.e0281847-e0281847 |
| issn | 1932-6203 1932-6203 |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Accuracy Acuity Agreements Analysis Bias Biology and Life Sciences Clinical trials Computer and Information Sciences Design Diabetes Diabetic retinopathy Engineering and Technology Evidence (Law) Eye Eye (anatomy) Health risks Humans Medical examination Medical personnel Medical research Medicine and Health Sciences Medicine, Experimental Ophthalmology Patients Pediatrics People and places Quality assessment Quality control Reliability Reproducibility of Results Social Sciences Statistical analysis Statistical methods Systematic review Telemedicine Vision Visual Acuity |
| title | Accuracy and reliability of self-administered visual acuity tests: Systematic review of pragmatic trials |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-26T08%3A07%3A00IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Accuracy%20and%20reliability%20of%20self-administered%20visual%20acuity%20tests:%20Systematic%20review%20of%20pragmatic%20trials&rft.jtitle=PloS%20one&rft.au=Thirunavukarasu,%20Arun%20James&rft.date=2023-06-22&rft.volume=18&rft.issue=6&rft.spage=e0281847&rft.epage=e0281847&rft.pages=e0281847-e0281847&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0281847&rft_dat=%3Cgale_plos_%3EA754140578%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2828662094&rft_id=info:pmid/37347757&rft_galeid=A754140578&rft_doaj_id=oai_doaj_org_article_1111bad1bf2e4813ab33f9c9531c0cec&rfr_iscdi=true |