title: A new objective digital computerized vision screening system.
abstract: OBJECTIVE
  Fewer than 40% of children in the crucial younger-than-4 age group are evaluated for visual problems by pediatricians. This is due to impracticality from either a clinical or practice efficiency standpoint. Current photoscreening methods require trained readers and suffer from significant subjectivity and interobserver variability. We report a cross-sectional, double-masked study using new digital imaging with objective, automated, computerized image analysis.
  
  
  METHODS
  Two-hundred six children aged 9 months to 16 years were prospectively studied in a University-based pediatric ophthalmology practice. Images were taken by volunteers with a modified digital camera which, when downloaded, were analyzed within 35 seconds by new image analysis software. The analysis was compared to a masked review of a complete pediatric ophthalmic exam.
  
  
  RESULTS
  Overall agreement between physician and the objective computerized analysis was 86.9%. Positive predictive value was 91%, sensitivity was 89%, and specificity was 83%.
  
  
  CONCLUSIONS
  This automated digital imaging screening system eliminates human bias and provides accurate and immediate results. The system requires no special expertise.
authors.affiliation: Ratner Children's Eye Center, Department of Ophthalmology, University of California San Diego, La Jolla 92093-0946, USA.
authors.forename: D B
authors.initials: DB
authors.lastname: Granet
authors.forename: A
authors.initials: A
authors.lastname: Hoover
authors.forename: A R
authors.initials: AR
authors.lastname: Smith
authors.forename: S I
authors.initials: SI
authors.lastname: Brown
authors.forename: D U
authors.initials: DU
authors.lastname: Bartsch
authors.forename: B
authors.initials: B
authors.lastname: Brody
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007223:Infant; D008297:Male; D015588:Observer Variation; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014786:Vision Disorders / Q000175:diagnosis*; D015351:Vision Screening / Q000295:instrumentation / Q000379:methods*