title: [How is ophthalmic undersupply demonstrated in socially disadvantaged people? Cross-sectional pilot investigation on the parametrisation of endpoints for patient-centred care research].
abstract: BACKGROUND
  Many people depend on additional help to maintain their daily needs. In these circumstances preventive medical check-ups are frequently not attended, so that disease development may remain undetected until advanced stages or correctable disorders may not be treated. A fully anonymised cross-sectional study was set up to assess feasibility of parametrisation and to quantify sensitive indicators for screening for possible ophthalmic undersupply in socially disadvantaged people.
  
  
  METHODS
  In 2011 a free, voluntary and anonymous ophthalmic examination was offered to attendees of the "Oberhausener Tafel" social project. The visual acuity was checked with adjustment of the objective refractional error via autorefractor, without or with glasses (if available). In addition, an examination of the anterior and posterior segments of the eye was done in miosis. As primary endpoint a corrected visual acuity of > 0.5 combined with a presenting visual acuity ≤ 0.5 on the same eye in at least one eye was considered. A key secondary endpoint was defined as the absolute deviation of at least 1 D in at least one eye between the spherical equivalent measurement of the corrective values of the glasses and the autorefractor readings. The primary intention of this pilot investigation was to assess the feasibility of this endpoint parametrisation and to quantify the corresponding endpoint prevalences.
  
  
  RESULTS
  Data of 37 participants could be evaluated, 28 of whom brought their glasses. The best available visual acuity ranged from 0.12 to 1.3 with a median per eye of 0.63. In comparison, the corrected visual acuity per eye was 0.8 (range 0.32-1.0). In 54 % the presenting visual acuity was one- or both-eyed ≤ 0.5, but could be reduced to 30 % (one- or both-eyed) after correction of the objective refractional error. In summary, presenting visual acuity in comparison to corrected visual acuity showed potential for an at least one-eyed improvement for at least two lines in 46 % of the participants. Furthermore, 19 participants showed disorders concerning the anterior or posterior eye segment.
  
  
  CONCLUSIONS
  In the examined population the visual acuity could be improved by two lines in merely 50 % of the participants by adjusting refractive errors. The results indicate the need for discussion on how to lower the threshold for attending preventive ophthalmic examinations.
authors.affiliation: Augenklinik, Ev. Krankenhaus Mülheim/Ruhr, Wertgasse 30, Mülheim an der Ruhr. BirgitBettina.Bestges@evkmh.de
authors.forename: B-B
authors.initials: BB
authors.lastname: Bestges
authors.forename: C C
authors.initials: CC
authors.lastname: Lösche
authors.forename: F
authors.initials: F
authors.lastname: Krummenauer
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D023381:Endpoint Determination / Q000379:methods*; D005139:Eyeglasses; D005260:Female; D005858:Germany; D015276:Health Care Rationing / Q000379:methods*; D006297:Health Services Accessibility; D006302:Health Services Research / Q000379:methods; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D018802:Patient-Centered Care / Q000379:methods; D010865:Pilot Projects; D012030:Refractive Errors / Q000175:diagnosis* / Q000534:rehabilitation*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014787:Vision Tests / Q000379:methods*; D014792:Visual Acuity; D035862:Vulnerable Populations; D055815:Young Adult