title: Field Evaluation of Automated Vision Screening Instruments: Impact of Referral Criteria Choice on Screening Outcome.
abstract: OBJECTIVE
  Automated vision screeners can identify children with amblyopia risk factors. Two screening instruments having different referral criteria were evaluated in a community setting: SPOT (Pediavision, Lake Mary, FL) (sensitive manufacturer's referral criteria) and plusoptiX S08 (Plusoptix GmbH, Nuremberg, Germany) (specific modified Arthur referral criteria).
  
  
  METHODS
  All children were screened by SPOT, and referred children were then screened using plusoptiX. Referred children received a gold standard examination to determine whether amblyopia risk factors were present.
  
  
  RESULTS
  A total of 2,801 treatment-naïve children were screened using SPOT. Of these, 307 (11.0%) were referred by SPOT and subsequently screened by plusoptiX; 100 received a gold standard examination. Amblyopia risk factors were present in 43% (43 of 100) referred by SPOT compared to 72.7% (32 of 44) for plusoptiX. Eleven of 56 referred by SPOT had amblyopia risk factors that would have been missed by plusoptiX, including three with mild amblyopia.
  
  
  CONCLUSIONS
  PlusoptiX with modified Arthur referral criteria can be a highly specific screening device detecting amblyopia risk factors without missing children with moderate/severe amblyopia.
authors.forename: Evan
authors.initials: E
authors.lastname: Silverstein
authors.forename: Sean P
authors.initials: SP
authors.lastname: Donahue
mesh_terms: D000550:Amblyopia / Q000175:diagnosis* / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005189:False Positive Reactions; D006801:Humans; D011237:Predictive Value of Tests; D012017:Referral and Consultation / Q000592:standards / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D015351:Vision Screening / Q000295:instrumentation*