title: High specificity of the Pediatric Vision Scanner in a private pediatric primary care setting.
abstract: OBJECTIVE
  To determine the specificity of the Pediatric Vision Scanner, a binocular retinal birefringence scanner, in its intended setting, a pediatric primary care office.
  
  
  METHODS
  A total of 102 preschool children (age 2-6 years) were screened during a well-child pediatric visit using the Pediatric Vision Scanner and the SureSight Autorefractor and completed a masked comprehensive pediatric ophthalmic examination (gold standard examination).
  
  
  RESULTS
  Based on the gold standard examination, one child had anisometropic amblyopia, and the remaining 101 had no amblyopia or strabismus. Specificity of the Pediatric Vision Scanner was 90% (95% CI, 82%-95%) while specificity of the SureSight was 87% (95%CI, 79-93%). Combining these results with the sensitivity of the devices determined in our previous study conducted in a pediatric ophthalmology office setting, the positive likelihood ratio for the Pediatric Vision Scanner was 10.2; for the SureSight, 5.0. The negative likelihood ratio for the Pediatric Vision Scanner was 0.03; for the SureSight, 0.42, a significant difference.
  
  
  CONCLUSIONS
  The Pediatric Vision Scanner had high specificity (90%) in screening for amblyopia and strabismus as part of a pediatric well-child visit. Likelihood ratio analysis suggests that affected children have a high probability of being correctly identified by the Pediatric Vision Scanner. The high level of confidence conferred by Pediatric Vision Scanner screening may remove an important barrier to vision screening in pediatric primary care.
authors.affiliation: Retina Foundation of the Southwest, Dallas, Texas. Electronic address: reedjost@retinafoundation.org.
authors.forename: Reed M
authors.initials: RM
authors.lastname: Jost
authors.affiliation: Center for Pediatric Ophthalmology & Adult Strabismus, Plano, Texas.
authors.forename: David
authors.initials: D
authors.lastname: Stager
authors.affiliation: Center for Pediatric Ophthalmology & Adult Strabismus, Plano, Texas.
authors.forename: Lori
authors.initials: L
authors.lastname: Dao
authors.affiliation: Plano Pediatrics, PA, Plano, Texas.
authors.forename: Scott
authors.initials: S
authors.lastname: Katz
authors.affiliation: Plano Pediatrics, PA, Plano, Texas.
authors.forename: Russ
authors.initials: R
authors.lastname: McDonald
authors.affiliation: Retina Foundation of the Southwest, Dallas, Texas; Department of Ophthalmology, UT Southwestern Medical Center, Dallas, Texas.
authors.forename: Eileen E
authors.initials: EE
authors.lastname: Birch
mesh_terms: D000550:Amblyopia / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011320:Primary Health Care; D011331:Private Practice; D012680:Sensitivity and Specificity; D013285:Strabismus / Q000175:diagnosis*; D015351:Vision Screening / Q000295:instrumentation*