title: Assessing accuracy of non-eye care professionals as trainee vision screeners for children.
abstract: OBJECTIVE
  To determine the level of agreement between non-eye care trainees and a trainer (ophthalmologist) in a vision screening program.
  
  
  METHODS
  Prospective, observational study carried out in 3 phases (Phase I-III).
  
  
  METHODS
  Study population included 1228 children, aged 6-14 years, at 5 elementary schools in the city of Hamilton.
  
  
  METHODS
  In Phase I, 1228 children were screened by the trainee screeners, of which 273 children failed the vision testing. Of these 273 children, 170 consented to enrolment into Phase II and were examined by an ophthalmologist, who confirmed that 105 of these children were true positives. On retesting (Phase III), the ophthalmologist passed 158 of the 163 randomly selected children who passed in Phase I.
  
  
  RESULTS
  Overall, trainee screeners had a sample sensitivity of 95.5% and sample specificity of 70.8% in detecting children who should fail vision screening. When we used the positive and negative prediction values obtained, 198 of the 1228 children had vision impairment-providing an estimated prevalence of 16.1%, or 161 children per 1000 population.
  
  
  CONCLUSIONS
  Non-eye care professionals can be trained to an acceptable degree of accuracy to perform certain vision screening tests on children. Such screening methods may be a useful approach to address existing gaps in provision of eye care for many Canadian children, thereby ensuring that all children receive timely vision screening.
authors.affiliation: Hamilton Health Sciences, Hamilton, Ont; McMaster University, Hamilton, Ont. Electronic address: sabrik@mcmaster.ca.
authors.forename: Kourosh
authors.initials: K
authors.lastname: Sabri
authors.affiliation: McMaster University, Hamilton, Ont.
authors.forename: Patrick
authors.initials: P
authors.lastname: Thornley
authors.affiliation: McMaster University, Hamilton, Ont.
authors.forename: Daniel
authors.initials: D
authors.lastname: Waltho
authors.affiliation: Hamilton Health Sciences, Hamilton, Ont.
authors.forename: Teresa
authors.initials: T
authors.lastname: Warren
authors.affiliation: Public Health Services for the city of Hamilton, Hamilton, Ont.
authors.forename: Laura
authors.initials: L
authors.lastname: Laverty
authors.affiliation: McMaster University, Hamilton, Ont.
authors.forename: Sahira
authors.initials: S
authors.lastname: Husain
authors.affiliation: McMaster University, Hamilton, Ont.
authors.forename: Forough
authors.initials: F
authors.lastname: Farrokhyar
authors.affiliation: St. Joseph's Healthcare, Hamilton, Ont.
authors.forename: David
authors.initials: D
authors.lastname: Higgins
mesh_terms: D000293:Adolescent; D000488:Allied Health Personnel / Q000193:education / Q000592:standards*; D002170:Canada / Q000453:epidemiology; D002648:Child; D002983:Clinical Competence / Q000592:standards*; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D009885:Ophthalmology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012030:Refractive Errors / Q000175:diagnosis* / Q000453:epidemiology; D015203:Reproducibility of Results; D042262:Retinoscopy; D012680:Sensitivity and Specificity; D013663:Teaching; D014786:Vision Disorders / Q000175:diagnosis* / Q000453:epidemiology; D015351:Vision Screening / Q000592:standards*