title: A Performance Comparison of Color Vision Tests for Military Screening.
abstract: BACKGROUND
  Current color vision (CV) tests used for aviation screening in the U.S. Army only provide pass-fail results, and previous studies have shown variable sensitivity and specificity. The purpose of this study was to evaluate seven CV tests to determine an optimal CV test screener that potentially could be implemented by the U.S. Army.
  
  
  METHODS
  There were 133 subjects [65 Color Vision Deficits (CVD), 68 Color Vision Normal (CVN)] who performed all of the tests in one setting. CVD and CVN determination was initially assessed with the Oculus anomaloscope. Each test was administered monocularly and according to the test protocol. The main outcome measures were test sensitivity, specificity, and administration time (automated tests).
  
  
  RESULTS
  Three of the four Pseudoisochromatic Plate (PIP) tests had a sensitivity/specificity > 0.90 OD/OS, whereas the FALANT tests had a sensitivity/specificity > 0.80 OD/OS. The Cone Contrast Test (CCT) demonstrated sensitivity/specificity > 0.90 OD/OS, whereas the Color Assessment and Diagnosis (CAD) test demonstrated sensitivity/specificity > 0.85 OD/OS. Comparison with the anomaloscope ("gold standard") revealed no significant difference of sensitivity and specificity OD/OS with the CCT, Dvorine PIP, and PIPC tests. Finally, the CCT administration time was significantly faster than the CAD test.
  
  
  CONCLUSIONS
  The current U.S. Army CV screening tests demonstrated good sensitivity and specificity, as did the automated tests. In addition, some current PIP tests (Dvorine, PIPC), and the CCT performed no worse statistically than the anomaloscope with regard to sensitivity/specificity. The CCT letter presentation is randomized and results would not be confounded by potential memorization, or fading, of book plates.
authors.affiliation: Vision Protection and Performance Division, U.S. Army Aeromedical Research Laboratory, Fort Rucker, AL, USA.
authors.forename: David V
authors.initials: DV
authors.lastname: Walsh
authors.forename: James
authors.initials: J
authors.lastname: Robinson
authors.forename: Gina M
authors.initials: GM
authors.lastname: Jurek
authors.forename: José E
authors.initials: JE
authors.lastname: Capó-Aponte
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Riggs
authors.forename: Leonard A
authors.initials: LA
authors.lastname: Temme
mesh_terms: D000328:Adult; D003119:Color Perception Tests; D055253:Color Vision; D003117:Color Vision Defects / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D008889:Military Personnel; D012680:Sensitivity and Specificity; D055815:Young Adult