title: A Validation of an Examination Protocol for Cerebral Visual Impairment Among Children in a Clinical Population in India.
abstract: BACKGROUND
  Cerebral Visual Impairment (CVI) is a leading cause of vision impairment in developed and developing countries due to and increased survival of preterm and low birth weight infants. There are few data concerning the validity of protocols available to diagnose CVI.
  
  
  OBJECTIVE
  This study aimed to document the face, content and construct validity of an assessment protocol namely, a 15-domain, Structured Clinical Question Inventory (SCQI), which is based on structured history taking and clinical examination, for the diagnosis of CVI in a clinical population of India.
  
  
  METHODS
  This study was a retro-spective chart analysis of all children below the age of 18years, referred to the CVI clinic of a tertiary care teaching hospital in Southern India from March 2011-Feb 2012. Clinical case-notes including the SCQI findings of all children referred to the clinic were reviewed. The data were extracted after Institutional Review Board approval.
  
  
  METHODS
  Pearson correlation coefficient, Cronbach's alpha and exploratory factor analysis were used to document the content and construct validity of the examination protocol.
  
  
  RESULTS
  A total of 342 children (35.7% male, 64.3% female), with a mean age of 3.8 years (range 0-17 years, the median was 3 years) were included in the study and their data were examined. The internal consistency of the SCQI was 0.93 suggesting it as an excellent tool to characterise and profile CVI and a 2-factor model (Dorsal Stream Dysfunction and Ventral Stream Dysfunction) based on a biologically plausible model explained 63% of the variance.
  
  
  CONCLUSIONS
  The results of using the SCQI affirm published data and endorse a theoretical construct similar across cultures. The potential diagnostic accuracy, reliability and utility of this measure for CVI needs to be studied further. The clinical use of a short version of the SCQI may be helpful to contribute to the identification of CVI, especially for middle and low-income countries.
authors.affiliation: Assistant Professor, Department of Ophthalmology, Christian Medical College , Vellore, Tamil Nadu, India .
authors.forename: Swetha Sara
authors.initials: SS
authors.lastname: Philip
authors.affiliation: Assistant Professor, Department of Child and Adolescent Psychiatry, Christian Medical College , Vellore, Tamil Nadu, India .
authors.forename: Sherab
authors.initials: S
authors.lastname: Tsherlinga
authors.affiliation: Professor, Department of Neurology, Christian Medical College , Vellore, Tamil Nadu, India .
authors.forename: Maya Mary
authors.initials: MM
authors.lastname: Thomas
authors.affiliation: Consultant Paediatric Ophthalmologist, Department of Vision Sciences, Glasgow Caledonian University , Road, Glasgow G4 0BA, UK .
authors.forename: Gordon N
authors.initials: GN
authors.lastname: Dutton
authors.affiliation: Consultant Paediatric Ophthalmologist, Department of Ophthalmology, International Centre for Eye Health London School of Hygiene and Medicine , London, UK .
authors.forename: Richard
authors.initials: R
authors.lastname: Bowman
keywords: Developing countries; Dorsal stream dysfunction; Structured clinical question inventory; Ventral stream dysfunction