Evaluation of decision rules for frequency-doubling technology screening tests.

Area of Science:

• Ophthalmology
• Medical Imaging
• Diagnostic Technology

Background:

• Glaucoma is a leading cause of irreversible blindness worldwide.
• Early detection of glaucoma is crucial for timely intervention and vision preservation.
• Frequency-doubling technology (FDT) perimetry is a potential screening tool for glaucoma.

Purpose of the Study:

• To investigate and compare the effectiveness of various decision rules for frequency-doubling technology (FDT) perimetry screening.
• To evaluate the sensitivity and specificity of different FDT screening criteria in distinguishing between normal and glaucoma subjects.

Main Methods:

• A total of 218 subjects (78 with glaucoma, 140 normal) were recruited across three centers.
• Each subject underwent two FDT perimetry screening tests.
• Fifteen distinct decision rules were applied to the collected FDT data for analysis.

Main Results:

• Estimated specificities for the decision rules varied from 78% to 99%.
• Estimated sensitivities ranged from 40% to 72%.
• Optimal criteria suggested include a cluster of two or more adjacent abnormal locations (p < 2%) with confirmation, or a single highly abnormal location (p < 1%) with confirmation.

Conclusions:

• Confirming abnormal FDT screening results by repeating the test significantly enhances specificity.
• The minor reduction in sensitivity due to confirmation is outweighed by the gain in specificity.
• These findings offer valuable guidance for selecting appropriate decision rules for FDT glaucoma screening.