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Reliability of vision screening tests for school children
Liora Ore1, Ada Tamir, Nili Stein
1Department of Research and Informatics, Ministry of Health, Northern District, Nazareth Illit, Israel. liorao@netvision.net.il
Summary
This study found moderate reliability in E-chart vision screenings for Israeli schoolchildren, with better agreement in older students and females. Improvements and targeted training are recommended for school vision screening programs.
Area of Science:
- Ophthalmology
- Public Health
- Pediatrics
Background:
- School vision screening is crucial for early detection of visual impairments in children.
- The illiterate E-chart is a common tool for vision screening in young children.
- Assessing the reliability of screening tools is essential for effective public health interventions.
Purpose of the Study:
- To estimate the reliability of the illiterate E-chart for vision screening in Israeli school children.
- To identify factors influencing the reliability of E-chart screenings and referral recommendations.
Main Methods:
- A cross-sectional, population-based study involving 751 Israeli students (6-7 and 13-14 years old).
- Two public health nurses independently administered the illiterate E-chart to each student.
- Reliability was assessed using percentage agreement and Kappa coefficients for both vision findings and referral decisions.
Main Results:
- Overall agreement on vision findings was 78.2% (Kappa=0.47), with higher agreement in females and older students (13-14 years).
- Agreement on referral recommendations was 85.8% (Kappa=0.58), influenced by student age, ethnicity, and nurse seniority.
- Reliability varied across different subdistricts, indicating potential for localized improvements.
Conclusions:
- The reliability of school vision screening using the E-chart needs improvement, particularly for younger children (6-7 years).
- Investigating factors affecting reliability and implementing targeted training programs for nurses are recommended.
- Further study on inter-subdistrict variations in referral reliability and enhanced supervision are necessary to improve adherence to public health guidelines.
