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Published on: July 9, 2016
A Validation of an Examination Protocol for Cerebral Visual Impairment Among Children in a Clinical Population in
Swetha Sara Philip1, Sherab Tsherlinga2, Maya Mary Thomas3
1Assistant Professor, Department of Ophthalmology, Christian Medical College , Vellore, Tamil Nadu, India .
Insights
The Structured Clinical Question Inventory (SCQI) effectively diagnoses Cerebral Visual Impairment (CVI) in children. This validated tool shows excellent internal consistency and a reliable two-factor model for CVI assessment.
Area of Science:
- Ophthalmology
- Pediatrics
- Neuroscience
Background:
- Cerebral Visual Impairment (CVI) is a significant cause of vision impairment in children globally, particularly due to increased survival rates of premature infants.
- Limited data exists on the validity of current CVI diagnostic protocols.
- CVI diagnosis is crucial for early intervention and management in affected children.
Purpose of the Study:
- To assess the face, content, and construct validity of the Structured Clinical Question Inventory (SCQI) for diagnosing CVI in Indian children.
- To evaluate the SCQI's reliability and utility as a diagnostic tool for CVI.
- To establish a culturally relevant and robust assessment protocol for CVI.
Main Methods:
- Retrospective chart analysis of 342 children under 18 years referred to a CVI clinic in Southern India (March 2011-Feb 2012).
- Utilized the 15-domain Structured Clinical Question Inventory (SCQI) based on history taking and clinical examination.
- Employed Pearson correlation, Cronbach's alpha, and exploratory factor analysis to determine validity and reliability.
Main Results:
- The SCQI demonstrated excellent internal consistency (Cronbach's alpha = 0.93), indicating its suitability for characterizing CVI.
- Exploratory factor analysis supported a two-factor model (Dorsal and Ventral Stream Dysfunction), explaining 63% of the variance.
- The study included a diverse pediatric population with a mean age of 3.8 years.
Conclusions:
- The SCQI's findings align with existing data, supporting a consistent theoretical construct for CVI across different cultures.
- Further research is needed to confirm the diagnostic accuracy, reliability, and utility of the SCQI for CVI.
- A shorter version of the SCQI could aid in CVI identification, especially in low- and middle-income countries.
Introduction:
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.
Aim:
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.
Materials And 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.
Statistical Analysis:
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.
Conclusion:
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.
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