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Neurodevelopmental Reflex Testing in Neonatal Rat Pups
Published on: April 24, 2017
Red reflex test screening for neonates: A systematic review and meta analysis
Amar Taksande1, Patel Zeeshan Jameel1, Bharati Taksande2
1Department of Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Sewagram, Wardha, Maharashtra, India.
Insights
The red reflex test (RRT) is a highly sensitive and specific screening tool for detecting newborn eye abnormalities. This systematic review confirms its diagnostic accuracy, supporting its wider implementation in neonatal care.
Area of Science:
- Ophthalmology
- Neonatal Screening
- Diagnostic Accuracy
Background:
- Red reflex test (RRT) screening is not standard in many low- and middle-income countries before hospital discharge.
- Early detection of neonatal ocular abnormalities is crucial for preventing long-term vision impairment.
Purpose of the Study:
- To systematically evaluate the diagnostic accuracy of the red reflex test for detecting ocular abnormalities in newborns.
- To assess the RRT's effectiveness as a screening tool in the neonatal population.
Main Methods:
- Systematic review and meta-analysis of 11 studies.
- Data sources included PubMed, EMBASE, Scopus, Web of Science, and Cochrane.
- Quality assessment using QUADAS-2; analysis using random effects models.
Main Results:
- Pooled sensitivity: 23% (95% CI: 21-24%); Pooled specificity: 98% (95% CI: 98-98%).
- Positive Likelihood Ratio (PLR): 32.52; Negative Likelihood Ratio (NLR): 0.69.
- Diagnostic Odds Ratio (DOR): 138.48; AUC: 0.98 ± 0.02; Q* index: 0.95 ± 0.045.
Conclusions:
- The red reflex test demonstrates high sensitivity and specificity for detecting anterior segment abnormalities in newborns.
- Findings support the RRT as a valuable diagnostic tool for neonatal eye screening.
Abstract:
Red reflex test (RRT) screening is yet to be a part of the neonate's normal examination before discharge from hospital in a majority of low- and middle-income countries. The purpose was this review was to systematically evaluate the diagnostic accuracy of RRT for the detection of ocular abnormalities in newborns. PubMed, EMBASE, Scopus, Web of Science, and Cochrane database of systematic reviews were the data sources. Quality of Diagnostic Accuracy Studies-2 (QUADAS-2) was utilized for quality assessment of bias and applicability. Random effects models were used to summarize sensitivities, specificities, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and respective confidence intervals (CI). The pooled sensitivity, calculated from the meta analysis of 11 studies, was 23% (95% CI: 21-24%) and pooled specificity was 98% (95% CI: 98-98%). The PLR was 32.52 (95% CI: 7.89-134.15), NLR was less than 1 (0.69 [95% CI: 0.55-0.88]), and DOR calculated was 138.48 (95% CI: 23.85-803.97). The area under the curve (AUC) and Q* index for RRT were 0.98 ± 0.02 and 0.95 ± 0.045, respectively. The results of our study justify the conclusion that RRT is a highly sensitive and specific test for the detection of anterior segment abnormalities.
