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Inter-Rater Reliability of EyeSpy Mobile for Pediatric Visual Acuity Assessments by Parent Volunteers
Elyssa Rosenthal1, James O'Neil1, Briggs Hoyt2
1Department of Ophthalmology, Phoenix Children's, Phoenix, AZ, USA.
Insights
The EyeSpy Mobile app shows reliable visual acuity test results in children, even when used by parents. This smartphone algorithm can improve vision screening accessibility and reduce training needs.
Area of Science:
- Ophthalmology
- Pediatric eye care
- Medical technology
Background:
- Accurate visual acuity testing is crucial for early detection of vision problems in children.
- Traditional methods can be resource-intensive, requiring trained professionals and specialized equipment.
- Smartphone-based visual acuity algorithms offer a potential solution for more accessible vision screening.
Purpose of the Study:
- To evaluate the inter-rater test reliability of the EyeSpy Mobile visual acuity smartphone algorithm.
- To compare the reliability of EyeSpy Mobile when administered by eye professionals versus parent volunteers.
- To assess the performance of EyeSpy Mobile against standard visual acuity testing methods.
Main Methods:
- 106 children participated in visual acuity retesting under three conditions.
- Conditions included: eye professionals using a standard M&S computer test, eye professionals using EyeSpy Mobile, and parent volunteers using EyeSpy Mobile.
- Test-retest results were analyzed for agreement and equivalency in logMAR units.
Main Results:
- All three testing phases showed strong agreement between testers (within 0.05 logMAR).
- Eye professionals achieved slightly closer test-retest results than parent volunteers (within 0.03 logMAR).
- EyeSpy Mobile use by parents resulted in more retests within 2 vision lines compared to the standard M&S computer test by professionals.
Conclusions:
- EyeSpy Mobile demonstrates clinically useful visual acuity test-retest reliability, even with untrained parent volunteers.
- Adaptive visual acuity algorithms like EyeSpy Mobile can enhance screening reliability and reduce training demands.
- This technology has the potential to broaden the reach of vision screening programs in community settings.
Purpose:
To assess the inter-rater test reliability of the EyeSpy Mobile visual acuity smartphone algorithm when administered to children by eye professionals and parent volunteers.
Patients And Methods:
Visual acuity test-retest results were analyzed for 106 children assigned to one of three different screenings: (1) An eye technician and pediatric ophthalmologist using their typical visual acuity testing method on a M&S computer; (2) An eye technician and pediatric ophthalmologist using EyeSpy Mobile; (3) An eye technician and parent volunteer using EyeSpy Mobile.
Results:
All three phases demonstrated a strong agreement between the two testers, with mean test-retest equivalency results within 0.05 logMAR (2.5 letters, 90% CI). Whether testing using their typical technique on an M&S computer or using EyeSpy Mobile, eye professionals obtained statistically closer mean test-retest results than parent volunteers by 1 letter, with equivalency results within 0.03 logMAR (1.5 letters, 90% CI). Conversely, the number of retests within 2 vision lines was statistically greater when EyeSpy mobile was used by parents as compared to eye professional's customary technique on the M&S computer.
Conclusion:
EyeSpy Mobile provides clinically useful visual acuity test-retest results even when used by first-time parent volunteers. Adaptive visual acuity algorithms have the potential to improve reliability, lessen training requirements, and expand the number of vision screening volunteers in community settings.
