The influence of clinical judgment on the rate of referral from a school vision screening program

It has been observed that black preschool children low income families have a higher than average rate of referral from a school vision screening program. One potential contributing factor results from the fact that examiners often modified the referral criteria based on their clinical judgment. This study was designed to investigate the influence of the application of clinical judgment on the proportion of referrals as a function of ethnicity and socioeconomic income level. The results suggest that modifying the referral criteria based on clinical judgment does not significantly influence the proportion of referrals based on ethnicity or socioeconomic income level.