Results of a primary care-based quality improvement project to optimize chart-based vision screening for preschool age children. Modest, J. R., Johnston, S. C., Majzoub, K. M., Moore, B., Trudell, E. K., Ramsey, J. E., & Vernacchio, L. Journal of AAPOS: the official publication of the American Association for Pediatric Ophthalmology and Strabismus, 20(4):305–309, August, 2016.
Results of a primary care-based quality improvement project to optimize chart-based vision screening for preschool age children [link]Paper  doi  abstract   bibtex   
PURPOSE: To design chart-based vision screening for preschool-aged children. METHODS: Our program consisted of educational sessions for providers as well as hands-on training for practice staff. We evaluated the intervention through pre- and post-intervention review of medical records. RESULTS: Completion of full vision screening (distance visual acuity in each eye plus stereovision beginning at 3 years of age, as recommended at the time of the project) at well-child visits improved for 5-year-olds (45.0% to 58.2%; risk difference +13.2% [95% CI, 1.7-24.7]) and 4-year-olds (39.3% to 51.4%; risk difference +12.0% [95% CI, 0.7-23.4]) but declined somewhat among 3-year-olds (23.1% to 14.3%; risk difference, -8.8% [95% CI, -17.7 to 0.0]). Risk factors for not being fully screened included being 3 years old (risk ratio of 4.1 compared to 5-year-olds) and being a patient of a small practice (risk ratio of 1.9 compared to large practices). CONCLUSIONS: This quality improvement project showed that screening for visual acuity and stereovision among preschool-aged children using chart-based techniques is difficult to accomplish and unlikely to be consistently successful, especially among 3-year-olds.
@article{modest_results_2016,
	title = {Results of a primary care-based quality improvement project to optimize chart-based vision screening for preschool age children},
	volume = {20},
	issn = {1528-3933},
	url = {http://ezproxynco.flo.org/login?url=https://doi.org/10.1016/j.jaapos.2016.04.005},
	doi = {10.1016/j.jaapos.2016.04.005},
	abstract = {PURPOSE: To design chart-based vision screening for preschool-aged children.
METHODS: Our program consisted of educational sessions for providers as well as hands-on training for practice staff. We evaluated the intervention through pre- and post-intervention review of medical records.
RESULTS: Completion of full vision screening (distance visual acuity in each eye plus stereovision beginning at 3 years of age, as recommended at the time of the project) at well-child visits improved for 5-year-olds (45.0\% to 58.2\%; risk difference +13.2\% [95\% CI, 1.7-24.7]) and 4-year-olds (39.3\% to 51.4\%; risk difference +12.0\% [95\% CI, 0.7-23.4]) but declined somewhat among 3-year-olds (23.1\% to 14.3\%; risk difference, -8.8\% [95\% CI, -17.7 to 0.0]). Risk factors for not being fully screened included being 3 years old (risk ratio of 4.1 compared to 5-year-olds) and being a patient of a small practice (risk ratio of 1.9 compared to large practices).
CONCLUSIONS: This quality improvement project showed that screening for visual acuity and stereovision among preschool-aged children using chart-based techniques is difficult to accomplish and unlikely to be consistently successful, especially among 3-year-olds.},
	number = {4},
	journal = {Journal of AAPOS: the official publication of the American Association for Pediatric Ophthalmology and Strabismus},
	author = {Modest, Jonathan R. and Johnston, Suzanne C. and Majzoub, Katherine M. and Moore, Bruce and Trudell, Emily K. and Ramsey, Jean E. and Vernacchio, Louis},
	month = aug,
	year = {2016},
	pmid = {27381529},
	keywords = {Child, Child, Preschool, Female, Humans, Male, Primary Health Care, Quality Improvement, Risk Factors, Vision Screening, Visual Acuity},
	pages = {305--309}
}
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