Improving quality vision outcomes in the managed care setting while reducing cost by use of accurate automated screening

DESCRIPTION provided by applicant Amblyopia andquot lazy eyeandquot and strabismus misaligned eyes are medical eye conditions that combine as the leading causes of preventable vision loss in children They are irreversible if not detected and corrected by the age of seven however half of all cases are missed because the conditions do not always manifest themselves and pediatricians are unable to reliably detect the conditions The current health care system badly needs an accurate and effective approach toward detecting amblyopia and strabismus in preschool children and this application aims to show that REBIScanandapos s Pediatric Vision Scanner is capable of detecting disease including the most difficult for providers to diagnose with a hig level of accuracy within a primary clinic with lay users as screeners The study will be conducted in busy ethnically and racially diverse primary care sites operated by the Kaiser Permanente system with outcomes and efficiency of testing compared to the current standard of care The research proposed in this SBIR application will complete the last significant milestones necessary for commercialization of the PVS While the technology has been tested in enriched populations there are no studies that test device performance when lay users perform testing in a busy pediatric setting and usability has not been tested in the primary care setting The Specific Aims will advance the health outcomes of children by using a scientifically rigorous approach to provide the efficiency and accuracy data that clinicians investors and payors require before the PVS can be adopted commercially A two phase study has been designed to compare the Pediatric Vision Scanner to the standard of care today The first phase includes a sample population of older children in whom a limited Gold Standard Examination visual acuity testing and non cycloplegic autorefraction is easily performed by a non specialist in the primary care clinic A linkage study will then be performed on a larger group of younger children who will receive the complete Gold Standard Examination If the results of this study are similar to published studies performed with enriched populations then the NIH will have funded a technology that has the potential to change the world and the way it detects amblyopia and strabismus PUBLIC HEALTH RELEVANCE Never before has an automated technology been advanced enough to allow lay screeners to accurately test preschool children for eye disease Published studies performed in specialty clinics show that the Pediatric Vision Scanner has unprecedented accuracy this study will test whether these impressive results can be reproduced on the front lines in Kaiser Permanenteandapos s primary care clinics A successful outcome will change how all primary care clinics perform vision screening which could eradicate severe forms of amblyopia the cause of vision loss worldwide