?Amblyopia ("lazy eye") 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 REBIScan'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 Statement: 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 Permanente'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 #1 cause of vision loss worldwide.
NIH Spending Category: Brain Disorders; Clinical Research; Comparative Effectiveness Research; Eye Disease and Disorders of Vision; Health Services; Neurosciences; Pediatric
Project Terms: Adopted; Age; Amblyopia; Anisometropia; base; Blindness; Caring; Child; Childhood; Clinic; Clinical; Clinical Trials; commercialization; cost; cost effective; cost effectiveness; cycloplegic; Data; deprivation; Depth Perception; design; Development; Devices; Diagnosis; Disease; Early Diagnosis; Enrollment; Evaluation; Eye; Eye diseases; Family; Funding; Gender; Gold; Grant; Health; Healthcare Systems; improved; instrument; Lazy Eyes; Managed Care; Masks; Measures; Medical; medical specialties; Methods; neglect; Older Population; Ophthalmic examination and evaluation; Outcome; Participant; Patients; pediatrician; Performance; Phase; Population; Preschool Child; primary care setting; Primary Health Care; Provider; public health relevance; Publishing; Quality of Care; Research; Research Support; Retinal; Sampling; Scanning; screening; Sensitivity and Specificity; Site; Small Business Innovation Research Grant; sound; standard of care; Strabismus; System; Technology; Testing; Time; tv watching; United States National Institutes of Health; usability; Vision; Vision Screening; Visit; Visual Acuity; Work
