Disinvestment and implementation of vision screening tests based on their effectiveness
Notice bibliographique
Résumé
OBJECTIVE To examine the diversity in paediatric vision and hearing screening programmes in Europe.METHODS Themes for comparison of screening programmes derived from literature were used to compile three questionnaires on vision, hearing and public health screening.Tests used, professions involved, age, and frequency of testing seem to influence sensitivity, specificity, and costs most.Questionnaires were sent to ophthalmologists, orthoptists, otolaryngologists and audiologists involved in paediatric screening in all EU full-member, candidate, and associate states.Answers were cross-checked.RESULTS Thirty-nine countries participated; 35 have a vision screening programme, 33 a nation-wide neonatal hearing screening programme.Visual acuity is measured in 35 countries, in 71% of these more than once.First measurement of visual acuity varies from three to seven years of age, but is usually before the age of five.At age three and four, picture charts, including Lea Hyvarinen, are used most; in children over four, Tumbling-E and Snellen.As first hearing screening test, otoacoustic emission is used most in healthy neonates, and auditory brainstem response in premature newborns.The majority of hearing testing programmes are staged; children are referred after 1-4 abnormal tests.Vision screening is performed mostly by paediatricians, ophthalmologists or nurses.Funding is mostly by health insurance or state.Coverage was reported as >95% in half of countries, but reporting was often not first-hand.CONCLUSIONS Largest differences were found in visual acuity charts used (12), professions involved in vision screening (10), number of hearing screening tests before referral (1-4), and funding sources (8).In the Netherlands and Sweden a combination of national and regional programmes exists.Almost all countries have a programme for all children, except Albania, where screening is selective.Screening is not free in Albania, Bulgaria, and Czech Republic, and is compulsory in Bulgaria, Flanders, Greece, Hungary, and Turkey. TestsWeight, height and head circumference are measured in all countries, cardiac function in all but Albania, lung function in all but Albania and Flanders, vision in all but Albania and Turkey, hearing in all but Albania and Malta, motor skills in all but Czech Republic and the UK, speech and language development in all but Albania, Bulgaria, Czech Republic, and the UK, cognitive development in all but Albania, Czech Republic, Flanders, and the UK.Psychosocial development is assessed in all countries but Albania, Bulgaria, Czech Republic, Flanders, Germany, Israel, Sweden, and the UK. Referral, funding and coverageReferral is most often to a specialist.Funding is provided mostly by the government or health insurance.Coverage is above 80% in all countries, except Albania.Further data is presented in table 4 and Appendix Map 3. Questionnaire answer checkChanges were made based on the first round of questionnaire answers.In hearing screening data: for Belgium (Flanders) the ASSR was added as test for neonates at risk; for Finland "testing one ear" was changed to "testing one ear or both ears"; for France "testing one ear and testing both ears" was changed to "always testing both ears"; for Italy coverage of "> 95%" was changed to "70%"; Malta selective screening, not population-wide screening, was confirmed; for Poland "non-staged screening" was changed to "staged screening"; for Israel, Italy, Lithuania, and Switzerland "only aABR testing" for neonates at risk was corrected to "OAE and/or aABR".Vision screening data was revised: for Austria funding was changed from "health insurance" to "health insurance and state"; for Belgium (Flanders) personnel was changed from "nurse" to "nurse and youth health care physician", testing of stereopsis and colour vision was added and VA chart was changed from "Landolt C" to "Pictures and HOTV"; for Croatia VA chart was changed from "only Tumbling E" to "Pictures, Lea and Tubling E"; for Czech Republic Pictures and Lea chart were added; for Denmark the "Snellen chart" was changed to "Pictures" and coverage was changed from ">80%" to ">95%"; for Iceland Snellen chart was added; for Israel coverage
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,009 | 0,023 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,004 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».