Detection of Amblyogenic Refractive Error Using the Spot Vision Screener in Children
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
SIGNIFICANCE: Vision screenings are conducted to detect significant refractive errors, amblyopia, and ocular diseases. Vision screening devices are desired to have high testability, sensitivity, and specificity. Spot has demonstrated high testability, but previous reports suggest that the Spot has low sensitivity for detecting amblyogenic hyperopia and moderate sensitivity for amblyogenic astigmatism. PURPOSE: This study assessed the concurrent validity of detecting amblyogenic refractive errors by the Spot (v.1.1.50; Welch Allyn Inc., Skaneateles Falls, NY) compared with cycloplegic retinoscopy. METHODS: A total of 475 subjects (24 to 96 months) were screened by Spot and then received a masked comprehensive examination. Sensitivity and specificity, Bland-Altman plot, receiver operating characteristic area under the curve, and paired t test were evaluated by comparing the results of the Spot (v1.1.50) using the manufacturer referral criteria with the results of the comprehensive examination using the 2013 American Association for Pediatric Ophthalmology and Strabismus criteria. RESULTS: The Spot (v.1.1.50) referred 107 subjects (22.53%) for the following: 18.73% (89/475) astigmatism, 4.63% (22/475) myopia, 0.42% (2/475) hyperopia, and 2.11% (10/475) anisometropia. The sensitivity and specificity of the Spot vision screener for detecting amblyogenic risk factors were 86.08% (95% confidence interval [CI], 76.45 to 92.84%) and 90.15% (95% CI, 86.78 to 92.90%). Areas under the curve were 0.906 (95% CI, 0.836 to 0.976) for hyperopia, 0.887 (95% CI, 0.803 to 0.972) for spherical equivalent, and 0.914 (95% CI, 0.866 to 0.962) for astigmatism. A modified hyperopia criteria cutoff of greater than +1.06 D improved the sensitivity from 25 to 80% with 90% specificity. The current cutoff criterion, greater than -1.75 D, for astigmatism seemed optimal. CONCLUSIONS: This study shows that the Spot vision screener accurately detects low spherical refractive errors and astigmatism. Lowering the hyperopia cutoff criteria from the current Spot screener referral criteria improves the sensitivity with desired (high) specificity.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it