Exploring vision tests as a surrogate for depression screening in patients with a visual impairment: A cross-sectional study
Bibliographic record
Abstract
• Patients with low vision are at increased risk of depression • Worsening vision and functional reading tests are not prognostic for increased risk of depression • Visual function questionnaire may be a better predictor of depression in the low vision population To investigate if vision tests can act as a surrogate for depression screening in visually impaired adult patients, and explore the association between self-reported visual function and depression. Cross-sectional. Consecutive adult patients (≥18 years) (n=237) who received a low vision assessment at a hospital-based vision rehabilitation clinic between July 2018 to March 2020, were recruited into the study. The clinic serves patients that have a visual acuity ≤6/15 in the better seeing eye, constricted visual fields less than 20 degrees, or functional deficits relating to vision loss. Patients were screened for depression using the Patient Health Questionnaire-9 (PHQ-9). The association between risk of depression and vision tests (distance visual acuity, reading acuity, critical print size, contrast sensitivity, and fixation stability) and patient reported visual function (The National Eye Institute, Visual Functioning Questionnaire-25 (VFQ-25)), was measured using multivariable linear regression modelling. Eighteen percent of patients scored ≥10 on the PHQ-9, indicating risk of major depression. There was no significant association between the vision test scores and the PHQ-9. However, there was a significant association between distance visual acuity (p=0.010), reading acuity (p=0.008), contrast sensitivity (p<.0001) and the VFQ-25 mental health domain. Further, all VFQ-25 domains were significantly associated with the PHQ-9. While the vision test scores were not significantly associated with risk of depression, self-reported visual functioning was. We were unable to demonstrate vision tests acting as a surrogate for the PHQ9 when identifying patients at risk of generalized depression. Further investigation is warranted to determine if a correlation can be found with a different mental health-screening tool.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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 itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".