Diagnostic Test Accuracy of the Red Reflex Test for Ocular Pathology in Infants: A Meta-analysis
| Autor: | Diana Chabané Schmidt, Yousif Subhi, Moug Al-Bakri, Line Kessel, Daniella Bach-Holm |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Ocular Pathology Population 01 natural sciences 03 medical and health sciences 0302 clinical medicine Red reflex Vision Screening Internal medicine Positive predicative value Reflex medicine Humans 0101 mathematics education Physical Examination Original Investigation education.field_of_study Red Reflex Test business.industry Diagnostic Tests Routine 010102 general mathematics Infant Newborn Infant Ophthalmology Predictive value of tests Meta-analysis 030221 ophthalmology & optometry Infant Screening business |
| Zdroj: | JAMA Ophthalmol |
| Popis: | Importance Red reflex testing is a simple and inexpensive method implemented in many countries as an important part of infant screening for ocular pathologies. Objectives To review the literature on the diagnostic accuracy of the red reflex test in infant screening for ocular pathologies and to perform meta-analyses to provide summary estimates. Data Sources The following literature databases were searched for English-language, peer-reviewed literature, published until April 19, 2020: Cochrane Central, PubMed/MEDLINE, Embase, Web of Science Core Collection, BIOSIS Previews, Current Contents Connect, Data Citation Index, Derwent Innovations Index, KCI-Korean Journal Database, Russian Science Citation Index, SciELO Citation Index, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and ClinicalTrials.gov. Study Selection Eligibility criteria were defined according to population (studies of consecutively screened infants), exposure (red reflex or Bruckner test as the index test), comparator (any ophthalmological examination), and study type (any study with diagnostic test accuracy data). Data Extraction and Synthesis The Preferred Reporting Items for Systematic Reviews and Meta-Analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA) guidelines were followed. Data were extracted independently by 2 authors. For summary estimates of diagnostic test accuracy, the hierarchical summary receiver operating characteristics curve was used. Prevalence of ocular pathologies was introduced for a prevalence meta-analysis, which was then used in calculations of diagnostic accuracy of the red reflex test when applied in infant screening. Main Outcomes and Measures True-positive, false-positive, true-negative, and false-negative findings; sensitivity; specificity; and positive and negative predictive values. Results In this meta-analysis, 8713 unique infants from 5 unique studies were eligible for qualitative and quantitative review. All studies used the red reflex test without pupillary dilation and were compared with a reference test performed with pupillary dilation. For any ocular pathology, an estimated sensitivity of 7.5% (95% CI, 7.4%-7.5%) and specificity of 97.5% (95% CI, 97.5%-97.5%) was found. Focusing on ocular pathologies that required a medical or surgical intervention, sensitivity improved to 17.5% (95% CI, 0.8%-84.8%) and specificity remained high at 97.6% (95% CI, 87.7%-99.6%). Conclusions and Relevance These findings suggest that an abnormal red reflex finding most likely reflects an underlying ocular pathology. However, a normal red reflex finding during screening does not exclude ocular disease. |
| Databáze: | OpenAIRE |
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