Qualidade da avaliação da acuidade visual realizada pelos professores do programa " Olho no olho" da cidade de Marília, SP / Assessment of visual acuity evaluation performed by teachers of the \"Eye in eye\" program in Marília-SP, Brazil
Arq. bras. oftalmol
;
71(4): 509-513, jul.-ago. 2008. graf, tab
Article
in Portuguese
| LILACS
| ID: lil-491880
RESUMO
OBJETIVOS: Avaliar a qualidade e o ponto de corte (AV <0,7) da acuidade visual verificada pelos professores, nos escolares da rede municipal de Marília participantes do programa "Olho no olho". MÉTODOS: Estudo transversal em 604 escolares (1.208 olhos), pertencentes às escolas municipais de Marília, SP, realizado através do exame feito pelos professores treinados para o programa comparando-o com o exame realizado pelos oftalmologistas, assumindo estes como o padrão-ouro para comparação. A análise foi feita por olhos examinados. Calculamos a sensibilidade (S), especificidade (E), valor preditivo positivo (VPP), valor preditivo negativo (VPN) e razão de verossimilhança (RV). Comparamos as médias das AV encontradas pelos professores com as dos oftalmologistas e uma curva ROC (Receiver Operating Characteristic Curve) foi gerada para avaliar se AV <0,7 foi o melhor valor para encaminhamento. RESULTADOS: A média da AV verificada pelos professores foi de 0,70 +/- 0,16 e a dos oftalmologistas foi de 0,88 +/- 0,2 com uma diferença entre as médias de 0,18 (p<0,0001). A S, E, VPP, VPN e RVP foram de: 82 por cento, 40 por cento, 27 por cento, 89 por cento e 1,37, respectivamente. As taxas de falso positivo e negativo foram de 59,5 por cento e 18 por cento, respectivamente. Na curva ROC AV <0,7 foi o melhor ponto para encaminhamento. CONCLUSÕES: Evidenciamos a importância da participação dos professores na melhoria da saúde ocular escolar. O teste realizado pelos professores teve satisfatória S, com baixa E, VPN e valores elevados de falsos positivos. Nossos dados confirmam que o melhor valor de corte para encaminhamento foi o valor de AV < 0,7.
ABSTRACT
PURPOSE: To assess quality and cut-off point (VA <0.7) of the examinations performed by teachers to detect reduced visual acuity (VA) in schoolchildren participants of the project called "Eye in eye " in Marilia-SP, Brazil. METHODS: Visual acuity measurements were performed by trained teachers using Snellen's chart. The children with VA <0.7 in one of the eyes were referred to an ophthalmic examination. The ophthalmic examination was considered gold standard to assess quality and cut-off point of the examinations performed by teachers. VA test was performed in 604 schoolchildren of state public schools (1,208 eyes). Analyses were based on examined eyes. We calculated sensitivity (S), specificity (E), positive predictive value (PPV), negative predictive value (NPV) and likelihood rate (LR). We compared the means obtained by the teachers' examinations to means of the ophthalmologist's examinations. ROC curve was produced to evaluate whether VA lower than 0.7 is the best value for referral to an ophthalmic examination. RESULTS: VA means obtained by teachers and ophthalmologic examinations were 0.70 ± 0.16 and 0.88 ± 0.2 respectively. The difference between teachers' and ophthalmologists' examinations was 0.18 (p<0.0001). S, E, PPV, NPV e LR were: 82 percent, 40 percent, 27 percent, 89 percent and 1.37, respectively. False positive and negative rates were 59.5 percent and 18 percent. ROC curve evidenced that visual acuity of 0.7 was the best cut-off point to refer schoolchildren to an ophthalmic exam. CONCLUSIONS: We demonstrated the importance of the teachers' participation in improved schoolchildren ocular health. The examination performed by teachers obtained a satisfactory S with low E, NPV and high values of false positive results. The best cut-off point to refer schoolchildren to an ophthalmic examination was VA of 0.7.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Physical Examination
/
Teaching
/
Vision Tests
/
Practice Patterns, Physicians'
/
Visual Acuity
Type of study:
Evaluation studies
/
Observational study
/
Prevalence study
/
Prognostic study
Limits:
Child
/
Child, preschool
/
Female
/
Humans
/
Male
Country/Region as subject:
South America
/
Brazil
Language:
Portuguese
Journal:
Arq. bras. oftalmol
Journal subject:
Ophthalmology
Year:
2008
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
FAMEMA/BR
/
Faculdade de Medicina de Marília/BR
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