Evaluating the Validity and Reliability of Telemedicine for Strabismus Detection: A Systematic Review and Meta-Analysis
Journal of Ophthalmic and Optometric Sciences,
Vol. 7 No. 4 (2023),
23 September 2023
,
Page 23-35
https://doi.org/10.22037/joos.v7i4.47443
Abstract
Purpose: This study aimed to systematically review the validity and reliability of telemedicine methods in evaluating strabismus.
Materials and Methods: Electronic medical databases, including Medline (PubMed), Web of Science, Scopus, and Embase, were systematically reviewed up to April 2021. Two authors independently conducted study selection, data extraction, and quality assessment. Restricted Maximum Likelihood was used to calculate pooled sensitivity, specificity, and reliability. Heterogeneity of the studies was assessed by I-squared statistic (I2) value, and a funnel plot was used to assess publication bias.
Results: A total of 1190 original studies were evaluated. Finally, 8 studies were selected for systematic review and meta-analysis. The pooled estimation of sensitivity was 0.80 (95 % CI: 0.69-0.88, I²: 81.8 %, T2: 0.01, P for heterogeneity < 0.001), the pooled estimation of specificity was 0.91 (95 % CI: 0.77-0.97, I²: 96.9 %, T2: 0.01, P for heterogeneity < 0.001), and the pooled estimation of reliability was 0.91 (95 % CI: 0.83-0.99, I²: 0.00 %, T2: 0.00, P for heterogeneity: 0.94). Additionally, the Diagnostic Odds Ratio (DOR) index for telemedicine strabismus detection was 43.3. In other words, the odds of a positive result in strabismic patients were 43 times higher than in non-strabismic patients.
Conclusion: The results of this review indicate that the sensitivity, specificity, and reliability of telemedicine in strabismus detection are acceptable. Telemedicine emerges as an easy, inexpensive, accurate, and reliable method for diagnosing strabismus.
- Telemedicine
- Smartphone Application
- Strabismus
- Accuracy
- Specificity
How to Cite
References
Dandona R, Dandona L, Srinivas M, Sahare P, Narsaiah S, Muñoz SR, et al. Refractive error in children in a rural population in India. Invest Ophthalmol Vis Sci. 2002;43(3):615-22.
Hashemi H, Pakzad R, Yekta A, Bostamzad P, Aghamirsalim M, Sardari S, et al. Global and regional estimates of prevalence of amblyopia: A systematic review and meta-analysis. Strabismus. 2018;26(4):168-83.
Rajavi Z, Ferdosi AA, Eslamdoust M, Yaseri M, Haftabadi N, Kroji S, et al. The prevalence of reoperation and related risk factors among patients with congenital esotropia. J Pediatr Ophthalmol Strabismus. 2013;50(1):53-9.
Buffenn AN. The impact of strabismus on psychosocial heath and quality of life: a systematic review. Surv Ophthalmol. 2021;66(6):1051-64.
Tadiotto TF, Hungria CCA, Ventorin BS, Morais AFL, Mariuzzo LCA, Issaho DC. Quality of life in children with strabismus. Rev bras oftalmol. 2022;81:e0018.
Al-Omari R, Jammal HM, Khader Y, Atoum D, Al-Dolat W, Khatatbeh M. Adults with Longstanding Strabismus: Psychosocial and Functional Impacts and Reasons behind Surgery Delay. J Ophthalmol. 2022;2022:8682675.
Rajavi Z, Sabbaghi H, Kheiri B, Sheibani K. Lateral rectus resection versus lateral rectus plication in patients with residual Esotropia. Strabismus. 2020;28(4):194-200.
Wajuihian SO. Prevalence of heterophoria and its association with near fusional vergence ranges and refractive errors. Afr Vis Eye Hlth. 2018;77(1):1-9.
Helveston EM. Understanding, detecting, and managing strabismus. Community Eye Health. 2010;23(72):12-4.
Al-Tamimi ER, Shakeel A, Yassin SA, Ali SI, Khan UA. A clinic-based study of refractive errors, strabismus, and amblyopia in pediatric age-group. J Family Community Med. 2015;22(3):158-62.
Magramm I, Schlossman A. Strabismus in patients over the age of 60 years. J Pediatr Ophthalmol Strabismus. 1991;28(1):28-31.
Carlton J, Karnon J, Czoski-Murray C, Smith KJ, Marr J. The clinical effectiveness and cost-effectiveness of screening programmes for amblyopia and strabismus in children up to the age of 4-5 years: a systematic review and economic evaluation. Health Technol Assess. 2008;12(25):iii, xi-194.
Carlton J, Czoski-Murray C. Screening for amblyopia and strabismus in children aged 4–5 years: where do we go from here? British and Irish Orthoptic Journal. 2015;6:15-21.
Junghans B, Kiely PM, Crewther DP, Crewther SG. Referral rates for a functional vision screening among a large cosmopolitan sample of Australian children. Ophthalmic Physiol Opt. 2002;22(1):10-25.
Shukla N, Pradhan B, Dikshit A, Chakraborty S, Alamri AM. A Review of Models Used for Investigating Barriers to Healthcare Access in Australia. Int J Environ Res Public Health. 2020;17(11):4087.
Agyemang-Duah W, Peprah C, Peprah P. Barriers to formal healthcare utilisation among poor older people under the livelihood empowerment against poverty programme in the Atwima Nwabiagya District of Ghana. BMC Public Health. 2019;19(1):1185.
Seidu AA, Agbaglo E, Dadzie LK, Ahinkorah BO, Ameyaw EK, Tetteh JK. Individual and contextual factors associated with barriers to accessing healthcare among women in Papua New Guinea: insights from a nationwide demographic and health survey. Int Health. 2021; 1;13(6):573-85.
Naing SHH, Isaramalai S-A, Sukmag P. Policy Literacy, barriers, and gender impact on accessibility to healthcare services under compulsory migrant health insurance among Myanmar migrant workers in Thailand. Journal of environmental and public health. 2020;2020:8165492.
Demeke HB, Merali S, Marks S, Pao LZ, Romero L, Sandhu P, et al. Trends in Use of Telehealth Among Health Centers During the COVID-19 Pandemic - United States, June 26-November 6, 2020. MMWR Morb Mortal Wkly Rep. 2021;70(7):240-4.
Phanphruk W, Liu Y, Morley K, Gavin J, Shah AS, Hunter DG. Validation of StrabisPIX, a Mobile Application for Home Measurement of Ocular Alignment. Transl Vis Sci Technol. 2019;8(2):9.
Tenório Albuquerque Madruga Mesquita MJ, Azevedo Valente TL, de Almeida JDS, Meireles Teixeira JA, Cord Medina FM, Dos Santos AM. A mhealth application for automated detection and diagnosis of strabismus. Int J Med Inform. 2021;153:104527.
Deshmukh AV, Badakere A, Sheth J, Bhate M, Kulkarni S, Kekunnaya R. Pivoting to teleconsultation for paediatric ophthalmology and strabismus: Our experience during COVID-19 times. Indian J Ophthalmol. 2020;68(7):1387-91.
Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097.
Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4(1):1.
Whiting PF, Rutjes AW, Westwood ME, Mallett S, Deeks JJ, Reitsma JB, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med. 2011;155(8):529-36.
Littenberg B, Moses LE. Estimating diagnostic accuracy from multiple conflicting reports: a new meta-analytic method. Med Decis Making. 1993;13(4):313-21.
Moses LE, Shapiro D, Littenberg B. Combining independent studies of a diagnostic test into a summary ROC curve: data-analytic approaches and some additional considerations. Stat Med. 1993;12(14):1293-316.
Cheng W, Lynn MH, Pundlik S, Almeida C, Luo G, Houston K. A smartphone ocular alignment measurement app in school screening for strabismus. BMC ophthalmol. 2021;21(1):1-10.
Ma S, Guan Y, Yuan Y, Tai Y, Wang T. A One-Step, Streamlined Children's Vision Screening Solution Based on Smartphone Imaging for Resource-Limited Areas: Design and Preliminary Field Evaluation. JMIR Mhealth Uhealth. 2020;8(7):e18226.
Ma YN, Low Ai L, Zhao BW, Wang X. The application and value of nine external photograph in clinical diagnosis of strabismus. Ophthalmology in China. 2017;26(5):314-6.
Peterseim MMW, Rhodes RS, Patel RN, Wilson ME, Edmondson LE, Logan SA, et al. Effectiveness of the GoCheck Kids Vision Screener in Detecting Amblyopia Risk Factors. Am J Ophthalmol. 2018;187:87-91.
Bastawrous A, Rono HK, Livingstone IA, Weiss HA, Jordan S, Kuper H, et al. Development and Validation of a Smartphone-Based Visual Acuity Test (Peek Acuity) for Clinical Practice and Community-Based Fieldwork. JAMA Ophthalmol. 2015;133(8):930-7.
Sabri K, Moinul P, Tehrani N, Wiggins R, Fleming N, Farrokhyar F. Video interpretation and diagnosis of pediatric amblyopia and eye disease. J Telemed Telecare. 2021;27(2):116-22.
Silbert DI, Arnold R. Do we need to directly detect astigmatism when photoscreening for amblyopia risk factors (ARFs)? Journal of American Association for Pediatric Ophthalmology and Strabismus {JAAPOS}. 2015;19(4):e61.
Arnold RW, O'Neil JW, Cooper KL, Silbert DI, Donahue SP. Evaluation of a smartphone photoscreening app to detect refractive amblyopia risk factors in children aged 1-6 years. Clin Ophthalmol. 2018;12:1533-7.
Rajavi Z, Sabbaghi H, Baghini AS, Yaseri M, Moein H, Akbarian S, et al. Prevalence of Amblyopia and Refractive Errors Among Primary School Children. J Ophthalmic Vis Res. 2015;10(4):408-16.
Mostafaie A, Ghojazadeh M, Hosseinifard H, Manaflouyan H, Farhadi F, Taheri N, et al. A systematic review of Amblyopia prevalence among the children of the world. Rom J Ophthalmol. 2020;64(4):342-55.
Hu B, Liu Z, Zhao J, Zeng L, Hao G, Shui D, et al. The Global Prevalence of Amblyopia in Children: A Systematic Review and Meta-Analysis. Front Pediatr. 2022;10:819998.
Lam M, Suh D. Screening, Diagnosis, and Treatment of Pediatric Ocular Diseases. Children (Basel). 2022;9(12):1939.
Panda L, Nayak S, Warkad VU, Das T, Khanna R. Tribal Odisha Eye Disease Study (TOES) report # 5: Comparison of prevalence and causes of visual impairment among tribal children in native and urban schools of Odisha (India). Indian J Ophthalmol. 2019;67(7):1012-5.
Raffa LH, Al-Shamrani AZ, Madani FM, AlQarni AS, Allinjawi KF, Fagih AK, et al. Prevalence of undiagnosed, preventable visual impairment in children with intellectual disability in special needs schools in Western Saudi Arab. Saudi Journal for Health Sciences. 2021;10(1):43-8.
Pineles SL, Repka MX, Yu F, Velez FG, Doppee D, Perez C, et al. Risk of physical injuries in children and teens with ophthalmic diagnoses in the OptumLabs Data Warehouse. J AAPOS. 2021;25(6):346.e1-346.e7.
Pineles SL, Repka MX, Yu F, Velez FG, Perez C, Sim D, et al. Strabismus Surgery Decreases the Risk of Injuries in Pediatric Patients in the OptumLabs Data Warehouse. Am J Ophthalmol. 2022;236:147-53.
Min YL, Su T, Shu YQ, Liu WF, Chen LL, Shi WQ, et al. Altered spontaneous brain activity patterns in strabismus with amblyopia patients using amplitude of low-frequency fluctuation: a resting-state fMRI study. Neuropsychiatr Dis Treat. 2018;14:2351-9.
Hatt SR, Leske DA, Castañeda YS, Wernimont SM, Liebermann L, Cheng-Patel CS, et al. Association of Strabismus With Functional Vision and Eye-Related Quality of Life in Children. JAMA Ophthalmol. 2020;138(5):528-35.
Hatt SR, Leske DA, Wernimont SM, Bothun ED, Birch EE, Holmes JM. Diplopic versus nondiplopic strabismus: effects on functional vision and eye-related quality of life in adolescents. J AAPOS. 2021;25(5):297-300.
Sabel BA, Wang J, Cárdenas-Morales L, Faiq M, Heim C. Mental stress as consequence and cause of vision loss: the dawn of psychosomatic ophthalmology for preventive and personalized medicine. EPMA J. 2018;9(2):133-60.
Earnshaw VA, Eaton LA, Kalichman SC, Brousseau NM, Hill EC, Fox AB. COVID-19 conspiracy beliefs, health behaviors, and policy support. Transl Behav Med. 2020;10(4):850-6.
Saqlain M, Munir MM, Rehman SU, Gulzar A, Naz S, Ahmed Z, et al. Knowledge, attitude, practice and perceived barriers among healthcare workers regarding COVID-19: a cross-sectional survey from Pakistan. J Hosp Infect. 2020;105(3):419-23.
Hill J, Rodriguez DX, McDaniel PN. Immigration status as a health care barrier in the USA during COVID-19. J Migr Health. 2021;4:100036.
Bhaskar S, Bradley S, Chattu VK, Adisesh A, Nurtazina A, Kyrykbayeva S, et al. Telemedicine Across the Globe-Position Paper From the COVID-19 Pandemic Health System Resilience PROGRAM (REPROGRAM) International Consortium (Part 1). Front Public Health. 2020;8:556720.
Mahmoud K, Jaramillo C, Barteit S. Telemedicine in Low- and Middle-Income Countries During the COVID-19 Pandemic: A Scoping Review. Front Public Health. 2022;10:914423.
Panda L, Das T, Nayak S, Barik U, Mohanta BC, Williams J, et al. Tribal Odisha Eye Disease Study (TOES # 2) Rayagada school screening program: efficacy of multistage screening of school teachers in detection of impaired vision and other ocular anomalies. Clin Ophthalmol. 2018;12:1181-7.
Chee RI, Chan RVP. Universal newborn eye screening: an effective strategy to improve ocular health? Eye (Lond). 2018;32(1):50-52.
Lennerstrand G, Jakobsson P, Kvarnström G. Screening for ocular dysfunction in children: approaching a common program. Acta Ophthalmol Scand Suppl. 1995;(214):26-38.
Ravindran M, Pawar N, Renagappa R, Ravilla T, Khadse R. Identifying barriers to referrals in preschool-age ocular screening in Southern India. Indian J Ophthalmol. 2020;68(10):2179-84.
Kvarnström G, Jakobsson P, Lennerstrand G. Screening for visual and ocular disorders in children, evaluation of the system in Sweden. Acta Paediatr. 1998;87(11):1173-9.
Tsegaye D, Abiy E, Mesele T, Tadesse T. Delay in seeking health care and associated factors among pulmonary tuberculosis patients in north Wollo zone, Northeast Ethiopia: Institution Based Cross-sectional Study. Arch Clin Microbiol. 2016;7(3):17.
Sommer AC, Blumenthal EZ. Telemedicine in ophthalmology in view of the emerging COVID-19 outbreak. Graefes Arch Clin Exp Ophthalmol. 2020;258(11):2341-52.
Takao H, Sakai K, Mitsumura H, Komatsu T, Yuki I, Takeshita K, et al. A Smartphone Application as a Telemedicine Tool for Stroke Care Management. Neurol Med Chir (Tokyo). 2021;61(4):260-7.
Hunt B, Ruiz A, Pogue B. Smartphone-based imaging systems for medical applications: a critical review. J Biomed Opt. 2021;26(4):040902.
Kapoor S, Eldib A, Hiasat J, Scanga H, Tomasello J, Alabek M, et al. Developing a pediatric ophthalmology telemedicine program in the COVID-19 crisis. J AAPOS. 2020;24(4):204-8.
Parikh D, Armstrong G, Liou V, Husain D. Advances in Telemedicine in Ophthalmology. Semin Ophthalmol. 2020;35(4):210-5.
Jonnatan L, Seaton CL, Rush KL, Li EPH, Hasan K. Mobile Device Usage before and during the COVID-19 Pandemic among Rural and Urban Adults. Int J Environ Res Public Health. 2022;19(14):8231.
- Abstract Viewed: 86 times
- pdf Downloaded: 100 times
