Mapping and documenting existing vision screening provision

By Jill Carlton, Helen Griffiths and Paolo Mazzone

Mapping and documenting existing vision screening provision across all European countries has involved several stages.

Analysis of the completed questionnaire data has been implemented. Progress on the analysis has been influenced by when country representatives submitted data, but also by the amount of data submitted.  Initially a numerical value was attributed to data reliability (i.e. 0: Missing data; 1: No data available; 2: I do not know; 3: Rough estimate; 4: Real estimate; 5: Actual data with source and year).  This was useful to identify which countries country reports could be created. There was great variation between countries regarding the amount of information provided, questions answered and the reliability of data. This reflected the complexity of the task and the general lack of information sources in all countries.

Responses to the questionnaire were used to create draft reports for each country. Each of the draft country reports followed the same template and contained sections relating to: the population and healthcare system; vision screening commissioning and guidance; vision screening procedure for each age group (premature babies to age 7 years); automated screening; provision for visually impaired; knowledge of existing screening programmes (coverage; referrals; screening evaluation of true/false positives, sensitivity and specificity; and cost of vision screening in children.

The draft reports were sent back to the relevant country representative for content validation checks. This step ensured that interpretation of the initial submitted responses to the questionnaire was verified.  Further questions for clarification purposes, were included within the draft report for the country representative to answer.  The additional questions relate to data required to populate and calibrate the model and to specific details of any photoscreening taking place within the country.

Once a response was received from the country representative, any additional information was incorporated into the report and final versions were produced. To date (09/01/19), 40 final country reports have been compiled and sent to the appropriate country representatives.  We are now in the process of producing a summary report of Vision Screening in Europe, with mapping across all 41 countries. This will be reported in Poznan in March 2019.

Additional work undertaken by WP3 includes:

  • Synthesis of United Kingdom (UK) screening data has been undertaken. Two UK specific reports have been compiled using data submitted to the British and Irish Orthoptic Society (BIOS) Special Interest Group.  Permission has been received from BIOS to provide raw data to WP5 for the model development and calibration.  The 2017 report is available here and the 2018 report here.
  • A review of literature on clinical and cost-effectiveness of screening programmes for amblyopia and strabismus in children. A literature search was conducted to identify any potential data sources that could be useful for the model.  The literature search replicated that undertaken by Carlton et al in 2008 (Carlton J, Karnon J, Czoski-Murray C, Smith KJ, Marr J. The clinical effectiveness and cost-effectiveness of screening programmes for amblyopia and stabismus in children up to the ages of 4-5 years: a systematic review and economic evaluation. Health Technology Assessment 2008;12:25).  All potential papers were then disseminated for consideration for inclusion in the model development and calibration.
  • A review of the literature on acceptability of childhood screening programmes. The aim of this piece of work is to identify, synthesise and critically appraise all methods that evaluate “acceptability” of childhood screening programmes. More details can be found here.

Dr Jill Carlton BMedSci, MMedSci, PhD is research fellow at the University of Sheffield’s Health Economics and Decision Science.

Dr Helen Griffiths PhD, BSc, DBO is senior lecturer in orthoptics at the University of Sheffield’s Department of Oncology & Metabolism.

Paolo Mazzone BSc, MSc is research assistant at the University of Sheffield’s Health Economics and Decision Science.

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