The Rotterdam AMblyopia Screening Effectiveness Study (RAMSES): compliance and predictive value in the first 2 years

Abstract

Background-RAMSES is a 7 year follow up study, aiming at the evaluation of the eVectiveness and the eYciency of screening for amblyopia. In this first report, concerning the first 2 years of life, the compliance with the prevention programme and the positive predictive value (PPV) of the screening tests used, are presented. Methods-All results of the standardised screening test for strabismus, applied by child healthcare physicians, within a birth cohort of 4072 Rotterdam children at the age of 9, 14, and 24 months, were registered. Children with a positive test result were referred to their general practitioner, who was asked to arrange a definitive referral to an ophthalmological centre. The results of the examinations at these centres were registered in standardised forms and served as reference for establishing the PPV. Results-The screening was (at least one time) attended by 3958 children (97%). 160 of these children (4%) were referred, of whom 101 (64%) visited an ophthalmological centre, so that a conclusive diagnostic evaluation was possible. For amblyopia, the predictive value of a positive test result followed by an eVective referral was 0.42. Conclusion-Referral procedures after a positive test result in the Dutch child healthcare screening programme for amblyopia need to be improved. The Dutch screening test used to detect amblyopia exhibits a relatively favourable PPV. (Br J Ophthalmol 2001;85:1332-1335

Effectiveness of screening for amblyopia and other eye disorders in a prospective birth cohort study

“…14 In the Netherlands, 97% of all children of this age attend the child health screening programme, which is government paid. All Child Health Care centres and municipal health service locations in the Rotterdam region participated in the study.…”

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

“…Juttmann, 82 on behalf of the Rotterdam Amblyopia Screening Effectiveness Study (RAMSES) steering committee, reported on the compliance with vision screening and the PPV of the screening tests used. In this programme children were screened during the first 2 years of life by healthcare physicians.…”

Determinants and outcome of unsuccessful referral after positive screening in a large birth-cohort study of population-based vision screening

“…Compliance with a referral after a positive screening test, however, may influence an amblyopia outcome as well. [12][13][14] Williamson and colleagues 15 showed that high rates of default in terms of vision screening appointments, particularly in geographical areas of lower socioeconomic classification, have hampered the attempts at reducing the incidence of insufficiently treated amblyopia. Early results of a large birth-cohort study on vision screening showed that approximately one third of the children had not been successfully referred after a positive screening test.…”

“…Early results of a large birth-cohort study on vision screening showed that approximately one third of the children had not been successfully referred after a positive screening test. 6,14 In the current study, we investigated noncompliance after a positive vision-screening examination to determine reasons for unsuccessful referral.…”