Background and objective

Amblyopia is a public health problem, and strabismus is its primary cause. Our objective is to evaluate the concordance of the diagnosis of strabismus between strabismus expert ophthalmologist and the mhealth application developed for this purpose.

Methods

We evaluated the concordance of the diagnosis of strabismus between the expert ophthalmologist and the mhealth application by screening 224 children and adolescents in the 5–15 years age group, with snapshots of patients’ eyes and their analysis thereof. We were using a multifunctional cell phone with Android and the ophthalmologist's clinical evaluation by analyzing the ocular deviations using simple cover and prism and alternate cover.

Results

Fraction measurements were used with two cutoff points of 6 and 11 prismatic diopters (PD). Results were compared according to their concordances, with a fair Kappa equal to 0.43 (95%CI = [0.38; 0.48]), which was statistically significant (p < 0.0001) at the cutoff point of 6 PD and Kappa equal to 0.49 (95% CI = [0.35; 0.61]), which was statistically significant (p < 0.042) in the cutoff point of 11 PD.

Conclusions

The cutoff point of 6 PD was chosen for screening by this mhealth application since it caused the loss of only two patients with strabismus, whereas, in the case of 11 PD, the loss was five patients in the universe of 224. These results are promising for the use of this software as a screening method for patients with strabismus.

中文翻译：

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用于自动检测和诊断斜视的移动健康应用

背景与目的

弱视是一个公共卫生问题，斜视是其主要原因。我们的目标是评估斜视专家眼科医生与为此目的开发的 mhealth 应用程序之间斜视诊断的一致性。

方法

我们通过筛选 224 名 5-15 岁年龄组的儿童和青少年，使用患者眼睛的快照及其分析来评估专家眼科医生和 mhealth 应用程序之间斜视诊断的一致性。我们正在使用带有 Android 的多功能手机和眼科医生的临床评估，通过使用简单的盖子和棱镜和交替的盖子分析眼部偏差。

结果

分数测量与 6 和 11 棱镜屈光度 (PD) 的两个截止点一起使用。结果根据它们的语词进行比较时，与合理的卡伯等于0.43（95％CI = [0.38 0.48]），这是统计上显著（p  6 PD和κ的截止点<0.0001）等于0.49（95 % CI = [0.35; 0.61])，这 在 11 PD 的截止点具有统计学意义（p < 0.042）。

结论

此 mhealth 应用程序选择了 6 PD 的截止点进行筛选，因为它仅导致 2 名斜视患者的损失，而在 11 PD 的情况下，224 名患者中损失了 5 名患者。这些结果很有希望使用该软件作为斜视患者的筛查方法。