TY - JOUR
T1 - A Screening Tool for Self-Evaluation of Risk for Age-Related Macular Degeneration
T2 - Validation in a Spanish Population
AU - García-Layana, Alfredo
AU - López-Gálvez, Maribel
AU - García-Arumí, José
AU - Arias, Luis
AU - Gea-Sánchez, Alfredo
AU - Marín-Méndez, Juan J
AU - Sayar-Beristain, Onintza
AU - Sedano-Gil, Germán
AU - Aslam, Tariq M
AU - Minnella, Angelo M
AU - Ibáñez, Isabel López
AU - de Dios Hernández, José M
AU - Seddon, Johanna M
N1 - Funding Information:
This study was promoted by the Spanish Retinal and Vitreous Society (SERV), the Health Research Cooperative Network in Ophthalmology (RETICS-OFTARED), and the Retina+ Foundation. Théa Laboratoires provided technical and logistics support for the development of the study. The protocol was approved by the Clinical Research Ethical Committee of the University Hospital of Valladolid (Valladolid, Spain) on July 26, 2013. The study was conducted in accordance with the ethical principles of the Declaration of Helsinki, good pharmaco-epidemiology practices (GPPs), and the applicable laws and regulations of Spain. All individuals were informed of the objectives of the study and authorized their inclusion by signing a consent form prior to participation.
Publisher Copyright:
2022 The Authors.
PY - 2022/6/24
Y1 - 2022/6/24
N2 - Purpose: The objectives of this study were the creation and validation of a screening tool for age-related macular degeneration (AMD) for routine assessment by primary care physicians, ophthalmologists, other healthcare professionals, and the general population.Methods: A simple, self-administered questionnaire (Simplified Théa AMD Risk-Assessment Scale [STARS] version 4.0) which included well-established risk factors for AMD, such as family history, smoking, and dietary factors, was administered to patients during ophthalmology visits. A fundus examination was performed to determine presence of large soft drusen, pigmentary abnormalities, or late AMD. Based on data from the questionnaire and the clinical examination, predictive models were developed to estimate probability of the Age-Related Eye Disease Study (AREDS) score (categorized as low risk/high risk). The models were evaluated by area under the receiving operating characteristic curve analysis.Results: A total of 3854 subjects completed the questionnaire and underwent a fundus examination. Early/intermediate and late AMD were detected in 15.9% and 23.8% of the patients, respectively. A predictive model was developed with training, validation, and test datasets. The model in the test set had an area under the curve of 0.745 (95% confidence interval [CI] = 0.705-0.784), a positive predictive value of 0.500 (95% CI = 0.449-0.557), and a negative predictive value of 0.810 (95% CI = 0.770-0.844).Conclusions: The STARS questionnaire version 4.0 and the model identify patients at high risk of developing late AMD.Translational Relevance: The screening instrument described could be useful to evaluate the risk of late AMD in patients >55 years without having an eye examination, which could lead to more timely referrals and encourage lifestyle changes.
AB - Purpose: The objectives of this study were the creation and validation of a screening tool for age-related macular degeneration (AMD) for routine assessment by primary care physicians, ophthalmologists, other healthcare professionals, and the general population.Methods: A simple, self-administered questionnaire (Simplified Théa AMD Risk-Assessment Scale [STARS] version 4.0) which included well-established risk factors for AMD, such as family history, smoking, and dietary factors, was administered to patients during ophthalmology visits. A fundus examination was performed to determine presence of large soft drusen, pigmentary abnormalities, or late AMD. Based on data from the questionnaire and the clinical examination, predictive models were developed to estimate probability of the Age-Related Eye Disease Study (AREDS) score (categorized as low risk/high risk). The models were evaluated by area under the receiving operating characteristic curve analysis.Results: A total of 3854 subjects completed the questionnaire and underwent a fundus examination. Early/intermediate and late AMD were detected in 15.9% and 23.8% of the patients, respectively. A predictive model was developed with training, validation, and test datasets. The model in the test set had an area under the curve of 0.745 (95% confidence interval [CI] = 0.705-0.784), a positive predictive value of 0.500 (95% CI = 0.449-0.557), and a negative predictive value of 0.810 (95% CI = 0.770-0.844).Conclusions: The STARS questionnaire version 4.0 and the model identify patients at high risk of developing late AMD.Translational Relevance: The screening instrument described could be useful to evaluate the risk of late AMD in patients >55 years without having an eye examination, which could lead to more timely referrals and encourage lifestyle changes.
KW - age-related macular degeneration
KW - dietary factors
KW - machine learning
KW - primary care
KW - risk model
KW - self-administered questionnaire
U2 - 10.1167/tvst.11.6.23
DO - 10.1167/tvst.11.6.23
M3 - Article
C2 - 35749108
SN - 2164-2591
VL - 11
JO - Translational vision science & technology
JF - Translational vision science & technology
IS - 6
M1 - 23
ER -