Automated Measurement of Visual Acuity in Pediatric Ophthalmic Patients Using Principles of Game Design and Tablet Computers

Tariq M Aslam; Humza J Tahir; Neil R A Parry; Ian J Murray; Kun Kwak; Richard Heyes; Mahani M Salleh; Gabriela Czanner; Jane Ashworth

doi:10.1016/j.ajo.2016.08.013

Automated Measurement of Visual Acuity in Pediatric Ophthalmic Patients Using Principles of Game Design and Tablet Computers

Tariq M Aslam, Humza J Tahir, Neil R A Parry, Ian J Murray, Kun Kwak, Richard Heyes, Mahani M Salleh, Gabriela Czanner, Jane Ashworth

University of Liverpool

Research output: Contribution to journal › Article › peer-review

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Abstract

PURPOSE: To report on the utility of a computer tablet-based method for automated testing of visual acuity in children based on the principles of game design. We describe the testing procedure and present repeatability as well as agreement of the score with accepted visual acuity measures.

DESIGN: Reliability and validity study.

METHODS: Setting: Manchester Royal Eye Hospital Pediatric Ophthalmology Outpatients Department.

PATIENT POPULATION: Total of 112 sequentially recruited patients.

INTERVENTION: For each patient 1 eye was tested with the Mobile Assessment of Vision by intERactIve Computer for Children (MAVERIC-C) system, consisting of a software application running on a computer tablet, housed in a bespoke viewing chamber. The application elicited touch screen responses using a game design to encourage compliance and automatically acquire visual acuity scores of participating patients. Acuity was then assessed by an examiner with a standard chart-based near ETDRS acuity test before the MAVERIC-C assessment was repeated.

MAIN OUTCOME MEASURE: Reliability of MAVERIC-C near visual acuity score and agreement of MAVERIC-C score with near ETDRS chart for visual acuity.

RESULTS: Altogether, 106 children (95%) completed the MAVERIC-C system without assistance. The vision scores demonstrated satisfactory reliability, with test-retest VA scores having a mean difference of 0.001 (SD ±0.136) and limits of agreement of 2 SD (LOA) of ±0.267. Comparison with the near EDTRS chart showed agreement with a mean difference of -0.0879 (±0.106) with LOA of ±0.208.

CONCLUSIONS: This study demonstrates promising utility for software using a game design to enable automated testing of acuity in children with ophthalmic disease in an objective and accurate manner.

Original language	English
Pages (from-to)	223-227
Number of pages	5
Journal	American journal of ophthalmology
Volume	170
Early online date	18 Aug 2016
DOIs	https://doi.org/10.1016/j.ajo.2016.08.013
Publication status	Published - Oct 2016

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10.1016/j.ajo.2016.08.013

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Smart inhaler improves adherence to treatment for children with asthma
Aslam, T. (Participant), Murray, C. (Participant), (Participant) & Murray, I. (Participant)
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@article{756d4014f5f64862b67ce715fd7fee55,

title = "Automated Measurement of Visual Acuity in Pediatric Ophthalmic Patients Using Principles of Game Design and Tablet Computers",

abstract = "PURPOSE: To report on the utility of a computer tablet-based method for automated testing of visual acuity in children based on the principles of game design. We describe the testing procedure and present repeatability as well as agreement of the score with accepted visual acuity measures.DESIGN: Reliability and validity study.METHODS: Setting: Manchester Royal Eye Hospital Pediatric Ophthalmology Outpatients Department.PATIENT POPULATION: Total of 112 sequentially recruited patients.INTERVENTION: For each patient 1 eye was tested with the Mobile Assessment of Vision by intERactIve Computer for Children (MAVERIC-C) system, consisting of a software application running on a computer tablet, housed in a bespoke viewing chamber. The application elicited touch screen responses using a game design to encourage compliance and automatically acquire visual acuity scores of participating patients. Acuity was then assessed by an examiner with a standard chart-based near ETDRS acuity test before the MAVERIC-C assessment was repeated.MAIN OUTCOME MEASURE: Reliability of MAVERIC-C near visual acuity score and agreement of MAVERIC-C score with near ETDRS chart for visual acuity.RESULTS: Altogether, 106 children (95%) completed the MAVERIC-C system without assistance. The vision scores demonstrated satisfactory reliability, with test-retest VA scores having a mean difference of 0.001 (SD ±0.136) and limits of agreement of 2 SD (LOA) of ±0.267. Comparison with the near EDTRS chart showed agreement with a mean difference of -0.0879 (±0.106) with LOA of ±0.208.CONCLUSIONS: This study demonstrates promising utility for software using a game design to enable automated testing of acuity in children with ophthalmic disease in an objective and accurate manner.",

author = "Aslam, {Tariq M} and Tahir, {Humza J} and Parry, {Neil R A} and Murray, {Ian J} and Kun Kwak and Richard Heyes and Salleh, {Mahani M} and Gabriela Czanner and Jane Ashworth",

year = "2016",

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doi = "10.1016/j.ajo.2016.08.013",

language = "English",

volume = "170",

pages = "223--227",

journal = "American journal of ophthalmology",

issn = "1879-1891",

publisher = "Elsevier BV",

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T1 - Automated Measurement of Visual Acuity in Pediatric Ophthalmic Patients Using Principles of Game Design and Tablet Computers

AU - Aslam, Tariq M

AU - Tahir, Humza J

AU - Parry, Neil R A

AU - Murray, Ian J

AU - Kwak, Kun

AU - Heyes, Richard

AU - Salleh, Mahani M

AU - Czanner, Gabriela

AU - Ashworth, Jane

PY - 2016/10

Y1 - 2016/10

N2 - PURPOSE: To report on the utility of a computer tablet-based method for automated testing of visual acuity in children based on the principles of game design. We describe the testing procedure and present repeatability as well as agreement of the score with accepted visual acuity measures.DESIGN: Reliability and validity study.METHODS: Setting: Manchester Royal Eye Hospital Pediatric Ophthalmology Outpatients Department.PATIENT POPULATION: Total of 112 sequentially recruited patients.INTERVENTION: For each patient 1 eye was tested with the Mobile Assessment of Vision by intERactIve Computer for Children (MAVERIC-C) system, consisting of a software application running on a computer tablet, housed in a bespoke viewing chamber. The application elicited touch screen responses using a game design to encourage compliance and automatically acquire visual acuity scores of participating patients. Acuity was then assessed by an examiner with a standard chart-based near ETDRS acuity test before the MAVERIC-C assessment was repeated.MAIN OUTCOME MEASURE: Reliability of MAVERIC-C near visual acuity score and agreement of MAVERIC-C score with near ETDRS chart for visual acuity.RESULTS: Altogether, 106 children (95%) completed the MAVERIC-C system without assistance. The vision scores demonstrated satisfactory reliability, with test-retest VA scores having a mean difference of 0.001 (SD ±0.136) and limits of agreement of 2 SD (LOA) of ±0.267. Comparison with the near EDTRS chart showed agreement with a mean difference of -0.0879 (±0.106) with LOA of ±0.208.CONCLUSIONS: This study demonstrates promising utility for software using a game design to enable automated testing of acuity in children with ophthalmic disease in an objective and accurate manner.

AB - PURPOSE: To report on the utility of a computer tablet-based method for automated testing of visual acuity in children based on the principles of game design. We describe the testing procedure and present repeatability as well as agreement of the score with accepted visual acuity measures.DESIGN: Reliability and validity study.METHODS: Setting: Manchester Royal Eye Hospital Pediatric Ophthalmology Outpatients Department.PATIENT POPULATION: Total of 112 sequentially recruited patients.INTERVENTION: For each patient 1 eye was tested with the Mobile Assessment of Vision by intERactIve Computer for Children (MAVERIC-C) system, consisting of a software application running on a computer tablet, housed in a bespoke viewing chamber. The application elicited touch screen responses using a game design to encourage compliance and automatically acquire visual acuity scores of participating patients. Acuity was then assessed by an examiner with a standard chart-based near ETDRS acuity test before the MAVERIC-C assessment was repeated.MAIN OUTCOME MEASURE: Reliability of MAVERIC-C near visual acuity score and agreement of MAVERIC-C score with near ETDRS chart for visual acuity.RESULTS: Altogether, 106 children (95%) completed the MAVERIC-C system without assistance. The vision scores demonstrated satisfactory reliability, with test-retest VA scores having a mean difference of 0.001 (SD ±0.136) and limits of agreement of 2 SD (LOA) of ±0.267. Comparison with the near EDTRS chart showed agreement with a mean difference of -0.0879 (±0.106) with LOA of ±0.208.CONCLUSIONS: This study demonstrates promising utility for software using a game design to enable automated testing of acuity in children with ophthalmic disease in an objective and accurate manner.

U2 - 10.1016/j.ajo.2016.08.013

DO - 10.1016/j.ajo.2016.08.013

M3 - Article

C2 - 27544479

SN - 1879-1891

VL - 170

SP - 223

EP - 227

JO - American journal of ophthalmology

JF - American journal of ophthalmology

ER -

Automated Measurement of Visual Acuity in Pediatric Ophthalmic Patients Using Principles of Game Design and Tablet Computers

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