Scientific correspondence
The Rotterdam AMblyopia Screening Effectiveness Study
(RAMSES): compliance and predictive value in the first 2 years
Rikard Juttmann*, on behalf of the Rotterdam Amblyopia
Screening Effectiveness Study (RAMSES) steering
committee
Department
of Public Health, Erasmus University Rotterdam, PO Box 1738, 3000 DR
Rotterdam, Netherlands
Correspondence to: R E Juttmann juttmann{at}mgz.fgg.eur.nl
Accepted for publication 6 June 2001
BACKGROUND
RAMSES is a
7 year follow up study, aiming at the evaluation of the effectiveness
and the efficiency 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.
METHODSAll 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.
RESULTSThe 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 effective referral was 0.42.
CONCLUSIONReferral
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.
* Members are listed at the end of the paper.
© 2001 by British Journal of Ophthalmology
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