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Clinical Trial
. 2003 Nov 1;327(7422):1027.
doi: 10.1136/bmj.327.7422.1027.

Screening older people for impaired vision in primary care: cluster randomised trial

Liam Smeeth  1 , Astrid E Fletcher, Smita Hanciles, Jennifer Evans, Richard Wormald
Affiliations
Clinical Trial

Screening older people for impaired vision in primary care: cluster randomised trial

Liam Smeeth et al. BMJ. .

Abstract

Objective: To determine the effectiveness of screening for visual impairment in people aged 75 or over as part of a multidimensional screening programme.

Design: Cluster randomised trial.

Setting: General practices in the United Kingdom participating in the MRC trial of assessment and management of older people in the community.

Participants: 4340 people aged 75 years or over randomly sampled from 20 general practices, excluding people resident in hospitals or nursing homes.

Intervention: Visual acuity testing and referral to eye services for people with visual impairment. Universal screening (assessment and visual acuity testing) was compared with targeted screening, in which only participants with a range of health related problems were offered an assessment that included acuity screening.

Main outcome measures: Proportion of people with visual acuity less than 6/18 in either eye; mean composite score of 25 item version of the National Eye Institute visual function questionnaire.

Results: Three to five years after screening, the relative risk of having visual acuity < 6/18 in either eye, comparing universal with targeted screening, was 1.07 (95% confidence interval 0.84 to 1.36; P = 0.58). The mean composite score of the visual function questionnaire was 85.6 in the targeted screening group and 86.0 in the universal group (difference 0.4, 95% confidence interval -1.7 to 2.5, P = 0.69).

Conclusions: Including a vision screening component by a practice nurse in a pragmatic trial of multidimensional screening for older people did not lead to improved visual outcomes.

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Figures

Fig 1
Fig 1
Randomisation and sampling
Fig 2
Fig 2
Flow of participants through the study
See this image and copyright information in PMC

References

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