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Cochrane Database of Systematic Reviews

Community screening for visual impairment in older people

Information

DOI:
https://doi.org/10.1002/14651858.CD001054.pub3Copy DOI
Database:
  1. Cochrane Database of Systematic Reviews
Version published:
  1. 20 February 2018see what's new
Type:
  1. Intervention
Stage:
  1. Review
Cochrane Editorial Group:
  1. Cochrane Eyes and Vision Group

Copyright:
  1. Copyright © 2018 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

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Authors

  • Emily L Clarke

    Correspondence to: Leeds Teaching Hospitals NHS Trust, Leeds, UK

    [email protected]

    University of Leeds, Leeds, UK

  • Jennifer R Evans

    Cochrane Eyes and Vision, ICEH, London School of Hygiene & Tropical Medicine, London, UK

  • Liam Smeeth

    Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK

Contributions of authors

Conceiving the idea for the review: SI
Developing the review: LS
Undertaking manual searches for trials: LS
Assessing quality of trials: ELC, LS, JE
Extracting data: ELC, LS, JE
Analysing data: ELC, LS, JE
Writing the review: ELC, LS, JE
Advising on the review: LS, JE
Updating the review: ELC, LS, JE

Sources of support

Internal sources

  • London Academic Training Scheme, UK.

External sources

  • Medical Research Council, UK.

  • National Institute for Health Research (NIHR), UK.

    • Richard Wormald, Co‐ordinating Editor for Cochrane Eyes and Vision (CEV) acknowledges financial support for his CEV research sessions from the Department of Health through the award made by the NIHR to Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology for a Specialist Biomedical Research Centre for Ophthalmology.

    • This review update was supported by the NIHR, via Cochrane Infrastructure funding to the CEV UK editorial base.

    The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the Systematic Reviews Programme, NIHR, NHS or the Department of Health.

Declarations of interest

None known.

Acknowledgements

  • We are very appreciative to Professor Steve Iliffe (SI), for his contributions as author of the previous version of this review.

  • We would like to thank all the study authors who responded to requests for additional information. The following provided unpublished data used in this review: R McEwan; N Vetter; E van Rossum; E Wagner; J Wang; and R Cumming.

  • We are grateful to Astrid Fletcher, Catey Bunce, Tasanee Braithwaite and Kristina Lindsley for peer review comments on this review.

  • The editorial team of the Cochrane Eyes and Vision Group developed and executed the electronic searches. We thank Anupa Shah and Iris Gordon for their assistance with the review process.

Version history

Published

Title

Stage

Authors

Version

2018 Feb 20

Community screening for visual impairment in older people

Review

Emily L Clarke, Jennifer R Evans, Liam Smeeth

https://doi.org/10.1002/14651858.CD001054.pub3

2006 Jul 19

Community screening for visual impairment in the elderly

Review

Liam L Smeeth, Steve Iliffe

https://doi.org/10.1002/14651858.CD001054.pub2

1998 Oct 26

Community screening for visual impairment in the elderly

Review

Liam L Smeeth, Steve Iliffe

https://doi.org/10.1002/14651858.CD001054

Differences between protocol and review

We made some changes because of updated Cochrane guidance (methods.cochrane.org/mecir).

  • Assessment of risk of bias (MECIR C52 to C60).

  • Grading the certainty of the evidence using GRADE (MECIR C74, C75).

  • We have amended the inclusion criteria to make it clear that we have excluded trials of multi‐component screening that did not consider the impact of screening on vision outcomes (C40).

  • Searches for the 2017 update now include searching the ISRCTN registry, ClinicalTrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). The UK Clinical Trials Gateway and PubMed are no longer being searched; (MECIR C27).

  • we compared fixed‐effect and random‐effects models to test our assumption as to the model required (C71).

We did not do some planned analyses because of lack of data.

  • We planned sensitivity analyses to assess the effects of including or excluding trials of different quality. We did not identify any trials at high risk of bias in any domain so did not do this planned sensitivity analysis.

The protocol specified the odds ratio but we have calculated the risk ratio which is more easily interpreted.

As a result of peer review comments, we performed a post hoc sensitivity analysis excluding studies that did not directly refer patients to eye specialists.

We also added in a sensitivity analysis for one analysis which included a cluster randomised trial for which we did not have adjusted estimates.

Keywords

MeSH

Medical Subject Headings Check Words

Aged; Humans;

PICOs

Population
Intervention
Comparison
Outcome

The PICO model is widely used and taught in evidence-based health care as a strategy for formulating questions and search strategies and for characterizing clinical studies or meta-analyses. PICO stands for four different potential components of a clinical question: Patient, Population or Problem; Intervention; Comparison; Outcome.

See more on using PICO in the Cochrane Handbook.

Study flow diagram.
Figures and Tables -
Figure 1

Study flow diagram.

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Figures and Tables -
Figure 2

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

Comparison 1 Vision screening as part of multi‐component screening package versus no vision screening (standard care), Outcome 1 Not seeing well (as defined by each trial).
Figures and Tables -
Analysis 1.1

Comparison 1 Vision screening as part of multi‐component screening package versus no vision screening (standard care), Outcome 1 Not seeing well (as defined by each trial).

Comparison 1. Vision screening as part of multi‐component screening package versus no vision screening (standard care)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Not seeing well (as defined by each trial) Show forest plot

6

4522

Risk Ratio (M‐H, Fixed, 95% CI)

1.05 [0.97, 1.14]

Figures and Tables -
Comparison 1. Vision screening as part of multi‐component screening package versus no vision screening (standard care)