BIOS Screening Audit report 2016-2017
Aim: This audit utilises data submitted by Head Orthoptists to the British and Irish Orthoptic Society (BIOS). The aim is to attempt to describe vision screening practices across the United Kingdom (UK) for the academic year 2016-2017, compare the findings to the previous vision screening audit for academic year 2015-2016 and provide evidence for future decision-making.
Method: Submitted data was integrated into an Excel spreadsheet and the information was analysed to identify the differences between screening programmes across sites. The method of calculating True +ve scores was explored using three methods (as explained in 2015-2016 audit) and the effects of training on True +ve are discussed. Data was deemed ‘accurate’, such as at the analysis of initial outcomes, only if all children seen after referral were accounted for in the initial outcomes section.
Results: Fifty sites provided basic data including consent policy and age at which tests are performed; a decrease from the previous academic year 2015-2016 (n=52 sites). Forty-three sites provided data on which professional administered the tests, the test(s) used and the pass criteria adopted. Forty-one sites provided data regarding the referral pathway and forty-three sites provided data on eye exam and management criteria. Forty-two sites provided data regarding the number of children screened (n=162,868), of which thirty sites provided ‘accurate’ data on the number of children who failed screening (n=15,383). Thirty-eight sites provided ‘accurate’ data on the number of children who attended their follow-up (n=10,748). Eighteen sites (n=4,645 children seen) provided data on initial outcomes of the eye examination and sixteen sites (n=4,060 children seen) provided diagnostic test data on the number of True positives (+ve). The mean coverage increased to 93% (2016-2016=89%). Using Method 1 of calculating True +ve: Orthoptic delivered screening (n=1,790) showed a mean True +ve of 89%; Vision Screener (VS) trained by an Orthoptist using the BIOS package (n=608) showed a mean True +ve of 81%; VS trained by an Orthoptist using a local package (n=804) showed a mean True +ve of 71%; and VS not trained by an Orthoptist (n=126) showed a mean True +ve of 59%.
Conclusions: This audit concludes that many screening services do not have methods to collect data to assess the effectiveness of the programme. Clarity is needed regarding the meaning of certain terms to achieve consistency in reporting and allow comparison and benchmarking of services, for example, in recording True+ve. Without this, it is not possible to definitively conclude whether professional delivering screening and type of vision screener training does influence True +ve rates or not. The current limited data suggests that the training received/professional administering the test affects the number of True +ve. The implications are discussed.