A Novel Bluetooth-Based Automated Flipper for Measuring Accommodative Facility: a Comparison with Conventional Manual Flipper

IF 3.2 Q1 OPHTHALMOLOGY

Ophthalmology science Pub Date : 2025-02-25 DOI:10.1016/j.xops.2025.100750

Hongxi Wang MD , Peiting Guo MD , Riping Zhang MD , Kunliang Qiu MD, PhD , Dongfeng Zhao BS , Liqiong Zhu BS , Mingzhi Zhang MD

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Abstract

Purpose

To evaluate the diagnostic accuracy of a Bluetooth-based automated flipper for measuring accommodative facility (AF) in children.

Design

A cross sectional study with crossover design.

Participants

Children aged 8 to 12 years were enrolled and randomly divided into 2 groups (A and B).

Methods

Initially, group A participants used the manual flipper to measure monocular (MAF) and binocular (BAF) AF, whereas participants in group B used the automated flipper. Subsequently, the groups underwent a crossover, exchanging the methods to measure AF. The diagnostic accuracy of the automated flipper was evaluated against gold standard, which defined inadequate AF as <7 cycles per minute (cpm) for MAF and <5 cpm for BAF, as measured with the manual flipper.

Main Outcome Measures

Accommodative facility measured using automated and manual flipper. Area under the receiver operating characteristic curve for automated flipper; sensitivity and specificity at the optimal cutoff (maximal Youden index).

Results

The average age of the 129 participants was 10.50 ± 1.42 years. The MAF and BAF values obtained using automated flipper were significantly correlated with those from the manual flipper (correlation coefficients of 0.819 and 0.813, respectively, both P < 0.001). The mean MAF and BAF measured with the automated flipper were 9.30 ± 2.30 cpm and 9.13 ± 2.34 cpm, respectively, significantly higher than the manual flipper's measurements (8.53 ± 2.16 cpm and 8.33 ± 2.22 cpm, respectively), even after adjusting for the learning effect associated with multiple measurements using analysis of variance for crossover design. The area under the curve for the automated flipper in diagnosing inadequate MAF and BAF was 0.911 (cutoff value = 9 cpm, sensitivity = 71.11%, specificity = 97.44%) and 0.920 (cutoff value = 7 cpm, sensitivity = 85.34%, specificity = 84.62%), respectively.

Conclusions

The automated flipper showed a strong correlation with the manual flipper, and demonstrated satisfactory sensitivity and specificity in diagnosing inadequate AF. It is recommended that the Bluetooth-based automated flipper be adopted as a novel tool to enhance the accuracy of AF testing in children.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

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一种新型的基于蓝牙的调节设施测量自动挡板：与传统手动挡板的比较

目的评价基于蓝牙的自动脚蹼测量儿童调节功能（AF）的诊断准确性。设计采用交叉设计的横断面研究。研究对象为8 ~ 12岁的儿童，随机分为A、B两组。方法A组使用手动翻动器测量单眼AF （MAF）和双眼AF (BAF)， B组使用自动翻动器。随后，两组进行交叉，交换测量AF的方法。根据金标准评估自动翻动的诊断准确性，金标准将AF不足定义为MAF为每分钟7次（cpm）， BAF为每分钟5次（cpm），用手动翻动测量。主要结果测量采用自动和手动鳍片测量调节设施。接收机工作特性曲线下的面积；灵敏度和特异性在最佳截止点（最大约登指数）。结果129例患者的平均年龄为10.50±1.42岁。自动倒鳍与手动倒鳍的MAF和BAF值呈显著相关（相关系数分别为0.819和0.813），P <；0.001)。使用交叉设计的方差分析调整了与多次测量相关的学习效应后，自动脚蹼测量的平均MAF和BAF分别为9.30±2.30 cpm和9.13±2.34 cpm，显著高于手动脚蹼测量的平均值（分别为8.53±2.16 cpm和8.33±2.22 cpm）。自动翻鳍诊断MAF和BAF不足的曲线下面积分别为0.911（截止值为9 cpm，灵敏度为71.11%，特异性为97.44%）和0.920（截止值为7 cpm，灵敏度为85.34%，特异性为84.62%）。结论自动翻动与手动翻动具有较强的相关性，在诊断不充分房颤方面具有良好的敏感性和特异性。建议采用蓝牙自动翻动作为一种新的工具来提高儿童房颤检测的准确性。财务披露专有或商业披露可在本文末尾的脚注和披露中找到。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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