Structured Abstract

Contents

• 1. Introduction
  • Purpose and Previous U.S. Preventive Services Task Force Recommendation
  • Condition Definition
  • Prevalence and Burden of Disease
  • Etiology and Natural History
  • Risk Factors
  • Rationale for Screening/Screening Strategies
  • Interventions/Treatment
  • Current Clinical Practice
  • Recommendations of Other Groups
• 2. Methods
  • Key Questions and Analytic Framework
  • Search Strategies
  • Study Selection
  • Data Abstraction and Quality Rating
  • Data Synthesis
  • External Review
  • Response to Public Comments
• 3. Results
  • Key Question 1 Does Vision Screening in Asymptomatic Older Adults Result in Improved Vision, Morbidity or Mortality, Quality of Life, Functional Status, or Cognition?
  • Key Question 2 Are There Harms Associated With Vision Screening in Asymptomatic Older Adults?
  • Key Question 3 What Is the Accuracy of Screening for Early Impairment in Visual Acuity Due to Uncorrected Refractive Error, Cataracts, or AMD?
  • Key Question 4 Does Treatment of Early Impairment in Visual Acuity Due to Uncorrected Refractive Error, Cataracts, or AMD Lead to Improved Morbidity or Mortality or Quality of Life?
  • Key Question 5 Are There Harms Associated With Treating Early Impairment in Visual Acuity Due to Uncorrected Refractive Error, Cataracts, or AMD?
  • Contextual Question What Is a Clinically Meaningful Difference in Visual Acuity?
• 4. Discussion
  • Summary of Review Findings
  • Limitations
  • Emerging Issues/Next Steps
  • Relevance for Priority Populations
  • Future Research
  • Conclusions
• References
• Appendix A Detailed Methods
• Appendix B Evidence Tables From Prior USPSTF Review
• Appendix C Evidence and Quality Tables of Published Studies From This Update
• Appendix D Appendix Figures

Acknowledgements: The authors acknowledge AHRQ Medical Officer Tracy Wolff, MD, MPH; as well as current and former members of the U.S. Preventive Services Task Force who contributed to topic deliberations.

Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services¹, Contract No. HHSA-290-2012-0001-5-I, Task Order No. 4, Prepared by: Pacific Northwest Evidence-Based Practice Center²

Suggested citation:

Chou R, Dana T, Bougatsos C, Grusing S, Blazina I. Screening for Impaired Visual Acuity in Older Adults: A Systematic Review to Update the 2009 U.S. Preventive Services Task Force Recommendation. Evidence Synthesis No. 127. AHRQ Publication No. 14-05209-EF-1. Rockville, MD: Agency for Healthcare Research and Quality; 2016.

This report is based on research conducted by the Pacific Northwest Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (HHSA-290-2012-0001-5-I, Task Order No. 4). The findings and conclusions in this document are those of the authors, who are responsible for its contents, and do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

The information in this report is intended to help health care decisionmakers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information (i.e., in the context of available resources and circumstances presented by individual patients).

The final report may be used, in whole or in part, as the basis for development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied.

None of the investigators has any affiliations or financial involvement that conflicts with the material presented in this report.

1

5600 Fishers Lane, Rockville, MD 20857; www​.ahrq.gov

2

Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239; www​.ohsu.edu/epc