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Visual impairment can affect up to 70% of stroke survivors, but many do not have their vision adequately assessed in hospital. An unidentified visual defect can cause significant problems for recovery and quality of life. The Stroke Vision app (an application currently scaled for a 10" Android tablet) has been developed to act as a screening tool for visual problems in stroke survivors; to help identify visual problems earlier and thereby improve rehabilitation outcomes. The app includes a suite of tests for assessing the patient's acuity, their visual fields and to aid in the identification of visual neglect / inattention. Furthermore, it includes educational information on visual stroke in order to better educate staff, patients and their carers. This study seeks to validate the novel digital assessments included in the Stroke Vision app against the current methods used for screening (clinical examination by confrontation field testing). Both screening measures will be compared with the gold standard methods for visual assessments, Octopus perimetry for fields and paper-based methods for visuospatial neglect
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Gold Standard Assessments | Other |
|
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| Usual Clinical Screening Practice | Other |
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| Stroke Vision App | Other |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Formal Perimetry (Goldman or Octopus visual Field) | Procedure |
| ||
| Albert's visual inattention test |
| Measure | Description | Time Frame |
|---|---|---|
| Accuracy of Stroke Vision Tablet App to support assessment of visual field defects when compared with visual field assessment to confrontation in standard clinical practice | Visual field will be captured either by the Stroke Vision App or by confrontation. Visual field will be reported by assessors (blinded to referral and comparator assessment) as either defect present, no defect present or unable to test. Agreement between visual field assessment supported by the Stroke Vision App and visual field assessment to confrontation in standard clincial practice will be quantified by the Kappa statistic. Accuracy metrics of sensitivity/specificity/predictive values will also be reported. | All assessments will be conducted following consent at standard clinical assessment visit |
| Accuracy of Stroke Vision Tablet App to support assessment of visual inattention defects when compared to visual inattention assessment to bilateral stimuli in standard clinical practice | Visual inattention tests will be conducted either by the Stroke Vision App or by inattention to bilateral stimuli in standard clinical practice. Inattention will be reported by assessors (blinded to referral and comparator assessment) as either defect present, no defect present or unable to test. Agreement between visual inattention assessment supported by the Stroke Vision App and inattention to bilateral stimuli in standard clincial practice will be quantified by the Kappa statistic. Accuracy metrics of sensitivity/specificity/predictive values will also be reported. | All assessments will be conducted following consent at standard clinical assessment visit |
| Measure | Description | Time Frame |
|---|---|---|
| Accuracy of Stroke Vision Tablet App to support assessment of visual field defects when compared with "Gold standard" formal perimetry assessments | Visual field will be captured either by the Stroke Vision App or by formal perimetry assessments. Visual field will be reported by assessors (blinded to referral and comparator assessment) as either defect present, no defect present or unable to test. Agreement between visual field assessment supported by the Stroke Vision App and visual field assessment to formal perimetry will be quantified by the Kappa statistic. Accuracy metrics of sensitivity/specificity/predictive values will also be reported. |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of patients completing Gold standard vision assessments | All assessments will be conducted following consent at standard clinical assessment visit | |
| Proportion of patients competing usual clinical practice vision assessments | All assessments will be conducted following consent at standard clinical assessment visit |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Christine McAlpine, MBChB FRCP | Contact | 44-141-211-4843 | christine.mcalpine@ggc.scot.nhs.uk |
| Name | Affiliation | Role |
|---|---|---|
| Christine McAlpine, MBChB FRCP | NHS Greater Glasgow & Clyde | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Gartnavel General Hospital | Recruiting | Glasgow | Scotland | G12 0YN | United Kingdom |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29643830 | Derived | Quinn TJ, Livingstone I, Weir A, Shaw R, Breckenridge A, McAlpine C, Tarbert CM. Accuracy and Feasibility of an Android-Based Digital Assessment Tool for Post Stroke Visual Disorders-The StrokeVision App. Front Neurol. 2018 Mar 28;9:146. doi: 10.3389/fneur.2018.00146. eCollection 2018. |
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| Procedure |
|
| Star cancellation visual inattention test | Procedure |
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| Visual field assessment to confrontation | Procedure |
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| Visual inattention assessment to bilateral stimuli | Procedure |
|
| Digital tumbling E visual accuity assessment | Device |
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| Digital visual field assessment | Device |
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| Digital line crossing assessment | Device |
|
| Digital shape cancellation assessment | Device |
|
| All assessments will be conducted following consent at standard clinical assessment visit |
| Accuracy of Stroke Vision Tablet App to support assessment of visual inattention defects when compared with "Gold standard" Albert's visual inattention test, Star cancellation visual inattention test, Line Bisection test | Visual inattention tests will be conducted either by the Stroke Vision App or by Gold standard" Albert's visual inattention test, Star cancellation visual inattention test, Line Bisection test conducted by a clinician. Inattention will be reported by assessors (blinded to referral and comparator assessment) as either defect present, no defect present or unable to test. Agreement between visual inattention assessment supported by the Stroke Vision App and "Gold standard" Albert's visual inattention test, Star cancellation visual inattention test, Line Bisection test will be quantified by the Kappa statistic. Accuracy metrics of sensitivity/specificity/predictive values will also be reported. | All assessments will be conducted following consent at standard clinical assessment visit |
| Proportion of patients competing Stroke vision app assessments | All assessments will be conducted following consent at standard clinical assessment visit |
| Time to complete Gold standard vision assessments | All assessments will be conducted following consent at standard clinical assessment visit |
| Time to complete usual clinical practice vision assessments | All assessments will be conducted following consent at standard clinical assessment visit |
| Time to complete Stroke vision app assessments | All assessments will be conducted following consent at standard clinical assessment visit |
| ID | Term |
|---|---|
| D005124 | Eye Abnormalities |
| D020521 | Stroke |
| ID | Term |
|---|---|
| D005128 | Eye Diseases |
| D000013 | Congenital Abnormalities |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
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