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PubMed1995

Evaluation of accuracy and reproducibility of E test for susceptibility testing of Streptococcus pneumoniae to penicillin, cefotaxime, and ceftriaxone.

We evaluated the reproducibility with which technologists perform and interpret the E test (AB Biodisk, North America, Inc., Piscataway, N.J.) for determining the susceptibility of Streptococcus pneumoniae to penicillin, cefotaxime, and ceftriaxone. Four technologists prepared E test assays to test 124 isolates of S. pneumoniae. Each technologist then interpreted the results of the E test blinded to the interpretation of the other technologists. In addition, E test results were compared with the reference method of broth microdilution. Intraobserver and interobserver agreement were assessed by use of the kappa statistic. Interpretation of the E test and broth microdilution results showed substantial to excellent agreement, with kappa values ranging from 0.878 to 0.987. Compared with broth microdilution, no very major errors and only four major errors were made with the E test. Most minor errors with penicillin and ceftriaxone occurred for isolates with intermediate or high-level resistance, whereas for cefotaxime the minor errors were more evenly distributed between susceptible and intermediate resistance and between intermediate and high-level resistance. These results indicate that there is good agreement between technologists for the interpretation of the E test when testing the susceptibility of S. pneumoniae to penicillin, cefotaxime, and ceftriaxone and that the results of the E test agree with those of broth microdilution.

Cefotaxime↗
PubMed1995

Effect of a test meal on the intragastric distribution of urea in the 13C-urea breath test for Helicobacter pylori.

Test meals are invariably used in the 13C-urea breath test (UBT) but their effect on the intragastric distribution and gastric residence time of urea given in the test is unknown. The site of Helicobacter pylori urease measured in the test is unknown and whether the test measures total or regional gastric urease is uncertain. This study reports the results of paired UBTs with simultaneous gastric distribution studies, one with and one without a fatty test meal, two weeks apart on seven H pylori infected subjects. The test meal did not affect UBT results at 10 minutes, but increased values at 30 minutes and thereafter. The amount of scintigraphic label in the antrum at 10 minutes was also unaffected by the meal but increased at 30 minutes and thereafter, whereas the amount in the body/fundus was greatly increased both at 10 minutes and throughout the test. There was considerable variation in intragastric distribution of urea between subjects, both with and without the test meal. This study shows that a test meal profoundly affects intragastric distribution of urea solution in the UBT, and increases UBT values at 30 minutes and later. Variability between subjects, however, means that accurate measurement of total or regional gastric urease is probably unrealistic.

Adult↗
PubMed1988

Short term reproducibility of exercise testing in patients with ST segment elevation and different responses to the dipyridamole test.

The short term reproducibility of exercise testing in 25 patients who had exercise induced ST segment elevation without baseline regional asynergy or a previous myocardial infarction, who had different responses to the dipyridamole test, was assessed. The patients performed a dipyridamole echocardiography test and a second exercise stress test. All underwent coronary arteriography. Seventeen patients had transient regional asynergy after dipyridamole (group 1) and either ST segment elevation (14 patients) or depression (three patients); a second group of eight had no asynergy and no electrocardiographic changes (group 2). The repeated exercise stress test was positive in 16 of the 17 patients of group 1 (11 with ST elevation and five with ST depression) and in two patients of group 2 (both had ST depression and one had coronary artery disease). The dipyridamole echocardiography test was positive in 17 of the 19 patients with coronary artery disease and was negative in all six patients without coronary artery disease. The repeated exercise stress test was positive in 17 of the 19 patients with coronary artery disease and in one patient without. The dipyridamole echocardiography test and a repeated exercise stress test, but not a single exercise stress test, identified coronary artery disease causing exercise induced ST segment elevation.

Adult↗
PubMed2006

Validity of cycling peak power as measured by a short-sprint test versus the Wingate anaerobic test.

To validate the measurement of peak power output (PPO) using a short cycling sprint test (inertial load (IL) test), we compare it to the widely accepted Wingate anaerobic test (WAnT). Fifteen healthy, young, active subjects performed 2 experimental trials. In each trial, subjects warmed up and sprinted 4 times for the IL test. After recovery, they cycled for 30 s at maximum capacity for the WAnT. The experimental trial was replicated 3 d later to test for reliability. Inter- and intra-day PPO measured with the IL test was very reliable (R(1) = 0.99 and R(1) = 0.94, respectively). The correlation between the IL and WAnT was highly significant (r = 0.82; P < 0.001), although the absolute PPO values were markedly higher for the IL test (1268 +/- 41 W vs. 786 +/- 27 W; P < 0.001). In conclusion, cycling PPO can be validly assessed with the IL test. The higher PPO attained with an IL test could be related to better identification of peak power, since both velocity and resistance are free to vary during the sprint in comparison with the WAnT, where resistance is fixed. Owing to the short duration of the sprint (4 s) and high intra-day reliability despite a short recovery time (180 s), the IL test is optimal for repeated measurements of anaerobic performance.

Adult↗
PubMed1979

Tuberculin test conversion during repeated skin testing, associated with sensitivity to nontuberculous mycobacteria.

To determine whether repeating the tuberculin test after a brief interval might result in tuberculin conversion, we tested 213 healthy volunteers twice, 1 month apart, with 5 TU of tuberculin purified protein derivative (PPD). Three nontuberculous mycobacterial antigens (PPD-G, PPD-Y, and PPD-B) were also applied with the first tuberculin test. By widely used criteria, 14 volunteers (6.6 per cent) converted their tuberculin tests from negative to positive on the second testing. Whereas 13 of 103 subjects (12.6 per cent) with nontuberculous antigen sensitivity converted their tuberculin test to positive, only one of 110 subjects (0.9 per cent) with no known prior mycobacterial sensitivity converted to positive (P less than 0.005; x2 = 10.05). When retested with 5 TU of tuberculin PPD 6.5 months after the second test, nine of 13 converters reverted to negative. We conclude that tuberculin conversion may occur when the skin test is repeated at 1 month, and that boosting of cross-reacting mycobacterial sensitivity might have caused a portion of the conversions in this population of young, healthy midwestern volunteers. Sensitivity to Mycobacterium tuberculosis might also be boosted by tuberculin testing. Because the prevalence of sensitization by tuberculous and nontuberculous mycobacteria can be expected to vary in different populations, the significance of tuberculin conversion will also vary with the population being tested.

Adolescent↗
PubMed1978

The status of psychological testing in clinical psychology: relationships between test use and professional activities and orientations.

A survey of clinical psychologists determined that both objective and projective tests were used with high frequency. The two tests clinicians most frequently recommended clinical students learn to administer were projective (the Rorschach and the TAT) and, among the 10 most frequently recommended tests, projective tests were recommended approximately 30% more often than objective tests. Clinicians who were frequent test users recommended both objective and projective tests more often than those not using tests. Clinicians doing substantial teaching and research tended to recommend projective tests less often than clinicians not engaged in those activities. Behavior therapists recommended projective tests less often than eclectic, Freudian, and neo-Freudian therapists.

Humans↗
PubMed2006

Atypical and typical (idiopathic) slipped capital femoral epiphysis. Reconfirmation of the age-weight test and description of the height and age-height tests.

BACKGROUND: The age-weight test was described to aid the clinician in defining demographic predictors of an atypical slipped capital femoral epiphysis. We wished to retest the accuracy and applicability of the age-weight test and height differences in children with atypical and typical slipped capital femoral epiphyses. METHODS: A retrospective review of the records for all children with slipped capital femoral epiphysis from 1998 through 2003 was performed. Gender, race, chronological age, weight, height, the duration of symptoms, and the laterality of the slip were recorded. The slip angle was classified as mild (< 30 degrees), moderate (30 to 50 degrees), or severe (> 50 degrees). Statistical analyses were performed. RESULTS: The study included 105 children (thirty-eight girls and sixty-seven boys) with 141 slipped capital femoral epiphyses; ten children had fifteen atypical slipped capital femoral epiphyses, and ninety-five children had 126 typical slipped capital femoral epiphyses. Sixty-nine children had unilateral involvement, and thirty-six had bilateral involvement. The average age at the time of presentation for the first slipped capital femoral epiphysis was 12.1 +/- 2.0 years. The average duration of symptoms was 3.7 +/- 5.5 months. In the group of 128 slipped capital femoral epiphyses for which the slip angle was known, there were ninety-three mild, twenty-seven moderate, and eight severe slips. The average slip angle was 24 degrees +/- 18 degrees. The age-weight test demonstrated a sensitivity of 50%, a specificity of 89%, a positive predictive value of 33%, and a negative predictive value of 94%. The age-height test, involving the same definition as the age-weight test except that the percentiles apply to height and not weight, demonstrated a sensitivity of 88%, a specificity of 73%, a positive predictive value of 30%, and a negative predictive value of 98%. The height test, which was defined as positive if the child's height was at or below the tenth percentile for age and as negative if it was above the tenth percentile, demonstrated a sensitivity of 75%, a specificity of 97%, a positive predictive value of 75%, and a negative predictive value of 97%. CONCLUSIONS: The present study reaffirmed the accuracy and applicability of the age-weight test for differentiating between typical and atypical slipped capital femoral epiphyses, and it further defined the age-height and height tests. If the height of a child can be obtained, the height test is likely to be most useful for differentiating between typical and atypical slipped capital femoral epiphysis. When height is not known, the age-weight test will result in a similar negative predictive value but with a lower sensitivity, specificity, and positive predictive value. LEVEL OF EVIDENCE: Diagnostic Level I. See Instructions to Authors for a complete description of levels of evidence.

Adolescent↗
PubMed2006

Positive patch test reactions to nickel sulphate are not modified by neighbouring negative fragrance patch tests. A multicenter-study by the German contact dermatitis research group.

It is tacitly assumed that a positive patch test reaction is not affected by adjacent negative tests. However, despite its fundamental importance for the interpretation of test reactions this assumption has not been proven. To test this assumption, special TRUE-test strips were prepared containing placebo, nickel sulphate and fragrance mix as the only allergens, separated by distances of 1 cm and 7 cm and blinded to the investigators. Patients were synchronously tested with two strips. Out of 493 patients tested in 6 centres, the 93 with positive reactions to nickel sulphate only were evaluated. No relevant difference was found between positive nickel reactions in the two different distances to a negative fragrance patch test. We conclude that a positive patch test reaction is not affected by adjacent negative patch tests, which therefore can be neglected for the interpretation of positive reactions.

Allergens↗
PubMed2001

Comparison of immediate intradermal test reactivity with serum IgE quantitation by use of a radioallergosorbent test and two ELISA in horses with and without atopy.

OBJECTIVE: To compare a radioallergosorbent test and 2 ELISA with intradermal testing for the determination of environmental allergen hypersensitivity in horses with and without atopic diseases. DESIGN: Prospective clinical study. ANIMALS: 10 horses with recurrent urticaria, 7 with atopic dermatitis, 16 with chronic obstructive pulmonary disease, and 22 without atopy. PROCEDURE: History, physical examination, hemogram, serum biochemical analyses, bronchoalveolar lavage, and an intradermal test (used as the criterion standard) with a regional panel of 73 allergens were performed in all horses. Serum was analyzed by use of the 3 in vitro assays of allergen-specific IgE. RESULTS: An ELISA based on the alpha chain of the high-affinity IgE receptor, the Fcepsilon receptor immunoglobin epsilon chain (FcepsilonRIalpha) for IgE, had the overall highest kappa statistic (0.238), positive predictive value (49%), and negative predictive value (78%). Overall agreement between the FcepsilonRIalpha-based ELISA and the intradermal test was fair. The highest kappa statistic was obtained by the FcepsilonRIalpha-based ELISA in horses with atopic dermatitis (0.330). Kappa statistics for the radioallergosorbent test and a polyclonal antibody-based ELISA agreed slightly with that of the intradermal test at best. CONCLUSIONS AND CLINICAL RELEVANCE: None of the 3 serum allergy tests reliably detected allergen hypersensitivity, compared with the intradermal test. The FcepsilonRIalpha-based ELISA performed significantly better overall than the other 2 tests. Low sensitivity of all 3 assays indicates the need for continued study to elucidate a more sensitive test for the determination of potentially pathogenic allergens in horses.

Animals↗
PubMed1998

Searching for the meaning of the Category Test and the Wisconsin Card Sort Test: a comparative analysis.

The Category Test (CT) and the Wisconsin Card Sort Test (WCST) have long been the major instruments used for the assessment of "frontal lobe" brain damage. These tests have often been used interchangeably by clinicians. However, research to date has disagreed on the extent to which these tests can be interpreted in a similar manner. The current paper examined the interrelationships between the tests in 112 mixed brain injured clients. The results showed relatively small correlations between the tests in the range of .4 to .6 which were eliminated when age, education, premorbid IQ (Vocabulary) and spatial skills (Block Design) were used as covariates. Regression analyses showed clear differences in which WAIS-R tests predicted each test, while factor analysis revealed little overlap between the tests except for a small relationship between the number of WCST categories completed and CT errors. The CT appeared to reflect spatial and spatial analysis skills while the WCST reflected verbal analysis and sequential skills. The results clearly indicate that the tests are not interchangeable and do not reflect the same underlying cognitive skills nor can they be interpreted in the same manner for neuropsychological purposes.

Adolescent↗
PubMedDate not supplied

The moving Dynamic Random Dot Stereosize test: development, age norms, and comparison with the Frisby, Randot, and Stereo Smile tests.

PURPOSE: To determine the response of infants and children to the Moving Dynamic Random Dot Stereosize (MDRS) test and to collect cross-sectional age-related data. METHODS: Sixty visually normal individuals were divided into four age groups: 0.5-<2, 2-<5, 5-<8, and 8-<20 years. Stereopsis was measured with the MDRS test on two occasions, plus the Frisby, Randot, or Stereo Smile tests, as was age appropriate. RESULTS: All children aged >2 years and 80% of the children between ages 6 months and 2 years were able to perform the MDRS test on at least one occasion. Sixty percent of the 6-month to 2-year-old children were able to perform the Stereo Smile test on both occasions. Performance on the MDRS test improved with age up to 9 years. Improvement on the Frisby and Randot tests was seen in children aged up to 7 years. Mean and 95% confidence interval ranges for each test are given. CONCLUSION: This study gives evidence that aspects of the visual system are not fully mature until age 7-9 years. The MDRS test is a visually demanding but cognitively simple test that shows potential for detecting visual anomalies in young children.

Adolescent↗
PubMed1999

Evaluation and implementation of the gel test for indirect antiglobulin testing in a community hospital laboratory.

BACKGROUND: The gel test, developed by Lapierre in 1984, was designed to standardize antiglobulin testing while improving sensitivity and specificity of the method. PRINCIPLE: Anti-human serum immunoglobulin G (IgG) mixed with Sephadex G100 (gel phase) in a microtube traps red cell-IgG agglutination complexes during migration through the gel in a centrifugation step. Agglutination complexes are visibly detectable at various levels in the microtube as an inverse function of antibody coated on red cells. Unsensitized red cells form a cell pellet at the base of the microtube. OBJECTIVE: To determine if indirect anti-human globulin testing could be standardized and simplified by replacing the tube test with the gel test without compromising quality or increasing costs. SETTING: A medium-sized community hospital. RESULTS: In a blinded retrospective study, we used patient sera (n = 40), which included 10 positive specimens containing 18 known antibodies. Sixteen antibodies were detected and identified with the tube method (1 anti-D and 1 anti-C not detected). By the gel test, 18 antibodies were detected and identified. All negative samples showed 100% concordance. Favorable results were obtained in a nonblinded prospective correlation study (n = 121). Our technologists found the gel test easier to read and more reproducible and reliable than the tube method; they also found increased sensitivity for detecting weakly reacting antibodies. We successfully introduced the gel test into our laboratory as the standard method for indirect antiglobulin testing. Following implementation, improved personnel management was achieved. CONCLUSIONS: The gel test is a reliable and advantageous method and is appropriate for routine use for detection and identification of alloantibodies in a community hospital transfusion service laboratory.

Coombs Test↗
PubMed2001

Method preferences and test accuracy of antimicrobial susceptibility testing: updates from the College of Amercian Pathologists Microbiology Surveys Program.

OBJECTIVE: To summarize the antimicrobial susceptibility testing results from the College of American Pathologists (CAP) Microbiology Surveys Program for 2000. Specifically, the frequency of tests used and the quantitative and qualitative (susceptibility category) accuracy were assessed. DESIGN: The CAP Microbiology Surveys challenged subscribers in 2000 with 3 well-characterized organisms for antimicrobial susceptibility testing in pure culture. Each laboratory was to use the test method and reporting procedures routinely applied to patient samples. The strains were National Committee for Clinical Laboratory Standards (NCCLS) quality control organisms with precisely defined antimicrobial susceptibility patterns and reproducibility. Results reported by participants (2685-2979/sample) were graded for categorical accuracy and quantitative performance by comparing reported minimal inhibitory concentrations (microg/mL) or zone diameters (mm) against quality control ranges published by the NCCLS. The appropriateness of reported drugs was determined in the context of the type and anatomic location of the infection. RESULTS: The tests most often used varied by the species of the organism and growth characteristics of the isolated strains. Nonfastidious, rapid-growing Surveys unknowns (Escherichia coli ATCC 25922, Pseudomonas aeruginosa ATCC 27853) were most often tested with commercial systems (MicroScan, 42.0%-42.4%; Vitek, 41.5%-43.0%) or with the standardized disk diffusion method (12.8%-13.9%). In contrast, fastidious species, such as Streptococcus pneumoniae (ATCC 49619), were predominantly tested by Etest (40.3%), followed by disk diffusion (27.6%) and MicroScan (23.2%). Categorical accuracy was essentially equal between dilution (98.9%) and diffusion (99.0%) methods. Among the minimal inhibitory concentration methods used to test penicillin against S pneumoniae, Etest method quantitative accuracy (96.3%) was greater than that of MicroScan (92.4%). Quantitative accuracy was greatest for dilution minimal inhibitory concentration methods, with more than 90% of results within NCCLS quality control ranges for nearly all reported antimicrobials. Reevaluations of quality control ranges may be needed for 4 to 7 agents, depending on method. Reporting errors were also detected in 2 areas: (1) reporting results for drugs not active at the site of infection and (2) reporting results for drugs tested with suboptimal methods without published NCCLS interpretive criteria. CONCLUSIONS: Antimicrobial susceptibility testing methods used in US laboratories were dominated by commercial products with relatively high accuracy (qualitative and quantitative). As available methods have become better suited to both fastidious and rapid-growing species, reporting errors have assumed a higher level of concern to the CAP Surveys in an effort to minimize prescription errors.

Anti-Bacterial Agents↗
PubMed1999

Predictors of failure to return for HIV test result and counseling by test site type.

The objective of this study was to determine the primary predictors of failure to return (FTR) for HIV test results and counseling by test site type from among those variables collected during the pretest, risk assessment session. The study sample consisted of 366,280 clients tested for HIV antibodies over an 18-month period at publicly funded testing sites throughout California. The FTR rate for the entire sample was 16.4%. The most significant predictor of FTR was the site type at which resting took place, with those testing at sexually transmitted disease clinics four times, and mobile testing clients over three times, more likely to fail to return than alternative test site clients. Independent predictors of FTR differed dramatically across the types of testing sites examined. Implications of these results for devising site-specific counseling strategies to reduce FTR are examined and possible effects on FTR of more rapid testing procedures and home testing are considered. Suggestions for future research are outlined.

AIDS Serodiagnosis↗
PubMedDate not supplied

Helicobacter pylori stool antigen (HpSA) test--a simple, accurate and non-invasive test for detection of Helicobacter pylori infection.

BACKGROUND/AIMS: To access the reliability of a newly developed test, the Helicobacter pylori (H. pylori) stool antigen (HpSA) test was used for detection of H. pylori infection. METHODOLOGY: Stool specimens were collected from 33 consecutive patients (19 males and 14 females, age range: 16-73 years, mean: 49 years) who received upper gastrointestinal endoscopic examination for gastrointestinal symptoms. The H. pylori status was evaluated based on six different tests: culture, histology, biopsy urease test, 13C-urea breath test (13C-UBT), serology, and HpSA test. A commercial kit using an enzyme-linked immunosorbent assay examined HpSA in the stool. H. pylori status was defined as positive when the culture was positive or concordance of three of the other four tests (histology, biopsy urease test, 13C-UBT, and serology) was positive. RESULTS: Twenty patients were diagnosed as H. pylori-positive. The HpSA test was positive in 19 patients and negative in 14 patients. The sensitivity and specificity were 95.0% and 100%, respectively. The overall accuracy rate was 96.3%. CONCLUSIONS: The HpSA test is a new, simple, non-invasive method for accurate diagnosis of H. pylori infection.

Adolescent↗
PubMed2000

Eduard Jaeger's Test-Types (Schrift-Scalen) and the historical development of vision tests.

PURPOSE: Eduard Jaeger's original Test-Types were carefully evaluated: (1) to determine whether Jaeger had maintained a consistent standard, (2) to establish the correct Snellen equivalent for Jaeger's Test-Types, (3) to answer the question of why and how the standard was lost, and (4) to compare the visual angle of optotypes to lines of continuous text. METHODS: All original Viennese editions of Jaeger's Test-Types, as well as first generation United Kingdom (UK) and United States (US) versions, were evaluated. Data were collected objectively using a microruler with a 20X loupe and subjectively using a laser distance-measuring device. The data were analyzed using Microsoft Excel. All previous measurements of Jaeger's Test-Types, objective and subjective, collected over the past 133 years were compared to the current data and to each other. RESULTS: The correct Snellen equivalent of Jaeger's Test-Types was determined. The visual angle created from the measurement of the height of lowercase letters, without ascenders or descenders, provides an accurate method of assigning a visual angle of a line of continuous text. Comparing the typefaces used in printing first generation UK and US versions of Jaeger's Test-Types to the Viennese editions provided an explanation for the absence of a consistent standard for Jaeger's Test-Types today. CONCLUSIONS: All 10 versions of Jaeger's original Test-Types are virtually identical and established a gold standard for reading vision tests. Jaeger's standard was lost when his Test-Types were first printed in the UK and the US using local typefaces. The Jaeger standard has been re-established. Visual angles determined using continuous text are comparable to those obtained by using optotypes.

Austria↗
PubMed2002

[Interpretive compatibility of antimycobacterial susceptibility for Mycobacterium tuberculosis determined by proportion test method on egg-based Ogawa media and broth microdilution test, BrothMIC MTB].

The antimycobacterial susceptibility test method newly proposed by the Japanese Society for Tuberculosis, a proportion method on egg-based Ogawa media, was evaluated in comparison with microdilution test for Mycobacterium tuberculosis complex, BrothMIC MTB-1 (Kyokuto Pharmaceutical Inc., Tokyo). In the evaluation, five antimicrobial agents, streptomycin, ethambutol, kanamycin, isoniazid and rifampicin were included. Through repeated testings of the three reference strains against five antimicrobial agents, both test methods were found to be highly precise. All the minimum inhibitory concentrations (MICs) determined by BrothMIC MTB fell within 3 log2 dilutions, however a total of 11 MICs resulted in indeterminate(I) interpretations. Whereas, all the test results by a proportion method on Ogawa media were comparable to the expected interpretations. However, three of 48 testings resulted in undeterminable interpretations due to insufficient growth on the growth control media. A total of 127 clinical isolates of M. tuberculosis complex were tested by both methods, and 89 to 90% of the test results were comparable with each other in category interpretations. However, 7.1 to 9.4% of MICs determined by BrothMIC MTB resulted in indeterminate(I), and 0.8 to 3.1% of discrepant interpretations were observed. In conclusion, both test methods were highly precise and comparable in determining antimycobacterial susceptibility for M. tuberculosis complex. Several advantages and disadvantages in each test method were discussed.

Antitubercular Agents↗
PubMed2002

Clinical testing of accommodative facility: part II. Development of an amplitude-scaled test.

BACKGROUND: Standard accommodative facility testing, using +/- 2.00 D lenses @ 40 cm, stresses a much different proportion of the available accommodation for a 10-year-old patient with a binocular accommodative amplitude of 12 D and a 35-year-old patient with a binocular amplitude of 5 D. This may explain why research using adult subjects has failed to associate reduced accommodative facility with symptoms. METHODS: For 19 adult subjects with normal age-related amplitudes of accommodation, accommodative facility was measured with the standard test (+/- 2.00 D @ 40 cm) and 36 experimental combinations of test distance demand and lens power range, based on percentages of each individual's amplitude. In a masked study. these results were compared to symptom scores, quantified by a 9-item quality of vision questionnaire. RESULTS: The strongest relation of facility with symptoms was for the 75% distance demand/30% power range (p = 0.0216), with six other combinations also significant. The standard test combination did not significantly differentiate symptomatic from asymptomatic subjects (p = 0.1 515). The combination of the 45% distance demand/30% power range was significantly related to symptom score (p = 0.0315; r = -0.47603). CONCLUSION: Amplitude scaled facility testing provides the same percentage test distance and range of amplitude stimulated for all patients. The 45%/30% test combination differentiates symptomatic from asymptomatic subjects better than the standard test (+/- 2.00 D @ 40 cm) and is the one we suggest for future clinical investigation. Care should be taken when testing symptomatic patients over a long period of time, as they may compensate by relying on a predictor operator during the highly repetitive accommodative facility test, thus achieving a more-rapid response.

Accommodation, Ocular↗