Development and Diagnostic Accuracy of a Novel Screening Tool for Early Detection of Pediatric Visual Impairment in Indonesian School-Aged Children
Penulis:Â Lukmana, Arya Ananda Indrajaya;Â Rahayu, Tri;Â Darusman, Kianti Raisa;Â Basrowi, Ray Wagiu;Â Moeloek, Nila Djuwita F.
Informasi
JurnalHealthcare (Switzerland)
PenerbitMultidisciplinary Digital Publishing Institute (MDPI)
Volume & EdisiVol. 14,Edisi 9
Halaman -
Tahun Publikasi2026
ISSN22279032
Jenis SumberScopus
Abstrak
Background/Objectives: Uncorrected refractive errors (UREs) are a primary cause of preventable visual impairment in children globally, impacting education and quality of life. In Jakarta, prevalence has surged to 40% post-pandemic, categorizing it as a serious public health problem. This study aimed to develop and validate the CIPSEL questionnaire as a rapid, culturally adapted screening tool for identifying visual impairment consistent with possible UREs among Indonesian school-aged children. Methods: A cross-sectional study was conducted in South Jakarta with 131 students aged 8–12 years. The 10-item CIPSEL questionnaire, exploring visual behaviors and symptoms, was administered via face-to-face interviews. Visual acuity was assessed using a standard Snellen chart by medical personnel blinded to the questionnaire results. Diagnostic accuracy was assessed using receiver operating characteristic (ROC) curve analysis, with optimal thresholds determined via the Youden Index and the shortest distance to (0, 1). Results: Visual impairment was identified in 26 students (19.8%). Mean CIPSEL scores were significantly higher in students with visual impairment (4.73) compared to those with normal vision (1.95). ROC analysis showed considerable diagnostic accuracy with an AUC of 0.887 (95% CI: 0.829–0.946). A safety-first cutoff of 2.5 prioritized sensitivity (96.2%), while a balanced cutoff of 3.5 provided 80.8% sensitivity and 79.0% specificity. A tiered risk system (Low, Medium, and High) demonstrated a robust statistical association with actual clinical findings (Cramer’s V = 0.534, p < 0.001). Conclusions: CIPSEL is a reliable and scalable screening tool for the early detection of visual impairment in Indonesian children. Its tiered risk stratification framework facilitates nuanced clinical decision-making and efficient resource allocation in school-based settings. Its accessibility for non-medical personnel and potential for digital integration support national efforts toward universal eye health. © 2026 by the authors.
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