Development and Validation of a Web-Based Reading Test for Normal and Low Vision Patients

Abstract

Purpose

To develop and validate a web-based reading test for normal and low vision patients.

Methods

This is a prospective, comparative trial. The web-based Democritus Digital Acuity Reading Test (wDDART) was developed. wDDART introduces a series of advanced characteristics (advanced text calibration, computer-vision-based estimation of patient’s distance, and automatic calculation of patient’s reading times) that facilitate the overall examination procedure. wDDART’s reading parameters [reading acuity (RA), maximum reading speed (MRS), critical print size (CPS) and reading accessibility index (ACC)] were compared to the corresponding ones of its conventional Windows-based reading test (DDART) in a sample of normal and low vision participants. wDDART’s test–retest reliability for all reading parameters was evaluated in a 15-day time-window.

Results

One hundred patients (normal vision group-NVG: 70; low vision group-LVG: 30 patients) responded to DDART and wDDART. Non-significant differences between the two reading tests were found for all parameters in NVG and LVG. Intraclass correlation coefficients (ICCs) between the two tests demonstrated good or excellent correlation for RA, MRS, ACC and moderate correlation for CPS. Test–retest reliability was excellent for RA and ACC, while ICCs were 0.715–0.895 for MRS and CPS.

Conclusion

The wDDART demonstrated sufficient validity and repeatability making it suitable for clinical and research settings.

Clinicaltrials.gov Identifier

NCT04618224.

Keywords:

• presbyopia
• reading speed
• critical print size
• reading acuity
• computer vision distance estimation
• automatic reading timing
• internet
• reading

Data Sharing Statement

wDDART can be accessed at the Democritus University main server (https://ddart.med.duth.gr).

The authors intend to share deidentified participant data including study information leaflets and written consent forms for at least one year after the manuscript publication, acceptable in print form. The data are available upon request (email: [email protected]). All relevant data are in Greek.

Written Informed Consent

Written informed consent has been obtained for the full-face images of Figures 4 and 7.

Author Contributions

GL was responsible for the conception, the design and the supervision of the study, and contributed to the data analysis, data interpretation, drafting and critical revision of the manuscript for important intellectual content. EKP contributed to the conception and design, data acquisition, analysis and interpretation, made the statistical analysis, as well as contributed to the writing and critical revision of the manuscript. ED was the basic developer of the web application (wDDART) and contributed to the conception and design, data analysis and critical revision of the manuscript. MT contributed to the development of wDDART application, conception and design, data analysis and critical revision of the manuscript. AP and AK contributed to the conception and design, clinical data acquisition, data analysis and critical revision of the manuscript. KD supervised the development of wDDART application and contributed to the conception and design, data analysis, data interpretation, drafting and critical revision of the manuscript. In general, all authors made substantial contributions to conception and design, acquisition of data, or data analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; agreed to submit to the current journal; gave final approval of the version to be published; and agreed to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.