{"doi":"10.1167/iovs.66.1.4","title":"Validating Rules for Defining No Improvement of Visual Acuity in Childhood Amblyopia","abstract":"Purpose: When treating amblyopia, it is important to define when visual acuity (VA) is no longer improving (i.e., stable) because treatment decisions may be altered based on this determination. Methods: Simulated observed VAs, incorporating measurement error, were compared with simulated true VAs to determine false-positive and false-negative rates for stable VA for six rules (using single VA or test/retest measurements, with or without averaging, over two or three visits). Four HOTV VA profiles were modeled: stable or improving VA over time with each of patching and spectacles. Results: Across six rules and two treatments, when true VA was stable, false-negative rates for stability ranged from 26% to 67%; when true VA was improving, false-positive rates for stability ranged from 0% to 38%. Single VA measurements at consecutive visits had a false-negative rate of 30% with patching and 29% with spectacles, a false-positive rate of 38% with patching and 35% with spectacles. Averaging two VA tests at each visit slightly increased the false-negative rate (35% with patching and 36% with spectacles), while reducing the false-positive rate (22% with patching and 21% with spectacles). Conclusions: Comparing false-negative and false-positive rates for stability across rules allows selection of the most appropriate rule for clinical practice or research. When considering less desirable treatments, a rule with a lower false-negative rate is preferable, whereas a rule with a lower false-positive rate would be preferred when it is important to correctly classify improving VA.","journal":"Investigative Ophthalmology & Visual Science","year":2025,"id":551010,"datarank":0.10397207708399181,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"self_citation_contribution":0.10397207708399181,"citation_network_contribution":0.0,"self_endowment_contribution":0.10397207708399181,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9615,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":452919,"name":"Ruth E. Manny","orcid":"0009-0000-6714-4859","position":1,"is_corresponding":false},{"id":383593,"name":"Jonathan M. Holmes","orcid":"0000-0002-7663-2034","position":2,"is_corresponding":false},{"id":384447,"name":"B. Michele Melia","orcid":null,"position":3,"is_corresponding":false},{"id":450846,"name":"Zhuokai Li","orcid":"0000-0001-7612-6265","position":4,"is_corresponding":false},{"id":383594,"name":"David K. Wallace","orcid":"0000-0002-1564-9027","position":5,"is_corresponding":false},{"id":384887,"name":"Eileen E. Birch","orcid":"0000-0001-8279-3291","position":6,"is_corresponding":false},{"id":383596,"name":"Raymond T. Kraker","orcid":"0000-0002-6606-8230","position":7,"is_corresponding":false},{"id":360628,"name":"Susan A. Cotter","orcid":"0000-0002-8402-0521","position":8,"is_corresponding":false},{"id":1446870,"name":"on behalf of the Pediatric Eye Disease Investigator Group","orcid":null,"position":9,"is_corresponding":false},{"id":383595,"name":"Rui Wu","orcid":"0000-0001-8883-5878","position":0,"is_corresponding":true}],"reference_count":12,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:54:20.915388Z","pmid":"39745678","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}