Village-Integrated Eye Worker Trial II - Pilot (VIEW II Pilot)
The vast majority of blindness is avoidable. The World Health Organization (WHO) estimates that 80% of cases of visual impairment could be prevented or reversed with early diagnosis and treatment. The leading causes of visual impairment are cataract and refractive error, followed by glaucoma, age-related macular degeneration (AMD), and diabetic retinopathy (DR). Loss of vision from these conditions is not inevitable; however, identifying at-risk cases and linking cases with appropriate care remain significant challenges.
Eye health care systems must determine optimal strategies for reaching people outside of their immediate orbit in order to reduce visual impairment. Visual impairment can be reduced by case detection of prevalent disease like cataract and refractive error, or by screening for early disease like glaucoma, AMD, and DR and preventing progression. Systems around the world have developed numerous approaches to both case detection and screening but there is very little research to support the choice of allocating resources to case detection or screening and little data exists on the cost effectiveness of the various approaches to each.
VIEW II Pilot is a cluster-randomized trial to determine the effectiveness of different approaches to community-based case detection and screening for ocular disease. Communities will be randomized to one of four arms: 1) a comprehensive ocular screening program, 2) a cataract camp-based program, 3) a community health worker-based program, and 4) no program.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Specific Aim 1: to determine whether screening leads to increased visual acuity compared to the cataract camp approach.
Specific Aim 2: to determine whether a community health volunteer program increases the rate of cataract surgery compared to a no program.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Chitwan
-
Bharatpur, Chitwan, Nepal
- Bharatpur Eye Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria(community-level):
- Wards in the Chitwan and Nawalparasi districts that participated in the VIEW trial and have not received a cataract camp in the past 6 months.
Inclusion Criteria (individual-level):
- Individuals aged 50 and older will be eligible to participate in the screening program, cataract camp programs, and the FCHV program
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
No Intervention: No intervention
|
|
|
Active Comparator: Community-based screening
|
In communities randomized to receive the screening program, all adults aged 50 and older will be eligible to receive screening for ocular disease.
Screening assessments include visual acuity, refraction, intra-ocular pressure, fundus photography, and anterior segment photography.
Participants meeting criteria for referral based on screening assessments will be referred to the nearest eye care center or eye hospital for further evaluation.
|
|
Active Comparator: Cataract camp program
|
In communities randomized to receive the cataract camp program, all adults aged 50 and older will be eligible to participate in a routine cataract camp run by Bharatpur Eye Hospital.
Trained ophthalmic personnel and assistants will perform case detection for cataract via visual acuity, pen light exam, and indirect ophthalmoscope exam per Bharatpur Eye Hospital's standard cataract camp program.
Participants with cataracts will be referred to the nearest eye care center or eye hospital for further evaluation.
|
|
Active Comparator: Community health worker program
|
In communities randomized to receive the community health worker program, all adults aged 50 and older will be eligible to participate.
Existing community health workers will be trained to perform case detection for cataract via visual acuity assessment.
Participants with cataracts will be referred to the nearest eye care center or eye hospital for further evaluation.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Visual acuity
Time Frame: 1 year
|
Primary outcome for specific aim 1, comparison between screening and case detection arms
|
1 year
|
|
Cataract surgical rate
Time Frame: 1 year
|
Primary outcome for specific aim 2, comparison between community health worker program and no program arms
|
1 year
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Cost-effectiveness
Time Frame: 1 year
|
Cost-effectiveness of all 4 arms will be assessed
|
1 year
|
|
Visual acuity
Time Frame: 1 year
|
Visual acuity of population 50 years and older in all arms will be compared
|
1 year
|
|
Number of cases of ocular disease detected
Time Frame: 1 year
|
Number of cases of ocular disease in the screening and case detection arms will be compared
|
1 year
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Jeremy D Keenan, MD, MPH, University of California, San Francisco
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 17-22776
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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