Diagnostic performance of color vision tests for color vision deficiency: a network meta-analysis on comparisons of multiple color vision tests

PurposeThis network meta-analysis (NMA) was done to compare the performance of color vision tests in the detection of individuals with color vision deficiency (CVD).MethodsMedline (via PubMed), Embase, and Web of Science were comprehensively searched from inception of the databases to 17 January, 2023. Conventional meta-analysis of diagnostic indicators was performed. The superiority of a diagnostic approach was depicted using the Superiority (S) Index.ResultsSix studies were enrolled. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the curve of summary receiver operating characteristic of the Ishihara tests were 0.89 (0.81, 0.94), 0.99 (0.96, 1.00), 110.8 (18.1, 677.0), 0.10 (0.05, 0.20), 1105 (112, 10,930), and 0.98 (0.96, 0.99). Waggoner Computerized Color Vision Test ranked the best performance in the detection of CVD, followed by CAD test, Ishihara test, Fletcher Lantern test, and HHR test as the rest second to the fifth most effective modalities.ConclusionThis NMA revealed that CAD test, Ishihara test, Fletcher Lantern test, and HHR test had favorable diagnostic validity in the detection of CVD.