Title: “Color Vision Deficiency in Medical Professionals: Prevalence and Impact, Literature Review”
Authors: Joanne Compo, MAMS; James Okubo, MAMS; Christian Pash, MAMS
Introduction
Color vision deficiency (CVD) is prevalent within the general population of men of the world with a prevalence upwards of 8% for red/green color vision deficiency. Medical students and professionals can be diagnosed with red/green color deficiency at an early age, which can interfere with educational and professional success in minor ways. In this literature review, we have reviewed the impact of color deficiency in the healthcare population.
Methods
Physicians and medical students were targeted as the population of study. We compiled journal articles from multiple published journals and summarized results based on statistical and qualitative results. Search criteria included keywords “Color vision deficiency,” “medicine,” “medical students,” and “medical professionals” which were inputted into PubMed, Google Scholar, and Clinical Key databases.
Journal articles were selected based on whether studies were performed on medical students or physicians. Sources that were not specific to the biomedical professional population or were published in a language other than English were excluded.
Results
Common difficulties shown by physicians and medical students with CVD are difficulties diagnosing many dermatology and color-dependent diagnoses. Prominent examples are jaundice, pallor, and cyanosis rashes. Medical students in a large cross-sectional study have shown that histopathologists have a lower mean score than their colleagues in being able to tell normal from pathological features in projecting micrographs. CVD prevalence in medical students/professionals is comparable to the approximated national average in the U.S. We have found there is an impact on how physicians alter their work and how medical students adjust to learning disadvantages with their color vision deficiency.
We found a few institutions’ recommendations on how to address CVD within the medical professional population. These recommendations included adjusting the color of laser pointers, providing high quality gray scale images alongside microscope images, and coaching around strategies for recognizing clinical indicators.
Discussion
General medical students and practitioners with CVD face more difficulties in their practice in determining clinical signs or impressions from physical exams or labs. Medical schools can benefit from facilitating students with CVD to make diagnoses beyond color-dependent symptoms. Interventions are recommended for physicians and medical students alike to overcome their CVD.
Very interesting topic – thanks for the presentation! As a judge reviewing this project, I was wondering why 2 of the 18 articles that included an analysis of gender didn’t find CVD more common in males. I also was wondering if you found any information comparing issues medical professionals have if they have red-green CVD versus blue-yellow CVD.
Thank you for your questions, Dr. Rhodes. For one of the articles that included analysis of gender and didn’t find CVD more common in males, the subject population had a significantly higher female population compared to males (1250 females versus 750 males). The CVD prevalence across the subject population was found to be 18 males and 56 females. The authors commented that this prevalence doesn’t match that of other studies found, though we speculate that the skewed population demographics for gender have a role to play in that.
The 2nd article that included analysis of gender and didn’t find CVD more common in males had a similar issue, though not to a significant degree (123 female subjects and 111 male subjects). Only 3 males and 10 females of the total subject population had CVD. The authors speculate that the reason for this prevalence ratio is due to the fact that they did not differentiate between acquired and congenital color deficiency. Males have a significantly higher likelihood of having congenital CVD than females, as it is an X-linked recessive disorder. However, both males and females have an equal incidence of acquired CVD, as it is not an inherited deficiency.
The second question comparing issues medical professionals face between red-green CVD and blue-yellow CVD is a topic that needs more research. Blue-yellow CVD is referred to as tritanopia and tritanomaly (milder version) and is not a sex-linked trait, meaning that both men and women are equally affected. Blue-yellow CVD is much rarer than red-green CVD, which gives plausible reason as to why the articles reviewed did not differentiate between the different types of CVD.
Thanks you for your presentation. As a judge, I am very curious if any of the articles discussed coping strategies and if these helped medical professionals and students in their work.
Thank you for your question Dr. Habecker. Many of the articles we reviewed highlighted recommendations and strategies for students and medical professionals in their discussions and conclusions. The most frequent recommendation given by the articles was for students and doctors to learn color-independent cues in their observations and physical examinations to avoid an error. An example of this would be focusing on the shapes, sizes, and densities of a specimen when viewing a stained slide. A review article mentioned Michigan State University, and how they utilize computer monitors adjusted to grayscale, as well as grayscale copies of color photomicrographs of histology slides for students with CVD, which has helped those students.
Another common recommendation given by some of the articles was for doctors to collaborate with their medical peers on physical examination and imaging findings. One article mentioned a survey given to pathologists and doctors with CVD and how one of the doctors relies on one of his nurses to mark out areas of redness in samples, skin, eardrums, etc.
Though many articles suggested certain recommendations for overcoming CVD in the workplace and in school, we did not find many that indicated outcomes as a result of implementing those recommendations.
This is very interesting. As a judge, I have a question. At the end of the presentation you suggest intervention approaches for those with CVD. What was the basis for your recommendations? The term ‘intervention’ does not appear to be part of the search criteria and so it is unclear if these recommendations come from the literature reviewed or other sources.
Thank you for your question, Dr. Fritz. You are correct in that the term “intervention” was not used in our search criteria in researching the prevalence and impact of CVD in medical professionals and medical students. Many of the articles we reviewed highlighted recommendations and strategies to help students and professionals to mitigate the impact CVD has on their work and learning. The culmination of the recommendations is in Table 2 in our presentation. The basis of our recommendations comes from the articles reviewed, as many of the articles indicated that screening and strategies to mitigate the impact of CVD are advised.