Combined Contrast Sensitivity, Color Vision and Visual Acuity: Is It Really Good?

read the recent publication on contrast sensitivity, color vision and visual acuity with a great interest.1 Heravian et al. concluded that “The findings also suggest that the appropriate combination of existing tests may be a useful method of improving screening accuracy in diabetic patients1”. I agree that the combination might be a good way to increase the sensitivity of screening. However, it is questionable whether this proposed combination a really good alternative choice. The use of many investigations might increase sensitivity but reduce specificity. This means increased false diagnosis. Although good agreement can be observed the problem in the case with disagreement might be expected. Finally, “Does the slightly increased sensitivity is cost effective for funding?” is the question for discussion.