Sensitivity Chart Research Articles

Using evolutionary artificial neural networks in monitoring binary and polytomous logistic profiles

A statistical profile is a relationship between a quality characteristic (a response) and one or more explanatory variables to characterize quality of a process or a product. Monitoring profiles or checking the stability of profiles over time, has been extensively studied under the normal response variable, but it has paid a little attention to the profile with the non-normal response variable denoted by generalized linear models (GLM). Whereas, some of the potential applications of profile monitoring are cases where the response can be modelled using logistic profiles entailing binary, nominal and ordinal models. Also, most of existing control charts in this field have been developed by statistical approach and employing machine learning techniques have been rarely addressed in the related literature. Hence, to implement on-line process monitoring of logistic profiles, a novel artificial neural network (ANN) as a control chart with a heuristic training procedure is proposed in this paper. Performance of the proposed approach is investigated and compared using simulation studies in binary and polytomous models based on average run length (ARL) criterion. Simulation results revealed a good performance of the proposed approach. Nevertheless, to enhance the detection ability of the proposed approach more, the idea of combining run-rule which is a supplementary tool for making more sensitive control chart with final statistic is also implemented in this paper. Furthermore, a diagnostic method with machine learning schemes is employed to identify the shifted parameters in the profile. Results indicate the superior performance of the proposed approaches in most of the simulations. Finally, an example is used to illustrate the implementation of the proposed charting scheme.

The impact of a random vector with variables from normal and non‐normal distributions on multivariate control charts

AbstractMultivariate control charts are widely used to simultaneously monitor several quality characteristics for detecting the mean changes in manufacturing industry processes. A multivariate Shewhart, multivariate exponentially weighted moving average (MEWMA) and multivariate cumulative sum (MCUSUM) are types of multivariate control charts which have been discussed extensively. For those control charts, a multivariate normal distribution is an important assumption that is used to describe a behavior of a set of quality characteristics. However, sometimes the normal assumption is violated. This research explores the sensitivity of an average run length (ARL), the standard deviation of run length (SDRL) and the shape of distribution of run length for multivariate Shewhart, MEWMA, and MCUSUM control charts when the distribution of some quality characteristics (or variables) in a random vector are not normal. The results show how robust or sensitive multivariate control charts are to violations of the multivariate normal assumption.

Test-retest Repeatability of the Ohio Contrast Cards.

The Ohio Contrast Cards are a repeatable test of contrast sensitivity, and they reveal higher contrast sensitivity for low-vision patients than is shown by the Pelli-Robson chart. This study aimed to compare the contrast sensitivity results and test/retest ±limits of agreement for the Ohio Contrast Cards and the Pelli-Robson letter contrast sensitivity chart on two challenging groups of participants, and to compare the Ohio Contrast Card results with grating acuity and the Pelli-Robson results with letter acuity. The Ohio Contrast Card and Pelli-Robson tests were each performed twice by two different examiners within one visit on 40 elder patients in Primary Vision Care (>65 years old) and 23 to 27 low-vision school-aged students. Grating acuity was measured using the Teller Acuity Cards (all participants), and letter acuity was measured using ClearChart (elders) or the Bailey-Lovie chart (students). The ±95% limits of agreement were similar for the Ohio Contrast Cards and the Pelli-Robson chart. The elders' limits of agreement were ±0.27 (Ohio Contrast Cards) and ±0.28 (Pelli-Robson); the students' limits of agreement were ±0.42 (Ohio Contrast Cards) and ±0.51 (Pelli-Robson). However, Ohio Contrast Card results were 0.41 log10 Michelson units more sensitive than the Pelli-Robson chart (over one line on the Pelli-Robson chart) for the elders and 0.90 log10 Michelson units (three lines on the Pelli-Robson chart) more sensitive for the elders (0.11 and 0.6 log10 Weber units, respectively). The Pelli-Robson results were correlated with letter acuities and Ohio Contrast Card results for both groups, and the Ohio Contrast Card results were correlated with Teller Acuity Card acuities for the elders. The Ohio Contrast Cards and Pelli-Robson chart are similarly repeatable. Both contrast sensitivity tests can provide additional clinical information that is not available through visual acuity testing, and Ohio Contrast Card may provide additional information not available from the Pelli-Robson chart.

Enhanced directionally sensitive and directionally invariant MCUSUM and MEWMA charts for process mean

Control charts with an appropriate use of auxiliary information based (AIB) strategies have shown improved run length performances compared with control charts without this feature. In this article, by adopting an AIB estimator, enhanced directionally sensitive and directionally invariant MCUSUM and MEWMA charts for monitoring the mean vector of a process that follows a multivariate normal distribution are proposed. The proposed AIB directionally sensitive and directionally invariant MCUSUM and MEWMA charts surpass their existing basic counterparts, in terms of the average run length (ARL), median run length (MRL) and standard deviation of the run length (SDRL) performances obtained via the Monte Carlo simulation approach. In general, it is found that the directionally sensitive charts outperform their directionally invariant counterparts in detecting shifts in the process mean vector, in terms of the ARL, MRL and SDRL criteria. A real dataset is considered to demonstrate the implementation of the existing and proposed charts.

Association of optical cataract indices with cataract severity and visual function.

The purpose of this study is to determine the correlation between subjective and optical measurements used during cataract evaluation, including the iTrace Dysfunctional Lens Index (DLI), the HD Analyzer Objective Scatter Index (OSI), Lens Opacities Classification System III (LOCS III), Visual Function-14 Questionnaire (VF-14), and the Pelli-Robson Contrast Sensitivity Chart (PRCSC). Seventy eyes from 70 patients were enrolled, including all stages of age-related nuclear cataracts. The LOCS III-NO with a cutoff of 3.2 was chosen to divide the population into two groups. Eyes with corneal or retinal pathology were excluded. All patients were evaluated with the iTrace's DLI, HD Analyzer's OSI, LOCS III, VF-14, and the PRCSC during each follow-up visit. Correlation analyses were performed using Stata software, version 14.0, StataCorp. The LOCS III-NO, DLI, OSI, and VF-14 questionnaire each correlated moderately with the BCVA with a Spearman rho value of 0.37, - 0.45, 0.40, and- 0.35, respectively. The DLI correlated moderately with LOCS III-NO with a rho value of - 0.37 and with the VF-14 questionnaire with a rho value of 0.35. The OSI correlated with both the contrast sensitivity and DLI with a rho value of - 0.35 and - 0.55, respectively. The DLI correlated with cataract symptoms (measured by the VF-14 questionnaire) in addition to BCVA. The OSI correlated moderately with contrast sensitivity and BCVA. The highest correlation was between DLI and OSI.

Optimal designs of the side sensitive synthetic chart for the coefficient of variation based on the median run length and expected median run length.

The side sensitive synthetic chart was proposed to improve the performance of the synthetic chart to monitor shifts in the coefficient of variation (γ), by incorporating the side sensitivity feature where successive non-conforming samples must fall on the same side of the control limits. The existing side sensitive synthetic- γ chart is only evaluated in terms of the average run length (ARL) and expected average run length (EARL). However, the run length distribution is skewed to the right, hence the actual performance of the chart may be frequently different from what is shown by the ARL and EARL. This paper evaluates the entire run length distribution by studying the percentiles of the run length distribution. It is shown that false alarms frequently happen much earlier than the in-control ARL (ARL0), and small shifts are often detected earlier compared to the ARL1. Subsequently, this paper proposes an alternative design based on the median run length (MRL) and expected median run length (EMRL). The optimal design based on the MRL shows smaller out-of-control MRL (MRL1), which shows a quicker detection of the out-of-control condition, compared to the existing design, while the results from the optimal design based on the EMRL is similar to that of the existing designs. Comparisons with the synthetic-γ chart without side sensitivity shows that side sensitivity reduces the median number of samples required to detect a shift and reduces the variability in the run length. Finally, the proposed designs are implemented on an actual industrial example.

Simulating Visibility and Reading Performance in Low Vision.

PurposeLow vision reduces text visibility and causes difficulties in reading. A valid low-vision simulation could be used to evaluate the accessibility of digital text for readers with low vision. We examined the validity of a digital simulation for replicating the text visibility and reading performance of low-vision individuals.MethodsLow-vision visibility was modeled with contrast sensitivity functions (CSFs) with parameters to represent reduced acuity and contrast sensitivity. Digital filtering incorporating these CSFs were applied to digital versions of the Lighthouse Letter Acuity Chart and the Pelli-Robson Contrast Sensitivity Chart. Reading performance (reading acuity, critical print size, and maximum reading speed) was assessed with filtered versions of the MNREAD reading acuity Chart. Thirty-six normally sighted young adults completed chart testing under normal and simulated low-vision conditions. Fifty-eight low-vision subjects (thirty with macular pathology and twenty-eight with non-macular pathology) and fifteen normally sighted older subjects completed chart testing with their habitual viewing. We hypothesized that the performance of the normally sighted young adults under simulated low-vision conditions would match the corresponding performance of actual low-vision subjects.ResultsWhen simulating low-vision conditions with visual acuity better than 1.50 logMAR (Snellen 20/630) and contrast sensitivity better than 0.15 log unit, the simulation adequately reduced the acuity and contrast sensitivity in normally sighted young subjects to the desired low-vision levels. When performing the MNREAD test with simulated low vision, the normally sighted young adults had faster maximum reading speed than both the Non-macular and Macular groups, by an average of 0.07 and 0.12 log word per minute, respectively. However, they adequately replicated the reading acuity as well as the critical print size, up to 2.00 logMAR of both low-vision groups.ConclusionA low-vision simulation based on clinical measures of visual acuity and contrast sensitivity can provide good estimates of reading performance and the accessibility of digital text for a broad range of low-vision conditions.

Visual field defects due to optic nerve drusen in Afro-Caribbean patients: A case series of 16 eyes

Optic Nerve Head Drusen (ONHD) are very rare among black patients but may cause more severe visual defects in these patients. The goal of our study was to describe the frequency of visual field defects secondary to OND in Afro-Caribbean patients and study the characteristics of their physical examination, color vision and contrast sensitivity. We carried out a prospective study at the Martinique university medical center on patients of African descent with ONHD diagnosed on fundus examination and B-scan ultrasonography. All patients received a complete neuro-ophthalmological examination. The primary study endpoint was the frequency of visual field defects. Secondary study endpoints were the results of ETDRS visual acuity, Pelli-Robson contrast sensitivity chart, and 15hue color vision test. Sixteen eyes of 10 patients from 11 to 68 years of age were included. Forteen eyes (87%) had exposed ONHD. Eleven eyes (69%) showed a visual field defect: 9 eyes (69%) had an enlarged blind spot, and 9 eyes (69%) had an arcuate scotoma. 3 eyes (19%) had loss of ETDRS visual acuity, and 12 eyes (75%) showed loss of Pelli-Robson contrast sensitivity. Five eyes (31%) had an abnormal color vision test. This is one of the largest case series of ONHD in Black patients. The frequency of visual field defects was high but comparable to that of studies in other ethnic groups. Larger comparative studies are necessary to confirm these results.

Directionally sensitive weighted adaptive multivariate CUSUM mean charts

AbstractIn many service and manufacturing industries, process monitoring involves multivariate data, instead of univariate data. In these situations, multivariate charts are employed for process monitoring. Very often when the mean vector shifts to an out‐of‐control situation, the exact shift size is unknown; hence, multivariate charts for monitoring a range of the mean shift sizes in the mean vector are adopted. In this paper, directionally sensitive weighted adaptive multivariate CUSUM charts are developed for monitoring a range of the mean shift sizes. Directionally sensitive charts are useful in situations where the aim lies in monitoring either an increasing or a decreasing shift in the mean vector of the quality characteristics of interest. The Monte Carlo simulation is used to compute the run length characteristics in comparing the sensitivities of the proposed and existing multivariate CUSUM charts. In general, the directionally sensitive and weighted adaptive features enhance the sensitivities of the proposed multivariate CUSUM charts in comparison with the existing multivariate CUSUM charts without the adaptive feature or those that are directionally invariant. It is also found that the variable sampling interval feature enhances the sensitivities of the proposed and existing charts as compared to their fixed sampling interval counterparts. The implementation of the proposed charts in detecting upward and downward shifts in the in‐control process mean vector is demonstrated using two different datasets.

On developing sensitive nonparametric mixed control charts with application to manufacturing industry

AbstractControl charts are designed under the normality assumption of the quality characteristic of the process. However, the normality assumption rarely holds in practice. In non‐normal conditions, parametric charts tend to display more false alarm rates and invalid out‐of‐control comparisons. The exponentially weighted moving average chart is a frequently used memory‐type control chart for monitoring the process target that only performs effectively under the smoothing parameter's small choices. This study proposes a nonparametric mixed exponentially weighted moving average‐progressive mean chart based on sign statistic (NPMEPSN) under simple and ranked set sampling schemes to address this said drawback. Normal and non‐normal distributions are included in this study to observe the proposed chart's in‐control behavior and out‐of‐control efficacy. The prominent feature of the proposed schemes is that it works efficiently in detecting small and persistent shifts in the process location corresponding to the given values of the smoothing parameter. The proposed scheme is also tested under the ranked set sampling scheme to enhance the NPMEPSN chart's performance (hereafter named “NPMEPRSN”). The performance of the proposed charts is investigated through simulations using run‐length profiles. The proposed schemes were seen to outperform other alternatives, specifically under the ranked set sampling scheme. A real data‐set related to the diameter of a piston ring is included as a demonstration of the proposal.

Hyperbaric Oxygen Effects on Contrast and Macular Light Sensitivity in Dry Type Age-Related Macular Degeneration Patients

This study was to compare the effectiveness of hyperbaric oxygen therapy (HBOT) on contrast and macular light sensitivity improvement in dry type age-related macular degeneration (AMD) patients. The subjects were eyes that had been diagnosed with dry type AMD which met inclusion criteria. The subjects were divided into two groups. The first group was given antioxidants and HBOT. The second group was given only antioxidants. Contrast and macular light sensitivity test were done using MARS contrast sensitivity chart and Humphrey Field Analyzer-3 for three times, pre-therapy, day-1 and 14 post- therapy. This study found that 25 eyes were included for analysis, 14 subjects in first group, and 11 subjects in second group. Statistical analysis results showed that there were significant increase on contrast sensitivity in intervention group between one-day post-therapy with pre-therapy, P = 0.003 (P <0.05), and between 14-days post-therapy with pre-therapy, P = 0,015 (P <0.05). From pre- and post-analysis, there were no significant difference found on contrast sensitivity in control group and macular light sensitivity in intervention group. In control group, there were significant increase on superotemporal, superonasal, and inferonasal area between one-day post-therapy and pra-therapy with P = 0.004, P = 0.013 and P = 0.008 (P <0.05), respectively, and there was significant decrease on inferonasal area between 14-days post-therapy and one-day post-therapy, P = 0.003 (P <0.05). In conclusion, patients with AMD who were subjected to HBOT achieved improvement in contrast sensitivity in cases considered as having low prognosis. HBOT should be considered as promising intervention for AMD management adjuvant and further research are needed to find optimal dosage.

Tracking Temperature Under Uncertainty Using EWMA-MA Control Chart

In this paper, a new neutrosophic exponentially weighted moving average (NEWMA) control chart based on the moving average statistic is proposed. Stated differently, the NEWMA chart is used to handle uncertain production numbers. Moreover, a NEWMA design is applied with moving average statistic to get a sensitive control chart for the quick detection of any unwanted process variations. The efficacy of the chart is evaluated with the average run lengths that are computed using Monte Carlo simulations. Also, a comparative study has been performed with some existing control charts that use the classical and neutrosophic moving average statistics. The implementation of the proposed control chart has been illustrated with the simulated and temperature datasets. It was found that the proposed chart performs well.

Comprehensive Care Improvement for Oncologic Fever and Neutropenia from a Pediatric Emergency Department.

Rapid time to antibiotics (TTA) for pediatric patients with fever and neutropenia in an emergency department decreases in-hospital mortality. Additionally, national guidelines recommend outpatient antibiotic management strategies for low-risk fever and neutropenia (LRFN). This study had two specific aims: (1) improve the percent of patients with suspected fever and neutropenia who receive antibiotics within 60 minutes of arrival from 55% to 90%, and (2) develop and operationalize a process for outpatient management of LRFN patients by October 2018. Using Lean methodologies, we implemented Plan-Do-Check-Act cycles focused on guideline development, electronic medical record reminders, order-set development, and a LRFN pathway as root causes for improvements. We used statistical process control charts to assess results. The project conducted from July 2016 to October 2018 showed special cause improvement in December 2016 on a G-chart. Monthly Xbar-chart showed improvement in average TTA from 68.5 minutes to 42.5 minutes. A P-chart showed improvement in patients receiving antibiotics within 60 minutes, from 55% to 86.4%. A LRFN guideline and workflow was developed and implemented in October 2017. Implementation of guidelines, electronic medical record reminders, and order sets are useful tools to improve TTA for suspected fever and neutropenia. Utilizing more sensitive statistical process control charts early in projects with fewer patients can help recognize and guide process improvement. The development of workflows for outpatient management of LRFN may be possible, though it requires further study.

GRAFIK PENGENDALI MIXED EXPONENTIALLY WEIGHTED MOVING AVERAGE – CUMULATIVE SUM (MEC) DALAM ANALISIS PENGAWASAN PROSES PRODUKSI (Studi Kasus : Wingko Babat Cap “Moel”)

Quality control is an important role in industry for maintain quality stability. Statistical process control can quickly investigate the occurrence of unforeseen causes or process shifts using control charts. Mixed Exponentially Weighted Moving Average - Cumulative Sum (MEC) control chart is a tool used to monitor and evaluate whether the production process is in control or not. The MEC control chart method is a combination of the Exponentially Weighted Moving Average (EWMA) and Cumulative Sum (CUSUM) charts. Combining the two charts aims to increase the sensitivity of the control chart in detecting out of control. To compare the sensitivity level of the EWMA, CUSUM, and MEC methods, the Average Run Length (ARL) was used. From the comparison of ARL values, the MEC chart is the most sensitive control chart in detecting out of control compared to EWMA and CUSUM charts for small shifts. Keywords: Grafik Pengendali, Exponentially Weighted Moving Average, Cumulative Sum, Mixed EWMA-CUSUM, Average Run Lenght, EWMA, CUSUM, MEC, ARL

Directionally sensitive MCUSUM mean charts

AbstractIn the context of a disease outbreak detection, a prime interest is to only detect increases in the process mean. It is thus desirable to have a directionally sensitive multivariate chart that can effectively detect either increases or decreases in the process mean vector. In this paper, with a suitable transformation that truncates multivariate observations either above or below the process mean vector, we propose one‐sided and two one‐sided MCUSUM charts for monitoring the mean of a multivariate normal process. Among the proposed charts, the one‐sided MCUSUM charts are directionally sensitive, while the two one‐sided MCUSUM charts are directionally insensitive. In addition, the fast initial response feature is also incorporated into the proposed charts to enhance their sensitivities against initial process shifts. The run length characteristics of these control charts are computed with the Monte Carlo simulation. Based on the run length comparisons, it is found that the proposed charts are more sensitive than the existing charts when detecting moderate‐to‐large shifts in the process mean. The proposed charts are also applied on real datasets to support the theory.

EFFECT OF MRIDWEEKADI KASHAYA SEKA IN RETINAL HAEMORRHAGES ASSOCIATED WITH NON-PROLIFERATIVE DIABETIC RETINOPATHY – A CLINICAL STUDY

Diabetic retinopathy (DR) is a leading cause of acquired vision loss in middle-aged and elderly people globally. In modern science, other than the meticulous control of diabetes there is no proven non-invasive management for the prevention or cure of Diabetic retinopathy.
 In this study, mild to moderate Non-proliferative diabetic retinopathy (NPDR) with retinal haemorrhages is considered as a Timira (symptomatically) and as Abhishyanda (considering etiopathogenesis) with Kapha-pitta predominance. Mridweekadi kashaya, predominantly Kapha Pitta samana, was selected for the study to be used as Seka. 
 Method: The study design was Interventional- pre and post evaluation without control, sample size fixed as 30 eyes. Mridweekadi kashaya was used as Seka for 21 days, twice daily. Fundus photographs were taken prior to commencement of Seka, on the 22nd day and then on 30th and 60th day after completion of the procedure. Change in extent of retinal hemorrhages were assessed as visualized in Fundus photographs and direct ophthalmoscopy. Change in visual acuity was assessed by LogMar Visual acuity chart and change in contrast sensitivity by Pelli-Robson contrast sensitivity chart consecutively, prior to the treatment, on the 10th day, 22nd day and then on 30th and 60th day after completion of procedure. Statistical analysis was done using Wilcoxon signed rank test and Paired t test according to the variable.
 Result: Control in retinal haemorrhages associated with NPDR and improvement in visual acuity and contrast sensitivity.
 Conclusion: Mridweekadi kashaya seka is effective in controlling retinal haemorrhages associated with NPDR.

Actual Visual Acuity Demands in the Classroom

Purpose: To address the knowledge gap regarding the actual acuity requirements needed in typical kindergarten through grade 12 classrooms by determining an actual logarithm of the minimum angle of resolution (logMAR) and contrast sensitivity requirements in a sample of classrooms for kindergarten through grade 12 in New York City. Methods: Measurements of classroom dimensions with specific attention to viewing distances were made in public and private school classrooms, at various grade levels from kindergarten through grade 12, in New York City. The dimensions of typical text shown to students on classroom smartboards and whiteboards was measured and the mean and range of logMAR values were calculated for various seating locations within the classrooms. Contrast between text and background was estimated by comparing digital images of actual classroom text to Pelli-Robson contrast sensitivity charts. Results: Fourteen classrooms in five schools were evaluated. Classroom dimensions varied from 8 × 10 feet to 23 × 23 feet. Mean logMAR values of lower case text on smartboards and whiteboards varied from 0.93 ± 0.29 (range: 0.83 to 1.32) in the center of the front row to 0.46 ± 0.21 (range: 0.10 to 0.79) in the center of the back row ( P < .001). Contrast was also variable, being highest for black markers on whiteboards (0.00) and lowest on smartboards (0.15 to 0.60). Neither logMAR nor contrast sensitivity values varied significantly by grade level or school ( P > .50 for both). Conclusions: The data reveal that logMAR demands and contrast vary substantially from classroom to classroom and within a classroom based on room dimensions and seating. Although generally supporting current acuity-based pediatric vision screening referral guidelines, the data also provide insight into the potential impact of reduced visual acuity and seating location on visual performance in the classroom. These findings suggest the need to develop logMAR and contrast standards that optimize visual content in classrooms while accommodating a wider range of visual capabilities. [ J Pediatr Ophthalmol Strabismus . 2021;58(1):48–54.]

Optical analysis of T-shaped stiffened plate under compressive loading using central composite design scheme

The buckling and post-buckling strength of stiffened panels subjected to compressive loads largely depends upon type and dimensions of stiffeners used. The current research investigates the use of T shaped stiffener in vertical configuration in rectangular plate with square opening for improving strength and buckling characteristics. The static structural analysis is conducted using ANSYS FEA software and dimensions of T shaped stiffeners are optimized using Taguchi response surface optimization. The design points are generated using CCD (Central Composite Design) scheme of response surface method and corresponding responses of optimization variables are captured in 3D plots. The sensitivity chart is generated to determine the effect of optimization variables on parameters of interest which are stress, strain, deformation, buckling load and safety factor. The optimization technique has successfully provided set of values for different parameters for which buckling and stresses are minimum and maximum.

Differential Eye Movements and Visual Contrast Acuity in National Collegiate Athletic Association Athletes

Though studies describe postconcussive changes in eye movements, there is a need for data describing baseline eye movements. The purpose of this study was to describe baseline eye movements and visual contrast acuity using the King-Devick (KD) Eye Tracking System and KD Visual Contrast Sensitivity Chart. Fewer total saccades were noted in soccer players than basketball players (soccer, 56.9 ± 14.3; basketball, 101.1 ± 41.3; p = .0005). No significant differences were noted for the number of saccades between sexes (males, 60.4 ± 20.3; females, 84.9 ± 41.8, p = .100) or in contrast acuity between all groups (p > .05). These results suggest the presence of sport-specific trends that may invalidate the comparison of postconcussion evaluation to generic baseline athlete eye movements.

Generational Differences in the 10-year Incidence of Impaired Contrast Sensitivity

ABSTRACT Purpose To determine if incidence of contrast sensitivity (CS) impairment differs by generation and identify factors to explain these differences. Methods The Beaver Dam Eye Study (BDES) and Beaver Dam Offspring Study (BOSS) are cohort studies of aging adults in Beaver Dam, Wisconsin. Baseline examinations occurred from 1993 to 1995 (BDES) and 2005–2008 (BOSS). Follow-up examinations occurred in five-year intervals. CS testing was conducted with Pelli-Robson letter sensitivity charts; Incident impairment was a log CS score <1.55 in either eye at follow-up. Associations of incidence with generation were investigated using estimated hazard ratios (HR) with 95% confidence intervals (CI). Results Participants (N = 3185) had a mean age of 51.9 years at baseline (standard deviation = 9.9) and 51.9% were female. Ten-year cumulative incidence of CS impairment was 40.1%, was higher among women (41.7%) than men (38.8%), and increased by age group. The risk of incident CS impairment decreased by 39% per generation. In multivariable models, the Baby Boom Generation (HR = 0.42, 95%CI = 0.31, 0.58) and Generation X (HR = 0.56, 95%CI = 0.34, 0.91) had a significantly decreased risk of CS impairment compared to the Greatest Generation. Results were similar in sensitivity analyses excluding those with cataract, age-related macular degeneration, or visual acuity impairment. Conclusion The risk of incident CS impairment decreased by birth cohort, with the greatest reduction in the Baby Boom Generation. The difference in risk suggests that there are unknown modifiable risk factors that may help to further explain the etiology of CS impairment and provide potential pathways for prevention in the future.