Identification and Description of Reliable Evidence for 2016 American Academy of Ophthalmology Preferred Practice Pattern Guidelines for Cataract in the Adult Eye

Abstract

IMPORTANCETrustworthy clinical practice guidelines require reliable systematic reviews of the evidence to support recommendations. Since 2016, the American Academy of Ophthalmology (AAO) has partnered with Cochrane Eyes and Vision US Satellite to update their guidelines, the Preferred Practice Patterns (PPP).OBJECTIVE To describe experiences and findings related to identifying reliable systematic reviews that support topics likely to be addressed in the 2016 update of the 2011 AAO PPP guidelines on cataract in the adult eye.DESIGN, SETTING, AND PARTICIPANTS Cross-sectional study. Systematic reviews on the management of cataract were searched for in an established database. Each relevant systematic review was mapped to 1 or more of the 24 management categories listed under the Management section of the table of contents of the 2011 AAO PPP guidelines. Data were extracted to determine the reliability of each systematic review using prespecified criteria, and the reliable systematic reviews were examined to find whether they were referenced in the 2016 AAO PPP guidelines. For comparison, we assessed whether the reliable systematic reviews published before February 2010 the last search date of the 2011 AAO PPP guidelines were referenced in the 2011 AAO PPP guidelines. Cochrane Eyes and Vision US Satellite did not provide systematic reviews to the AAO during the development of the 2011 AAO PPP guidelines.MAIN OUTCOMES AND MEASURES Systematic review reliability was defined by reporting eligibility criteria, performing a comprehensive literature search, assessing methodologic quality of included studies, using appropriate methods for meta-analysis, and basing conclusions on review findings. RESULTSFrom 99 systematic reviews on management of cataract, 46 (46%) were classified as reliable. No evidence that a comprehensive search had been conducted was the most common reason a review was classified as unreliable. All 46 reliable systematic reviews were cited in the 2016 AAO PPP guidelines, and 8 of 15 available reliable reviews (53%) were cited in the 2011 PPP guidelines. CONCLUSIONS AND RELEVANCEThe partnership between Cochrane Eyes and Vision US Satellite and the AAO provides the AAO access to an evidence base of relevant and reliable systematic reviews, thereby supporting robust and efficient clinical practice guidelines development to improve the quality of eye care.

Authorship diversity among systematic reviews in eyes and vision

“…5,[13][14][15] Recruiting and training these authors in Cochrane methods would greatly increase the capacity of Cochrane Eyes and Vision research output and the geographic diversity and representation in Cochrane reviews, as well as improve the overall quality of the evidence for eyes and vision conditions. [6][7][8][9] With regard to gender, we found that both Cochrane and non-Cochrane reviews in the field of eye and vision research had approximately equal representation of gender among first authors who were also the corresponding authors, but that non-Cochrane reviews were less likely to have women than men among authors who had a single role as either first or corresponding author. Our sensitivity analyses There is a substantial amount of literature to support that women are underrepresented in leadership positions in academia.…”

“…5 Details of the generation of this database and its use are reported elsewhere. [6][7][8][9] We selected all Cochrane reviews in the database (n = 313) and randomly selected 313 non-Cochrane intervention reviews from the remaining records in the database. The 313 non-Cochrane reviews were selected using Microsoft Excel's random number function to assign each record a unique identifier and then ordering all records, then selecting the first 313 intervention reviews.…”

Authorship diversity among systematic reviews in eyes and vision

“…14,[27][28][29] Recruiting and training these authors in Cochrane methods would greatly increase the capacity of Cochrane Eyes and Vision research output and the geographic diversity and representation in Cochrane reviews, as well as improve the overall quality of the evidence for eyes and vision conditions. [15][16][17][18] This research is not without limitations, primarily in the method of ascertaining gender and the restriction to rst and corresponding author positions. We used an algorithm which we had previously developed and tested to ascertain the gender of included authors.…”

“…14 Details of the generation of this database and its use are reported elsewhere. [15][16][17][18] We selected all Cochrane reviews of intervention in the database (n = 313) and randomly selected 313 non-Cochrane intervention reviews from the remaining 4,138 records in the database. We selected the 313 non-Cochrane reviews by assigning each record a randomly-generated, unique identi er and selected the rst 313 intervention reviews.…”

Authorship diversity among systematic reviews in eyes and vision

“…We used a database of 4451 systematic reviews in eyes and vision maintained by the Cochrane Eyes and Vision US Satellite (CEV@US) [14]. Details of the generation of this database and its use are reported elsewhere [15][16][17][18]. We selected all Cochrane reviews of intervention in the database (n = 313) and randomly selected 313 non-Cochrane intervention reviews from the remaining 4138 records in the database.…”