Surveillance for ocular hypertension: an evidence synthesis and economic evaluation.

Abstract

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Automated imaging technologies for the diagnosis of glaucoma: a comparative diagnostic study for the evaluation of the diagnostic accuracy, performance as triage tests and cost-effectiveness (GATE study)

“…The EQ-5D 3 Level data were obtained from responses from 640 participants with OHT and glaucoma sampled from a secondary glaucoma service. 42 Similar to the study by Burr et al, 42 who suggested that the degree of visual impairment for mild glaucoma is minimal, it was assumed that the score for those individuals in the 'at risk of glaucoma' state would be the same as the score for those with mild glaucoma. Table 47 shows the utility weights used in the model.…”

“…When the referral IOP was used in place of the ophthalmologist's IOP the specificity was reduced. Such an impact is unsurprising given the known variability in IOP measurements 42 and the use of an absolute cut-off will lead to a regression to the mean effect when another measurement is taken (in this case by a different observer). Removing the VA component had very little impact on the diagnostic accuracy with a slight reduction in the sensitivity and corresponding increase in specificity.…”

“…Incidence data and progression data as well as relative rate of progression between treated and untreated individuals were obtained from previous models of glaucoma management and surveillance. 18,42,43 The annual probability of having an eye test was informed by Burr et al, 18 who used data on eye test, sex and age from the British Household Panel Survey 45 to estimate the annual probabilities in different age groups of having an eye test by a community optometrist. We used the average of two probabilities estimated in the report, 0.248 per year for those in the 40-59 years range and 0.3769 per year for those in the 60-75 years age range, to give 0.312 visits per year.…”

Assessing methods to specify the target difference for a randomised controlled trial: DELTA (Difference ELicitation in TriAls) review

“…The optimal mode of measurement may be impractical or even unethical. The most reliable way to measure eye pressure (intraocular pressure) is through manometry; 446 however, this requires invasive eye surgery. Subjecting participants to clinically unnecessary surgery for the purpose of a RCT is clearly not ethical without very strong mitigating circumstances, particularly as an alternative, even if less accurate, way of measuring intraocular pressure exists.…”

Clinical Metabolomics and Glaucoma

“…The individual rate of progression varies considerably between patients, and it is impossible to know which patients will progress faster; therefore, intensive follow-up is advised (according to glaucoma management guidelines) until the rate is known [46][47][48][49][50] . To avoid an unacceptable burden on future health resources, it is important to better stratify patients according to their risk profiles.…”