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1 General aspects (0)   1.1 Epidemiology (10)   1.2 Population genetics (1)   1.3 Pathogenesis (9)   1.4 Quality of life (20)   1.5 Glaucomas as cause of blindness (11)   1.6 Prevention and screening (14) 2 Anatomical structures in glaucoma (0)   2.1 Conjunctiva (8)   2.2 Cornea (39)   2.3 Sclera (17)   2.4 Anterior chamber angle (13)   2.5 Meshwork (0)     2.5.1 Trabecular meshwork (16)     2.5.2 Schlemms canal (13)     2.5.3 Scleral outlet channels (2)   2.6 Aqueous humor dynamics (0)     2.6.1 Production (1)     2.6.2 Outflow (1)       2.6.2.1 Trabecular meshwork (7)       2.6.2.2 Uveoscleral (1)     2.6.3 Compostion (7)   2.7 Episcleral veins and venous pressure (0)   2.8 Iris (8)   2.9 Ciliary body (2)   2.10 Lens (2)   2.11 Vitreous body (1)   2.12 Choroid, peripapillary choroid, peripapillary atrophy (9)   2.13 Retina and retinal nerve fibre layer (69)   2.14 Optic disc (37)   2.15 Optic nerve (3)   2.16 Chiasma and retrochiasmal central nervous system (14)   2.17 Stem cells (8)   2.20 Other (0) 3 Laboratory methods (0)   3.1 Microscopy (1)   3.2 Electron microscopy (2)   3.3 Immunohistochemistry (2)   3.4 Molecular genetics (0)     3.4.1 Linkage studies (1)     3.4.2 Gene studies (60)   3.5 Molecular biology incl. SiRNA (23)   3.6 Cellular biology (64)   3.7 Biochemistry (18)   3.8 Pharmacology (20)   3.9 Pathophysiology (10)   3.10 Immunobiology (12)   3.11 Pharmacogenetics (0)   3.12 Proteomics (2)   3.13 In vivo imaging (0)     3.13.1 Laser Scanning (0)       3.13.1.1 Confocal Scanning Laser Ophthalmoscopy (0)       3.13.1.2 Confocal Scanning Laser Polarimetry (0)     3.13.2 Optical Coherence Tomography (0)       3.13.2.1 Anterior Segment (0)       3.13.2.2 Posterior Segment (0)     3.13.3 RGC Imaging (4)     3.13.4 Other (0)   3.20 Other (0) 4 Tissue culture of ocular cells (0) 5 Experimental glaucoma; animal models (0)   5.1 Rodent (42)   5.2 Primates (5)   5.3 Other (14) 6 Clinical examination methods (0)   6.1 Intraocular pressure measurement; factors affecting IOP (0)     6.1.1 Devices, techniques (17)     6.1.2 Fluctuation, circadian rhythms (15)     6.1.3 Factors affecting IOP (20)   6.2 Tonography, aqueous flow measurement (see also 2.6) (0)   6.3 Biomicroscopy (slitlamp) (0) 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  6.30 Other (6) 8 Refractive errors in relation to glaucoma (0)   8.1 Myopia (6)   8.2 Hypermetropia (0)   8.3 Contact lenses (0)   8.4 Refractive surgical procedures (2)   8.5 Other (0) 9 Clinical forms of glaucomas (0)   9.1 Developmental glaucomas (0)     9.1.1 Congenital glaucoma, Buphthalmos (19)     9.1.2 Juvenile glaucoma (20)     9.1.3 Syndromes of Axenfeld, Rieger, Peters, aniridia (2)     9.1.4 Other (1)   9.2 Primary open angle glaucomas (0)     9.2.1 Ocular hypertension (6)     9.2.2 Other risk factors for glaucoma (12)     9.2.3 Open angle glaucoma with elevated IOP (5)     9.2.4 Normal pressure glaucoma (28)   9.3 Primary angle closure glaucomas (0)     9.3.1 Acute primary angle closure glaucoma (pupillary block) (20)     9.3.2 Chronic primary angle closure glaucoma (pupillary block) (9)     9.3.3 Plateau iris syndrome (2)     9.3.4 Primary angle closure suspect (2)     9.3.5 Primary angle closure (8)     9.3.10 Other (1)   9.4 Glaucomas associated with other ocular and systemic disorders (0)     9.4.1 Steroid-induced glaucoma (13)     9.4.2 Glaucomas associated with disorders of the cornea, conjunctiva, sclera (0)       9.4.2.1 Iridocorneal endothelial syndrome (ICE, incl. irisatrophy) (0)       9.4.2.2 Posterior polymorphous dystrophy (0)       9.4.2.3 Fuchs' endothelial dystrophy (1)       9.4.2.5 Other (0)     9.4.3 Glaucomas associated with disorders of the iris and ciliary body (0)       9.4.3.1 Pigmentary glaucoma (2)       9.4.3.5 Other (1)     9.4.4 Glaucomas associated with disorders of the lens (0)       9.4.4.1 Exfoliation syndrome (38)       9.4.4.2 Glaucomas associated with cataracts (5)       9.4.4.3 Glaucomas associated with lens dislocation (3)       9.4.4.5 Other (2)     9.4.5 Glaucomas associated with disorders of the retina, choroid and vitreous (0)       9.4.5.1 Neovascular glaucoma (12)       9.4.5.5 Other (9)     9.4.6 Glaucomas associated with inflammation, uveitis (14)     9.4.7 Glaucomas associated with ocular trauma (3)     9.4.8 Glaucomas associated with intraocular tumors (8)     9.4.9 Glaucomas associated with elevated episcleral venous pressure (0)       9.4.10 Glaucomas associated with hemorrhage (4)     9.4.11 Glaucomas following intraocular surgery (0)       9.4.11.1 Ciliary block (malignant) glaucoma (2)       9.4.11.2 Glaucomas in aphakia and pseudophakia (12)       9.4.11.3 Epithelial, fibrous, and endothelial proliferation (0)       9.4.11.4 Glaucomas associated with corneal surgery (18)       9.4.11.5 Glaucomas associated with vitreoretinal surgery (5)     9.4.15 Glaucoma in relation to systemic disease (72)     9.4.20 Other (0) 10 Differential diagnosis e.g. anterior and posterior ischemic optic neuropathy (9) 11 Medical treatment (0)   11.1 General management, indication (2)   11.2 Cholinergic drugs (0)   11.3 Adrenergic drugs (0)     11.3.1 Epinephrine (0)     11.3.2 Thymoxamine, dapiprazole (0)     11.3.3 Apraclonidine, brimonidine (7)     11.3.4 Betablocker (6)     11.3.5 Other (0)   11.4 Prostaglandins (26)   11.5 Carbonic anhydrase inhibitors (0)     11.5.1 Systemic (2)     11.5.2 Topical (8)   11.6 Osmotic treatment (0)   11.7 Treatment of bloodflow (0)   11.8 Neuroprotection (59)   11.9 Gene therapy (1)   11.13 Combination therapy (1)     11.13.1 Betablocker and pilocarpine (0)     11.13.2 Betablocker and carbon anhydrase inhibitor (4)     11.13.3 Betablocker and brimonidine (2)     11.13.4 Betablocker and prostaglandin (9)     11.13.5 Other (4)   11.14 Investigational drugs; pharmacological experiments (23)   11.15 Other drugs in relation to glaucoma (24)   11.16 Vehicles, delivery systems, pharmacokinetics, formulation (21)   11.17 Cooperation with medical therapy e.g. persistency, compliance, adherence (6)   11.20 Other (1) 12 Surgical treatment (0)   12.1 General management, indication (2)   12.2 Laser iridotomy (5)   12.3 Laser iridoplasty (0)   12.4 Laser trabeculoplasty and other laser treatment of the angle (11)   12.7 Surgical iridectomy (0)   12.8 Filtering surgery (0)     12.8.1 Without tube implant (17)     12.8.2 With tube implant or other drainage devices (44)     12.8.3 Non-perforating (6)     12.8.4 Using laser (1)     12.8.5 Other (1)     12.8.10 Woundhealing antifibrosis (18)     12.8.11 Complications, endophthalmitis (16)   12.9 Trabeculotomy, goniotomy (18)   12.10 Cyclodestruction (8)   12.11 Cyclodialysis (1)   12.12 Cataract extraction (0)     12.12.1 Intracapsular (0)     12.12.2 Extracapsular (0)     12.12.3 Phacoemulsification (9)   12.14 Combined cataract extraction and glaucoma surgery (0)     12.14.1 Intracapsular (0)     12.14.2 Extracapsular (0)     12.14.3 Phacoemulsification (11)   12.15 Capsulotomy (1)   12.16 Vitrectomy (2)   12.17 Anesthesia (1)   12.20 Other (3) 13 Therapeutic prognosis and outcome (0)   13.1 Prognostic factors (4)   13.2 Outcome (0)     13.2.1 IOP (1)     13.2.2 Visual field (0)       13.2.2.1 Progression (0)       13.2.2.2 Improvement (1)     13.2.3 Other (2) 14 Costing studies; pharmacoeconomics (10) 15 Miscellaneous (25)

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Abstract #59383 Published in IGR 16-3

Outcomes in Cochrane systematic reviews addressing four common eye conditions: an evaluation of completeness and comparability

Saldanha IJ; Dickersin K; Wang X; Li T
PLoS ONE 2014; 9: e109400

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INTRODUCTION: Choice of outcomes is critical for clinical trialists and systematic reviewers. It is currently unclear how systematic reviewers choose and pre-specify outcomes for systematic reviews. Our objective was to assess the completeness of pre-specification and comparability of outcomes in all Cochrane reviews addressing four common eye conditions. METHODS: We examined protocols for all Cochrane reviews as of June 2013 that addressed glaucoma, cataract, age-related macular degeneration (AMD), and diabetic retinopathy (DR). We assessed completeness and comparability for each outcome that was named in ≥ 25% of protocols on those topics. We defined a completely-specified outcome as including information about five elements: domain, specific measurement, specific metric, method of aggregation, and time-points. For each domain, we assessed comparability in how individual elements were specified across protocols. RESULTS: We identified 57 protocols addressing glaucoma (22), cataract (16), AMD (15), and DR (4). We assessed completeness and comparability for five outcome domains: quality-of-life, visual acuity, intraocular pressure, disease progression, and contrast sensitivity. Overall, these five outcome domains appeared 145 times (instances). Only 15/145 instances (10.3%) were completely specified (all five elements) (median = three elements per outcome). Primary outcomes were more completely specified than non-primary (median = four versus two elements). Quality-of-life was least completely specified (median = one element). Due to largely incomplete outcome pre-specification, conclusive assessment of comparability in outcome usage across the various protocols per condition was not possible. DISCUSSION: Outcome pre-specification was largely incomplete; we encourage systematic reviewers to consider all five elements. This will indicate the importance of complete specification to clinical trialists, on whose work systematic reviewers depend, and will indirectly encourage comparable outcome choice to reviewers undertaking related research questions. Complete pre-specification could improve efficiency and reduce bias in data abstraction and analysis during a systematic review. Ultimately, more completely specified and comparable outcomes could make systematic reviews more useful to decision-makers.

Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.

Full article

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Classification:

15 Miscellaneous
13.2.3 Other (Part of: 13 Therapeutic prognosis and outcome > 13.2 Outcome)

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