advertisement

---

Editorial IGR 5-3

Dear Reader,

This issue of IGR is special because it contains the reports and statements of the Global WGA Consensus Meeting on 'Structure and Function in the Management of Glaucoma'. This Consensus Meeting is the first in a series of meetings that the WGA plans to organize on topics in glaucoma where a consensus is badly needed. As Paul Lee states in his report: "Consensus is important in medical care 1) to delineate diagnostic criteria and staging severity of disease and 2) to provide guidance on how best to monitor and treat a disease. The quality and nature of consensus will improve over time, moving from expert opinion to evidence-based assessments." Given the tremendous activity in glaucoma research, particularly on this first consensus topic, it is expected that updating and upgrading of the consensus statements will be possible within a relatively short period. The bullet-point summaries and statements printed in this issue of IGR present a quick overview of the results of the Consensus Meeting. The reader is wholeheartedly advised to read the full reports that will soon appear in a special book (click here for more information). These reports are excellent updates on the daily practice of diagnosing glaucoma.

More on WGA

The first meeting of the WGA Glaucoma Patient Organization Liaison Committee will take place in October 2004 in New Orleans. Representatives of glaucoma patient organizations from all over the world will discuss topics of interest to both glaucoma patients and glaucoma experts.

Status of WGA reports:

• Code of Practice: available on www.GlobalAIGS.org

• Guidelines on Reporting and Publishing: revision by all WGA parties involved

• Guidelines on Quality and Quantity of Glaucoma Meetings: revision by all WGA parties involved
  

The WGA will organize its first WORLD GLAUCOMA CONGRESS in Vienna, Austria on July 6-9, 2005. See inside back cover and www.worldglaucoma.org , and make a note in your agenda.

On the Qualities of Reviewers

In their first introductory 'perspective' editorial (American Journal of Ophthalmology 2003; 136: 109) Liesegang and friends (editors of major ophthalmology journals) cite the profile of a good reviewer: time spent on the review (three hours!), younger age (sic!), academic, editor's friend (!). Masking of the authors of papers to be reviewed seems to help but is rarely done, and reviewers usually recognize the authors anyway. Furthermore, the authors write, there is no way round reviewer or editor bias.
IGR acknowledges its excellent reviewers. Even though not all of them may qualify as young, they certainly have a friendly relationship with the Editors. They are invaluable to the quality of the IGR reviews. One of the attractive aspects of IGR is that it publishes comments, whereas most journals have to keep these secret.

Safe and Effective

. . . . are words frequently used in glaucoma research. This does not necessarily mean that we all understand the meaning, nor that we mean the same when we use them. Three editors and one FDA official realized this dilemma and discussed the topic in an editorial (Ophthalmology 2003; 110: 2073): "To allow readers to make informed judgments, authors should spell out their definitions of safe and effective". The editors spell out some of their own rules, which are helpful to authors writing on treatment studies. The reader should be aware of these considerations and so should organizers, review committees, and chairs of scientific meetings.

Physicians and Economic Value

We, physicians, are not used to thinking about ourselves in terms of economic value. We will have to get used to this though. It may well be that "physicians are prodigious producers of human economic value" (see "Your Special Attention For"). In an editorial (EBEC 2003; 4: 184), Beauchamp emphasized that we have to demonstrate our economic contribution: "Evidence-based medicine will increasingly be required to analyze economic performance. In the marketplace, there will be many who will not wish to know of the economic power of physician contributions to the economy. For physicians, it may be a critical matter that dictates much about the future of medicine and its practitioners. We must be knowledgeable, specific, and courageous in presenting our evidence _ as producers of human and economic value." The interesting aspect of this approach to physicians' production is that it may turn out that physicians' economic value far exceeds that of many other professions. A comforting thought indeed.

Editors' Selection

The Editors' Selection has its range of interesting topics discussed by the already-mentioned highly appreciated experts: among other things, glaucoma and Alzheimer, satisfaction with glaucoma specialists, optineurin and NPG, loss of ganglion cells with age, CCT-free IOP measurements, what is progression, vascular risk factors and the benefit of IOP reduction, NPFS, drainage implants, and a lot more besides.

Erik L. Greve