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Editors Selection IGR 24-3

Screening Tests

Comment by Steve Mansberger on:

22330 Screening tests for detecting open-angle glaucoma: Systematic review and meta-analysis, Mowatt G; Burr JM; Cook JA et al., Investigative Ophthalmology and Visual Science, 2008; 49: 5373-5385

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Mowatt et al. (1311) used a metaanalysis to compare the accuracy of potential screening tests for openangle glaucoma (OAG). They included forty studies representing over 48,000 subjects. They found that FDT, oculokinetic perimetry, and HRT II showed promising results; while ophthalmoscopy, SAP, retinal photography, and GAT had relatively poor performance as single tests. However, the studies results varied widely in their sensitivity and specificity. Also, the authors considered only 8 (20%) of the studies as high quality since they avoided various biases. The authors should be congratulated for their work. Which screening test should you use? The authors show that the results of the screening test will vary widely depending on such factors such as the screening population, the prevalence of glaucoma, severity of glaucoma, study design and setting. Researchers should pay attention to these factors as well as the criteria for a well-designed screening study as outlined by the authors. Overall, we still need research on the accuracy of screening tests for glaucoma.

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