2.4.7 Conclusion
A number of randomized, controlled clinical trials have been completed in recent years, yielding valuable information for the management of ocular hypertension and glaucoma patients. The first patient in the Introduction has a high risk of developing glaucoma without treatment. The second patient could undergo treatment using medications or surgery, but CITGS indicates that while visual field loss would be similar between treatments, quality of life and visual acuity would be more likely to be preserved with medications rather than with surgery. Utilizing the data from these studies can be difficult, however, as the results are derived from specific patient populations and outcomes are not easily compared. A risk calculator is one tool to assist clinicians in integrating and applying the data from well-designed clinical studies. While risk calculators have some limitations, they provide benefits to patients, clinicians, and to society as a whole.
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References
American Academy of Ophthalmology. Preferred Practice Patterns. Available at http://www.aao.org/aao/education/library/ppp/prod = Preferred %20Practice%20Pattern. Accessed 1 March 2005.
Balas E, Boren S. Managing clinical knowledge for health care improvement. Yearbook Med Inform 2000:65–70.
Devers Eye Institute, Legacy Health System. Devers OHTN to Glaucoma Risk Calculator. Available at http://www.discoveriesinsight.org/glaucomarisk.htm. Accessed 9 February 2004.
Drance S, Anderson DR, Schulzer M. Risk factors for progression of visual field abnormalities in normal-tension glaucoma. Am J Ophthalmol 2001;131:699–708.
Fong DS, Ferris FL III. Evidence-guided ophthalmology. Arch Ophthalmol 2001;119:585–9.
Glanz K, Lewis FM, Rimer BK. Health behavior and health education: theory, research, and practice, 2nd edn. San Francisco: Jossey-Bass, 1997.
Gordon MO, Kass MA. The Ocular Hypertension Treatment Study: design and baseline description of the participants. Arch Ophthalmol 1999;117:573–83.
Gordon MO, Beiser JA, Brandt JD, et al. The Ocular Hypertension Treatment Study: baseline factors that predict the onset of primary open-angle glaucoma. Arch Ophthalmol 2002;120:714–20, 829–30.
Herndon LW, Weizer JS, Stinnett SS. Central corneal thickness as a risk factor for advanced glaucoma damage. Arch Ophthalmol 2004;122:17–21.
Hosmer DW, Lemeshow S. Applied survival analysis: regression modeling of time to event data. New York: Wiley, 1999:xiii, 386.
Hosmer DW, Lemeshow S. Applied logistic regression. New York: Wiley, 2000.
Institute of Medicine: U.S. Committee on Quality of Health Care in America. Crossing the quality chasm: a new health system for the 21st century. Washington, D.C.: National Academy Press, 2001: xx, 337 p.
Kass MA, Heuer DK, Higginbotham EJ, et al. The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. Arch Ophthalmol 2002;120:701–13, 829–30.
Leske MC, Heijl A, Hussein M, Bengtsson B, Hyman L, Komaroff E. Factors for glaucoma progression and the effect of treatment: the early manifest glaucoma trial. Arch Ophthalmol 2003;121:48–56.
Leske MC, Heijl A, Hyman L, Bengtsson B. Early Manifest Glaucoma Trial: design and baseline data. Ophthalmology 1999;106:2144–53.
Lichter PR, Musch DC, Gillespie BW, et al. Interim clinical outcomes in the Collaborative Initial Glaucoma Treatment Study comparing initial treatment randomized to medications or surgery. Ophthalmology 2001;108:1943–53.
Mansberger SL. A risk calculator to determine the probability of glaucoma. J Glaucoma 2004;13:345–7.
Medeiros FA, Sample PA, Zangwill LM, Bowd C, Aihara M, Weinreb RN. Corneal thickness as a risk factor for visual field loss in patients with preperimetric glaucomatous optic neuropathy. Am J Ophthalmol 2003;136:805–13.
Miglior S, Zeyen T, Pfeiffer N, Cunha-Vaz J, Torri V, Adamsons I. Results of the European Glaucoma Prevention Study. Ophthalmology 2005;112:366–75.
Musch DC, Lichter PR, Guire KE, Standardi CL. The Collaborative Initial Glaucoma Treatment Study: study design, methods, and baseline characteristics of enrolled patients. Ophthalmology 1999;106:653–62.
National Library of Medicine. HTA 101: Glossary. Available at http://www.nlm.nih.gov/nichsr/hta101/ta101014.html. Accessed 1 February 2004.
The Advanced Glaucoma Intervention Study (AGIS): 4. Comparison of treatment outcomes within race. Seven-year results. Ophthalmology 1998;105:1146–64.
The Advanced Glaucoma Intervention Study (AGIS): 12. Baseline risk factors for sustained loss of visual field and visual acuity in patients with advanced glaucoma. Am J Ophthalmol 2002;134:499–512.
The SUPPORT Principal Investigators. A controlled trial to improve care for seriously ill hospitalized patients. The study to understand prognoses and preferences for outcomes and risks of treatments (SUPPORT). J Am Med Assoc 1995;274:1591–8.
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Mansberger, S.L., Patterson, E.L. (2006). Risk Calculators: Evidence-Based Care of Ocular Hypertension and Glaucoma Patients. In: Grehn, F., Stamper, R. (eds) Glaucoma. Essentials in Ophthalmology. Springer, Berlin, Heidelberg . https://doi.org/10.1007/3-540-34773-9_2
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