A database of systematic reviews in eyes and vision – a cross-section of the evidence available to underpin clinical practice guidelines and set the research agenda

Article type
Authors
Lindsley K1, Rouse B2, Hawkins B3, Rosman L2, Twose C2, Li T2, Scherer R2, Lum F4, Hooft L5, Scholten R5, Dickersin K2
1UMC-Utrecht and Cochrane Eyes and Vision US Satellite
2Cochrane Eyes and Vision US Satellite
3Johns Hopkins University School of Medicine
4American Academy of Ophthalmology
5Cochrane Netherlands, UMC-Utrecht
Abstract
Background: As the number of systematic reviews (SRs) published in the health literature grows, we need to alert users about reliability of the evidence presented. Mapping treatment recommendations to existing reliable SRs ensures clinical practice guidelines (CPGs) are evidence-based and highlight where more research is needed.

Objective: To describe our experience in creating a database of SRs in eyes and vision.

Methods: We searched PubMed, EMBASE, and the Cochrane Library for eligible SRs in eyes and vision. We used no language or date restrictions. We used a two-stage screening process to identify eligible records. We defined SRs as investigations addressing a focused research question and employing scientific methods to identify, select, assess and summarise individual studies to answer the research question. For each SR, we extracted or classified the publication information (e.g. journal, year), eye condition (e.g. glaucoma, cataract), and research question category (e.g. diagnostic, intervention). For intervention SRs, we assessed reliability based on five criteria: the presence or use of 1) eligibility criteria for including studies; 2) comprehensive searches for studies; 3) assessment of risk of bias of included studies; 4) appropriate methods for meta-analysis, when applicable; and, 5) conclusions supported by results of the review. Reliable SRs identified are used to underpin the American Academy of Ophthalmology's (AAO) CPGs.

Results: Our database includes 1846 full reports of SRs in eyes and vision as of 15 March 2016 (Table). Most reports were published from 2011 to 2015 (59.4%). Cochrane contributed more SRs (18.3%) than any other single source (494 unique sources). The five most common eye conditions addressed were glaucoma, age-related macular degeneration, cataract, diabetic eye disease, and refractive error. In 2016, the AAO updated two CPGs. We identified 50 reliable SRs from a total of 106 intervention SRs of cataract and 11 reliable SRs from a total of 40 intervention SRs of refractive error to support the AAO’s CPGs on these topics.

Conclusions: Our database of SRs serves as a source of evidence in eyes and vision.