Priority setting project for open-angle glaucoma and angle-closure glaucoma: where we are now?

Article type
Authors
Wang X1, Hui X1, Lindsley K1, Li T1, Yu T1, Wormald R2, Dickersin K1
1Cochrane Eyes and Vision Group, USA
2Cochrane Eyes and Vision Group, United Kingdom
Abstract
Background:
In 2007, the Cochrane Eyes and Vision Group US satellite was funded by Cochrane to undertake a priority-setting project for primary open-angle glaucoma (POAG). With funding from the National Eye Institute, we expanded the project to include angle-closure glaucoma (ACG). Findings were published in 2012 and 2013 for POAG and ACG, respectively.

Objectives:
To assess the progress of the priority-setting project in terms of CEVG review completion.

Methods:
We surveyed specialists and asked them to rank the importance of having an answer to questions derived from clinical practice guidelines. For POAG, 105 American Glaucoma Society members ranked 9/45 questions, and for ACG, 96 clinicians from Asia-Pacific glaucoma societies ranked 15/42 questions as high-priority topics.
We searched for existing CEVG systematic review (SR) topics on all 24 prioritized topics and submitted titles for new SRs to the CEVG editorial base as needed. We assessed the current status of each SR topic as of 20 March 2014.

Results:
For the nine POAG high priority topics (Table 1):
- four topics required a new SR, of which three topics were newly registered and one topic was not pursued because it cannot be ethically addressed by randomized controlled trials (RCTs);
- three topics had existing SRs with inconclusive findings and will be updated as new RCTs are conducted;
- two topics had high-quality SRs with conclusive findings and will be updated as needed.
For the 15 ACG high priority topics (Table 2):
- four topics did not have registered SRs and were not pursued by the editorial base, of which three topics would be 'empty' reviews and one topic cannot be ethically addressed by RCTs;
- 11 topics had existing Cochrane Protocols or SRs in progress.
For the 36 POAG and 27 ACG non-priority topics,
- four topics have been undertaken in new SRs and three review topics have been updated for POAG;
- one topic has been undertaken in a new SR for ACG (Table 3).

Conclusions:
CEVG reviews do not cover all specialty society members’ priority topics for Cochrane SRs, especially in ACG. Funder priorities (e.g. no empty reviews) are a non-ignorable factor.