Partnership between Cochrane Eyes and Vision and the American Academy of Ophthalmology to identify systematic review evidence for clinical practice guidelines

Golozar A1, Lindsley K2, Musch D3, Lum F4, Dickersin KD2, Li T2
1Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, USA, 2Center for Clinical Trials and Evidence Synthesis, Johns Hopkins Bloomberg School of Public Health, USA, 3Departments of Ophthalmology and Visual Sciences and Epidemiology, University of Michigan, Ann Arbor, Michigan, USA, 4Vice President of Quality and Data Science, American Academy of Ophthalmology, San Francisco, California, USA

Background: Trustworthy clinical practice guidelines (CPGs) require reliable systematic reviews as supporting evidence for recommendations.

Objective: The Cochrane Eyes and Vision US Satellite (CEV@US) identifies and notifies the American Academy of Ophthalmology (AAO) of reliable systematic reviews on guideline topics as part of the CPG updating process.

Methods: In 2016, CEV@US and the AAO initiated a formal partnership whereby CEV@US provides reliable systematic reviews addressing topics covered in the AAO’s CPGs, 'Preferred Practice Patterns' (PPP). Eligible topics address questions of effectiveness and safety of interventions that could be addressed by randomized controlled trials. To prepare, CEV@US performs a broad search of an established systematic review database it updates regularly in eyes and vision. This database includes systematic reviews on etiology, screening, diagnostic test accuracy, and intervention effectiveness. Two reviewers independently perform record screening, data extraction, and quality assessment. Disagreements between the two are resolved through discussion. The classification of a systematic review’s reliability is based on a tool that combines AMSTAR, PRISMA, and other data items; reviews are classified as reliable if they report eligibility criteria, conduct comprehensive searches, assess the risk of bias of the included studies, use appropriate methods for meta-analysis, and present conclusions that reflect the results.

Results: For the first topic, 'Management of adult cataract', we identified 33 relevant and reliable reviews, only eight of which had been cited in the 2010 PPP. We also identified several areas for continuing attention: keeping the database of systematic reviews up-to-date; continuous project-specific training for staff; and regular and timely communication between CEV@US and AAO.

Conclusion: The partnership between CEV@US and the AAO provides AAO with access to an evidence base of relevant and reliable systematic reviews, thereby supporting robust and efficient CPG development for improving the quality of eye care.