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IOVS_2008Screening_tests_for_detecting_open_angle_glaucoma.pdf1.05 MBAdobe PDFView/Open
Title: Screening tests for detecting open-angle glaucoma : systematic review and meta-analysis
Authors: Mowatt, Graham
Burr, Jennifer Margaret
Cook, Jonathan A.
Siddiqui, M. A. Rehman
Ramsay, Craig
Fraser, Cynthia
Azuara-Blanco, Augusto
Deeks, Jonathan J.
O.A.G. Screening Project Grp
Keywords: Frequency-doubling-technology
Visual-field defects
Baltimore eye survey
Test accuracy evaluations
Optic-nerve damage
Automated perimetry
Oculokinetic perimetry
RE Ophthalmology
Issue Date: Dec-2008
Citation: Mowatt , G , Burr , J M , Cook , J A , Siddiqui , M A R , Ramsay , C , Fraser , C , Azuara-Blanco , A , Deeks , J J & O.A.G. Screening Project Grp 2008 , ' Screening tests for detecting open-angle glaucoma : systematic review and meta-analysis ' Investigative Ophthalmology & Visual Science , vol 49 , no. 12 , pp. 5373-5385 . , 10.1167/iovs.07-1501
Abstract: PURPOSE. To assess the comparative accuracy of potential screening tests for open angle glaucoma (OAG). METHODS. Medline, Embase, Biosis (to November 2005), Science Citation Index (to December 2005), and The Cochrane Library (Issue 4, 2005) were searched. Studies assessing candidate screening tests for detecting OAG in persons older than 40 years that reported true and false positives and negatives were included. Meta-analysis was undertaken using the hierarchical summary receiver operating characteristic model. RESULTS. Forty studies enrolling over 48,000 people reported nine tests. Most tests were reported by only a few studies. Frequency-doubling technology (FDT; C-20-1) was significantly more sensitive than ophthalmoscopy (30, 95% credible interval [CrI] 0-62) and Goldmann applanation tonometry (GAT; 45, 95% CrI 17-68), whereas threshold standard automated perimetry (SAP) and Heidelberg Retinal Tomograph (HRT II) were both more sensitive than GAT (41, 95% CrI 14-64 and 39, 95% CrI 3-64, respectively). GAT was more specific than both FDT C-20-5 (19, 95% CrI 0-53) and threshold SAP (14, 95% CrI 1-37). Judging performance by diagnostic odds ratio, FDT, oculokinetic perimetry, and HRT II are promising tests. Ophthalmoscopy, SAP, retinal photography, and GAT had relatively poor performance as single tests. These findings are based on heterogeneous data of limited quality and as such are associated with considerable uncertainty. CONCLUSIONS. No test or group of tests was clearly superior for glaucoma screening. Further research is needed to evaluate the comparative accuracy of the most promising tests. (Invest Ophthalmol Vis Sci. 2008;49:5373-5385) DOI: 10.1167/iovs.07-1501
Version: Postprint
Status: Peer reviewed
ISSN: 0146-0404
Type: Journal article
Rights: Copyright 2008 The Association for Research in Vision and Ophthalmology, Inc. This is the author's version of this article.
Appears in Collections:University of St Andrews Research
Medicine Research

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