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Consensus generation of a minimum set of outcome measures for auditing glaucoma surgery outcomes—a Delphi exercise

  • Glaucoma
  • Published:
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Abstract

Purpose

To identify the key set of glaucoma surgery outcome measures considered most important and practical to collect by glaucoma specialists.

Methods

One hundred two glaucoma specialists (57 members of the UK and Eire Glaucoma Society (UKEGS) and 45 members of the European Glaucoma society (EGS)) took part in an Online Delphi exercise. The RAND/UCLA appropriateness method was used analyse data from each round and generate a disagreement index.

Results

Participants agreed on 13 baseline data points and 12 outcomes that were considered important and practical to collect. For intraocular pressure (IOP) percentage reduction in IOP from baseline (last three IOP readings pre-op) and reduction below a specified target were considered important. For visual fields, change in a global visual field index, e.g. MD, and development of progression as assessed by linear regression were considered important. From a safety perspective, any visual loss resulting in a doubling of the minimal angle of resolution, loss of 5 dB or more of visual field or development of advanced field loss (Hodapp Parrish Anderson Stage 4) was considered important. The importance of routinely using patient reported outcome measures (PROMs) was highlighted. Consensus suggested that outcomes of glaucoma treatments should be reported at 1, 5 and 10 years.

Conclusions

There was broad consensus on a minimum dataset for reporting the outcomes of glaucoma surgery and outcome measurement intervals.

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Acknowledgements

Thanks to UKEGS and EGS for providing access to their mailing lists, to all the consultants who took the time to fill out the questionnaire and to Professor Anja Tuulonen for critical reading of the manuscript and helpful suggestions. RF is a director and shareholder of Clinvivo Ltd., a University of Warwick spin-out company that provides services including design and administration of Delphi studies. These services were not used in this study and notwithstanding the disclosure, RF declares no conflicts of interest. None of the other authors has any competing financial interests in relation to the work described.

Author information

Authors and Affiliations

  1. Vision and Eye Research Unit, Anglia Ruskin University, Cambridge Campus, Young Street, Cambridge, CB1 2LZ, UK

    J. E. A. Somner

  2. Royal Victoria Infirmary, Newcastle upon Tyne, UK

    R. Ismail

  3. Warwick Medical School, University of Warwick, Coventry, UK

    R. Froud

  4. Kristiania University College, Oslo, Norway

    R. Froud

  5. Centre for Public Health, Queen’s University Belfast, Belfast, UK

    A. Azuara-Blanco

  6. Nottingham University Hospital, Nottingham, NG7 2UH, UK

    A. J. King

Authors
  1. J. E. A. Somner
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  2. R. Ismail
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  3. R. Froud
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  4. A. Azuara-Blanco
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  5. A. J. King
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Corresponding author

Correspondence to A. J. King.

Ethics declarations

Conflict of interest

Somner declares that he has no conflict of interest. Ismail declares that she has no conflict of interest. Azuara-Blanco declares that he has no conflict of interest. King has received honoraria from Allergan UK for lectures performed. Froud declares that he has no conflict of interest. He is a director and shareholder of Clinvivo Ltd., a University of Warwick spin-out company that provides services including design and administration of Delphi studies. These services were not used in this study.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

Informed consent

Informed consent was not required for this survey.

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Somner, J.E.A., Ismail, R., Froud, R. et al. Consensus generation of a minimum set of outcome measures for auditing glaucoma surgery outcomes—a Delphi exercise. Graefes Arch Clin Exp Ophthalmol 256, 2407–2411 (2018). https://doi.org/10.1007/s00417-018-4140-4

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  • DOI: https://doi.org/10.1007/s00417-018-4140-4

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