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. 2018 May 1;136(5):514-523.
doi: 10.1001/jamaophthalmol.2018.0786.

Identification and Description of Reliable Evidence for 2016 American Academy of Ophthalmology Preferred Practice Pattern Guidelines for Cataract in the Adult Eye

Asieh Golozar  1 , Yujiang Chen  1 , Kristina Lindsley  2 , Benjamin Rouse  1 , David C Musch  3   4 , Flora Lum  5 , Barbara S Hawkins  2   6 , Tianjing Li  2
Affiliations

Identification and Description of Reliable Evidence for 2016 American Academy of Ophthalmology Preferred Practice Pattern Guidelines for Cataract in the Adult Eye

Asieh Golozar et al. JAMA Ophthalmol. .

Abstract

Importance: Trustworthy clinical practice guidelines require reliable systematic reviews of the evidence to support recommendations. Since 2016, the American Academy of Ophthalmology (AAO) has partnered with Cochrane Eyes and Vision US Satellite to update their guidelines, the Preferred Practice Patterns (PPP).

Objective: To describe experiences and findings related to identifying reliable systematic reviews that support topics likely to be addressed in the 2016 update of the 2011 AAO PPP guidelines on cataract in the adult eye.

Design, setting, and participants: Cross-sectional study. Systematic reviews on the management of cataract were searched for in an established database. Each relevant systematic review was mapped to 1 or more of the 24 management categories listed under the Management section of the table of contents of the 2011 AAO PPP guidelines. Data were extracted to determine the reliability of each systematic review using prespecified criteria, and the reliable systematic reviews were examined to find whether they were referenced in the 2016 AAO PPP guidelines. For comparison, we assessed whether the reliable systematic reviews published before February 2010 the last search date of the 2011 AAO PPP guidelines were referenced in the 2011 AAO PPP guidelines. Cochrane Eyes and Vision US Satellite did not provide systematic reviews to the AAO during the development of the 2011 AAO PPP guidelines.

Main outcomes and measures: Systematic review reliability was defined by reporting eligibility criteria, performing a comprehensive literature search, assessing methodologic quality of included studies, using appropriate methods for meta-analysis, and basing conclusions on review findings.

Results: From 99 systematic reviews on management of cataract, 46 (46%) were classified as reliable. No evidence that a comprehensive search had been conducted was the most common reason a review was classified as unreliable. All 46 reliable systematic reviews were cited in the 2016 AAO PPP guidelines, and 8 of 15 available reliable reviews (53%) were cited in the 2011 PPP guidelines.

Conclusions and relevance: The partnership between Cochrane Eyes and Vision US Satellite and the AAO provides the AAO access to an evidence base of relevant and reliable systematic reviews, thereby supporting robust and efficient clinical practice guidelines development to improve the quality of eye care.

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Conflict of interest statement

Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Dr Golozar, Ms Chen, Ms Lindsley, Mr Rouse, Dr Hawkins, and Dr Li were affiliated with Cochrane Eyes and Vision US Satellite during the course of this study. Dr Musch is a member of the Cataract and Anterior Segment Preferred Practice Pattern Panel, which wrote the 2016 American Academy of Ophthalmology Cataract in the Adult Eye Preferred Practice Pattern. Dr Lum is the vice president of Quality and Data Science at the American Academy of Ophthalmology. No other disclosures are reported.

Figures

Figure 1.
Figure 1.. Identification of Cataract Systematic Reviews of the Management of Cataract in the Adult Eye
Figure 2.
Figure 2.. Assessment of Reliability of 99 Systematic Reviews on the Management of Cataract in the Adult Eye
aFive criteria used for classifying reliability of systematic reviews. bThe denominator was 92 for systematic reviews with defined eligibility criteria. cThe denominator was 54 for systematic reviews reporting 2 or more title/abstract screeners. dThe denominator was 50 for systematic reviews reporting 2 or more methodologic quality assessors. eThe denominator was 56 for systematic reviews reporting 2 or more data abstractors. fThe denominator was 97 for systematic reviews including at least 1 primary study. gThe denominator was 59 for systematic reviews reporting at least 1 meta-analysis.
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References

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