NHMRC Glaucoma Guidelines - ANZGIG

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NHMRC GUIDELINES FOR THE SCREENING, PROGNOSIS, DIAGNOSIS, MANAGEMENT AND PREVENTION OF GLAUCOMA Appendix 1 – Process report NHMRC Project Staff Ms Vesna Cvjeticanin (Director, Evidence Translation) National Health and Medical Research Council (2007/2010) Ms Carla Rodeghiero (Senior Project Officer, Evidence Translation) National Health and Medical Research Council (2007/2008) Mr Fethon Ileris (Senior Project Officer, Evidence Translation) National Health and Medical Research Council (2008/2009) Ms Tess Winslade (Senior Project Officer, Evidence Translation) National Health and Medical Research Council (2009/2010) Ms Marion Hewitt (Project Officer, Evidence Translation Section) National Health and Medical Research Council (2010) Ms Kay Currie (Director, National Institute for Clinical Studies (NICS) National Health and Medical Research Council Tasks NHMRC staff coordinated the guideline development process, facilitated the dissemination of information between the Technical Team and the Working Committee, and assisted as required with resolution of debate on wording and guideline intent. Contact details glaucoma@nhmrc.gov.au Guideline purpose This guideline presents the current best evidence for screening, prognosis, diagnosis, management and prevention of glaucoma. Its purpose is to inform practice for Australian health care providers, particularly utilising a multi-disciplinary team approach. Target users This guideline is primarily targeted to Australian primary health care providers undertaking any task related to screening, prognosis, diagnosis, management and prevention of glaucoma, in any setting. Information is also provided for secondary health care providers. National Health and Medical Research Council 171
NHMRC GUIDELINES FOR THE SCREENING, PROGNOSIS, DIAGNOSIS, MANAGEMENT AND PREVENTION OF GLAUCOMA Appendix 1 – Process report Review questions Specific review questions were formulated by the CAHE Technical Team and the Working Committee. The review questions were addressed in the underpinning NHMRC Systematic Review of the literature, which provided a comprehensive synthesis of the current literature for the screening, prognosis, diagnosis, management and prevention of glaucoma. The research questions comprised: 1. What is the definition of glaucoma? 2. What are the recognised types and/or classifications of glaucoma? 3. How do they differ pathophysiologically from each other? 4. What is the prevalence and incidence of glaucoma within Australia and internationally? 5. What is the natural history of glaucoma? 6. What is the best available evidence for the prognosis of patients with glaucoma, and the ability of any given intervention to alter this prognosis, from population-based studies? 7. What is the best available evidence for the prognosis of glaucoma and the ability of any given intervention to alter this prognosis from experimental studies? 8. Based on the best available evidence, what, if any, are the recognised risk factors for: • developing glaucoma? • the progression of established glaucoma? 9. Does the evidence support widespread general population screening, or targeted population screening, for glaucoma? If so, based on the best available evidence, what are the most appropriate screening methods? 10. What is the recommended methodology for the monitoring and surveillance of individuals suspected of having glaucoma or individuals at-risk of having glaucoma? 11. What is the recommended methodology for the monitoring and surveillance of patients with established glaucoma? 12. What is the best available evidence for appropriate methods and techniques to diagnose glaucoma? 13. Does the evidence identify threshold values at which a diagnosis of glaucoma can be made? 14. What does the literature have to offer regarding the pragmatic elements and logistics of diagnosing glaucoma, with respect to the health care professionals involved, health care settings and resources required? Systematic review methods Each question was interpreted using a PECOT format, which assisted in defining the scope, search terms/ key words and inclusion/ exclusion criteria. These search terms were systematically applied to a range of library databases to ensure a replicable and comprehensive search of the academic literature. The literature for each question was examined using five evidence dimensions (hierarchy, methodological quality, significance, effect size, and applicability). A consistent approach was taken to critically appraise the literature for each question, and to summarise and report the findings. The methodology of the systematic review which underpins these guidelines is reported in full in Systematic Literature Review on the Detection, Diagnosis, Management and Prevention of Glaucoma, prepared for NHMRC and the Department of Health and Ageing, by the Centre for Allied Health Evidence, University of South Australia, Division of Health Sciences (Sept 2008). This report is available on www.nhmrc.gov.au. 172 National Health and Medical Research Council
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NHMRC Glaucoma Guidelines - ANZGIG

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