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  • Preferred Practice Pattern Guidelines and the Process of Attaining Reliable Evidence

    By Lynda Seminara Selected By: Neil M. Bressler, MD, and Deputy Editors
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    Journal Highlights

    JAMA Ophthalmology, May 2018

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    Golozar et al. described their experi­ence in identifying reliable evidence supporting the topics addressed in the 2016 update of the Academy’s 2011 Pre­ferred Practice Pattern (PPP) guidelines for treating cataract in adults. They found that the partnership between the Academy and Cochrane Eyes and Vision US Satellite (CEV@US) facilitat­ed the process of locating robust data relevant to the update.

    Initially, searches of systematic re­views on the management of cataract, published in English or Chinese, were conducted. Reliable systematic reviews were required to include the following: eligibility criteria, a comprehensive search/review of the literature, assess­ment of methodologic quality of stud­ies included, use of appropriate meta-analysis methods, and conclusions derived from the studies reviewed. Each relevant review was mapped to at least 1 of the 24 management categories list­ed in the table of contents of the 2011 Academy PPP guidelines. Data were ex­tracted from each review to determine its reliability, and the reviews deemed reliable were cross-checked against the guidelines. The authors studied wheth­er any reliable reviews published before February 2010 (the cutoff search date for the 2011 guidelines) had been cited in the 2011 version. (CEV@US did not supply systematic reviews for the 2011 guidelines.)

    The search returned 99 systematic reviews on cataract management, 46 of which were classified as reliable. The most common reason for exclusion was no mention of a comprehensive literature search. All 46 reliable reviews have been cited in the Academy’s 2016 PPP guidelines. In the 2011 guidelines, which were published before the Acad­emy/CEV@US partnership began, only 8 of 15 reliable systemic reviews were referenced.

    The authors believe that the part­nership was successful for producing robust evidence to enrich the practice guidelines and, in turn, improve the care of adults with cataract.

    The original article can be found here.