Outcome Measures in Glaucoma: a systematic review of Cochrane Reviews and Protocols

Rehab Ahmed Ismail, Augusto Azuara-Blanco, Craig Robert Ramsay

Research output: Contribution to journalArticlepeer-review

24 Citations (Scopus)
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In clinical trials the selection of appropriate outcomes is crucial to the assessment of whether one intervention is better than another. Selection of inappropriate outcomes can compromise the utility of a trial. However, the process of selecting the most suitable outcomes to include can be complex.
Ideally glaucoma trials aim to evaluate important outcomes for clinicians and patients. A high variability in the selection of outcomes suggests that there is no consensus on how best to evaluate the effect of glaucoma interventions. Further, it makes evidence synthesis difficult. The purpose of this review is to determine the extent of clinical outcome measures used in published glaucoma Cochrane Reviews and Protocols
A systematic review was conducted (up to February 2012) of all Cochrane Reviews and Protocols related to glaucoma interventions and published in English language. All clinical, patient-reported, as well as economic outcomes were included.
In the Cochrane Library there were 12 Reviews and 9 Protocols on glaucoma. A total of 118 clinical outcomes were reported. IOP was the most commonly used clinical outcome (n=40), and it was used in 11 Reviews and five Protocols.IOP was evaluated in many different ways; the most common one was a composite definition of success. Safety outcomes were also frequently reported. Visual field progression or change was reported in 6 reviews and 3 protocols, but in 13 different ways. Patient-reported quality of life measures were chosen as main outcome measure in one Review.
There is a large variability in outcomes selected in glaucoma Cochrane Reviews and Protocols. This heterogeneity in outcome selection impairs the ability for evidence synthesis. There is an urgent need for standardisation of outcomes used in glaucoma trials.
Original languageEnglish
Pages (from-to)533-538
Number of pages6
JournalJournal of Glaucoma
Issue number7
Early online date14 Nov 2013
Publication statusPublished - Sept 2015


  • Cochrane reviews
  • outcome measures
  • glaucoma
  • heterogeneity
  • variations


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