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Am J Ophthalmol. 2008 Mar;145(3):575-581. doi: 10.1016/j.ajo.2007.10.009. Epub 2008 Jan 11.

A panel assessment of glaucoma management: modification of existing RAND-like methodology for consensus in ophthalmology. Part II: Results and interpretation.

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Glaucoma Service, Department of Ophthalmology, Stanford University School of Medicine, Stanford, California, USA.



To present the results of a panel consensus assessment of evaluation and therapy relating to primary open-angle glaucoma based on available evidence and expert opinion.


A panel consensus assessment of glaucoma diagnosis and therapy using a modified RAND-like appropriateness methodology.


One hundred and forty-eight questions, most of which related to glaucoma therapy, were created by a core nonvoting executive committee based on common clinical questions. An evidence-based review of the literature pertaining to these questions was provided to 10 voting panelists. These panelists, who did not participate in either the creation of the questions or the conduct of the literature review, then were polled using a modified technique derived from existing methodology.


Consensus agreement or disagreement was reached for 55.4% and 74.3% of the polling statements before and after the panel meeting, respectively. This represents a consensus agreement or disagreement on a majority of polling statements both before and after a meeting of all panelists and the two co-chairs of the program. There was an increase in the proportion of statements where consensus agreement was reached after the panel meeting.


Given the paucity of high-quality evidence relating to many of the issues addressed in this assessment and the variability of practice patterns among ophthalmologists, consensus agreement or disagreement was reached for a high proportion of polling statements.

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