RAND-like appropriateness methodology consensus for primary open-angle glaucoma in Latin America

Am J Ophthalmol. 2012 Sep;154(3):460-465.e7. doi: 10.1016/j.ajo.2012.03.015. Epub 2012 May 23.

Abstract

Purpose: To report the results of a Latin American consensus panel regarding the diagnosis and management of primary open-angle glaucoma and to compare these results with those from a similar panel in the United States.

Design: A RAND-like (Research and Development) appropriateness methodology was used to assess glaucoma practice in Latin America.

Methods: The 148 polling statements created for the RAND- like analysis in the United States and 10 additional statements specific to glaucoma care in Latin America were presented to a panel of Latin American glaucoma experts. Panelists were polled in private using the RAND- like methodology before and after the panel meeting.

Results: Consensus agreement or disagreement among Latin American experts was reached for 51.3% of statements before the meeting and increased to 66.5% in the private, anonymous meeting after polling (79.0% agreement, 21.0% disagreement). Although there was a high degree of concordance (111 of 148 statements; 75%) between the results of this Latin American panel and the United States panel, there were some notable exceptions relating to diagnostic and therapeutic decision making.

Conclusions: This RAND-like consensus methodology provides a perspective of how Latin American glaucoma practitioners view many aspects of glaucoma and compares these results with those obtained using a similar methodology from practitioners in the United States. These findings may be helpful to ophthalmologists providing glaucoma care in Latin America and in other regions of the world.

Publication types

  • Comparative Study
  • Consensus Development Conference
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antihypertensive Agents / administration & dosage*
  • Evidence-Based Medicine
  • Expert Testimony
  • Filtering Surgery / methods*
  • Glaucoma Drainage Implants*
  • Glaucoma, Open-Angle / diagnosis*
  • Glaucoma, Open-Angle / therapy*
  • Humans
  • Intraocular Pressure
  • Latin America
  • Ophthalmology / standards*
  • Outcome Assessment, Health Care
  • Practice Patterns, Physicians'*
  • Primary Health Care / standards
  • Surveys and Questionnaires
  • United States
  • Utilization Review

Substances

  • Antihypertensive Agents