Wednesday, November 18, 2015

Glaucoma - All the options - What's the data?

Primary open angle glaucoma (POAG) is a very common disease which affects millions worldwide.  This disease is chronic and requires life-long monitoring to hopefully prevent vision loss. There are three ways that POAG is traditionally approached; eye drops, laser surgery, or conventional surgery. These treatments are aimed at lowering intraocular pressure. You'll hear some people discuss more alternative treatments such as marijuana or physical exercise to regulate intraocular pressure. While there are intricacies to each patient's case which need to be evaluated and discussed with an individual's physician and we certainly do not want to suggest treatments for patients, I wonder what the data is behind each therapy. This is where SOM™ Treatment Scores come into play. The Treatment Scores system helps one to quantify the science of medicine behind potential treatments, but we must keep in mind that each patient is unique and treatments are tailored to individual patients and that treatment decisions must be made in concert with your ophthalmologist.  

In our effort to quantify the evidence behind treatments for POAG using the Treatment Scores Analyzer™, the first step is to set up the Diagnosis Tool™. Below is a screen shot of the Diagnosis Tool™ (figure 1).  

Figure 1. Diagnosis ToolTM showing the search diagnosis box and the add diagnosis tab.  On the left the Tx button will take you to the Treatment OrganizerTM

The first thing you will see is the search box. This box allows us to search for a diagnosis. Diagnoses already evaluated will show up and give you a starting point. If your diagnosis does not yet exist, you will need to use the Add Diagnosis tab. This tab will allow you to add up to 10 levels of your diagnosis (figure 2).  


Figure 2. Diagnosis Entry form showing my set up for primary open angle glaucoma.

You’ll see that I chose Glaucoma, Open angle, and Intraocular pressure greater than 22 as my diagnoses levels. Next is the Main Statistic. This requires a bit of searching through the literature to pick the main outcome measure you are interested in modelling. For this example I chose Reduction of IOP. The follow up is greater than 3 months and I am interested in studies of adult patients. Once you get the correct diagnosis entered into the Diganosis Tool™ you will be ready to hit the Tx button on the left and enter the Treatment Organizer™ and begin evaluating the treatment options for your diagnosis.  

To be continued...

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You must consult your own licensed physician, or other licensed medical professional, for diagnosis, treatment, and for the interpretation of all medical statistics including SOM® Treatment Scores. Treatment Scores are for educational purposes only. Treatment Scores may be incomplete, inaccurate, harmful, or even cause death if used for treatment instead of consulting a licensed medical professional. No medical advice is being given. We DO NOT CLAIM to cure, treat, or prevent any illness or condition. Nor do our services provide medical advice or constitute a physician patient relationship. Contact a physician or other medical professional if you suspect that you are ill. Call emergency services (call 911 if available) or go to the nearest emergency room if an emergency is suspected. We are not responsible for any delays in care from using our website, our services, or for any other reason. We are not responsible for any consequential damages of any nature whatsoever. We make no warranties of any kind in connection with our writings or the use of TreatmentScoresBlog.com or TreatmentScores.com. Treatment Scores are about what happened in the past they do not predict the future.

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