Thursday, December 10, 2015

Gathering the evidence - STAR™ Block formation for Glaucoma Lasers

Our third post in the assessment of the evidence behind SLT for glaucoma we will enter the data into the STAR™ Block, allowing us to create the Treatment Score.  STAR™ stands for Statistic and a Reference.  At the top of the screen you'll see the Diagnosis Levels, Treatment, Statistic We Want, Follow up, and Patients (figure 1) carried over from our entry into the Diagnosis Tool™ from our earlier post.


After searching PubMed and identifying the highest quality research, we need to create a STAR™ Block for each.  Below the Diagnosis Level you'll find that Treatment Scores™ allows you to either create an empty STAR™ Block or enter a PubMed ID.  Figure 2 shows the view after a PubMed ID is entered to create a new Star Block™.  Treatment Scores™ pulls in the abstract and auto-populates the first few columns of the Star Block™.  The rest of the columns we enter.  Of particular importance is the Statistic We Have, which is the main outcome statistic at the heart of the study.


For our analysis, I chose to use the percentage of patients who did not require additional therapy during the study.  This statistic was available in all the studies I included and represents clinical success of the treatment.  The next important blocks to fill are the Quality and Relevance of the study.  These are somewhat subjective analyses, using evidence-based medicine guidelines, and I gave relatively high quality and relevance scores because the studies included were randomized controlled trials with similar design and endpoints. These numbers would be lower should I include case series or non-controlled trials.  Figure 3 shows the completed STAR™ Blocks.


Once the relevant STAR™ Blocks are completed we can chose whether or not to include the STAR™ Blocks in our analysis on the right.  The last thing to do on the STAR™ Block entry is to set the description of the statistic we have and the ceiling number.  Once these are entered we are ready to go back to the Treatment Calculator™ and finish our analysis.  We'll pick up there in our next post. See the disclaimers below.

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