Developing the specifications of an open angle glaucoma screening intervention in the United Kingdom: a Delphi approach
Open accessAbstract
BACKGROUND: Glaucoma is a leading cause of blindness. Early detection is advocated but there is insufficient evidence from randomized controlled trials (RCTs) to inform health policy on population screening. Primarily, there is no agreed screening intervention. For a screening programme, agreement is required on the screening tests to be used, either individually or in combination, the person to deliver the test and the location where testing should take place. This study aimed to use ophthalmologists (who were experienced glaucoma subspecialists), optometrists, ophthalmic nurses and patients to develop a reduced set of potential screening tests and testing arrangements that could then be explored in depth in a further study of their feasibility for evaluation in a glaucoma screening RCT. METHODS: A two-round Delphi survey involving 38 participants was conducted. Materials were developed from a prior evidence synthesis. For round one, after some initial priming questions in four domains, specialists were asked to nominate three screening interventions, the intervention being a combination of the four domains; target population, (age and higher risk groups), site, screening test and test operator (provider). More than 250 screening interventions were identified. For round two, responses were condensed into 72 interventions and each was rated by participants on a 0-10 scale in terms of feasibility. RESULTS: Using a cut-off of a median rating of feasibility of ≥5.5 as evidence of agreement of intervention feasibility, six interventions were identified from round 2. These were initiating screening at age 50, with a combination of two or three screening tests (varying combinations of tonometry/measures of visual function/optic nerve damage) organized in a community setting with an ophthalmic trained technical assistant delivering the tests. An alternative intervention was a 'glaucoma risk score' ascertained by questionnaire. The advisory panel recommended that further exploration of the feasibility of screening higher risk populations and detailed specification of the screening tests was required. CONCLUSIONS: With systematic use of expert opinions, a shortlist of potential screening interventions was identified. Views of users, service providers and cost-effectiveness modeling are now required to identify a feasible intervention to evaluate in a future glaucoma screening trial.
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- Authors
- Campbell, S. E., Azuara-Blanco, A., Campbell, M. K., Francis, J. J., Greene, A. C., Ramsay, C. R., & Burr, J. M.
- Affiliations
- University of East Anglia (GB)
- University of Aberdeen (GB)
- University of Dundee (GB)
- Corresponding author
- Campbell, Susan E
- Venue
- BMC Health Services Research
- Published
- 2012-12
- Volume
- 12
- Issue
- 1
- Pages
- 447-447
- ISSN
- 1472-6963 (ISSN-L)
- PMC
- PMC3563574
- OpenAlex
- W2130623749
- Cited by
- 13
- References
- 32
- Citations by year
- 2024: 3 · 2023: 1 · 2021: 1 · 2020: 1 · 2019: 2 · 2018: 1 · 2017: 1 · 2016: 1 · 2014: 1 · 2013: 1
- FWCI
- 0.60
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Health Services Research (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Discovery Research Portal (University of Dundee) (publishedVersion)
- City Research Online (City University London) (acceptedVersion)
- Aberdeen University Research Archive (Aberdeen University) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- Research Portal (Queen's University Belfast) (submittedVersion)
- UEA Digital Repository (University of East Anglia) (submittedVersion)
- Funders
- Scottish Government
- National Institute for Health and Care Research (04/08/02)
- Chief Scientist Office, Scottish Government Health and Social Care Directorate
- Medical Research Council (G0701759)
- Topics
- Health Sciences › Medicine › Ophthalmology › Glaucoma and retinal disorders
- Health Sciences › Medicine › Epidemiology › Ophthalmology and Visual Impairment Studies
- Social Sciences › Sociology and Political Science › Delphi Technique in Research
- Keywords
- open-angle glaucoma, glaucoma screening, feasibility, tonometry, visual function assessment, optic nerve injury, community-based screening, expert consensus, mass screening, blindness prevention
- MeSH terms
- Delphi Technique, Feasibility Studies, Glaucoma, Open-Angle, United Kingdom, Humans, Mass Screening, Optic Nerve Diseases, Surveys and Questionnaires, Tonometry, Ocular, Vision Tests
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