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Systematic analysis of levels of evidence supporting American Academy of Ophthalmology Preferred Practice Pattern guidelines, 2012-2021.

Publication ,  Journal Article
Song, A; Lusk, JB; Kuo, AN; Muir, KW; Stinnett, SS; Borkar, DS
Published in: BMC Ophthalmol
March 31, 2023

BACKGROUND: Despite the increased emphasis on evidence-based medicine, the current state of evidence behind ophthalmology clinical practice guidelines is unknown. The purpose of this systematic analysis was to understand the levels of evidence (LOE) supporting American Academy of Ophthalmology (AAO) Preferred Practice Pattern (PPP) guidelines, assess changes over time, and compare LOE across ophthalmology subspecialties. METHODS: All current PPP guidelines and their immediate predecessors were comprehensively reviewed to identify all recommendations with LOE provided (I [randomized controlled trials], II [case-control or cohort studies], and III [nonanalytic studies]). RESULTS: Twenty-three out of 24 current PPPs had a prior edition. Among the PPPs with a prior edition, the number of recommendations with LOE decreased from 1254 in prior PPPs to 94 in current PPPs. The number of recommendations with LOE I decreased from 114 to 83, LOE II decreased from 147 to 2, and LOE III decreased from 993 to 9. However, the proportion of LOE I recommendations increased from 9 to 88%, driven by a disproportionate decrease in reporting of evidence lower than LOE I. Subgroup analysis by subspecialty showed similar trends (LOE I recommendations in prior PPPs vs current PPPs: retina: 57 [12%] vs 19 [100%]; cornea: 33 [5%] vs 24 [100%]; glaucoma: 9 [23%] vs 17 [100%]; cataract: 13 [17%] vs 18 [100%]). CONCLUSIONS: Trends in LOE reporting in PPP guidelines indicate an increasing emphasis on evidence from randomized controlled trials from 2012 to 2021. The decline in the number of recommendations with LOE reported suggests an area for improvement in future guidelines as the presence of LOE is crucial to facilitate interpretation of clinical practice guidelines.

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Published In

BMC Ophthalmol

DOI

EISSN

1471-2415

Publication Date

March 31, 2023

Volume

23

Issue

1

Start / End Page

132

Location

England

Related Subject Headings

  • United States
  • Retina
  • Practice Guidelines as Topic
  • Ophthalmology & Optometry
  • Ophthalmology
  • Humans
  • Evidence-Based Medicine
  • Cataract
  • 3212 Ophthalmology and optometry
  • 1113 Opthalmology and Optometry
 

Citation

APA
Chicago
ICMJE
MLA
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Song, A., Lusk, J. B., Kuo, A. N., Muir, K. W., Stinnett, S. S., & Borkar, D. S. (2023). Systematic analysis of levels of evidence supporting American Academy of Ophthalmology Preferred Practice Pattern guidelines, 2012-2021. BMC Ophthalmol, 23(1), 132. https://doi.org/10.1186/s12886-023-02866-9
Song, Ailin, Jay B. Lusk, Anthony N. Kuo, Kelly W. Muir, Sandra S. Stinnett, and Durga S. Borkar. “Systematic analysis of levels of evidence supporting American Academy of Ophthalmology Preferred Practice Pattern guidelines, 2012-2021.BMC Ophthalmol 23, no. 1 (March 31, 2023): 132. https://doi.org/10.1186/s12886-023-02866-9.
Song A, Lusk JB, Kuo AN, Muir KW, Stinnett SS, Borkar DS. Systematic analysis of levels of evidence supporting American Academy of Ophthalmology Preferred Practice Pattern guidelines, 2012-2021. BMC Ophthalmol. 2023 Mar 31;23(1):132.
Song, Ailin, et al. “Systematic analysis of levels of evidence supporting American Academy of Ophthalmology Preferred Practice Pattern guidelines, 2012-2021.BMC Ophthalmol, vol. 23, no. 1, Mar. 2023, p. 132. Pubmed, doi:10.1186/s12886-023-02866-9.
Song A, Lusk JB, Kuo AN, Muir KW, Stinnett SS, Borkar DS. Systematic analysis of levels of evidence supporting American Academy of Ophthalmology Preferred Practice Pattern guidelines, 2012-2021. BMC Ophthalmol. 2023 Mar 31;23(1):132.
Journal cover image

Published In

BMC Ophthalmol

DOI

EISSN

1471-2415

Publication Date

March 31, 2023

Volume

23

Issue

1

Start / End Page

132

Location

England

Related Subject Headings

  • United States
  • Retina
  • Practice Guidelines as Topic
  • Ophthalmology & Optometry
  • Ophthalmology
  • Humans
  • Evidence-Based Medicine
  • Cataract
  • 3212 Ophthalmology and optometry
  • 1113 Opthalmology and Optometry