Applying an evidence-based approach to the management of patients with ocular hypertension: Evaluating and synthesizing published evidence

PURPOSE: The use of evidence-based medicine in managing patients with ocular hypertension has been con, strained by the limited availability of high-quality data from controlled clinical trials and by limited formal training of clinicians in evaluating published evidence. This article will provide strategies and techniques to evaluate critically the quality of published research, synthesize the findings, and integrate published evidence in the care of patients with ocular hypertension. DESIGN: Review of the published literature and con, sensus of a panel of experts. METHODS: The published literature on evidence-based medicine was reviewed. Strategies and techniques in evaluating the quality of evidence and how to integrate evidence into the practice setting using the following three major questions were discussed by a panel of experts: Are the results of the study valid? What are the results? Do the study outcomes apply to individual patient care? RESULTS: Approaches to assessing study validity and the importance of considering the size of the treatment effect and precision of the effect size were detailed. The importance of using the "number-needed-to-treat" as a tool for translating results of clinical trials to individual patient care and the "number-needed-to-harm" as a method of comparing the potential benefit and harm of a given therapy was acknowledged. CONCLUSION: As the volume of high,quality data increases, the information provided herein may help ophthalmologists apply evidence,based medicine techniques as they seek to optimize the care of individual patients with ocular hypertension. (C) 2004 by Elsevier Inc. All rights reserved.