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The accuracy and clinical application of predictive models for primary open-angle glaucoma in ocular hypertensive individuals.
Ophthalmology 2008; 115(11):2030-6O

Abstract

OBJECTIVE

This report compares the accuracy of 3 prediction models for the development of primary open-angle glaucoma (POAG). The models differ primarily in their handling of these eye-specific variables: intraocular pressure (IOP), central corneal thickness (CCT), vertical cup-to-disc ratio (VCD), and visual field pattern standard deviation (PSD). The "means" model includes age and the means of right and left eyes; the "means plus asymmetry" model includes age, the means of right and left eyes as well as the absolute difference between eyes for eye-specific variables; and the "worse" eye model includes age and values from the eye at higher risk for developing POAG.

DESIGN

This report uses data from the observation group of the Ocular Hypertension Treatment Study (OHTS) and the placebo group of the European Glaucoma Prevention Study (EGPS) who have complete data on both eyes at baseline. Performance of the prediction models is assessed using the c-statistic, calibration chi-square, and Pearson correlation coefficient.

PARTICIPANTS

The OHTS observation group (n = 717; 6.7 years median follow-up) and the EGPS placebo group (n = 324; 4.9 years median follow-up).

TESTING

Baseline data included demographic characteristics, medical history, ocular examination, visual fields, and optic disc photographs.

MAIN OUTCOME MEASURES

Development of reproducible visual field abnormality or optic disc deterioration as determined by masked readers and attributed to POAG by a masked end point committee.

RESULTS

Baseline factors that were statistically significant in all predictive models were age, IOP, CCT, VCD, and PSD. Also, statistically significant were baseline asymmetry in IOP and asymmetry in VCD. The c-statistics for the "means" model, "means plus asymmetry" model, and "worse" eye model were 0.74, 0.77, and 0.75, respectively. The calibration chi-square values were 7.32, 11.19, and 1.81, respectively. Correlation coefficients between risk estimates calculated by different models ranged from 0.94 to 0.98.

CONCLUSIONS

The high agreement between the risk estimates from 3 different predictive models for the development of POAG suggests little difference in their statistical or clinical performance. The predictive model that uses the means of both eyes for eye-specific variables is the simplest to use and the most robust to measurement variability and error.

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18801578

Citation

Ocular Hypertension Treatment Study Group and the European Glaucoma Prevention Study Group. "The Accuracy and Clinical Application of Predictive Models for Primary Open-angle Glaucoma in Ocular Hypertensive Individuals." Ophthalmology, vol. 115, no. 11, 2008, pp. 2030-6.
Ocular Hypertension Treatment Study Group and the European Glaucoma Prevention Study Group. The accuracy and clinical application of predictive models for primary open-angle glaucoma in ocular hypertensive individuals. Ophthalmology. 2008;115(11):2030-6.
Ocular Hypertension Treatment Study Group and the European Glaucoma Prevention Study Group. (2008). The accuracy and clinical application of predictive models for primary open-angle glaucoma in ocular hypertensive individuals. Ophthalmology, 115(11), pp. 2030-6. doi:10.1016/j.ophtha.2008.06.036.
Ocular Hypertension Treatment Study Group and the European Glaucoma Prevention Study Group. The Accuracy and Clinical Application of Predictive Models for Primary Open-angle Glaucoma in Ocular Hypertensive Individuals. Ophthalmology. 2008;115(11):2030-6. PubMed PMID: 18801578.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The accuracy and clinical application of predictive models for primary open-angle glaucoma in ocular hypertensive individuals. A1 - ,, Y1 - 2008/09/18/ PY - 2008/04/03/received PY - 2008/05/22/revised PY - 2008/06/26/accepted PY - 2008/9/20/pubmed PY - 2008/12/31/medline PY - 2008/9/20/entrez SP - 2030 EP - 6 JF - Ophthalmology JO - Ophthalmology VL - 115 IS - 11 N2 - OBJECTIVE: This report compares the accuracy of 3 prediction models for the development of primary open-angle glaucoma (POAG). The models differ primarily in their handling of these eye-specific variables: intraocular pressure (IOP), central corneal thickness (CCT), vertical cup-to-disc ratio (VCD), and visual field pattern standard deviation (PSD). The "means" model includes age and the means of right and left eyes; the "means plus asymmetry" model includes age, the means of right and left eyes as well as the absolute difference between eyes for eye-specific variables; and the "worse" eye model includes age and values from the eye at higher risk for developing POAG. DESIGN: This report uses data from the observation group of the Ocular Hypertension Treatment Study (OHTS) and the placebo group of the European Glaucoma Prevention Study (EGPS) who have complete data on both eyes at baseline. Performance of the prediction models is assessed using the c-statistic, calibration chi-square, and Pearson correlation coefficient. PARTICIPANTS: The OHTS observation group (n = 717; 6.7 years median follow-up) and the EGPS placebo group (n = 324; 4.9 years median follow-up). TESTING: Baseline data included demographic characteristics, medical history, ocular examination, visual fields, and optic disc photographs. MAIN OUTCOME MEASURES: Development of reproducible visual field abnormality or optic disc deterioration as determined by masked readers and attributed to POAG by a masked end point committee. RESULTS: Baseline factors that were statistically significant in all predictive models were age, IOP, CCT, VCD, and PSD. Also, statistically significant were baseline asymmetry in IOP and asymmetry in VCD. The c-statistics for the "means" model, "means plus asymmetry" model, and "worse" eye model were 0.74, 0.77, and 0.75, respectively. The calibration chi-square values were 7.32, 11.19, and 1.81, respectively. Correlation coefficients between risk estimates calculated by different models ranged from 0.94 to 0.98. CONCLUSIONS: The high agreement between the risk estimates from 3 different predictive models for the development of POAG suggests little difference in their statistical or clinical performance. The predictive model that uses the means of both eyes for eye-specific variables is the simplest to use and the most robust to measurement variability and error. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/18801578/The_accuracy_and_clinical_application_of_predictive_models_for_primary_open_angle_glaucoma_in_ocular_hypertensive_individuals_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(08)00649-0 DB - PRIME DP - Unbound Medicine ER -