New Eye Test May Help Predict Risk of Glaucoma

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story didn’t include anything about costs.

What will it cost to use the “computer-based imaging tool” described in the story?  We’re not told. There is no information on the cost of expanding the use of retinal photographs to a wider population.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

A clear example of how incomplete relative risk reduction/benefit figures can be.  The story only says that “Those with the narrowest vessels at the beginning of the study were four times more likely to have developed glaucoma a decade later.”

But it does not explain:

• Four times more likely than what?  Four times more likely than 1 in 1,000?  Four times more likely than 1 in 100?  What’s the baseline?  “Four times more likely” loses meaning without this context.
• Was it the blood vessel thickness measurement by “computer-based imaging tool” that was key?  Or was blood pressure just as good a predictor?  The story stated that “Compared with the group as a whole, those people who were diagnosed with the eye disease during the following decade were older, had higher blood pressure, and were more likely to be female.”

Does the story adequately explain/quantify the harms of the intervention?

Not Applicable

Not applicable.  There wasn’t any discussion of potential harms and we can’t think of any – besides the obvious one of unnecessary glaucoma screening in some cases.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

At least the story included the independent perspective from an eye surgeon, who said:

“It remains to be seen if this approach will help us identify people at risk for glaucoma sooner,” he says. “We have a number of tools now to help us do that, but we’ve got to get people in our offices to use them.”

But there certainly wasn’t the kind of rigorous evaluation of the evidence that we would have liked to see in such a story.

The test is actually just computer analysis of retinal photographs, which many people have experience with for diabetic eye screening.  Placing the study in that context would be very helpful for readers who are trying to understand the study.  Also, the story doesn’t mention that 33% of participants are lost to follow-up.  Since only about 3% of participants with complete follow-up developed glaucoma, the actual number of patients among the “missing” 33% who developed glaucoma are likely to significantly influence the results and potentially the conclusions to be drawn.

Does the story commit disease-mongering?

Satisfactory

No disease mongering of glaucoma in the story.

Does the story use independent sources and identify conflicts of interest?

Satisfactory

The closing comment from an independent eye surgeon provided some necessary – albeit late and brief – perspective.

Does the story compare the new approach with existing alternatives?

Satisfactory

Again, we’ll give the story the benefit of the doubt for at least nodding in the direction of other alternatives.  For example:

• The researchers concluded that measuring retinal-vessel narrowing could help identify people at risk for glaucoma. But they added that blood pressure and other factors that can contribute to vessel size would need to be considered.
• Eye surgeon Mark Fromer, MD, of Lenox Hill Hospital in New York City, agrees that having regular eye exams is the best protection against vision loss associated with aging.“It remains to be seen if this approach will help us identify people at risk for glaucoma sooner,” he says. “We have a number of tools now to help us do that, but we’ve got to get people in our offices to use them.”

Does the story establish the availability of the treatment/test/product/procedure?

Not Satisfactory

There was no discussion of what the “computer-based imaging tool” really was.  Is it equipment already readily available and in use?  If not, what is it, and what would it take to implement?

No details were provided – a weak spot in the story.

The story should have made the connection between retinal photography that is currently done for diabetic eye screening and this new, alternative use of the same images.

Does the story establish the true novelty of the approach?

Not Satisfactory

Related to the unsatisfactory “Availability” score above, since no details were given about the “computer-based imaging tool,” we don’t know anything about how novel it is (or isn’t).

Does the story appear to rely solely or largely on a news release?

Satisfactory

It does not appear that the story relied solely or largely on a news release.