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D. V. Do, B. S. Hawkins; Implications of Inconclusive Systematic Reviews in Retina Published by the Cochrane Eyes and Vision Group. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5210.
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To examine the availability of controlled clinical trials, either randomized or quasi-randomized, in any language, that address retina questions posed by investigators affiliated with the Cochrane Eyes and Vision Group (CEVG) and the implications for eye caregivers.
We identified systematic reviews in retina published by the CEVG that could not evaluate the effectiveness of interventions because of inability to identify one or more clinical trials that addressed the question of interest. Sytematic reviews concerned with retinal conditions were examined in detail, with particular emphasis on the importance of the question addressed based on the incidence of the ocular condition and evidence regarding intervention effectiveness from studies of other designs.
Of 55 systematic reviews published by the CEVG as of November 7, 2007, 13 (24%) reviews were identified that focused on retina-related topics. Among these 13 reviews, 2 (15%) identified no pertinent trials;. both of these reviews were conducted to evaluate the effects of interventions on retinal disorders that could lead to vision loss: (1) acute non-arteritic central retinal artery occlusion and (2) asymptomatic retinal breaks and lattice degeneration. Of the remaining 11 reviews that identified one or more clinical trials to address the questions, 6 (55%) reviews concluded that additional randomized clinical trials are necessary to properly guide the management of the specific retinal condition.
To date, some systematic reviews in retina conducted by Cochrane methods found no or inadequate evidence on which eye caregivers can base recommendations for treatment or other types of intervention. In addition, 55% of systematic reviews conclude that additional randomized clinical trials are needed to provide more conclusive evidence for treatment recommendations. These data highlight the need for well-designed clincal trials in retina. Innovative sources of funding may be required to conduct the clinical trials needed.
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