Abstract
Abstract: :
Purpose:To determine the validity of the American Academy of Ophthalmology's Glaucoma Risk Factor Analysis (GRFA) in identifying glaucoma suspect Methods:Patient eligibility was restricted to new patients 18 years of age or older who attended general ophthalmology clinic sessions at a public hospital eye clinic. Patients with previously diagnosed or suspected glaucoma were excluded. Glaucoma risk factor score was based on information concerning age, race, family history of glaucoma, and time of last visit to an eye doctor. We used four as cut off point for the classification of GRFS. A classification of glaucoma status was based on clinical assessment of resident physicians utilizing standard criteria for IOP and disc changes. Results:Of the 387 patients who completed the survey, 43 (11.1%) were diagnosed as glaucoma suspect. The total of the GRFS ranges from zero to seven. Patients diagnosed as glaucoma suspects did not differ significantly from non–suspects in the GRFS (F=2.4, P=0.12). Among the four questions that form the GRFS, race and family history of glaucoma were correlated with glaucoma suspect indicator (r=0.12, p=0.02 & r=0.2, p=0.002 respectively). Patients with GRFS ≥4, their odds of being diagnosed as glaucoma suspect was 1.4 times than patients with GRFS<4 (OR=1.44, CI=0.8–2.7, p=0.3). The validity of the GRFS in our patient population using four as cut off was as follows: sensitivity=44.2%, specificity=64.5%, predictive value positive=13.5%, and predicted value negative=90.2%. Using three as cut off for GRFS, the sensitivity was 72.1% and the specificity was 31.7%. Using two as cut off for GRFS, the sensitivity was 95.3% and the specificity was 8.1%. Conclusions:Glaucoma risk factor score is not associated with glaucoma suspect indicator. Modification of the cut off point for the GRFS could improve the sensitivity. GRFS could be used with lower cut off in a primary care setting to identify glaucoma suspect. Larger study is needed to assess the validity of GRFS.
Keywords: clinical (human) or epidemiologic studies: risk factor assessment • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • clinical (human) or epidemiologic studies: biostatistics/epidemiology methodology