Errors in the Diagnosis of Visual Field Progression in Normal-tension Glaucoma

The Normal-tension Glaucoma Study Group

Research output: Contribution to journalArticle

95 Citations (Scopus)

Abstract

Background: Despite strictly defined criteria for visual field progression in the ongoing Normal-tension Glaucoma Study, the authors noted a surprisingly large number of patients reaching the endpoint. Traditional methods could not be used to check the diagnostic accuracy of their criteria, because no "gold standard" was established for distinguishing true change from physiologic long-term fluctuation. Methods: The authors developed a statistical method based on the results of duplicate tests for progression in their subjects. This method allowed the authors to assess the sensitivity, specificity, and predictive values of their diagnostic criterion. It also estimated the true incidence of progression and provided standard errors for the estimates. Results: The authors found that their original strict criteria for progression, based on duplicate testing, produced false calls of progression 57% of the time. By raising the requirement for deterioration and by repeating the entire sequence of duplicate testing once more, the authors have successfully reduced the rate of false calls to 2%. Conclusion: Accuracy in recognizing progression is improved by not accepting small changes as evidence of progression and by confirming the findings on repeat testing.

Original languageEnglish (US)
Pages (from-to)1589-1595
Number of pages7
JournalOphthalmology
Volume101
Issue number9
DOIs
StatePublished - 1994
Externally publishedYes

Fingerprint

Low Tension Glaucoma
Visual Fields
Sensitivity and Specificity
Incidence

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Errors in the Diagnosis of Visual Field Progression in Normal-tension Glaucoma. / The Normal-tension Glaucoma Study Group.

In: Ophthalmology, Vol. 101, No. 9, 1994, p. 1589-1595.

Research output: Contribution to journalArticle

The Normal-tension Glaucoma Study Group. / Errors in the Diagnosis of Visual Field Progression in Normal-tension Glaucoma. In: Ophthalmology. 1994 ; Vol. 101, No. 9. pp. 1589-1595.
@article{af55702e52ac4e6aba9f47c7e852d264,
title = "Errors in the Diagnosis of Visual Field Progression in Normal-tension Glaucoma",
abstract = "Background: Despite strictly defined criteria for visual field progression in the ongoing Normal-tension Glaucoma Study, the authors noted a surprisingly large number of patients reaching the endpoint. Traditional methods could not be used to check the diagnostic accuracy of their criteria, because no {"}gold standard{"} was established for distinguishing true change from physiologic long-term fluctuation. Methods: The authors developed a statistical method based on the results of duplicate tests for progression in their subjects. This method allowed the authors to assess the sensitivity, specificity, and predictive values of their diagnostic criterion. It also estimated the true incidence of progression and provided standard errors for the estimates. Results: The authors found that their original strict criteria for progression, based on duplicate testing, produced false calls of progression 57{\%} of the time. By raising the requirement for deterioration and by repeating the entire sequence of duplicate testing once more, the authors have successfully reduced the rate of false calls to 2{\%}. Conclusion: Accuracy in recognizing progression is improved by not accepting small changes as evidence of progression and by confirming the findings on repeat testing.",
author = "{The Normal-tension Glaucoma Study Group} and Michael Schulzer and Airaksinen, {P. Juhani} and Alward, {Wallace L.} and Marcel Amyot and Douglas Anderson and Gordon Balazsi and Pierre Blondeau and Cashwell, {L. Frank} and Cohen, {John S.} and Daniel Desjardins and Christopher Dickens and Douglas, {Gordon R.} and Drance, {Stephen M.} and Frederick Feldman and Geijssen, {H. Caroline} and Grajewski, {Alana Lee} and Erik Greve and John Hetherington and Dale Heuer and Elizabeth Hodapp and Hoskins, {H. Dunbar} and Andrew Iwach and Henry Jampel and Oscar Kasner and Yoshiaki Kitazawa and Rauni Komulainen and Ralph Levene and Jeffrey Liebmann and Mikelberg, {Frederick S.} and Richard Mills and Donald Minckler and Michael Motolko and Todd Perkins and Irvin Pollock and Harry Quigley and Robert Ritch and Rosanelli, {E. George} and Arthur Schwartz and Shiroki Shirato and Geoji Tomita and Graham Trope and Anja Tuulonen and Jacob Wilensky",
year = "1994",
doi = "10.1016/S0161-6420(94)31133-X",
language = "English (US)",
volume = "101",
pages = "1589--1595",
journal = "Ophthalmology",
issn = "0161-6420",
publisher = "Elsevier Inc.",
number = "9",

}

TY - JOUR

T1 - Errors in the Diagnosis of Visual Field Progression in Normal-tension Glaucoma

AU - The Normal-tension Glaucoma Study Group

AU - Schulzer, Michael

AU - Airaksinen, P. Juhani

AU - Alward, Wallace L.

AU - Amyot, Marcel

AU - Anderson, Douglas

AU - Balazsi, Gordon

AU - Blondeau, Pierre

AU - Cashwell, L. Frank

AU - Cohen, John S.

AU - Desjardins, Daniel

AU - Dickens, Christopher

AU - Douglas, Gordon R.

AU - Drance, Stephen M.

AU - Feldman, Frederick

AU - Geijssen, H. Caroline

AU - Grajewski, Alana Lee

AU - Greve, Erik

AU - Hetherington, John

AU - Heuer, Dale

AU - Hodapp, Elizabeth

AU - Hoskins, H. Dunbar

AU - Iwach, Andrew

AU - Jampel, Henry

AU - Kasner, Oscar

AU - Kitazawa, Yoshiaki

AU - Komulainen, Rauni

AU - Levene, Ralph

AU - Liebmann, Jeffrey

AU - Mikelberg, Frederick S.

AU - Mills, Richard

AU - Minckler, Donald

AU - Motolko, Michael

AU - Perkins, Todd

AU - Pollock, Irvin

AU - Quigley, Harry

AU - Ritch, Robert

AU - Rosanelli, E. George

AU - Schwartz, Arthur

AU - Shirato, Shiroki

AU - Tomita, Geoji

AU - Trope, Graham

AU - Tuulonen, Anja

AU - Wilensky, Jacob

PY - 1994

Y1 - 1994

N2 - Background: Despite strictly defined criteria for visual field progression in the ongoing Normal-tension Glaucoma Study, the authors noted a surprisingly large number of patients reaching the endpoint. Traditional methods could not be used to check the diagnostic accuracy of their criteria, because no "gold standard" was established for distinguishing true change from physiologic long-term fluctuation. Methods: The authors developed a statistical method based on the results of duplicate tests for progression in their subjects. This method allowed the authors to assess the sensitivity, specificity, and predictive values of their diagnostic criterion. It also estimated the true incidence of progression and provided standard errors for the estimates. Results: The authors found that their original strict criteria for progression, based on duplicate testing, produced false calls of progression 57% of the time. By raising the requirement for deterioration and by repeating the entire sequence of duplicate testing once more, the authors have successfully reduced the rate of false calls to 2%. Conclusion: Accuracy in recognizing progression is improved by not accepting small changes as evidence of progression and by confirming the findings on repeat testing.

AB - Background: Despite strictly defined criteria for visual field progression in the ongoing Normal-tension Glaucoma Study, the authors noted a surprisingly large number of patients reaching the endpoint. Traditional methods could not be used to check the diagnostic accuracy of their criteria, because no "gold standard" was established for distinguishing true change from physiologic long-term fluctuation. Methods: The authors developed a statistical method based on the results of duplicate tests for progression in their subjects. This method allowed the authors to assess the sensitivity, specificity, and predictive values of their diagnostic criterion. It also estimated the true incidence of progression and provided standard errors for the estimates. Results: The authors found that their original strict criteria for progression, based on duplicate testing, produced false calls of progression 57% of the time. By raising the requirement for deterioration and by repeating the entire sequence of duplicate testing once more, the authors have successfully reduced the rate of false calls to 2%. Conclusion: Accuracy in recognizing progression is improved by not accepting small changes as evidence of progression and by confirming the findings on repeat testing.

UR - http://www.scopus.com/inward/record.url?scp=0027970668&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027970668&partnerID=8YFLogxK

U2 - 10.1016/S0161-6420(94)31133-X

DO - 10.1016/S0161-6420(94)31133-X

M3 - Article

C2 - 8090461

AN - SCOPUS:0027970668

VL - 101

SP - 1589

EP - 1595

JO - Ophthalmology

JF - Ophthalmology

SN - 0161-6420

IS - 9

ER -