Safety recommendation
It is recommended that the International Glaucoma Association facilitate the funding of research into the development and evaluation of an automated, predictive risk stratification tool.
Response:
We agree that a predictive risk stratification tool would be very valuable in glaucoma care in England and indeed across the UK. A tool that would rank patients according to the risk to their sight would help target resources to those who need it most, and ensure a consistent approach across Hospital Eye Services This would ease pressure on glaucoma clinics that are already full to overflowing, and are getting busier as the population ages and more people develop glaucoma.
We are keen to support the development of a tool based on work already carried out in Bristol by Professor John Sparrow. We have indicated to Prof Sparrow that we agree in principle to support this research from our own charitable funds, pending agreement of the details of the research.
- The Royal College of Ophthalmologists in partnership with the UK & Eire Glaucoma Society (UKEGS, part of the IGA) will produce a joint document setting out risk stratification parameters which can be applied in all services, both those using paper based and electronic medical records (EMR).
- The next step will be to adopt the agreed thresholds and use them to produce EMR provider agnostic algorithms to allow for automation of risk stratification at a service level.
- Once developed, there will need to be a validation exercise where the automated stratification is checked manually against the original patient record to make sure that important issues are not being missed by the algorithm. This will be a fairly time intensive exercise, but our hope is that the work will be carried out in Bristol by Professor John Sparrow, and the IGA agrees in principle to fund this research, pending agreement of the details of the study.
The reason for not proceeding directly to an automated electronic solution as recommended by the Report is that the majority of glaucoma services do not yet have the required electronic data for this to be useful across the board - hence the 2 stage approach. As services move to EMR systems, the electronic option will become increasingly useful, but this is expected to take quite some time as a move to electronic working for glaucoma involves back entry of significant amounts of clinical data. TIMELINE: TBA.
The coronavirus emergency sadly means clinicians are focused on front-line medical care and much research is having to take a back seat. The IGA is able to respond as soon as researchers and clinicians time becomes available.
Response received on 6 April 2020.