Comparative Effectiveness & Medical Interventions for Primary Open Angle Glaucoma

描述（由申请人提供）： 本申请涉及广泛的挑战领域（05）比较有效性研究（CER）和特定的挑战主题，05-EY-103：眼睛和视力系统评价。比较有效性研究是“对特定患者的特定医疗条件下的许多治疗方案的有效性和危害进行严格评估”。混合治疗比较（MTC）荟萃分析是一种新的技术，吸引了相当大的兴趣，因为它的潜力比较有效性研究。它扩大了典型的系统性综述的范围，通过同时综合同一试验（“直接证据”）和不同试验（“间接证据”）的证据，比较一系列可用干预措施对给定条件的相对益处和危害。在这样做的过程中，MTC荟萃分析有效地利用了现有的信息，并更紧密地平行于临床医生，患者和决策者所面临的决策，他们必须在各种替代干预措施中做出选择。与该领域的领导者合作，我们建议使用最先进的贝叶斯MTC荟萃分析模型来评估原发性开角型青光眼（POAG）多种医疗干预措施的比较有效性。POAG给患者和医疗资源带来了巨大的负担。利用现有高质量随机对照试验的数据，我们将进行MTC荟萃分析，并对POAG的多种药物治疗方案进行排名。我们将验证MTC荟萃分析模型，并评估发表偏倚的影响。我们将报告和传播我们关于POAG医疗干预的比较有效性的研究结果，以及MTC荟萃分析技术在比较有效性研究中的实用性和有效性。通过提供干预措施的比较有效性的证据，我们的工作成果将对临床实践产生重大影响，并影响比较有效性研究方法的发展。本研究还将展示和验证一个元分析模型，用于以加速和实用的格式生成比较有效性证据，该模型具有吸引力，适用于所有医疗保健领域。本申请涉及广泛的挑战领域（05）比较有效性研究（CER）和特定的挑战主题，05-EY-103：眼睛和视力系统评价。

DESCRIPTION (provided by applicant): This application addresses broad Challenge Area (05) Comparative Effectiveness Research (CER) and specific Challenge Topic, 05-EY-103: Eyes and Vision Systematic Reviews. Comparative effectiveness research is "a rigorous evaluation of the effectiveness and harms of many treatment options available for a given medical condition for a particular set of patients". Mixed treatment comparison (MTC) meta-analysis is a novel technique attracting considerable interest because of its potential for comparative effectiveness research. It expands the scope of a typical systematic review by comparing the relative benefits and harms among a range of available interventions for a given condition, through synthesizing simultaneously evidence not only within the same trials ("direct evidence") but also across trials ("indirect evidence"). In doing so, MTC meta-analysis efficiently utilizes existing information and parallels more closely the decisions facing clinicians, patients and policymakers who must choose among a variety of alternative interventions. Working in collaboration with leaders in the field, we propose to assess the comparative effectiveness of multiple medical interventions available for primary open angle glaucoma (POAG) using the state-of-art Bayesian MTC meta-analysis models. POAG poses substantial burdens on patients and health care resources. Utilizing data from existing high quality randomized controlled trials, we will perform MTC meta-analysis and rank multiple medical treatment options for POAG. We will validate the MTC meta-analysis models and assess the impact of publication bias. We will report and disseminate our findings on the comparative effectiveness of medical interventions for POAG, as well as utility and validity of MTC meta-analysis techniques for comparative effectiveness research. By providing evidence on comparative effectiveness of interventions, the outcome of our work will have substantial impact on clinical practice, and influence on development of methodology for comparative effectiveness research. This study will also demonstrate and validate a meta-analytical model for generating comparative effectiveness evidence in an accelerated and practical format, which can be attractive and applied across all health care fields. This application addresses broad Challenge Area (05) Comparative Effectiveness Research (CER) and specific Challenge Topic, 05-EY-103: Eyes and Vision Systematic Reviews.