Research Questions and Outcomes Prioritized by Patients With Dry Eye
- 1 October 2018
- journal article
- research article
- Published by American Medical Association (AMA) in JAMA Ophthalmology
- Vol. 136 (10), 1170-1179
- https://doi.org/10.1001/jamaophthalmol.2018.3352
Abstract
Question What are patient priorities for future dry eye research? Findings A 6-step process (identifying research questions from a prior survey of clinicians and identifying outcomes from existing research, followed by a 2-round online Delphi survey of 420 patients with dry eye) was used to identify 8 research questions and 26 outcomes important to patients with dry eye. The top 3 questions pertained to effectiveness of patient education, environmental modifications, and topical anti-inflammatory drops, and the top 3 outcomes included ocular burning or stinging, ocular discomfort, and ocular pain. Meaning Results of this study may refine future research assessing dry eye treatments. Importance Dry eye is a common ocular surface condition with significant influence on patient quality of life and societal economic burden. There is an urgent need to prioritize new research for dry eye. Objective To identify and rank research questions and outcomes important to patients with dry eye. Design, Setting, and Participants This study was conducted using the following 6 steps: (1) identifying research questions from a previous survey of clinicians who treat patients with dry eye; (2) identifying outcomes from existing research (systematic reviews and their cited clinical trials in the Cochrane Eyes and Vision US Satellite database of eyes and vision reviews, and National Eye Institute–funded clinical trials registered on ClinicalTrials.gov) as of June 13, 2017; (3) identifying a sample of patients with dry eye from the email subscribers to the online newsletter KeratoScoop; (4) and (5) conducting a 2-round Delphi survey of those patients online in November and December 2017, respectively; and (6) designating and ranking questions and outcomes as important. Main Outcomes and Measures Importance assigned to research questions and outcomes for dry eye. A research question or outcome ranked by at least 75% of patients as 6 or higher on a scale of 0 to 10 was considered important. Results Among the 420 patients from 15 countries who completed both rounds of the Delphi survey, most were 60 years of age or older (233 [56%]), female (348 [83%]), white (393 [94%]), and of non-Hispanic ethnicity (398 [95%]). Among the 12 questions that clinicians had previously prioritized, patients rated 8 as important. The top 3 questions pertained to effectiveness of patient education, environmental modifications, and topical anti-inflammatory eye drops for dry eye. Among the 109 outcomes identified in existing research on dry eye, patients rated 26 as important. Ten of these 26 were unpopular in existing research, with fewer than 10% of 158 studies reporting these outcomes. Of the 10 most important outcomes, 9 were associated with symptoms or quality of life. The 3 outcomes rated most important by patients were ocular burning or stinging, ocular discomfort, and ocular pain. Conclusions and Relevance This study identified research questions and outcomes important to patients with dry eye. A considerable gap was noted between outcomes in existing research on dry eye and outcomes patients consider important. Future research on dry eye should consider addressing the important research questions and outcomes identified herein, taking into account the patient perspective.Keywords
This publication has 35 references indexed in Scilit:
- Impact of dry eye on reading in a population-based sample of the elderly: the Salisbury Eye EvaluationBritish Journal of Ophthalmology, 2013
- Prevalence of dry eye syndrome in an adult populationClinical & Experimental Ophthalmology, 2013
- Dry Eye Disease: Impact on Quality of Life and VisionCurrent Ophthalmology Reports, 2013
- Developing core outcome sets for clinical trials: issues to considerTrials, 2012
- The ClinicalTrials.gov Results Database — Update and Key IssuesThe New England Journal of Medicine, 2011
- The International Workshop on Meibomian Gland Dysfunction: Report of the Subcommittee on the Epidemiology of, and Associated Risk Factors for, MGDInvestigative Ophthalmology & Visual Science, 2011
- Impact of dry eye disease and treatment on quality of lifeCurrent Opinion in Opthalmology, 2010
- Avoidable waste in the production and reporting of research evidenceThe Lancet, 2009
- Research in Dry Eye: Report of the Research Subcommittee of the International Dry Eye WorkShop (2007)The Ocular Surface, 2007
- Dysfunctional Tear SyndromeCornea, 2006