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. 2020 May 29;2020(5):CD012947. doi: 10.1002/14651858.CD012947.pub2

Gracitelli 2014.

Study characteristics
Patient Sampling Cohort study. Participants with glaucoma or who were glaucoma suspects were enrolled when attending an outpatient clinic. Data from one eye were included in the analysis.
Patient characteristics and setting Sample size: 45 eyes (9 narrow angle and 36 open angle).
Age: mean (SD), 47.1 ± 16.4, range 19‐85 years.
Sex: 30 (67.7%) female.
Setting: secondary care.
Country: Brazil.
Ethnicity: not reported.
Exclusions: conditions precluding clear visualization of the AC (e.g. pterygium, corneal opacity), congenital anterior segment, abnormalities, eyelid alterations, ocular trauma and intraocular surgery (incisional or laser procedures).
Index tests Flashlight: A flashlight beam was directed parallel to the iris from the temporal side. Eyes identified as having a narrow anterior chamber were those in which a nasal iris shadow, formed between the limbus and the pupillary edge, was visualised (grade 1). Cut‐off value grade 1 was used for the analysis.
Target condition and reference standard(s) Gonioscopy was performed in a dark room. An occludable angle was defined as the posterior trabecular meshwork not visible in 2 or more quadrants without indentation (≥ 180 degrees).
Flow and timing Eyes which were excluded or had uninterpretable test results were not reported. The index test and reference standard were conducted on the same occasion.
Comparative  
Notes Conflict of interest: authors reported no conflicts of interest.
Methodological quality
Item Authors' judgement Risk of bias Applicability concerns
DOMAIN 1: Patient Selection
Was a consecutive or random sample of patients enrolled? Unclear    
Was a case‐control design avoided? Yes    
Did the study avoid inappropriate exclusions? Yes    
Could the selection of patients have introduced bias?   Unclear risk  
Are there concerns that the included patients and setting do not match the review question?     Low concern
DOMAIN 2: Index Test (LACD)
DOMAIN 2: Index Test (Scheimpflug photography)
DOMAIN 2: Index Test (AS‐OCT)
DOMAIN 2: Index Test (SPAC)
DOMAIN 2: Index Test (Flashlight)
Were the index test results interpreted without knowledge of the results of the reference standard? Yes    
If a threshold was used, was it pre‐specified? Yes    
Could the conduct or interpretation of the index test have introduced bias?   Low risk  
Are there concerns that the index test, its conduct, or interpretation differ from the review question?     Unclear
DOMAIN 3: Reference Standard
Is the reference standards likely to correctly classify the target condition? Yes    
Were the reference standard results interpreted without knowledge of the results of the index tests? Yes    
Could the reference standard, its conduct, or its interpretation have introduced bias?   Low risk  
Are there concerns that the target condition as defined by the reference standard does not match the question?     Low concern
DOMAIN 4: Flow and Timing
Was there an appropriate interval between index test and reference standard? Yes    
Were all patients included in the analysis? Yes    
Did all patients receive a reference standard Yes    
Could the patient flow have introduced bias?   Low risk