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

Johnson 2018.

Study characteristics
Patient Sampling Cohort study. Participants aged 50 years or older were selected by inspection of clinical data from visits to the glaucoma clinic between November 2015 and November 2017. Data from one eye were included in the analysis.
Patient characteristics and setting Sample size: 131 eyes (19 narrow angle and 112 open angle).
Age: mean (SD), 62.0 ± 8.7 years.
Sex: 58 (44.3%) female.
Setting: secondary care.
Country: USA.
Ethnicity: 110 (84.0%) Black, 8 (6.1%) White (non‐Hispanic), 6 (4.6%) Hispanic (7.1%), 5 (3.8%) Asian, 2 (1.5%) Middle Eastern.
Exclusions: pseudophakia, aphakia, previous glaucoma surgery, previous iridotomy or iridectomy, anterior segment dysgenesis, phthisis bulbi and corneal opacities.
Index tests LACD: original van Herick grading scheme used (grade 1‐4) performed at the temporal angle. Grade 2 and less was used as the cut‐off (≤ 25%).
Target condition and reference standard(s) Static gonioscopy, an angle was defined as occludable when the posterior trabecular meshwork was not visible in 2 or more quadrants (≥ 180 degrees) in dim illumination.
Flow and timing 131 participants recruited and there were 2 participants who were excluded from the analysis, reason was not reported. Data from 129 eyes were included in the analysis. The index test and reference standard were conducted on the same occasion.
Comparative  
Notes Conflict of interest: authors reported no conflict 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? No    
Was a case‐control design avoided? Yes    
Did the study avoid inappropriate exclusions? Yes    
Could the selection of patients have introduced bias?   High risk  
Are there concerns that the included patients and setting do not match the review question?     High
DOMAIN 2: Index Test (LACD)
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?     Low concern
DOMAIN 2: Index Test (Scheimpflug photography)
DOMAIN 2: Index Test (AS‐OCT)
DOMAIN 2: Index Test (SPAC)
DOMAIN 2: Index Test (Flashlight)
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