Article Text

Original research
Interests and needs of eye care providers in clinical decision support for glaucoma
  1. Brian Stagg1,2,
  2. Joshua D Stein3,4,5,
  3. Felipe A Medeiros6,
  4. Mollie Cummins7,
  5. Kensaku Kawamoto8,
  6. Rachel Hess2,9
  1. 1Ophthalmology and Visual Sciences, University of Utah Health John A Moran Eye Center, Salt Lake City, Utah, USA
  2. 2Population Health Sciences, University of Utah Health, Salt Lake City, Utah, USA
  3. 3Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, USA
  4. 4Institute for Healthcare Policty and Innovation, University of Michigan, Ann Arbor, Michigan, USA
  5. 5Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
  6. 6Ophthalmology, Duke University, Durham, North Carolina, USA
  7. 7College of Nursing, University of Utah Health, Salt Lake City, Utah, USA
  8. 8Biomedical Informatics, University of Utah Health, Salt Lake City, Utah, USA
  9. 9Internal Medicine, University of Utah, Salt Lake City, Utah, USA
  1. Correspondence to Dr Brian Stagg; brian.stagg{at}


Objective To study whether clinicians who treat glaucoma are interested in using clinical decision support (CDS) tools for glaucoma, what glaucoma clinical decisions they feel would benefit from CDS, and what characteristics of CDS design they feel would be important in glaucoma clinical practice.

Methods and analysis Working with the American Glaucoma Society, the Utah Ophthalmology Society and the Utah Optometric Association, we identified a group of clinicians who care for patients with glaucoma. We asked these clinicians about interest in CDS, what glaucoma clinical decisions would benefit from CDS, and what characteristics of CDS tool design would be important in glaucoma clinical practice.

Results Of the 105 clinicians (31 optometrists, 10 general ophthalmologists and 64 glaucoma specialists), 93 (88.6%) were either ‘definitely’ or ‘probably’ interested in using CDS for glaucoma. There were no statistically significant differences in interest between clinical specialties (p=0.12), years in practice (p=0.85) or numbers of patients seen daily (p=0.99). Identifying progression of glaucoma was the clinical decision the largest number of clinicians felt would benefit from CDS (104/105, 99.1%). An easy to use interface was the CDS characteristic the largest number of clinicians felt would be ‘very important’ (93/105, 88.6%).

Conclusion Of this group of clinicians who treat glaucoma, 88.6% were interested in using CDS for glaucoma and 99.1% felt that identification of glaucomatous progression could benefit from CDS. This level of interest supports future work to develop CDS for glaucoma.

  • glaucoma
  • epidemiology

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  • Contributors BS developed the research plan, designed the data collection tools, collected the data, analysed the data and drafted the manuscript. He is the guarantor. JDS, FAM, MC, KK and RH helped prepare the research plan, provided feedback regarding the data collection tools, provided critical analysis of the data results, and revised the manuscript. All authors were involved in all stages of the research project and manuscript preparation.

  • Funding This work was supported by National Institutes of Health (R01 EY026641 to JDS and R01 EY029885 to FAM) and an Unrestricted Grant from Research to Prevent Blindness, New York, New York, USA to the Department of Ophthalmology & Visual Sciences, University of Utah.

  • Disclaimer The funding organisations had no role in the design or conduct of this research.

  • Competing interests KK reports honoraria, consulting or sponsored research outside the submitted work with McKesson InterQual, Hitachi, Pfizer, Premier, Klesis Healthcare, RTI International, Mayo Clinic, Vanderbilt University, the University of Washington, the University of California at San Francisco, MD Aware, and the US Office of the National Coordinator for Health IT (via ESAC, JBS International, A+Government Solutions, Hausam Consulting and Security Risk Solutions) in the area of health information technology. KK is also an unpaid board member of the non-profit Health Level Seven International health IT standard development organisation, and he has helped develop a number of health IT tools which may be commercialised to enable wider impact. None of these relationships have direct relevance to the manuscript but are reported in the interest of full disclosure. RH reports personal fees from Astellas Pharmaceuticals, outside the submitted work. FAM reports grants from National Eye Institute, during the conduct of the study; personal fees from Aeri Pharmaceuticals, personal fees from Allergan, personal fees from Novartis, personal fees from Biogen, personal fees from Galimedix, personal fees from Annexon, grants from Google, grants from Carl-Zeiss Meditec, personal fees from Heidelberg Engineering, personal fees from Stealth Biotherapeutics, personal fees from IDx, personal fees from Reichert, outside the submitted work.

  • Patient consent for publication Not required.

  • Ethics approval This study was approved by the University of Utah Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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