title: RAND-like appropriateness methodology consensus for primary open-angle glaucoma in Latin America.
abstract: OBJECTIVE
  To report the results of a Latin American consensus panel regarding the diagnosis and management of primary open-angle glaucoma and to compare these results with those from a similar panel in the United States.
  
  
  METHODS
  A RAND-like (Research and Development) appropriateness methodology was used to assess glaucoma practice in Latin America.
  
  
  METHODS
  The 148 polling statements created for the RAND- like analysis in the United States and 10 additional statements specific to glaucoma care in Latin America were presented to a panel of Latin American glaucoma experts. Panelists were polled in private using the RAND- like methodology before and after the panel meeting.
  
  
  RESULTS
  Consensus agreement or disagreement among Latin American experts was reached for 51.3% of statements before the meeting and increased to 66.5% in the private, anonymous meeting after polling (79.0% agreement, 21.0% disagreement). Although there was a high degree of concordance (111 of 148 statements; 75%) between the results of this Latin American panel and the United States panel, there were some notable exceptions relating to diagnostic and therapeutic decision making.
  
  
  CONCLUSIONS
  This RAND-like consensus methodology provides a perspective of how Latin American glaucoma practitioners view many aspects of glaucoma and compares these results with those obtained using a similar methodology from practitioners in the United States. These findings may be helpful to ophthalmologists providing glaucoma care in Latin America and in other regions of the world.
authors.affiliation: Fundacion para el Estudio del Glaucoma and Facultad de Posgrado, Universidad Favaloro, Buenos Aires, Argentina. fabianlerner@fibertel.com.ar
authors.forename: S Fabian
authors.initials: SF
authors.lastname: Lerner
authors.forename: Kuldev
authors.initials: K
authors.lastname: Singh
authors.forename: Remo
authors.initials: R
authors.lastname: Susanna
authors.forename: M Roy
authors.initials: MR
authors.lastname: Wilson
authors.forename: Brian L
authors.initials: BL
authors.lastname: Lee
authors.forename: Eugenio
authors.initials: E
authors.lastname: Maul
mesh_terms: D000959:Antihypertensive Agents / Q000008:administration & dosage*; D019317:Evidence-Based Medicine; D005104:Expert Testimony; D018463:Filtering Surgery / Q000379:methods*; D020327:Glaucoma Drainage Implants; D005902:Glaucoma, Open-Angle / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D007429:Intraocular Pressure; D007843:Latin America; D009885:Ophthalmology / Q000592:standards*; D017063:Outcome Assessment, Health Care; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000592:standards; D011795:Surveys and Questionnaires; D014481:United States; D014600:Utilization Review
chemical_list: D000959:Antihypertensive Agents