Data Volume and the Need for Clinical Decision Support in Glaucoma Care.

PURPOSE: Glaucoma providers longitudinally integrate clinical data to inform treatment decisions. While information overload is an increasingly well-recognized issue in medicine, the volume of information associated with glaucoma care remains poorly understood. In this descriptive study, we aim to quantify the cumulative data volume associated with longitudinal glaucoma care in the Sight Outcomes Research Collaborative (SOURCE) database.

DESIGN

Retrospective, multicenter cross-sectional study.

SUBJECTS: Patients with glaucoma in SOURCE database who saw an eye care provider in 2021 and >2 years prior.

METHODS

The number of glaucoma-relevant data points (intraocular pressure [IOP] measurements, retinal nerve fiber layer [RNFL] OCT scans, visual field [VF] tests, prior treatments, comorbidities, and prior eye care providers seen) was determined per patient and stratified by years of database enrollment. Subanalyses based on provider-type and individual year were also performed.

MAIN OUTCOME MEASURES: Number of cumulative glaucoma-relevant clinical data points per patient.

RESULTS

In 2021, 60 624 patients with glaucoma with median enrollment of 2641 days and a median age of 77 years were seen across 11 sites; 13 426 patients (22.1%) were enrolled for 2 to 5 years, 38 630 (63.7%) for 6 to 8 years, and 8568 (14.1%) for ≥9 years. In total, patients underwent a median of 30 IOP measurements (interquartile range [IQR] 16-52), 2 VF tests (IQR 0-6), and 3 RNFL OCT scans (IQR 0-8) within the study period. After stratifying by enrollment time, patients followed for ≥9 years had up to 636 IOP measurements on record (median 40) and saw up to 76 unique eye care providers (median 8). By 2021, 59 472 (98.1%) patients had >7 glaucoma-relevant clinical data points on record. In 2021, eye care providers saw a median of 31 unique patients with glaucoma each (range 1-1812).

CONCLUSIONS

The SOURCE database contains a large volume of data associated with longitudinal glaucoma care. As the prevalence of glaucoma is expected to grow substantially in coming decades, improved clinical decision support may be helpful for accurately and efficiently appraising large amounts of clinical data. Understanding the data volume associated with glaucoma care may be useful for developing future clinical decision-support strategies and further studying this topic.

FINANCIAL DISCLOSURES: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.