Evidence map›Paper›PMID 25906974›Full record

Trial reportTrials2015

Personalized versus standardized dosing strategies for the treatment of childhood amblyopia: study protocol for a randomized controlled trial.

Merrick J Moseley, Michael P Wallace, David A Stephens, Alistair R Fielder, Laura C Smith, Catherine E Stewart, RODS (Randomized Occlusion Dosing Strategies) Study Cooperative

Open access · goldAbstract readComparative StudyRandomized Controlled Trial
In one paragraph

Trial report in Trials, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 2 countries.

Merrick J MoseleyDivision of Optometry and Visual Science, City University, London, EC1V 0HB, UK. m.j.moseley@city.ac.uk.
Michael P WallaceDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada. michael.wallace@mcgill.ca.
David A StephensDepartment of Mathematics and Statistics, McGill University, Montreal, Canada. dstephens@math.mcgill.ca.
Alistair R FielderDivision of Optometry and Visual Science, City University, London, EC1V 0HB, UK. a.fielder@city.ac.uk.
Laura C SmithDivision of Optometry and Visual Science, City University, London, EC1V 0HB, UK. laura.smith.2@city.ac.uk.
Catherine E StewartDivision of Optometry and Visual Science, City University, London, EC1V 0HB, UK. c.e.stewart@city.ac.uk.
RODS (Randomized Occlusion Dosing Strategies) Study Cooperative
City, University of London · GBMcGill University Health Centre · CA

Funding

Department of Health CAT CL09-13Department of Health PB-PG-0808-16087
6 · The paper itself

Abstract

backgroundAmblyopia is the commonest visual disorder of childhood in Western societies, affecting, predominantly, spatial visual function. Treatment typically requires a period of refractive correction ('optical treatment') followed by occlusion: covering the nonamblyopic eye with a fabric patch for varying daily durations. Recent studies have provided insight into the optimal amount of patching ('dose'), leading to the adoption of standardized dosing strategies, which, though an advance on previous ad-hoc regimens, take little account of individual patient characteristics. This trial compares the effectiveness of a standardized dosing strategy (that is, a fixed daily occlusion dose based on disease severity) with a personalized dosing strategy (derived from known treatment dose-response functions), in which an initially prescribed occlusion dose is modulated, in a systematic manner, dependent on treatment compliance. METHODS/

designA total of 120 children aged between 3 and 8 years of age diagnosed with amblyopia in association with either anisometropia or strabismus, or both, will be randomized to receive either a standardized or a personalized occlusion dose regimen. To avoid confounding by the known benefits of refractive correction, participants will not be randomized until they have completed an optical treatment phase. The primary study objective is to determine whether, at trial endpoint, participants receiving a personalized dosing strategy require fewer hours of occlusion than those in receipt of a standardized dosing strategy. Secondary objectives are to quantify the relationship between observed changes in visual acuity (logMAR, logarithm of the Minimum Angle of Resolution) with age, amblyopia type, and severity of amblyopic visual acuity deficit. DISCUSSION: This is the first randomized controlled trial of occlusion therapy for amblyopia to compare a treatment arm representative of current best practice with an arm representative of an entirely novel treatment regimen based on statistical modelling of previous trial outcome data. Should the personalized dosing strategy demonstrate superiority over the standardized dosing strategy, then its adoption into routine practice could bring practical benefits in reducing the duration of treatment needed to achieve an optimal outcome.

trial registrationISRCTN ISRCTN12292232.

Indexed as

BandagesSensory DeprivationVision, OcularVisual AcuityAge FactorsAmblyopiaChildChild, PreschoolClinical ProtocolsFemaleHumansLondonMaleRecovery of FunctionResearch DesignTime Factors

Identifiers

PMID25906974
PMCPMC4414426
OpenAlexW2152047454

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.