Evidence map›Paper›PMID 39147325›Full record

ArticleOphthalmology. Glaucoma

Gap Analysis of Glaucoma Examination Concept Representations within Standard Systemized Nomenclature of Medicine - Clinical Terms.

Shahin Hallaj, Anthony P Khawaja, Ian A S Rodrigues, Michael V Boland, Eric N Brown, Aiyin Chen, Brian C Stagg, Joshua D Stein, Catherine Q Sun, Anne-Laure Mahe-Cook and 5 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Ophthalmology. Glaucoma. 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
–field-weighted citation impact
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.

  1. Ahmed and baerveldt in glaucoma surgery: what is the safest choice? - a systematic review and meta-analysis.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2025
    Pooled it
  2. Article
  3. Review
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

15 authors.

Shahin HallajDivision of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California, San Diego, La Jolla, California; Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, California; Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California, San Diego, La Jolla, California.
Anthony P KhawajaNational Institute for Health and Care Research Biomedical Research Centre, Moorfields Eye Hospital National Health Service Foundation Trust and University College London Institute of Ophthalmology, London, UK.
Ian A S RodriguesDepartment of Ophthalmology, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Michael V BolandDepartment of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts.
Eric N BrownDepartment of Ophthalmology, Vanderbilt University Medical Center, Nashville, Tennessee.
Aiyin ChenCasey Eye Institute, Oregon Health & Science University, Portland, Oregon.
Brian C StaggDepartment of Ophthalmology and Visual Sciences, John Moran Eye Center, University of Utah, Salt Lake City, Utah; Department of Population Health Sciences, University of Utah, Salt Lake City, Utah.
Joshua D SteinDepartment of Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor, Michigan.
Catherine Q SunDepartment of Ophthalmology (C.Q.S.), University of California, San Francisco, California; F.I. Proctor Foundation (C.Q.S.), University of California, San Francisco, California.
Anne-Laure Mahe-CookMedisoft Limited, Leeds, UK.
Swarup S SwaminathanBascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
Sophia Y WangByers Eye Institute, Department of Ophthalmology, Stanford University, Palo Alto, California.
Benjamin Y XuRoski Eye Institute, Department of Ophthalmology, Keck School of Medicine at the University of Southern California, Los Angeles, California.
Robert N WeinrebHamilton Glaucoma Center, Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California, San Diego, La Jolla, California.
Sally L BaxterDivision of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California, San Diego, La Jolla, California; Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, California; Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California, San Diego, La Jolla, California. Electronic address: s1baxter@health.ucsd.edu.

Funding

Bridge2AI:Salutogenesis Data Generation ProjectOT2OD032644 · OD · WASHINGTON UNIVERSITY · PI BAXTER, SALLY LIU, CHUTE, CHRISTOPHER G · 2022 to 2025
$32.7M
Vision BiostatisticsP30EY022589 · NEI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Radha Ayyagari · 2012 to 2026
$10.3M
San Diego Biomedical Informatics Education & Research (SABER)T15LM011271 · NLM · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI SHAMIM NEMATI · 2012 to 2026
$9.7M
Enhanced Identification of Ocular Phenotypes and Outcomes in Electronic Health Record DataR01EY032475 · NEI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI STEIN, JOSHUA D · 2022 to 2025
$2.7M
Mentored Vision Clinician-Scientist Program at OHSUK12EY027720 · NEI · OREGON HEALTH & SCIENCE UNIVERSITY · PI David Huang · 2018 to 2026
$2.2M
Multi-modal Health Information Technology Innovations for Precision Management of GlaucomaDP5OD029610 · OD · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI BAXTER, SALLY LIU · 2020 to 2024
$2.1M
Improving Glaucoma Care Using a Scalable Decision Support SystemK23EY032577 · NEI · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · PI Brian Stagg · 2022 to 2026
$1.3M
Real-world outcomes of proliferative diabetic retinopathyK23EY032637 · NEI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI SUN, CATHERINE QING · 2021 to 2025
$1.3M
Improving Individualized Assessments of Glaucoma Progression with Population-Based Electronic Health Record DataK23EY033831 · NEI · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI Swarup Sai Swaminathan · 2022 to 2026
$1.1M
NEI NIH HHS K12 EY027720NEI NIH HHS K23 EY032577NEI NIH HHS K23 EY032637NEI NIH HHS K23 EY033831NEI NIH HHS P30 EY022589NEI NIH HHS R01 EY032475NIH HHS DP5 OD029610NIH HHS OT2 OD032644NLM NIH HHS T15 LM011271
6 · The paper itself

Abstract

objective/purposeStandardization of eye care data is important for clinical interoperability and research. We aimed to address gaps in the representations of glaucoma examination concepts within Systemized Nomenclature of Medicine - Clinical Terms (SNOMED-CT), the preferred terminology of the American Academy of Ophthalmology.

designStudy of data elements.

methodsStructured eye examination data fields from 2 electronic health records (EHR) systems (Epic Systems and Medisoft) were compared against existing SNOMED-CT codes for concepts representing glaucoma examination findings. Glaucoma specialists from multiple institutions were surveyed to identify high-priority gaps in representation, which were discussed among the SNOMED International Eye Care Clinical Reference Group. Proposals for new codes to address the gaps were formulated and submitted for inclusion in SNOMED-CT.

main outcome measuresGaps in SNOMED-CT glaucoma examination concept representations.

resultsWe identified several gaps in SNOMED-CT regarding glaucoma examination concepts. A survey of glaucoma specialists identified high-priority data elements within the categories of tonometry and gonioscopy. For tonometry, there was consensus that we need to define new codes related to maximum intraocular pressure (IOP) and target IOP and delineate all methods of measuring IOP. These new codes were proposed and successfully added to SNOMED-CT for future use. Regarding gonioscopy, the current terminology did not include the ability to denote the gonioscopic grading system used (e.g., Shaffer or Spaeth), degree of angle pigmentation, iris configuration (except for plateau iris), and iris approach. There was also no ability to specify eye laterality or angle quadrant for gonioscopic findings. We proposed a framework for representing gonioscopic findings as observable entities in SNOMED-CT.

conclusionThere are existing gaps in the standardized representation of findings related to tonometry and gonioscopy within SNOMED-CT. These are important areas for evaluating clinical outcomes and enabling secondary use of EHR data for glaucoma research. This international multi-institutional collaborative process enabled identification of gaps, prioritization, and development of data standards to address these gaps. Addressing these gaps and augmenting SNOMED-CT coverage of glaucoma examination findings could enhance clinical documentation and future research efforts related to glaucoma. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Indexed as

Electronic Health RecordsGlaucomaIntraocular PressureOphthalmologySystematized Nomenclature of MedicineTerminology as TopicGonioscopyHumansTonometry, OcularElectronic health recordsGlaucomaGonioscopySystematized Nomenclature of MedicineTonometry

Identifiers

PMID39147325
PMCPMC11781150

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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.