SynthesisTrials2026
Pinpointing precision: axial length and refraction in paediatric myopia trials-a mixed methods study.
Synthesis in Trials, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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.
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.
Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeMost paediatric myopia intervention trials report two primary outcomes: axial length and cycloplegic autorefraction. Having one single primary outcome would increase trial efficiency, reduce participant burden, and may improve trial retention. This article aims to evaluate precision of axial length and cycloplegic autorefraction and to explore eye care professionals' and young people's views of cycloplegia.
methodsMixed methods study with meta-analysis of axial length and cycloplegic spherical equivalent measurements reported by paediatric myopia treatment trials; interviews with eye care professionals; engagement/involvement discussion with children and young people.
resultsIn the meta-analysis, mean effect size (standard error, SE) was -0.52 (0.12, p < 0.001, 95% confidence interval (CI) -0.76 to -0.29) for axial length and 0.49 (0.11, p < 0.001, CI 0.27 to 0.71) for cycloplegic spherical equivalent refraction. Difference in mean point estimates was 0.033, SE of the difference 0.164 (CI -0.29 to +0.535). With t-statistic (mean difference/SE of mean difference) of 0.20, two-tailed p value was 0.84. Eye care professionals report that children dislike cycloplegia, describing discomfort, distress, and potential refusal to attend follow-up appointments. Children and young people describe pain and discomfort, remember prolonged effects such as blurred vision and light sensitivity, and complain about receiving insufficient information about adverse effects.
conclusionsWhilst the precision of axial length and cycloplegic autorefraction spherical equivalent measurements is similar, cycloplegic autorefraction requires longer study visits and inflicts more discomfort. In the design of future trials, researchers, funders, and regulators should consider increasing trial efficiency by selecting axial length as primary outcome and removing cycloplegic refraction from follow-up assessments.
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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.