Incorporating Mortality Risk Into Estimates of 5-Year Glaucoma Risk

Published In: American Journal of Ophthalmology, v. 148, no. 6, Dec. 2009, p. 925-931, Appendix 931.e1-931.e7

Posted on RAND.org on December 31, 2008

by Beth Ann Griffin, Marc N. Elliott, Anne L. Coleman, Eric M. Cheng

Read More

Access further information on this document at Elsevier, Inc

This article was published outside of RAND. The full text of the article can be found at the link above.

PURPOSE: To incorporate mortality risk, a potentially important factor to consider when deciding whether to initiate therapy for ocular hypertensives, into estimates of 5-year glaucoma risk. DESIGN: Comparison study of estimates of glaucoma risk that do and do not account for mortality risk. METHODS: The authors computed 5-year risk of glaucoma for a set of hypothetical glaucoma suspects. They then determined their 5-year risk of death using the Charlson index, which is based on age and comorbidity, and computed mortality-adjusted 5-year risk that the individual will develop glaucoma before death. RESULTS: Accounting for mortality risk reduces the risk of developing glaucoma in one's lifetime. For example, a 75-year-old patient with an unadjusted 5-year glaucoma risk of 51.0% can have mortality-adjusted 5-year glaucoma risks of 41.8% (18% relative risk reduction) or 20.2% (60% relative risk reduction) assuming the patient has a Charlson comorbidity score of 1 or 3, respectively. CONCLUSIONS: Shortened life expectancy reduces 5-year risk of developing glaucoma. Thus, mortality risk is another factor clinicians should consider when deciding whether to initiate treatment of glaucoma suspects.

This report is part of the RAND Corporation external publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.