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Randomized Controlled Trial Evaluating a Standardized Strategy for Uveitis Etiologic Diagnosis (ULISSE)
Audrey de Parisot1, Laurent Kodjikian2, Marie-Hélène Errera3
1Department of Internal Medicine, Hospices Civils de Lyon, Croix-Rousse Hospital, Lyon, France.
American Journal of Ophthalmology
|April 4, 2017
Summary
A standardized diagnostic approach for uveitis showed similar diagnostic efficiency to an open strategy, with fewer investigations. This suggests it
Area of Science:
- Ophthalmology
- Immunology
- Internal Medicine
Background:
- Uveitis diagnosis can be complex and resource-intensive.
- Evaluating diagnostic strategies is crucial for efficient patient care.
Purpose of the Study:
- To compare the efficiency of a standardized diagnostic approach versus an open strategy for uveitis.
- To determine the percentage of etiologic diagnoses achieved within six months for both strategies.
Main Methods:
- A noninferiority, prospective, multicenter, clustered randomized controlled trial.
- Included consecutive patients with uveitis across participating ophthalmology departments.
- Compared a minimal standardized evaluation followed by targeted investigations against an open, clinician-directed investigative approach.
Main Results:
- An etiologic diagnosis was established in 54.4% of the open group and 49.5% of the standardized group (P = .2029).
- The standardized strategy involved significantly fewer investigations (3759 vs 5371, P < .0001).
- The difference in diagnostic rates was -4.9% (95% CI [-12.5%; 2.6%]).
Conclusions:
- The standardized diagnostic strategy appears efficient for uveitis etiology.
- Noninferiority of the standardized approach could not be definitively proven.
- The standardized method reduced the number of investigations performed.