Management of ocular hypertension and open angle glaucoma: clinical practice and computer-assisted decision-making

To evaluate the feasibility of computerized decision support in the management of patients with open angle glaucoma or ocular hypertension.

Based on a Swedish consensus document a computer program was developed, which provided one of 25 different recommendations for appropriate action. In 373 patient visits to seven different eye clinics, the program's recommendations were compared to the actual decisions made by the responsible ophthalmologists.

Notable differences were observed between the clinics' management strategies, especially regarding follow-up frequency and start or increase of anti-glaucoma treatment. The program's recommendations conformed with the clinical decisions in 23 to 92% of the cases when a standard management strategy was simulated. The concordance increased to 93 to 100%, when policy differences between the clinics were taken into account.

Clinical decision-making in the management of patients with ocular hypertension or open angle glaucoma can be implemented in a computer program. The optimum management protocol remains to be defined.