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Investigation of current guidelines for prescribing spectacles to children using a modified Delphi approach and the AGREE II tool

Wilson, S., Suttle, C. ORCID: 0000-0001-8694-195X, Shah, R. ORCID: 0000-0002-6134-0936 , Conway, M. ORCID: 0000-0001-5016-0529 & Ctori, I. ORCID: 0000-0003-1523-4996 (2024). Investigation of current guidelines for prescribing spectacles to children using a modified Delphi approach and the AGREE II tool. Ophthalmic and Physiological Optics, 44(6), pp. 1162-1187. doi: 10.1111/opo.13358

Abstract

Purpose
This study aimed to identify clinical guidelines that provide recommendations on prescribing refractive error correction in children, evaluate the overall quality of these guidelines using the Appraisal of Guidelines for REsearch and Evaluation II (AGREE II) tool and subsequently gain consensus on the prescribing recommendations from high‐quality guidelines using the modified Delphi technique.

Methods
A comprehensive search for prescribing guidelines was conducted using databases and professional websites. The quality appraisal of eligible guidelines was undertaken by scoring the six AGREE II domains. Subsequently, the modified Delphi technique was used by 10 experts (sub‐specialist optometrists, ophthalmologists and orthoptists) to gain consensus on the prescribing recommendation statements extracted from guidelines that had been identified as high quality. Three rounds were conducted in which agreement of these statements were scored using a 9‐point Likert scale with a free‐text option for any additional comments.

Results
Five eligible guidelines were identified. The AGREE II tool demonstrated that the guidelines varied substantially in quality, with only one guideline identified as being of high quality. A total of 168 prescribing statements were reviewed in the Delphi procedure. Of these, 95 statements reached expert consensus as being appropriate prescribing recommendations.

Conclusion
There is significant scope for improving current guidelines for prescribing refractive error correction in children. We used the modified Delphi technique to find points of agreement on prescribing recommendations to support professionals prescribing refractive error correction in children. We recommend that further work is needed to address gaps in the guidelines.

Publication Type: Article
Additional Information: © 2024 The Author(s). Ophthalmic and Physiological Optics published by John Wiley & Sons Ltd on behalf of College of Optometrists. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Publisher Keywords: AGREE II, child, clinical guidelines, Delphi technique, refractive prescribing
Subjects: R Medicine > RE Ophthalmology
Departments: School of Health & Psychological Sciences
School of Health & Psychological Sciences > Optometry & Visual Sciences
SWORD Depositor:
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