MCW Eye reVIEW Virtual Journal Club
Our Virtual Journal Club is led by Dr. David Weinberg. In this section, you will be challenged to improve in your ability to understand and analyze various medical literature within the ophthalmology space, to expand your knowledge, and to become better consumers. The articles are selected because they are classics within the ophthalmology space, are new and important, and/or have a particular educational value.
Review the materials below and at the end take an optional quiz on the findings from the study. Answers will be sent you directly if you provide an email address.
Virtual Journal Club #1
For Journal Club #1, please review the study “Low-Concentration Atropine for Myopia Progression (LAMP) Study.” The focus of the quiz will be linked to this main article. In addition, there are two more supplemental articles linked to the same clinical trial if you are interested in reading those as well.
The goal is to consider clinical relevance and implementation of study results.
The goal is to consider clinical relevance and implementation of study results.
Journal Club #1 Articles
Virtual Journal Club #2
For Journal Club #2, please review the study “Association of Fenofibrate Use and the Risk of Progression to Vision-Threatening Diabetic Retinopathy.”
Journal Club #2 Articles
Virtual Journal Club #3
For Journal Club #3, please review the study “The Effect of Intensive Treatment of Diabetes on the Development and Progression of Long-Term Complications in Insulin-Dependent Diabetes Mellitus.”
To provide some historical context, the discovery of insulin and the ability to administer it to patients with type 1 diabetes was a life-saving/life changing advance. With longer survival came the chronic complications such as retinopathy and nephropathy. It was unclear if improving glycemic control would decrease the long term complications of IDDM. This was an important question, because tight control of blood sugars is inconvenient, expensive, and associated with some morbidity (hypoglycemia, for instance).
The Diabetes Control and Complications Study (DCCT) was organized to answer this critical question. It was and incredibly ambitious study and, in my opinion, one of the most important clinical trials in the history of clinical trials. The primary report has been cited over 16,000 times.
There were dozens of publications from the DCCT, but this is the report of the primary results.
To provide some historical context, the discovery of insulin and the ability to administer it to patients with type 1 diabetes was a life-saving/life changing advance. With longer survival came the chronic complications such as retinopathy and nephropathy. It was unclear if improving glycemic control would decrease the long term complications of IDDM. This was an important question, because tight control of blood sugars is inconvenient, expensive, and associated with some morbidity (hypoglycemia, for instance).
The Diabetes Control and Complications Study (DCCT) was organized to answer this critical question. It was and incredibly ambitious study and, in my opinion, one of the most important clinical trials in the history of clinical trials. The primary report has been cited over 16,000 times.
There were dozens of publications from the DCCT, but this is the report of the primary results.
Journal Club #3 Articles
Virtual Journal Club #4
For Journal Club #4, please review the study “Anecortave Acetate (15 Milligrams) versus Photodynamic Therapy for Treatment of Subfoveal Neovascularization in Age-Related Macular Degeneration.”
This was one of the first high-profile articles that used a non-inferiority design. To give you some context for this study, we were still in the dark-ages of treatment for wet macular degeneration. There was no anti-vegf therapy. The only available treatment was photodynamic study with VIsudyne. This study compared the efficacy of an experimental treatment to photodynamic therapy.
At the time this study was done, treatments for exudative ARMD were limited (compared to today). Photodynamic therapy (PDT) with verteporfin had been FDA approved, and was a big step forward, but by today’s standards the results were unimpressive. PDDT reduced the rate of vision loss, but few patients experienced increased vision. Since PDT was an available, effective treatment, other drugs vying for approval could not ethically do placebo-controlled trials. This is the situation in which noninferiority studies are intended.
This was one of the first high-profile articles that used a non-inferiority design. To give you some context for this study, we were still in the dark-ages of treatment for wet macular degeneration. There was no anti-vegf therapy. The only available treatment was photodynamic study with VIsudyne. This study compared the efficacy of an experimental treatment to photodynamic therapy.
At the time this study was done, treatments for exudative ARMD were limited (compared to today). Photodynamic therapy (PDT) with verteporfin had been FDA approved, and was a big step forward, but by today’s standards the results were unimpressive. PDDT reduced the rate of vision loss, but few patients experienced increased vision. Since PDT was an available, effective treatment, other drugs vying for approval could not ethically do placebo-controlled trials. This is the situation in which noninferiority studies are intended.
Journal Club #4 Articles