Abstract
The dynamic structure–function (DSF) model was previously shown to have better prediction accuracy than ordinary least square linear regression (OLSLR) for short series of visits. The current study assessed the external validity of the DSF model by testing its performance in an independent dataset (Ocular Hypertension Treatment Study–Confocal Scanning Laser Ophthalmoscopy [OHTS–CSLO] ancillary study; N = 178 eyes), and also on different test parameters in a sample selected from the Diagnostic Innovations in Glaucoma Study or the African Descent and Glaucoma Evaluation Study (DIGS/ADAGES). Each model was used to predict structure–function paired data at visits 4–7. The resulting prediction errors for both models were compared using the Wilcoxon signed-rank test. In the independent dataset, the DSF model predicted rim area and mean sensitivity paired measurements more accurately than OLSLR by 1.8–5.5% (p ≤ 0.004) from visits 4–6. Using the DIGS/ADAGES dataset, the DSF model predicted retinal nerve fiber layer thickness and mean deviation paired measurements more accurately than OLSLR by 1.2–2.5% (p ≤ 0. 007). These results demonstrate the external validity of the DSF model and provide a strong basis to develop it into a useful clinical tool.
Highlights
The dynamic structure–function (DSF) model was previously shown to have better prediction accuracy than ordinary least square linear regression (OLSLR) for short series of visits
To determine the applicability of the DSF model to different parameters, we compared prediction error (PE) obtained for the joint prediction of retinal nerve fiber layer thickness (RNFLT) and mean deviation (MD) from a resampled cohort of primary open-angle glaucoma (POAG) eyes enrolled in the Diagnostic Innovations in Glaucoma Study (DIGS) and African Descent and Glaucoma Evaluation Study (ADAGES) studies
When rim area (RA) was predicted jointly with mean sensitivity (MS) derived from the 30–2 static automated perimetry (SAP) test pattern, the median PE obtained for the DSF model was significantly lower (1.8–5.5%, p ≤ 0.004) than for OLSLR at the 4th–6th visits (Fig. 1a)
Summary
The dynamic structure–function (DSF) model was previously shown to have better prediction accuracy than ordinary least square linear regression (OLSLR) for short series of visits. The current study assessed the external validity of the DSF model by testing its performance in an independent dataset (Ocular Hypertension Treatment Study–Confocal Scanning Laser Ophthalmoscopy [OHTS–CSLO] ancillary study; N = 178 eyes), and on different test parameters in a sample selected from the Diagnostic Innovations in Glaucoma Study or the African Descent and Glaucoma Evaluation Study (DIGS/ADAGES). In comparison with the ordinary least square linear regression (OLSLR) model, the DSF model made significantly more accurate prediction of rim area (RA) and mean sensitivity (MS) paired measurements for short series of up to 7 v isits[26] This encouraging finding prompted the need to determine whether the DSF model could yield similar results when tested in different populations, and with different tests and parameters. The objective here was to ascertain whether the DSF model will perform well with new tests and parameters that will emerge as clinically useful in the future
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