gms | German Medical Science

There is no doubt that the ideas of "evidence based medicine" focused our thinking once more on planning and executing clinical studies adequately. On the other hand, when reviewing of the older literature, one may find evidence based papers, even though the term itself was unknown in those days. Such papers may be ignored in modern reviews as sources cannot be found in database systems. Prevention and treatment of amblyopia may serve as an example.

From their metaanalysis "Preschool Vision Screening" [1] Snowdon and Stewart-Brown draw the following conclusion: "There is a lack of good quality research into the natural history of the target conditions, the disabilities associated with them, and the efficacy of available treatments." This statement is true, as far as the lack of studies is concerned that conform with "good clinical practice (GCP)", but is rather misleading in other respect. The essential issues of the metaanalysis would have been more cautious and reasonable had the authors known the fundamental investigations of Sattler [2] and as well considered the results of Scandinavian screening programs.

Nevertheless the metaanalysis of Snowdon and Stewart-Brown had a most positive impact: It stimulated a number of new studies complying with GCP-rules, that confirmed and improved the concepts of prevention and treatment of amblyopia.

In conclusion it could be said: As far as amblyopia is concerned, there is no need to reinvent the wheel, but it may be sill awarding to improve its running.