Part of a module

The diagram attached discusses the factors and conclusion of application for Irlen lenses to the original clinical case.
 

The clinical practice guidelines and secondary sources found require appraisal to determine how believable the conclusions are.

However developed and published appraisal tools are lacking for secondary sources, unlike primary sources.

The National Health and Medical Research Council clinical practice guideline portal reports 4 criteria for which practice guidelines, policy statements and other summaries can be appraised:

   Searching using the PICO:

The suggested PICO from Step 1: Ask was For children with reading difficulties (P) does coloured lenses (I) improve vision and/or reading ability (0). Using the PICO table keywords and synonyms were established, developing a search string of:

You have been referred a 12 year old female who is having trouble reading at school for assessment, diagnosis and management. The child is also seeing a psychologist, speech pathologist and educational tutor regarding her learning. Her mother heard about coloured lenses and overlays in the media and wants to see whether these strategies could be beneficial for her daughter's reading.

Your 14-year-old patient has myopia. You have been seeing the patient at approximately yearly intervals over the past four years. Over this time, the myopia has increased by approximately 0.75D at each visit. The patient’s father asks whether anything can be done to prevent further increase.

Your 6-year-old patient has never had his eyes tested before. He was referred from a school screening, but he says he has no problems seeing things. On examination, you find significant anisometropia, no strabismus and no pathology. You diagnose amblyopia. You prescribe refractive correction, and you mention that at the next appointment you may prescribe patching treatment.

In advising the patient and in anticipation of the need to advise other patients, you wish to:

A 46 year old Caucasian female patient in good ocular and systemic health and with nothing significant in her family history tells you that she heard on about age-related macular degeneration on a radio programme. She was worried by the possibility of acquiring this condition and would like to find out the likelihood of this happening. She later saw an advertisement in a magazine for nutritional supplements that can help prevent this from happening.