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H. Dunbar Hoskins, Jr, MD
American Academy of Ophthalmology San Francisco, Calif

JAMA. 1990;264(12):1533-1534.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

I read with great interest Dr Eddy's^1,2 dissertation in which he described five methodologies for developing practice policies. These included the old "traditional method" and four new methods called "global subjective judgment," "evidence based," "outcome based," and "preference based." He states that the "traditional approach" is based on the assumption that "outcomes of medical practice can be sensed intuitively without explicit analysis or description." He used as an example of the traditional approach the current recommendations for treatment of ocular hypertension. In reality, the treatment for ocular hypertension has evolved over a number of years since the collaborative glaucoma study in the 1960s established the concept of ocular hypertension.

Subsequent observation of individual patients by individual physicians showed that some of these patients would go on to develop true glaucoma, thus indicating a need for treatment in some cases. Two recent studies have confirmed that treatment . . . [Full Text PDF of this Article]

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