Workshop Report: A VISION 2020 Workshop on Research for Global Blindness Prevention

On 27 29 September 2010 a VISION 2020 workshop on research for global blindness prevention was held in Lions Aravind Institute of Community Ophthalmology (LAICO) in Madurai India. The meeting was sponsored by the International Association for the Prevention of Blindness (IAPB) and supported by the International Council of Ophthalmology (ICO). The meeting was organised by LAICO and funded by ORBIS, CBM and Sightsavers.

The purpose of the workshop was to develop a research plan and identify priorities which will lead to improved control of avoidable visual impairment and blindness over the next ten years and towards the goals of VISION 2020, The Right to Sight. Expected outcomes of the meeting were:

• Prioritized list of research areas and topics with an action plan for taking it forward
• Action Plan and road map for strengthening research capacity in low and middle income countries.

The thirty two invited participants came from around the world and included Ophthalmologists, Optometrists, representatives of research and training institutes and representatives of INGOs.

Workshop process
The meeting was organised and planned by a small working group, which provided advice on the agenda, devised the domains of research being considered and selected the experts to present and attend the workshop.

Participants were welcomed to the workshop by Dr R.D. Ravindran, the Chairman of Aravind Eye Care System. The meeting context was then provided by Mr Peter Ackland, IAPB and Professor Hugh Taylor representing ICO. The meeting was facilitated by Ann Porcino and Thulasiraj R.D as co facilitator.

Day ones aim was to generate a list of possible research themes. Days two and three were focused on determining research priorities - day two sought to identify research priorities and map capacity for research and; day three was designed to develop a plan of action.

The methodology for priority setting utilised at the workshop The majority of the meeting was devoted to determining global and regional research priorities; those research topics which would be most likely to contribute to the achievement of V2020 goals.

Research in the following domains were considered:

• Basic science (laboratory research): Molecular biology and applied genetics; immunology; cell biology etc
• Epidemiology (population research): Definitions; who is affected in the population; why are they affected (risk factors); what can be done about it (e.g. clinical trials); what evidence is already available (systematic reviews); screening
• Clinical research (patient/disease research): Diagnostics; measurement; natural history; treatment outcomes etc
• Health systems/services (systems research): Health workforce; medicines/technology; information management; health financing; leadership and governance; service delivery; Access; coverage; quality; safety
• Health economics: Economic evaluations e.g. cost effectiveness, cost minimization
• Impact assessments (consequences): On individuals (QoL, Patient Reported Outcome measures , economics); on communities (e.g. prevalence) Community development: Knowledge and awareness; health seeking behaviour; community participation
• Policy research: Factors influencing formulation, adoption and implementation

Part 1: Identification of research topics On the first day of the workshop, a list of potential research topics was generated through the following process:

• Generation of a list of possible research questions: Experts in cataract, glaucoma, trachoma, corneal blindness, macular degeneration, diabetic retinopathy, other ocular morbidity, refractive error, low vision and childhood blindness spoke on day one of the workshop, proposing a spectrum of disease specific research questions grouped under the domains suggested (see above) , indicating which ones they felt were priorities and providing the rationale. Workshop participants added to this combined list of disease specific research questions with both disease specific and cross cutting research themes. This process yielded an initial list of approximately 170 research themes.
• Identification of topics of relevance to different regions: Small groups reviewed the experts priorities, identifying the regions of the world where each priority was most relevant and identifying the purpose of each proposed research topic. The end result of this process was lists of potential research topics for each region of the world.

Part 2: Determination of research priorities
Five criteria for evaluating each research question were tested prior to the workshop and agreed upon as shown in the box below. The process used to identify priorities is as follows:
Scoring regional research themes: Most workshop participants divided into regional groupings for the second day of the workshop. Each group was given the list of potential research topics identified on day one. Lists varied in length from 120 165 topics and most groups therefore opted to consolidate and narrow down the list first, to make the task more manageable. Groups discussed each topic and then gave a score for the topic according to the five agreed criteria. The overall research priority score was then computed by the addition of the five scores and the top 5-10 priorities for each region were thus identified.