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For evaluation of the efficacy of neuroprotective agents in glaucoma, one of the challenges facing the development of new psychophysical tests is to be able to distinguish visual function losses that are due to ganglion cell drop-out ("dead" cells) from those that are due to malfunctioning retinal nerve fibers ("sick" cells).
However, several points must be taken into account if a comparison between independent tests is to be made.
The significance level used in all statistical tests is to be 5% (alpha = 0.05), with tests having a P value less than 0.05 being statistically significant.
This problem will need to be tackled if treatment according to rapid diagnostic tests is to be more effective and cost effective than presumptive treatment.
If cost-effectiveness of screening tests is to be evaluated in randomised trials, two study designs should be considered i.e. randomisation prior to, or after the application of a screening test.
The diagnostic accuracy of the two screening tests is to be compared using a paired comparison for the difference in area under the ROC curve for each screening test.
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