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Poor Methodology Teaches Us Nothing About Undetected Eye Disease

David A. Greenberg, OD, MPH; Osvaldo I. Lopez, MD; James M. Sinacore, PhD; Lawrence A. May, MD
Arch Intern Med. 1995;155(10):1102-1106. doi:10.1001/archinte.1995.00430100138017.
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The recent article "Undetected Eye Disease in a Primary Care Clinic Population" by Wang et al1 advanced laudable goals but, unfortunately, the quality of the research and the possibility that it may have been influenced by politically motivated bias necessitates the following critique. The significant limitations and flaws of this study are too numerous to address fully in this venue, so we will focus on what we consider to be its most egregious errors.

Pursuit of Incompatible Research Questions. Wang and colleagues stated:

This study was designed to determine the value of a battery of screening tests for the detection of four major eye diseases. In addition, the study was designed to address the prevalence of ocular disease in patients attending a general medical clinic, the proportion of prevalent ocular disease that is undetected....

It is inappropriate and illogical for Wang and colleagues to examine the prevalence of detected


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