Discussion
SECONDARY
DIAMONDS was a pragmatic clinical trial carried out in 16 NHS ophthalmology departments throughout the UK. The DIAMONDS trial was powered to detect not only differences in the primary outcome (BCVA) but also in important secondary outcomes (CRT and vision quality of life).As noted in the main clinical effectiveness manuscript,In DIAMONDS, two vision-specific patient-reported outcome quality-of-life instruments were used in addition to the generic preference-based EQ-5D-5L. Neither showed any statistically significant differences between laser arms. It has sometimes been mentioned that changes in vision that are sufficient to affect some activities of daily living, may not be reflected in changes in EQ-5D, because the EQ-5D may not be as sensitive to detect changes in quality of life as other visual-specific questionnaires such as the NEI-VFQ-25.One limitation in the current analysis is the fact that we had to use published costs of anti-VEGF drugs (at list prices, these can range from £5 to £7k a year),Both SML and SL were successful in 80% of participants.