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Validation of priority criteria for cataract extraction
Author(s) -
Gutiérrez Susana García,
Quintana Jose Maria,
Bilbao Amaia,
Escobar Antonio,
Milla Emilio Perea,
Elizalde Belen,
Baré Marisa,
Fernandez de Larrea MD MPH Nerea
Publication year - 2009
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/j.1365-2753.2008.01083.x
Subject(s) - medicine , cataract surgery , prioritization , cataract extraction , visual acuity , phacoemulsification , cohort , intervention (counseling) , data extraction , quality of life (healthcare) , prospective cohort study , physical therapy , optometry , medline , emergency medicine , ophthalmology , surgery , nursing , management science , political science , law , economics
Rationale, aims and objectives Given the increasing prevalence of cataract and demand for cataract extraction surgery, patients must often wait to undergo this procedure. We validated a previously developed priority scoring system in terms of clinical variables, pre‐intervention health status, appropriateness of surgery and gain in visual acuity (VA) and health‐related quality of life (HRQoL). Methods Explicit prioritization criteria for cataract extraction created by a variation of the Research and Development (RAND) and University of California Los Angeles appropriateness methodology were retrospectively applied to a prospective cohort of 5257 patients on waiting lists to undergo cataract by phacoemulsification at 17 hospitals in Spain. Demographic data, clinical data and data related to surgical technique were collected by trained ophthalmologists. Patients were evaluated by their ophthalmologist before the intervention and 6 weeks afterward. They also completed, by mail, the Visual Function Index (VF‐14) before the intervention and 3 months afterward. Results High‐priority patients experienced greater improvement in VA and HRQoL than those classified as intermediate or low‐priority ( P < 0.0001), even after adjusting by VA and the VF‐14 score at baseline. The time to intervention was the same for high‐priority patients as it was for intermediate and low‐priority patients. Conclusions The priority score we developed identified patients most likely to experience the greatest improvements from cataract extraction. Use of this tool could provide a fairer and more rational way to prioritize patients for cataract extraction.