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Session Title: Practice Styles
Session Date/Time: Monday 07/10/2013 | 14:30-16:10
Paper Time: 15:27
Venue: Emerald (First Floor)
First Author: : K.Mollazadegan SWEDEN
Co Author(s): : M. Lundström U. Stenevi
The purpose of this study was to analyze how patient-reported outcome measures can be connected to clinical outcome measures in cataract surgery in order to identify opportunities for improvement of quality of care.
Forty-two Swedish cataract surgery clinics
Two models were used to analyze the following questions: 1. Is there a relationship between clinical parameters and a poor patient-reported outcome? 2. What characterizes patients with a good clinical outcome but a poor patient-reported outcome? The study material consisted of follow-up data on cataract extractions collected by the Swedish National Cataract Register in 2008-2011. Patient-reported outcome was measured using the Catquest-9SF questionnaire. A total of 14,928 pairs of questionnaires completed before and after a cataract extraction were analyzed together with clinical data. The number of participating clinics was 42. The analyses were performed for each clinic.
For almost all clinics a factor related to a poor patient-reported outcome after surgery was a good preoperative self-assessed visual function. For some clinics this was very obvious with up to 50% of the patients stating that they were very satisfied with their vision before surgery. For single clinics different factors like large anisometropia (?3D), capsule complications, ocular co-morbidity and long waiting time were related to a poor patient-reported outcome. In situations where the clinical outcome was good and the patient-reported outcome poor problems with near vision activities after surgery was the main factor noted. The clinics showed a large variation of which clinical parameters that were related to a poor patient-reported outcome.
Analyzing the risk factors for a poor patient-reported outcome for each clinic showed a large variation. Weak indication for surgery, refractive problems after surgery, surgical complications and a poor chance of visual recovery due to ocular co-morbidity were among the reasons for a poor patient-reported outcome. Post-operative care in terms of establishing a good near vision seemed to be another problem for some clinics.
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