EUREQUO RESEARCH

With over 1.4 million cataract extractions now included in its database, the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO) continues to go from strength to strength. A research project is now being funded by the ESCRS over a three-year period which will enable patient-reported outcomes to be added to the database. According to Mats Lundström MD, PhD, who led the initial development of EUREQUO, the drive to add patientreported data to the database is proceeding as planned.

“The ESCRS research project was specifically aimed at including patient questionnaires in the database. Linked to this aim was the translation of questionnaires into different languages, validation studies in the new languages and finally adding a system that makes analyses of clinical and patient-reported data possible. Things are going well so far. The technical part is almost ready and we are translating the questionnaires into Spanish and Slovak at the moment,” he said. The actual implementation process of the EUREQUO system turned out to be more challenging and time-consuming than initially anticipated, said Dr Lundström.

“The web-based model made it possible to enter data manually via the web. This meant for many surgeons and clinics, entering data twice, in both their own system and in EUREQUO. No one likes double entry of data, and so we had to start building interfaces for transfer of data from existing registries and electronic medical record (EMR) systems to EUREQUO. Building interfaces means incurring costs and also having to update them over time as new electronic versions of EMR systems appear. Today EUREQUO contains data from almost 1,450,000 cataract extractions and 90 per cent of this data comes from transfer from existing electronic systems and only 10 per cent from manual input of data,” he said.

PATIENT FOLLOW -UP
Another hurdle to be negotiated was the sometimes inadequate follow-up of patients, said Dr Lundström. “When we created EUREQUO we believed that quality control and quality improvement meant knowing what happened to the patient. We thought that the soul of all healthcare seeks to answer the question: what happened to the patient? If we don’t know what happened to the patient, how can we improve our care? Many surgeons don’t see their patients after surgery. This means that it is difficult for some potential users of the EUREQUO to register follow-up data. Different administrative and reimbursement rules in countries and clinics are behind this problem,” he said.

An important next step for EUREQUO will be to use the database as a valuable resource for evidence-based medicine. “The whole database has already been used for analyses and publications but the next step will be to use the EUREQUO forms as Case Report Forms in new studies. The first study will be to compare the outcomes of femtosecond laser-assisted cataract surgery with conventional phacoemulsification. The database will serve as a source for control cases,” he said.