The Better Operative Outcomes Software Tool (BOOST) Prospective Study: Improving the Quality of Cataract Surgery Outcomes in Low-Resource Settings.

Autor: McGuinness MB; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia.; Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia., Moo E; Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.; Global Programs, The Fred Hollows Foundation, Melbourne, Australia., Varga B; Global Programs, The Fred Hollows Foundation, Melbourne, Australia., Dodson S; Global Programs, The Fred Hollows Foundation, Melbourne, Australia., Lansingh VC; Help Me See, Jersey City, New Jersey, USA.; Instituto Mexicano de Oftalmologia, Queretaro, Mexico.; Department of Public Health Sciences, University of Miami, Miami, Florida, USA., Resnikoff S; Brien Holden Vision Institute, Sydney, New South Wales, Australia.; School of Optometry and Vision Science, Faculty of Medicine, University of New South Wales, Sydney, Australia., Schmidt E; Evidence Research and Innovations, Sightsavers, Chippenham, UK., Ravilla T; LAICO-Aravind Eye Care System, Madurai, India., Balu Subburaman GB; LAICO-Aravind Eye Care System, Madurai, India., Khanna RC; School of Optometry and Vision Science, Faculty of Medicine, University of New South Wales, Sydney, Australia.; Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India.; Brien Holden Eye Research Centre, L.V. Prasad Eye Institute, Hyderabad, India.; School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA., Rathi VM; Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India., Arunga S; Department of Ophthalmology, Mbarara University of Science and Technology, Mbarara, Uganda., Limburg H; Health Information Services, Grootebroek, Netherlands., Congdon N; Centre for Public Health, Queen's University Belfast, Belfast, UK.; Orbis International, New York, New York, USA.; Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Jazyk: angličtina
Zdroj: Ophthalmic epidemiology [Ophthalmic Epidemiol] 2024 Apr 18, pp. 1-11. Date of Electronic Publication: 2024 Apr 18.
DOI: 10.1080/09286586.2024.2336518
Abstrakt: Purpose: Post-operative vision impairment is common among patients who have undergone cataract surgery in low-resource settings, impacting quality of clinical outcomes and patient experience. This prospective, multisite, single-armed, pragmatic validation study aimed to assess whether receiving tailored recommendations via the free Better Operative Outcomes Software Tool (BOOST) app improved surgical outcomes, as quantified by post-operative unaided distance visual acuity (UVA) measured 1-3 days after surgery.
Methods: During the baseline data collection round, surgeons in low and middle-income countries recorded clinical characteristics of 60 consecutive cataract cases in BOOST. Additional data on the causes of poor outcomes from 20 consecutive cases with post-operative UVA of <6/60 (4-12 weeks post-surgery) were entered to automatically generate tailored recommendations for improvement, before 60 additional consecutive cases were recorded during the follow-up study round. Average UVA was compared between cases recorded in the baseline study round and those recorded during follow-up.
Results: Among 4,233 cataract surgeries performed by 41 surgeons in 18 countries, only 2,002 (47.3%) had post-operative UVA 6/12 or better. Among the 14 surgeons (34.1%) who completed both rounds of the study (1,680 cases total), there was no clinically significant improvement in post-operative average UVA (logMAR units ±SD) between baseline (0.50 ± 0.37) and follow-up (0.47 ± 0.36) rounds (mean improvement 0.03, p  = 0.486).
Conclusions: Receiving BOOST-generated recommendations did not result in improved UVA beyond what could be expected from prospective monitoring of surgical outcomes alone. Additional research is required to assess whether targeted support to implement changes could potentiate the uptake of app-generated recommendations and improve outcomes.
Databáze: MEDLINE
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