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Int J Qual Health Care. 2010 Feb;22(1):31-8. doi: 10.1093/intqhc/mzp052. Epub 2009 Dec 6.

Appropriateness of phacoemulsification in Spain.

Author information

1
Unidad de Evaluación de Tecnologías Sanitarias, Agencia Laín Entralgo, C/ Gran Vía 27, 28013 Madrid, Spain. nerea.fernandez@salud.madrid.org

Abstract

OBJECTIVE:

To evaluate the appropriateness of phacoemulsification procedures performed in four Spanish regions, applying criteria developed by means of RAND/UCLA methodology.

DESIGN:

Prospective observational study.

SETTING:

Seventeen public teaching hospitals in four regions of Spain.

PARTICIPANTS:

Patients on waiting list to undergo cataract extraction by phacoemulsification.

INTERVENTION:

Cataract surgery by phacoemulsification.

MAIN OUTCOME MEASURE:

Level of appropriateness of each intervention, according to criteria developed by means of the RAND/UCLA appropriateness methodology.

RESULTS:

Among the 5442 analysed patients the indication of phacoemulsification was appropriate in 69.6%, inappropriate in 7.3% and uncertain in 23.0%. Presence of ocular comorbidity, lack of cataract-induced visual function limitation, anticipated postoperative visual acuity of <0.5, preoperative visual acuity of >0.1 and high surgical complexity were associated with inappropriateness.

CONCLUSIONS:

Some clinical characteristics, when present, make it especially important to obtain a careful assessment of the risks and benefits of surgery. Consideration of these characteristics may improve the appropriateness of phacoemulsification.

PMID:
19969551
DOI:
10.1093/intqhc/mzp052
[Indexed for MEDLINE]
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