Klin Monbl Augenheilkd 2022; 239(03): 293-301
DOI: 10.1055/a-1553-4497
Klinische Studie

Quality Assurance in Cataract and Lens Surgery with Special Consideration of Subjective Patient Reported Outcome Measures and Clinical Reported Outcome Measures

Article in several languages: English | deutsch
Ekkehard Fabian
1   Augenklinik, Augencentrum Rosenheim, Deutschland
,
Max Birkl
2   Fakultät für Angewandte Gesundheits- und Sozialwissenschaften, TH Rosenheim, Deutschland
,
Franz Benstetter
2   Fakultät für Angewandte Gesundheits- und Sozialwissenschaften, TH Rosenheim, Deutschland
,
Philipp Eberwein
1   Augenklinik, Augencentrum Rosenheim, Deutschland
,
Ulrich Seher
1   Augenklinik, Augencentrum Rosenheim, Deutschland
,
Thomas Pfeiler
1   Augenklinik, Augencentrum Rosenheim, Deutschland
› Author Affiliations

Abstract

Background Results of medical interventions must be documented and evaluated. In studies, this is done with clinical outcomes data (clinician/clinical reported outcome measure, CROM). In the past, less weight has been given to patient surveys with questionnaires (patient reported outcome measure, PROM).

Patients/Materials and Methods This retrospective study included 104 eyes from 53 patients. Of these, 35 patients had cataract surgery and 15 patients had a refractive lens exchange. The implanted lenses included 62 trifocal IOLs (Asphina trifiocal 839, Zeiss), 34 trifocal toric IOLs (Asphina trifocal toric 939, Zeiss) and 8 bifocal IOLs (Asphina 808, Zeiss) with the same IOL platform. Patients completed a modified questionnaire before surgery and one year after surgery. We made changes to the CatQuest-9SF questionnaire so as to also document side effects.

Results The effort required by the patients to answer the questionnaire was a burden. Transcribing the data into electronic files so as they could be saved and analyzed was a lot of work for the staff. Among the patients, 88.7% were spectacle-independent in everyday life, and 77.5% for reading. 44.4% had a halo problem. 92% reported the operation as a success. 100% had a prediction error of ≤ ± 0.75 dpt.

Conclusion There is a high rate of patient satisfaction with the outcome of the intervention. New questionnaires are needed for new IOLs. The Catquest-9SF is from 2009. Accordingly, revisions and new validation is necessary. Beyond that, only automatic data transfer will reduce the amount of work involved in data input.



Publication History

Received: 07 March 2021

Accepted: 05 July 2021

Article published online:
03 November 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References/Literatur

  • 1 Codmann EA. Study in Hospital Efficiency. Boston: T Todd Co.; 1917
  • 2 Garratt A, Schmidt L, Mackintosh A. et al. Quality of life measurement: bibliographic study of patient assessed health outcome measures. BMJ 2002; 324: 1417
  • 3 Pesudovs K, Garamendi E, Elliott DB. The Quality of Life Impact of Refractive Correction (QIRC) Questionnaire: Development and Validation. Optom Vis Sci 2004; 81: 769-777
  • 4 Schein OD. The measurement of patient-reported outcomes of refractive surgery: the refractive status and vision profile. Trans Am Ophthalmol Soc 2000; 98: 439-469
  • 5 Hays RD, Mangione CM, Ellwein L. et al. Psychometric properties of the National Eye Institute-Refractive Error Quality of Life instrument. Ophthalmology 2003; 110: 2292-2301
  • 6 Kugelberg M, Lundström M. Factors related to the degree of success in achieving target refraction in cataract surgery. J Cataract Refract Surg 2008; 34: 1935-1939
  • 7 Gothwal VK, Wright TA, Lamoureux EL. et al. Measuring outcomes of cataract surgery using the Visual Function Index-14. J Cataract Refract Surg 2010; 36: 1181-1188
  • 8 Pesudovs K. Item banking. A generational change in patient-reported outcome-measurement. Optom Vis Sci 2010; 87: 285-293
  • 9 Lundström M, Stenevi U, Thorburn W. The Swedish National Cataract Register: a 9-year review. Acta Ophthalmol Scand 2002; 80: 248-257
  • 10 Khadka J, Gothwal VK, McLinden C. et al. The importance of rating scales in measuring patient-reported outcomes. Health Qual Life Outcomes 2012; 10: 80
  • 11 Salowi MA, Goh PP, Lee MY. et al. The Malaysian Cataract Surgery Registry: Profile of Patients Presenting for Cataract Surgery. Asia Pac J Ophthalmol (Phila) 2015; 4: 191-196
  • 12 § 135a SGB V Verpflichtung der Leistungserbringer zur Qualitätssicherung. Im Internet (Stand: 19.09.2021): http://www.sozialgesetzbuch-sgb.de/sgbv/135a
  • 13 aQua-Institut für angewandte Qualitätsförderung und Forschung im Gesundheitswesen GmbH. Ergebnisbericht zum Probebetrieb für das Qualitätssicherungsverfahren Kataraktoperation. Stand: 5. Juni 2013. Im Internet (Stand: 19.09.2019): https://www.aqua-institut.de/fileadmin/aqua_de/Projekte/548_Probebetrieb_Katarakt/Kataraktoperation_Abschlussbericht_Probebetrieb.pdf
  • 14 Rüggeber J-A, Bröckelmann J. Qualitätssicherung AQS1 hat sich für das Ambulante Operieren bewährt. Ambulant operieren 2004; 4: 151-156
  • 15 Bäcker K, Fabian E. QS-Dokumentation zu Prozess- und Ergebnisqualität in der Katarakt-Chirurgie: AQS1-Katarakt online. Im Internet (Stand: 30.09.2021): https://www.dgii.org/archiv/2009/pdf/44.pdf
  • 16 Bäcker K. AQS1 – Patientensicherheitsfragebogen. Qualitätsdokumentation, Langzeitergebnisse und Versorgungsforschung. In: Deindl C. Hrsg. Manual Ambulantes Operieren: Techniken, perioperative Verfahren und Management. Berlin: Walter de Gruyter; 2016: 150-161
  • 17 Zollmann P. Innovative Praxis-EDV. Optimierung der Patientensicherheit. In: Deindl C. Hrsg. Manual Ambulantes Operieren: Techniken, perioperative Verfahren und Management. Berlin: Walter de Gruyter; 2016: 143-149
  • 18 Mangione CM, Philipps RS, Seddon JM. et al. Development of the ‘Activities of daily Vision Scale’. A measure of visual functional status. Med Care 1992; 30: 1111-1126
  • 19 Mangione CM, Berry S, Spitzer K. et al. Identifying the content area for the 51-item National Eye Institute Visual Function Questionnaire: results from focus groups with visually impaired persons. Arch Ophthalmol 1998; 116: 227-233 DOI: 10.1001/archopht.116.2.227.
  • 20 Magione CM, Lee PP, Gutierrez PR. et al. National Eye Institute Visual Function Questionnaire Field Test Investigators. Development of the 25-item National Eye Institute Visual Function Questionnaire. Arch Ophthalmol 2001; 119: 1050-1058
  • 21 McAlinden C, Gothwal VK, Khadka J. et al. A head-to-head comparison of 16 cataract surgery outcome questionnaires. Ophthalmology 2011; 118: 2374-2381
  • 22 Kohnen T. Questionnaires for cataract and refractive surgery. J Cataract Refract Surg 2019; 45: 119-120
  • 23 Lundström M, Roos P, Jensen S. et al. Catquest questionnaire for use in cataract surgery care: description, validity, and reliability. J Cataract Refract Surg 1997; 23: 966-974
  • 24 Lundström M, Pesudovs K. Catquest-9SF patient outcomes questionnaire: Nine-item short form Rasch-scaled revision of the Catquest questionnaire. J Cataract Refract Surg 2009; 35: 504-513
  • 25 McAlinden C, Pesudovs K, Moore JE. The development of an instrument to measure quality of vision: the Quality of Vision questionnaire. Invest Ophthalmol Vis Sci 2010; 51: 5537-5545
  • 26 Gerstmeyer K, Harreer A, Hirnschall N. et al. Pesudovs K, Lundström M, Findl O. Validierung der deutschen Version des schwedischen Catquest-9SF Fragebogens. In: DGII c/o Congress-Organisation Gerling GmbH. Hrsg. DGII Kongressband 2012. Düsseldorf: DGII; 2012: 214-222
  • 27 Sparrow JM, Grzeda MT, Frost NA. et al. Cataract surgery patient-reported outcome measures: a head-to-head comparison of the psychometric performance and patient acceptability of the Cat-PROM5 and Catquest-9SF self-report questionnaires. Eye (Lond) 2018; 32: 788-795
  • 28 International Consortium for Health Outcomes Measurement. Cataracts. The Standard Set. Im Internet (Stand: 19.09.2019): http://connect.ichom.org/standard-sets/cataracts/