Mapping standard ophthalmic outcome sets to metrics currently reported in eight eye hospitals

Abstract

BackgroundTo determine alignment of proposed international standard outcomes sets for ophthalmic conditions to metrics currently reported by eye hospitals.MethodsMixed methods comparative benchmark study, including eight eye hospitals in Australia, India, Singapore, Sweden, U.K., and U.S. All are major international tertiary care and training centers in ophthalmology. Main outcome measure is consistency of ophthalmic outcomes measures reported.ResultsInternational agreed standard outcomes (ICHOM) sets are available for cataract surgery (10 metrics) and macular degeneration (7 metrics). The eight hospitals reported 22 different metrics for cataract surgery and 2 for macular degeneration, which showed only limited overlap with the proposed ICHOM metrics. None of the hospitals reported patient reported visual functioning or vision-related quality of life outcomes measures (PROMs). Three hospitals (38%) reported rates for uncomplicated cataract surgeries only. There was marked variation in how and at what point postoperatively visual outcomes following cataract, cornea, glaucoma, strabismus and oculoplastics procedures were reported. Seven (87.5%) measured post-operative infections and four (50%) measured 30 day unplanned reoperation rates.ConclusionsOutcomes reporting for ophthalmic conditions currently widely varies across hospitals internationally and does not include patient-reported outcomes. Reaching consensus on measures and consistency in data collection will allow meaningful comparisons and provide an evidence base enabling improved sharing of “best practices” to improve eye care globally. Implementation of international standards is still a major challenge and practice-based knowledge on measures should be one of the inputs of the international standardization process.Electronic supplementary materialThe online version of this article (doi: 10.1186/s12886-017-0667-0) contains supplementary material, which is available to authorized users.

Results of the standard set for pulmonary sarcoidosis: feasibility and multicentre outcomes

“…Until now, to our knowledge, there have been no scientific papers implementing and reflecting on a standard set for pulmonary sarcoidosis patients in a clinical setting. Although many standard sets for other conditions have been developed recently, real-world implementation of outcome measures and how they function in practice are lacking [1]. Our study provides information on the feasibility of implementing the pulmonary sarcoidosis standard set.…”

“…Healthcare systems are complex and there are large differences between healthcare systems globally, which can be a barrier to having valid international comparison of outcomes [1]. In order to have solid ongoing data collection, it is crucial to have a dedicated person in each centre to manage the data collection process.…”

“…Reporting outcomes improves healthcare transparency and is increasingly important in daily clinical practice [1–3]. Reporting of outcomes enables quality improvement, optimises patient safety and improves care and cost-effectiveness.…”

“…Reporting of outcomes enables quality improvement, optimises patient safety and improves care and cost-effectiveness. It is important to select outcomes consistently and apply transparent methodologies to ensure data comparison between institutions [1, 4]. The patient primarily benefits from increasing the value of care per dollar spent as the key stakeholder [2, 3].…”

<p>The use of patient-reported outcome research in modern ophthalmology: impact on clinical trials and routine clinical practice</p>

“…The international consortium for health outcome measurement (ICHOM) has proposed standard outcome sets including PROMs for clinical assessment of cataract (using Catquest-9SF) and age-related macular degeneration (AMD) (using the Impact of Vision Impairment, IVI) (http://www.ichom.org/medical-conditions/). Reporting of ICHOM outcome sets for ophthalmic conditions was recently mapped to current reporting practices in eight large eye centers internationally 14. This exercise revealed wide variation in current reporting practice, and no reporting of vision or eye disease-related PROMs by any hospital.…”