Prioritization of cataract surgery: Visual analogue scale versus scoring system

Abstract

The use of a VAS for prioritizing cataract surgery may be suboptimal due to high subjectivity. Adoption of an objective criteria-validated priority-setting scoring system may allow better stratification of patients to ensure better service provision.

Prioritisation of patients on waiting lists for hip and knee arthroplasties and cataract surgery: Instruments validation

“…In New Zealand the AI presented weak correlations both with the EQ-5D (0.23) and with the WOMAC (0.26) [ 24 , 25 , 32 ]. For the CI, the correlations between the priority score and the opinion of the specialist measured through a VAS (0.41) [ 33 ] and the VF-14 (0.45) were moderate, and low (0.22) for the EQ-5D [ 24 , 25 ]. In Canada the correlation found between the AI and the opinion of the specialist measured by VAS was strong (0.79), and moderate with the EQ-5D (0.33) and the WOMAC (0.33).…”

“…The fact that doctors answered the VAS and also administered the prioritisation instrument may have affected the results on the correlations between the VAS and the prioritisation instruments, but they were similar to other studies. On the other hand, the lack of information on the doctor who assessed the priority has made it impossible to analyse the variability of the VAS assessments, as was done in New Zealand [ 33 ].…”

“…Moreover, in Canada the VAS showed an inter-observer reliability of between 0.70 and 0.82 similar to that of CAHTA's AI and CI [ 12 ]. However, using this kind of instruments does not make explicit the criteria used to determine the need for surgery, and the instruments themselves may show significant variability [ 33 ]. The main contribution of the prioritisation instruments is a greater transparency in the management of waiting lists which may increase trust in the health care system among the general population.…”

Can an appropriateness evaluation tool be used to prioritize patients on a waiting list for cataract extraction?

“…Fantini et al used a visual analogue scale (VAS) to assign priority, whereas we created and used a specific point-count measure. It is possible that using a VAS for prioritizing cataract surgery may be suboptimal due to the high degree of variability in scores from VAS tests administered by ophthalmologists [36]. By taking into account seven variables, our appropriateness-derived system for prioritization generated less variability in the judgment compared to a single VAS measurement.…”

Validation of priority criteria for cataract extraction

“…Other investigators have validated priority scoring systems developed in New Zealand and Canada that largely reflect individual clinicians' quantitative methods to measure urgency [9,27–29], such as using a visual analogue scale (VAS). Although VAS scores correlated well with priority, it was conclude that the use of VAS by ophthalmologists was not reliable because of the large amount of variation among the clinicians and that VAS scores were more subjective than the priority score system.…”