Appropriateness of phacoemulsification in Spain

Unidad de Evaluación de Tecnologías Sanitarias, Agencia Laín Entralgo, C/ Gran Vía 27, 28013 Madrid, Spain.
International Journal for Quality in Health Care (Impact Factor: 1.76). 12/2009; 22(1):31-8. DOI: 10.1093/intqhc/mzp052
Source: PubMed


To evaluate the appropriateness of phacoemulsification procedures performed in four Spanish regions, applying criteria developed by means of RAND/UCLA methodology.
Prospective observational study.
Seventeen public teaching hospitals in four regions of Spain.
Patients on waiting list to undergo cataract extraction by phacoemulsification.
Cataract surgery by phacoemulsification.
Level of appropriateness of each intervention, according to criteria developed by means of the RAND/UCLA appropriateness methodology.
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.
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.

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