Novel system for distant assessment of cataract surgical quality in rural China.
Clin Exp Ophthalmol
; 43(7): 621-8, 2015.
Article
em En
| MEDLINE
| ID: mdl-25800932
ABSTRACT
BACKGROUND:
This study aims to assess the quality of various steps of manual small incision cataract surgery and predictors of quality, using video recordings.DESIGN:
This paper applies a retrospective study.PARTICIPANTS:
Fifty-two trainees participated in a hands-on small incision cataract surgery training programme at rural Chinese hospitals.METHODS:
Trainees provided one video each recorded by a tripod-mounted digital recorder after completing a one-week theoretical course and hands-on training monitored by expert trainers. Videos were graded by two different experts, using a 4-point scale developed by the International Council of Ophthalmology for each of 12 surgical steps and six global factors. Grades ranged from 2 (worst) to 5 (best), with a score of 0 if the step was performed by trainers. MAIN OUTCOMEMEASURES:
Mean score for the performance of each cataract surgical step rated by trainers.RESULTS:
Videos and data were available for 49/52 trainees (94.2%, median age 38 years, 16.3% women and 77.5% completing > 50 training cases). The majority (53.1%, 26/49) had performed ≤ 50 cataract surgeries prior to training. Kappa was 0.57â¼0.98 for the steps (mean 0.85). Poorest-rated steps were draping the surgical field (mean ± standard deviation = 3.27 ± 0.78), hydro-dissection (3.88 ± 1.22) and wound closure (3.92 ± 1.03), and top-rated steps were insertion of viscoelastic (4.96 ± 0.20) and anterior chamber entry (4.69 ± 0.74). In linear regression models, higher total score was associated with younger age (P = 0.015) and having performed >50 independent manual small incision cases (P = 0.039).CONCLUSIONS:
More training should be given to preoperative draping, which is poorly performed and crucial in preventing infection. Surgical experience improves ratings.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Oftalmologia
/
Extração de Catarata
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Serviços de Saúde Rural
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Indicadores de Qualidade em Assistência à Saúde
/
Implante de Lente Intraocular
/
Avaliação Educacional
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Clin Exp Ophthalmol
Assunto da revista:
OFTALMOLOGIA
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
China