Decision trees for indication of cataract surgery based on changes in visual acuity.

Objective: To develop decision trees based on prospectively collected data for determining the appropriateness of cataract extraction.

Design: Prospective observational cohort study.

Participants: Consecutive patients with a diagnosis of cataract who are on waiting lists to undergo cataract extraction by phacoemulsification.

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

Objectives: To determine whether a system originally developed to ascertain the appropriateness of cataract intervention may also be used to prioritize patients on cataract extraction waiting lists.

Methods: The IRYSS-appropriateness of indication for cataract surgery tool and the IRYSS-Cataract Priority Score were applied to a sample of 5448 patients consecutively placed on waiting lists for cataract surgery. Clinical data were gathered by ophthalmologists, and patients self-completed the Visual Function Index-14.

Appropriateness of phacoemulsification in Spain.

Objective: To evaluate the appropriateness of phacoemulsification procedures performed in four Spanish regions, applying criteria developed by means of RAND/UCLA methodology.

Design: Prospective observational study.

Setting: Seventeen public teaching hospitals in four regions of Spain.

Validation of priority criteria for cataract extraction.

Rationale, Aims And Objectives: Given the increasing prevalence of cataract and demand for cataract extraction surgery, patients must often wait to undergo this procedure. We validated a previously developed priority scoring system in terms of clinical variables, pre-intervention health status, appropriateness of surgery and gain in visual acuity (VA) and health-related quality of life (HRQoL).

Methods: Explicit prioritization criteria for cataract extraction created by a variation of the Research and Development (RAND) and University of California Los Angeles appropriateness methodology were retrospectively applied to a prospective cohort of 5257 patients on waiting lists to undergo cataract by phacoemulsification at 17 hospitals in Spain.

Responsiveness and clinically important differences for the VF-14 index, SF-36, and visual acuity in patients undergoing cataract surgery.

Objective: To assess visual acuity (VA) and 2 questionnaires of health-related quality of life--the Visual Function 14 (VF-14) index and the Medical Outcomes Study Short Form 36 Health Survey (SF-36)--as instruments for capturing clinically important changes after cataract surgery.

Design: Prospective, observational study.

Participants: Four thousand three hundred fifty-six consecutive patients attending ophthalmologic clinics in 17 hospitals in preparation for cataract surgery were recruited.

[Singularization processes: a proposal for continuity between clinical activity and health policy objectives].

Backgrounds And Objectives: In 1996 the Gipuzkoa Territorial Health Agency (Basque Country, Spain) created the Health Plan Service. The aim was to transform the health objectives prioritized by the Health Department into intervention strategies to be incorporated into the local contract services.

Process And Results: One of the procedures the service uses for this purpose, known as <>, involves selecting a process linked to a prioritized health problem, and analyzing and reconstructing it so that the related activity, expected results, financial costs and its impact on the population's health can be identified.