Eyeworld

DEC 2013

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

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36 EW FEATURE February 2011 2014 December 2013 What's ahead in Clinical value dossiers help contribute to ASCRS educational efforts by Vanessa Caceres EyeWorld Contributing Writer AT A GLANCE that education has changed clinical opinion and practice patterns. • ASCRS is continuing to improve educational offerings with something called a clinical value dossier. • The dossier will continue to help precisely identify education gaps and create educational opportunities for members to help close those gaps. • Educational opportunities will include meeting presentations and symposia, articles in EyeWorld and the Journal of Cataract & Refractive Surgery, and web seminars. • Results of these educational efforts will be measured with the help of the new annual ASCRS Clinical Trends Survey. Clinical value dossiers Dossiers will help further guide, reinforce ASCRS education O phthalmic surgeons have long looked to ASCRS for cutting-edge educational guidance. A new effort underway will help to further guide the focus of ASCRS educational efforts to address some of the most compelling and controversial issues facing members today. The ultimate goal is to continue to refine the process of defining precise educational needs, provide that education, and then measure how A new element called a clinical value dossier is being developed in order to help with this education process. A clinical value dossier is a concept used commonly in other parts of the medical industry. "In medical economics, a value dossier is a summary of evidence to support a new product that addresses a need," said Doyle Stulting, MD, PhD, director, Stulting Research Center, and professor of ophthalmology emeritus, Emory University, Atlanta. Dr. Stulting is also a past president of ASCRS and chair of the ASCRS Refractive Surgery Clinical Committee. "A dossier includes background information about the need, a review of the existing literature, a humanistic value assessment of the product, a survey of current knowledge and beliefs, identification of knowledge gaps, educational needs, and a strategy for promoting the product." However, instead of focusing on a product or economics, leaders will focus on clinical educational gaps, as determined by a broad analysis of membership feedback including results from the Society's recently released 2013 ASCRS Clinical Survey, which surveyed 1,000 members. The survey asked members 89 questions about the most controversial and compelling topics facing the mem- More than 1,000 ASCRS members responded with 168 data points for the ASCRS Clinical Survey completed in April 2013. bership in cataract, refractive, cornea, glaucoma, and retina surgery. How it works Based on the survey results and other important feedback from the membership, the ASCRS leadership, including the ASCRS Clinical Committees, are determining key educational gaps and needs. According to Dr. Stulting, the subtopics determined by the Refractive Surgery Clinical Committee are • astigmatism measurement basics, • vector calculations, • posterior corneal astigmatism, • surgical correction of astigmatism with relaxing incisions, • nomograms, • femtosecond laser correction of astigmatism, • the use of toric IOLs, and • the role of astigmatism in multifocal IOL implantation. For example, the 2013 ASCRS Clinical Survey found that 0.71 D is the average level of postop astigmatic cylinder at which survey respondents believe patients start to have a significant degradation of visual quality and patient satisfaction after presbyopia-correcting IOL implantation is affected. However, previously published studies have found that the threshold may actually be lower—and that difference indicates the educational gap that needs to be addressed. The Refractive Surgery Clinical Committee will then work via various educational tactics to help close that educational gap. These will include a more formal literature review, papers for publication, articles in EyeWorld, and of course, educational symposia. As these research and presentation efforts will take time to develop, Clinical Committees will simultaneously target other educational gaps, said John Vukich, MD, Madison, Wis., a member of the Refractive Surgery Clinical Committee. The ASCRS Clinical Survey will now be conducted annually, with the idea that the survey results will help reveal how clinical opinions and practice patterns change over time and how ASCRS education influences those opinions and patterns. "The use of surveys to identify member interests and potential knowledge gaps is an excellent way for ASCRS to better target its multipronged educational efforts," said David F. Chang, MD, clinical professor of ophthalmology, University of California, San Francisco. Dr. Chang is chief medical editor for EyeWorld and a former ASCRS president. "At the heart of this effort is our active group of Clinical Committees, which will be developing and directing new educational programs based upon the surveyderived member feedback." ASCRS Clinical Survey results when respondents were asked to indicate the maximum amount of residual refractive error that could be left in a presbyopia IOL patient before it has a significant impact on visual quality and patient satisfaction. Source (all): ASCRS

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