Department of Ophthalmology, University of California, San Francisco, California; F.I. Proctor Foundation, University of California, San Francisco, California.
Department of Ophthalmology, University of California, San Francisco, California; Carl Zeiss Meditec, Dublin, California.
Ophthalmology. 2021 Sep;128(9):1284-1291. doi: 10.1016/j.ophtha.2021.01.030. Epub 2021 Feb 2.
To examine factors contributing to completion of a patient-reported outcome (PRO) measure in patients undergoing laser vision correction.
Retrospective, population-based study.
All patients who underwent primary laser vision correction with a target of plano from July 1, 2014, to June 30, 2016, at a large refractive surgery center.
Patients were asked to complete a PRO measure at the time of their preoperative and months 1 and 3 postoperative visits. Characteristics between patients who attended and did not attend the follow-up visits and completed and did not complete the PRO measure were compared. A logistic regression was performed to identify factors associated with likelihood of follow-up and completion of PRO measure. An inverse probability censoring weighted model was created to account for selective loss to follow-up and used to adjust the PRO satisfaction measure.
Completion of the PRO measure at 1 and 3 months.
A total of 37 043 patients were identified. Of these, 20 501 completed a 1-month postoperative PRO measure and 10 474 completed a 3-month postoperative PRO measure. Patients completing a PRO measure were more likely to be older, be female, have had photorefractive keratectomy (PRK), have completed a preoperative PRO measure, and have had a preoperative hyperopic correction (P < 0.001 for all comparisons). For every line of postoperative uncorrected acuity worse than 20/16, the odds ratio of completing a PRO measure was 1.33 (95% confidence interval [CI], 1.30-1.36, P < 0.001) at 1 month and 1.29 (95% CI, 1.26-1.33, P < 0.001) at 3 months. At 1 month, there was no difference between the raw and model-adjusted rates of satisfaction with vision, but at 3 months the adjusted rate was significantly higher than the raw rate.
Patients with worse objective visual outcomes were more likely to complete PRO measures in this population-based study. In a setting with loss to follow-up, PRO measures require methods to address missing data for correct interpretation.
探讨影响行激光视力矫正患者完成患者报告结局（PRO）测量的因素。
回顾性、基于人群的研究。
2014 年 7 月 1 日至 2016 年 6 月 30 日期间在一家大型屈光手术中心接受初次激光视力矫正且目标为正视的所有患者。
患者在术前和术后 1 个月及 3 个月就诊时被要求完成 PRO 测量。比较了参加和未参加随访以及完成和未完成 PRO 测量的患者之间的特征。采用逻辑回归确定与随访和 PRO 测量完成可能性相关的因素。创建逆概率删失加权模型以考虑选择性随访丢失，并用于调整 PRO 满意度测量。
1 个月和 3 个月时完成 PRO 测量。
共确定了 37043 名患者。其中，20501 名患者完成了 1 个月的术后 PRO 测量，10474 名患者完成了 3 个月的术后 PRO 测量。完成 PRO 测量的患者更有可能年龄较大、为女性、行过光折射性角膜切削术（PRK）、完成了术前 PRO 测量且术前有远视矫正（所有比较的 P 值均<0.001）。与术后未矫正视力每差一行 20/16 以上相比，术后 1 个月和 3 个月完成 PRO 测量的可能性分别增加 1.33（95%置信区间[CI]，1.30-1.36；P<0.001）和 1.29（95% CI，1.26-1.33；P<0.001）。术后 1 个月时，调整前后模型的视觉满意度率之间无差异，但术后 3 个月时，调整后模型的满意度率显著高于原始率。
在这项基于人群的研究中，客观视觉结果较差的患者更有可能完成 PRO 测量。在存在随访丢失的情况下，PRO 测量需要采用方法来解决缺失数据，以正确解释结果。
