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临床数据登记处弱视治疗结果的多变量分析

Multivariable Analyses of Amblyopia Treatment Outcomes from a Clinical Data Registry.

作者信息

Repka Michael X, Li Charles, Lum Flora

机构信息

Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.

American Academy of Ophthalmology, San Francisco, California.

出版信息

Ophthalmology. 2023 Feb;130(2):164-166. doi: 10.1016/j.ophtha.2022.09.005. Epub 2022 Sep 11.

Abstract

PURPOSE

To present multivariable analyses of factors associated with amblyopia treatment success using outcomes from a clinical registry.

DESIGN

Retrospective database study.

PARTICIPANTS

New patients 3 to 12 years of age being enrolled in the registry from 2013 to 2019.

MAIN OUTCOME MEASURE

The IRIS-50 is an outcome measure for amblyopia treatment developed by the American Academy of Ophthalmology for use with data in the Intelligent Research in Sight (IRIS®) Registry. The measure specifications include unilateral amblyopia associated with strabismus, refractive error, or both.

METHODS

Clinical care prescribed by the ophthalmologist.

RESULTS

Eighteen thousand eight hundred forty-one children 3 to 7 years of age were eligible for IRIS-50, with 77.3% successful. Nine thousand seven hundred sixty-two children 8 to 12 years of age were eligible, with 55.5% successful. For the younger age group, multivariable analyses found that odds ratios (ORs) for success were significantly lower for Black children (0.71; 95% confidence interval [CI], 0.62-0.83) compared with White children. Medicaid insurance was associated independently with significantly lower success (OR, 0.65; 95% CI, 0.60-0.71). Among older children, Black children were less likely to be treated successfully (OR, 0.81; 95% CI, 0.68-0.96) compared with White children, whereas Hispanic children showed an increased chance of success (OR, 1.16; 95% CI, 1.03-1.31). Medicaid insurance for the older children also was associated with a decreased chance of success (OR, 0.84; 95% CI, 0.77-0.93).

CONCLUSIONS

Amblyopia treatment outcomes measured by IRIS-50 were significantly poorer for Black children and those with Medicaid insurance 3 to 12 years of age. Disparate health outcomes demonstrated for these two factors emphasize the need to develop and test strategies to improve treatment outcomes for these children.

摘要

目的

利用临床登记库的结果,对与弱视治疗成功相关的因素进行多变量分析。

设计

回顾性数据库研究。

参与者

2013年至2019年登记在册的3至12岁新患者。

主要结局指标

IRIS - 50是美国眼科学会开发的一种弱视治疗结局指标,用于智能视力研究(IRIS®)登记库中的数据。该指标规范包括与斜视、屈光不正或两者相关的单侧弱视。

方法

由眼科医生开具临床治疗方案。

结果

18841名3至7岁儿童符合IRIS - 50标准,成功率为77.3%。9762名8至12岁儿童符合标准,成功率为55.5%。对于较年幼的年龄组,多变量分析发现,与白人儿童相比,黑人儿童治疗成功的优势比(OR)显著更低(0.71;95%置信区间[CI],0.62 - 0.83)。医疗补助保险独立与显著更低的成功率相关(OR,0.65;95% CI,0.60 - 0.71)。在较大儿童中,与白人儿童相比,黑人儿童成功治疗的可能性较小(OR,0.81;95% CI,0.68 - 0.96),而西班牙裔儿童成功的机会增加(OR,1.16;95% CI,1.03 - 1.31)。较大儿童的医疗补助保险也与成功机会降低相关(OR,0.84;95% CI,0.77 - 0.93)。

结论

用IRIS - 50衡量的弱视治疗结局在3至12岁的黑人儿童和有医疗补助保险的儿童中显著更差。这两个因素所显示的不同健康结局强调了制定和测试改善这些儿童治疗结局策略的必要性。

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