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白内障手术后的远程随访(CORE-RCT):一项随机对照试验的研究方案。

Remote follow-up after cataract surgery (CORE-RCT): study protocol of a randomized controlled trial.

机构信息

Department of Ophthalmology, University Medical Center Utrecht, Postbus 85500, Huispostnummer E03.136, Utrecht, 3508 GA, the Netherlands.

University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands.

出版信息

BMC Ophthalmol. 2023 Jan 30;23(1):41. doi: 10.1186/s12886-023-02779-7.

Abstract

BACKGROUND

Cataract surgery has become one of the most performed surgical procedures worldwide. Postoperative management consists of routine clinical examinations to assess post-operative visual function and detect possible adverse events. Due to the low incidence of complications, the majority of clinic visits after cataract surgery are uneventful. Nonetheless, valuable time and hospital resources are consumed. We hypothesize that remote post-operative follow-up involving teleconsultations and self-assessments of visual function and health status, could be a valid alternative to face-to-face clinical examinations in selected patient groups. The practice of remote follow-up after cataract surgery has not yet been evaluated. The aim of this study is to investigate the validity, safety and cost-effectiveness of remote cataract surgery follow-up, and to report on the patients' experiences with remotely self-assessing visual function.

METHODS

This study is a multicenter, open-label, randomized controlled trial. Patients planned for cataract surgery on both eyes, without ocular comorbidities, are eligible for participation. Participants will be allocated (1:1) into one of the two study groups: 'telemonitoring' or 'usual care'. Participants in the 'telemonitoring' group will perform in-home assessments after cataract surgery (remote web-based eye exams and digital questionnaires on their own devices). Participants in the 'usual care' group will have regular post-operative consultations, according to the study site's regular practice. Outcome measures include accuracy of the web-based eye exam for assessing visual acuity and refraction, patient-reported outcome measures (visual function and quality of life), adverse events, and cost aspects.

DISCUSSION

Investigating remote follow-up after cataract surgery fits the current trends of digitization of health care. We believe that remote self-care can be a promising avenue to comply with the increasing demands of cataract care. This randomized controlled trial provides scientific evidence on this unmet need and delivers the desired insights on (cost)effectiveness of remote follow-up after cataract surgery.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT04809402. Date of registration: March 22, 2021.

摘要

背景

白内障手术已成为全球施行最多的手术之一。术后管理包括常规临床检查,以评估术后视力并发现可能的不良事件。由于并发症发生率低,大多数白内障手术后的就诊都没有异常情况。尽管如此,还是浪费了宝贵的时间和医院资源。我们假设,通过远程医疗咨询和自我评估视力和健康状况的方式进行远程术后随访,可能成为选择患者群体后进行面对面临床检查的有效替代方法。远程随访在白内障手术后的应用尚未得到评估。本研究旨在调查远程白内障手术随访的有效性、安全性和成本效益,并报告患者远程自我评估视力的体验。

方法

这是一项多中心、开放标签、随机对照试验。计划接受双眼白内障手术、无眼部合并症的患者符合入组条件。参与者将按照 1:1 的比例分配至两组研究之一:“远程监测”或“常规护理”。“远程监测”组的参与者将在白内障手术后进行家庭评估(远程基于网络的眼部检查和他们自己的设备上的数字问卷调查)。“常规护理”组的参与者将根据研究地点的常规实践进行定期术后就诊。主要结局指标包括基于网络的眼部检查评估视力和屈光度的准确性、患者报告的结局指标(视力和生活质量)、不良事件和成本方面。

讨论

调查白内障手术后的远程随访符合医疗数字化的当前趋势。我们相信,远程自我护理可能是满足不断增长的白内障护理需求的有前途的途径。这项随机对照试验为这一未满足的需求提供了科学证据,并提供了有关白内障手术后远程随访的(成本)效益的预期见解。

试验注册

ClinicalTrials.gov:NCT04809402。注册日期:2021 年 3 月 22 日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/133c/9885558/8e56b924fcba/12886_2023_2779_Fig1_HTML.jpg

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