Mismatch of corneal specialists' expectations and keratoconus knowledge in general ophthalmologists - a prospective observational study in Switzerland

Comparing the influence of big data resources on medical knowledge recall for staff with and without medical collaboration platform

BACKGROUND

This study aims to examine how big data resources affect the recall of prior medical knowledge by healthcare professionals, and how this differs in environments with and without remote consultation platforms.

METHOD

This study investigated two distinct categories of medical institutions, namely 132 medical institutions with platforms, and 176 medical institutions without the platforms. Big data resources are categorized into two levels-medical institutional level and public level-and three types, namely data, technology, and services. The data are analyzed using SmartPLS2.

RESULTS

(1) In both scenarios, shared big data resources at the public level have a significant direct impact on the recall of prior medical knowledge. However, there is a significant difference in the direct impact of big data resources at the institutional level in both scenarios. (2) In institutions with platforms, for the three big data resources (the medical big data assets and big data deployment technical capacity at the medical institutional level, and policies of medical big data at the public level) without direct impacts, there exist three indirect pathways. (3) In institutions without platforms, for the two big data resources (the service capability and big data technical capacity at the medical institutional level) without direct impacts, there exist three indirect pathways.

CONCLUSIONS

The different interactions between big data, technology, and services, as well as between different levels of big data resources, affect the way clinical doctors recall relevant medical knowledge. These interaction patterns vary between institutions with and without platforms. This study provides a reference for governments and institutions to design big data environments for improving clinical capabilities.

Differences in minimal disease knowledge of keratoconus patients: results from an international survey

BACKGROUND/AIMS

The objective of this multicentre, multinational, prospective study was to assess the level of basic understanding that individuals with keratoconus possessed about their condition.

METHODS

We recruited 200 active keratoconus patients who were under regular review, and cornea specialists established a standard of 'minimal keratoconus knowledge' (MKK) that included an understanding of the definition, risk factors, symptoms and treatment options for the condition. We collected data from each participant regarding their clinical characteristics, highest level of education, (para)medical background and experiences with keratoconus within their social circle, and calculated the percentage of MKK attained by each patient.

RESULTS

Our findings revealed that none of the participants met the MKK standard, with the average MKK score being 34.6% and ranging from 0.0% to 94.4%. Furthermore, our study showed that patients with a university degree, previous surgical intervention for keratoconus or affected parents had a higher MKK. However, age, gender, disease severity, paramedical knowledge, disease duration and best-corrected visual acuity did not significantly affect the MKK score.

CONCLUSIONS

Our study demonstrates a concerning lack of basic disease knowledge among keratoconus patients in three different countries. The level of knowledge exhibited by our sample was only one-third of what cornea specialists would typically anticipate from patients. This highlights the need for greater education and awareness campaigns surrounding keratoconus. Further research is needed to determine the most efficient approaches for enhancing MKK and subsequently improving the management and treatment of keratoconus.

Automated cornea diagnosis using deep convolutional neural networks based on cornea topography maps

Cornea topography maps allow ophthalmologists to screen and diagnose cornea pathologies. We aim to automatically identify any cornea abnormalities based on such cornea topography maps, with focus on diagnosing keratoconus. To do so, we represent the OCT scans as images and apply Convolutional Neural Networks (CNNs) for the automatic analysis. The model is based on a state-of-the-art ConvNeXt CNN architecture with weights fine-tuned for the given specific application using the cornea scans dataset. A set of 1940 consecutive screening scans from the Saarland University Hospital Clinic for Ophthalmology was annotated and used for model training and validation. All scans were recorded with a CASIA2 anterior segment Optical Coherence Tomography (OCT) scanner. The proposed model achieves a sensitivity of 98.46% and a specificity of 91.96% when distinguishing between healthy and pathological corneas. Our approach enables the screening of cornea pathologies and the classification of common pathologies like keratoconus. Furthermore, the approach is independent of the topography scanner and enables the visualization of those scan regions which drive the model's decisions.

Clinical-epidemiological characteristics of keratoconus in Asturias

INTRODUCTION

Keratoconus is the most frequent corneal ectasia and second most common cause of keratoplasty worldwide. The clinical and epidemiological characteristics of keratoconus have rarely been studied in Spain, and to date, no study has been done in Asturias.

MATERIAL AND METHODS

A cross-sectional study was conducted to analyze all cases of keratoconus diagnosed in the first consultations of the Cornea and Surface section of the Hospital Universitario Central de Asturias (Oviedo) and Hospital Universitario de Cabueñes (Gijón) between 2017 and 2020. Demographic data, visual acuity and corneal topography were collected.

RESULTS

A total of 112 patients (42.0% women and 58.0% men) were included. The mean age was 36.84 ± 15.59, with 39.3% being older than 40 years. 31.8%, 28.0%, 15.0%, and 25.2% were in stages I, II, III and IV, Amsler-Krumeich scale, respectively. Corneal segments were implanted in 7.5% of patients, cross-linking was performed in 4.7%, and keratoplasty was performed in 13.2%.

CONCLUSION

Approximately 40% of keratoconus cases are detected at advanced stages and another 40% are detected at an age over 40 years. 13% of these patients require keratoplasty, which is why it is frequently performed in our setting. Therefore, early diagnosis before irreversible visual loss is necessary.

Knowledge about Prescribing Antibiotics as Prophylaxis in Patients with Open Globe Injury: A Survey in Iranian Ophthalmologists

Objective

This study aimed to evaluate the Iranian ophthalmologists' knowledge of prescribing prophylactic antibiotics to patients with open globe injury (OGI) in Iran.

Methods

In this cross-sectional study, we utilized a questionnaire to evaluate the ophthalmologists' knowledge about prescribing antibiotics as prophylaxis. This survey was conducted in Tehran and its suburbs. The questionnaire included demographic information as well as ophthalmologists' knowledge levels. Cronbach's alpha was used to determine its validity and reliability. The obtained data were analyzed using SPSS 24.0.

Results

Of 192 subjects, 111 (35 women, 76 men) were included. About 65 (58.6%) specialists and 45 (41.4%) subspecialists with different orientations completed the questionnaires. The total knowledge score was 13.04±2.96. The following are the results of ophthalmologists' responses to questions regarding the cornea/scleral injury (1.09±1.72), prophylactic antibiotics administration (2.79±1.11), the infectious agents in eye surgeries (3.21±1.49), diagnosis and treatment (2.84±0.944), and the effects of ocular antibiotics as well as their proper dosage (2.96±2.35). There was no significant relationship between some demographic information such as sex, working hours, workplace, and the number of studied articles (p>0.05). In addition, ophthalmologists with less work experience had significantly higher levels of knowledge than those with more work experience.

Conclusion

The findings indicated that the majority of ophthalmologists had a basic knowledge of prescribing prophylactic antibiotics in OGI.

Self-reported knowledge and skills related to diagnosis and management of keratoconus among public sector optometrists in the Limpopo province, South Africa

BACKGROUND

Keratoconus (KC) has been regarded as a rare condition, although recent studies, including those in South Africa, suggest it is common and is increasing in prevalence. Furthermore, South African-based studies have shown that KC is normally detected at advanced or severe stages. Knowledge and skills for examination, diagnosis and management of KC by optometrists are important for the early detection and management of the disease.

AIM

This study aimed to evaluate self-reported knowledge and skills for examination, diagnosis and management of KC patients among public sector optometrists.

SETTING

Seven public hospitals of the Capricorn district of the Limpopo province, South Africa.

METHODS

A quantitative cross-sectional descriptive study design was used. A self-administered online questionnaire was used to collect data on demographic characteristics of participants and their knowledge, skills and practice for the diagnosis and management of KC.

RESULTS

Twenty-four optometrists (n = 24) with a mean age of 39 ± 5.67 years, 18 (75%) of whom were female, participated in the study. Nineteen (79%) reported that their hospitals did not have the appropriate equipment to examine, diagnose and manage KC patients. Lack of equipment, poor knowledge, skills and competencies, hospital's level of services, policy and lack of interest were cited as barriers to contact lens fittings in KC patients. Using a dichotomised summation of self-reported knowledge and skills of KC, 13 (54.2%) of the optometrists were knowledgeable and skilled on risk factors of KC and examining, diagnosing and managing KC patients.

CONCLUSION

A significant proportion of optometrists did not have the appropriate knowledge and skills to examine, diagnose and manage KC patients. Lack of equipment and poor knowledge and skills were the main barriers to contact lens fittings in managing KC.Contribution: This article highlights the need for the district to upskill the optometrists through a structured programme with a theory and practical component and also provide the necessary equipment to enhance patient care.

Diagnosis and Management of Keratoconus-A Narrative Review of Clinicians' Perspectives

This review discusses the current practices, attitudes, and trends in diagnosing and managing keratoconus (KC) in adults and children by optometrists and ophthalmologists in order to highlight the differences on a global scale. Two independent reviewers searched the electronic databases and grey literature for all potential articles published from 1 January 2000 to 1 June 2022 on management of KC. Keywords used in searches included "keratoconus", "diagnosis", "management", "treatment", "attitude", "practices", "opinion", "optometrist", "ophthalmologist", "consensus", and "protocol". A total of 19 articles was included in this review-12 from the database search and seven from the grey literature. Although a common stepwise approach of non-surgical management was noted, there were differences in the rates of prescribing rigid gas permeable lenses. Furthermore, while clinicians agreed on the need for early diagnosis, the timeline and type of referral varied significantly. A similar discordance was found in the milestones for surgical intervention and preferred surgical techniques. Practice patterns in keratoconus diagnosis and management vary throughout the world. Multiple recommendations and suggestions to minimise the differences have been provided in the literature, with the main themes being improvement in education, interdisciplinary patient care, and further research to reach consensus.

Impact of big data resources on clinicians’ activation of prior medical knowledge

Background

Activating prior medical knowledge in diagnosis and treatment is an important basis for clinicians to improve their care ability. However, it has not been systematically explained whether and how various big data resources affect the activation of prior knowledge in the big data environment faced by clinicians.

Objective

The aim of this study is to contribute to a better understanding on how the activation of prior knowledge of clinicians is affected by a wide range of shared and private big data resources, to reveal the impact of big data resources on clinical competence and professional development of clinicians.

Method

Through the comprehensive analysis of extant research results, big data resources are classified as big data itself, big data technology and big data services at the public and institutional levels. A survey was conducted on clinicians and IT personnel in Chinese hospitals. A total of 616 surveys are completed, involving 308 medical institutions. Each medical institution includes a clinician and an IT personnel. SmartPLS version 2.0 software package was used to test the direct impact of big data resources on the activation of prior knowledge. We further analyze their indirect impact of those big data resources without direct impact.

Results

(1) Big data quality environment at the institutional level and the big data sharing environment at the public level directly affect activation of prior medical knowledge; (2) Big data service environment at the institutional level directly affects activation of prior medical knowledge; (3) Big data deployment environment at the institutional level and big data service environment at the public level have no direct impact on activation of prior knowledge of clinicians, but they have an indirect impact through big data quality environment and service environment at the institutional level and the big data sharing environment at the public level.

Conclusions

Big data technology, big data itself and big data service at the public level and institutional level interact and influence each other to activate prior medical knowledge. This study highlights the implications of big data resources on improvement of clinicians’ diagnosis and treatment ability.