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Berkowitz ST, Groth S, Sternberg P, Patel S. Drug Savings for Medicare Part D Beneficiaries Using a Direct-to-Consumer Model. Ophthalmology 2024; 131:509-510. [PMID: 38072014 DOI: 10.1016/j.ophtha.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 11/20/2023] [Accepted: 12/05/2023] [Indexed: 01/15/2024] Open
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Wright A, Wilkinson MD, Mungall C, Cain S, Richards S, Sternberg P, Provin E, Jacobs JL, Geib S, Raciti D, Yook K, Stein L, Molik DC. FAIR Header Reference genome: a TRUSTworthy standard. Brief Bioinform 2024; 25:bbae122. [PMID: 38555475 PMCID: PMC10981671 DOI: 10.1093/bib/bbae122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/16/2024] [Accepted: 02/22/2024] [Indexed: 04/02/2024] Open
Abstract
The lack of interoperable data standards among reference genome data-sharing platforms inhibits cross-platform analysis while increasing the risk of data provenance loss. Here, we describe the FAIR bioHeaders Reference genome (FHR), a metadata standard guided by the principles of Findability, Accessibility, Interoperability and Reuse (FAIR) in addition to the principles of Transparency, Responsibility, User focus, Sustainability and Technology. The objective of FHR is to provide an extensive set of data serialisation methods and minimum data field requirements while still maintaining extensibility, flexibility and expressivity in an increasingly decentralised genomic data ecosystem. The effort needed to implement FHR is low; FHR's design philosophy ensures easy implementation while retaining the benefits gained from recording both machine and human-readable provenance.
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Groth SL, Sternberg P. The Unfolding Story of Private Equity in Ophthalmology. Ophthalmology 2024; 131:159-160. [PMID: 38246704 DOI: 10.1016/j.ophtha.2023.12.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 01/23/2024] Open
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Patel S, Kim SJ, Sternberg P. Reply. Ophthalmology 2024; 131:e7-e8. [PMID: 38069942 DOI: 10.1016/j.ophtha.2023.10.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 10/31/2023] [Indexed: 01/23/2024] Open
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Wright A, Wilkinson MD, Mungall C, Cain S, Richards S, Sternberg P, Provin E, Jacobs JL, Geib S, Raciti D, Yook K, Stein L, Molik DC. DATA RESOURCES AND ANALYSES FAIR Header Reference genome: A TRUSTworthy standard. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.11.29.569306. [PMID: 38076838 PMCID: PMC10705436 DOI: 10.1101/2023.11.29.569306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
The lack of interoperable data standards among reference genome data-sharing platforms inhibits cross-platform analysis while increasing the risk of data provenance loss. Here, we describe the FAIR-bioHeaders Reference genome (FHR), a metadata standard guided by the principles of Findability, Accessibility, Interoperability, and Reuse (FAIR) in addition to the principles of Transparency, Responsibility, User focus, Sustainability, and Technology (TRUST). The objective of FHR is to provide an extensive set of data serialisation methods and minimum data field requirements while still maintaining extensibility, flexibility, and expressivity in an increasingly decentralised genomic data ecosystem. The effort needed to implement FHR is low; FHR's design philosophy ensures easy implementation while retaining the benefits gained from recording both machine and human-readable provenance.
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Finn AP, Ji X, Chen Q, Sternberg P, Patel S. Trends in Imaging Utilization Among United States Medicare Beneficiaries and the Impact of the COVID-19 Pandemic. Ophthalmic Surg Lasers Imaging Retina 2023; 54:661-665. [PMID: 37855832 DOI: 10.3928/23258160-20231011-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
This study characterizes trends in ophthalmic imaging volume and utilization in the United States among and assesses the potential impact of the COVID-19 pandemic using data from the Centers for Medicare and Medicaid Services. Utilization of macular optical coherence tomography (OCT), optic nerve OCT, and fundus photography steadily increased from 2013 to 2020 and was not impacted by the COVID-19 pandemic. At the same time, there was minimal adoption of anterior segment OCT and a decline in the utilization of dye-based angiography. Utilization patterns may be impacted by the advent of new technologies, role of the clinician, and alignment with treatment paradigms. [Ophthalmic Surg Lasers Imaging Retina 2023;54:661-665.].
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Berkowitz ST, Lam S, Sternberg P, Patel SN, Finn AP. Time-driven Activity-based Costing Analysis of Fluorescein Angiography. Ophthalmol Retina 2023; 7:804-810. [PMID: 37244412 DOI: 10.1016/j.oret.2023.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/23/2023] [Accepted: 05/19/2023] [Indexed: 05/29/2023]
Abstract
PURPOSE To use electronic health record (EHR) time logs and time-driven activity-based costing (TDABC) to calculate the complete cost profile of office-based fluorescein angiography (FA). DESIGN Economic analysis. SUBJECTS Patients undergoing routine FA (Current Procedural Terminology [CPT] 92235) at Vanderbilt Eye Institute in fiscal year 2022. METHODS Process flow mapping for routine FA was used to define the care episode after manual observation. Deidentified time logs were sourced from the EHR and all manually validated to calculate durations for each stage. The cost of materials was calculated from internal financial figures. Cost per minute for space, equipment, and personnel were based on internal figures. Published fluorescein costs were used for base-case analysis with scenario analysis based on a range of internal figures from pharmacy quotes. These inputs were used for a TDABC analysis. MAIN OUTCOME MEASURES Time-driven activity-based costing of FA episode of care. Secondary scenario analyses focus on breakeven scenarios for key inputs, including medication costs RESULTS: Cost analysis of office-based FA resulted in an average total cost of $152.95 (nominal) per interpreted study per patient, which was $36.52 more than the maximum Medicare reimbursement for CPT 92235 in Mac Locality for Tennessee 10312 for fiscal year 2022 ($116.43; $76.11 [technical component] and $40.33 [physician component]). The negative contribution margin is strongly influenced by the cost of fluorescein, which comprises 39.8% of the episode costs, excluding overhead. CONCLUSIONS The current analysis here shows that the recently increased cost of fluorescein has driven up the cost of office-based FA relative to the current maximum allowable Medicare reimbursement, leading to a negative contribution margin and financial loss. Given conservative cost estimates here, it is unlikely for profitability to be achieved without changes in the cost of fluorescein or increased reimbursement. These results may be informative for policy discussion regarding appropriate reimbursement for codes using injectable fluorescein. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Taubenslag KJ, Al Hussein Al Awamlh S, Sternberg P. BILATERAL CHOROIDAL VASCULAR MALFORMATIONS IN HEREDITARY HEMORRHAGIC TELANGIECTASIA. Retin Cases Brief Rep 2023; 17:346-347. [PMID: 34710889 DOI: 10.1097/icb.0000000000001203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe a case of bilateral choroidal vascular malformations in a patient with hereditary hemorrhagic telangiectasia. METHODS Case report. RESULTS A 78-year-old man with hereditary hemorrhagic telangiectasia was incidentally noted to have focal, large deep choroidal vessels on optical coherence tomography with corresponding elevation of the overlying retina. Indocyanine green angiography revealed dilated, intensely fluorescent vessels in arterial phase emptying into massively dilated choroidal veins consistent with choroidal arteriovenous malformation. CONCLUSION This case presents multimodal imaging findings of choroidal arteriovenous malformations in hereditary hemorrhagic telangiectasia. Choroidal vascular malformations may represent an underrecognized clinical feature of this syndrome.
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Siktberg J, Kim SJ, Sternberg P, Patel S. Effectiveness of bevacizumab step therapy for neovascular age-related macular degeneration. Eye (Lond) 2023; 37:1844-1849. [PMID: 36127425 PMCID: PMC10275928 DOI: 10.1038/s41433-022-02253-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 08/04/2022] [Accepted: 09/08/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To determine the effectiveness of bevacizumab step therapy for neovascular age-related macular degeneration (nAMD) in routine clinical practice. METHODS In this retrospective case series, eyes initiating treatment for nAMD at an academic medical centre from 2011-2019 were included. Exclusion criteria included previous intravitreal anti-VEGF injections, prior non-cataract intraocular surgery, <1 year of treatment, and not starting on monthly bevacizumab therapy. Of 895 eligible eyes, 548 were excluded, yielding 347 eyes in the study population. These eyes were treated for nAMD under the bevacizumab step therapy protocol with an option to switch to another agent in the event of predefined treatment failure. Treatment failure was defined as losing 15 or more Early Treatment Diabetic Retinopathy Study letters or switching to an alternative anti-VEGF agent. Eyes that did not meet these criteria were deemed treatment successes. Annual change in mean VA from baseline (ΔVA) was the primary outcome. Secondary outcomes included treatment success rate, medication switch rate, and post-switch ΔVA. RESULTS After 1 year, mean ΔVA was +8.4 letters (95% CI: +6.1 to +10.6 letters). 86% had treatment success, and 6% of eyes had switched to aflibercept. In years 2-7, ΔVA ranged from +7.0 to -0.7 letters, and treatment success rates ranged from 68 to 82%. 11% (n = 38) of eyes were switched to aflibercept. The post-switch ΔVA in these eyes was -7.1 letters (95% CI: -13.3 to -0.1) after a mean of 17.7 ± 12.6 injections over an average of 2.7 ± 2.0 years. CONCLUSION A bevacizumab step therapy protocol in routine clinical practice is effective for long-term treatment of nAMD.
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Finn AP, Sternberg P. Considering the Patient, Surgeon, and Health Care System in the Timing of Retinal Detachment Repair. Ophthalmol Retina 2023; 7:373-374. [PMID: 37147035 DOI: 10.1016/j.oret.2023.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 02/18/2023] [Accepted: 02/22/2023] [Indexed: 05/07/2023]
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Patel S, Kim S, Sternberg P. Considerations When Offering Minimally Proven Investigational Treatments. Ophthalmology 2023; 130:351-353. [PMID: 36517278 DOI: 10.1016/j.ophtha.2022.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/02/2022] [Accepted: 11/08/2022] [Indexed: 12/14/2022] Open
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Steitz BD, Turer RW, Lin CT, MacDonald S, Salmi L, Wright A, Lehmann CU, Langford K, McDonald SA, Reese TJ, Sternberg P, Chen Q, Rosenbloom ST, DesRoches CM. Perspectives of Patients About Immediate Access to Test Results Through an Online Patient Portal. JAMA Netw Open 2023; 6:e233572. [PMID: 36939703 PMCID: PMC10028486 DOI: 10.1001/jamanetworkopen.2023.3572] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 01/17/2023] [Indexed: 03/21/2023] Open
Abstract
Importance The 21st Century Cures Act Final Rule mandates the immediate electronic availability of test results to patients, likely empowering them to better manage their health. Concerns remain about unintended effects of releasing abnormal test results to patients. Objective To assess patient and caregiver attitudes and preferences related to receiving immediately released test results through an online patient portal. Design, Setting, and Participants This large, multisite survey study was conducted at 4 geographically distributed academic medical centers in the US using an instrument adapted from validated surveys. The survey was delivered in May 2022 to adult patients and care partners who had accessed test results via an online patient portal account between April 5, 2021, and April 4, 2022. Exposures Access to test results via a patient portal between April 5, 2021, and April 4, 2022. Main Outcomes and Measures Responses to questions related to demographics, test type and result, reaction to result, notification experience and future preferences, and effect on health and well-being were aggregated. To evaluate characteristics associated with patient worry, logistic regression and pooled random-effects models were used to assess level of worry as a function of whether test results were perceived by patients as normal or not normal and whether patients were precounseled. Results Of 43 380 surveys delivered, there were 8139 respondents (18.8%). Most respondents were female (5129 [63.0%]) and spoke English as their primary language (7690 [94.5%]). The median age was 64 years (IQR, 50-72 years). Most respondents (7520 of 7859 [95.7%]), including 2337 of 2453 individuals (95.3%) who received nonnormal results, preferred to immediately receive test results through the portal. Few respondents (411 of 5473 [7.5%]) reported that reviewing results before they were contacted by a health care practitioner increased worry, though increased worry was more common among respondents who received abnormal results (403 of 2442 [16.5%]) than those whose results were normal (294 of 5918 [5.0%]). The result of the pooled model for worry as a function of test result normality was statistically significant (odds ratio [OR], 2.71; 99% CI, 1.96-3.74), suggesting an association between worry and nonnormal results. The result of the pooled model evaluating the association between worry and precounseling was not significant (OR, 0.70; 99% CI, 0.31-1.59). Conclusions and Relevance In this multisite survey study of patient attitudes and preferences toward receiving immediately released test results via a patient portal, most respondents preferred to receive test results via the patient portal despite viewing results prior to discussion with a health care professional. This preference persisted among patients with nonnormal results.
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Patel S, Finn A, Kim S, Sternberg P. Retina Procedure Volume Changes during the COVID-19 Pandemic. Ophthalmol Retina 2023:S2468-6530(23)00035-0. [PMID: 36736461 PMCID: PMC9892319 DOI: 10.1016/j.oret.2023.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 02/05/2023]
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Finn AP, Law JC, Sternberg P, Patel SN. Striking a Balance: The Role of Virtual Learning in Ophthalmic Education. JOURNAL OF ACADEMIC OPHTHALMOLOGY (2017) 2023; 15:e73-e74. [PMID: 38737157 PMCID: PMC10804739 DOI: 10.1055/s-0043-1764462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 01/17/2023] [Indexed: 03/12/2023]
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Besagar S, Yonekawa Y, Sridhar J, Finn A, Padovani-Claudio DA, Sternberg P, Patel S. Association of Socioeconomic, Demographic, and Health Care Access Disparities With Severe Visual Impairment in the US. JAMA Ophthalmol 2022; 140:1219-1226. [PMID: 36326732 PMCID: PMC9634598 DOI: 10.1001/jamaophthalmol.2022.4566] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 09/15/2022] [Indexed: 11/06/2022]
Abstract
Importance Approximately 13% of US adults are affected by visual disability, with disproportionately higher rates in groups impacted by certain social determinants of health (SDOH). Objective To evaluate SDOH associated with severe visual impairment (SVI) to ultimately guide targeted interventions to improve ophthalmic health. Design, Setting, and Participants This quality improvement study used cross-sectional data from a telephone survey from the Behavioral Risk Factor Surveillance System (BRFSS) that was conducted in the US from January 2019 to December 2020. Participants were noninstitutionalized adult civilians who were randomly selected and interviewed and self-identified as "blind or having serious difficulty seeing, even while wearing glasses." Exposures Demographic and health care access factors. Main Outcomes and Measures The main outcome was risk of SVI associated with various factors as measured by odds ratios (ORs) and 95% CIs. Descriptive and logistic regression analyses were performed using the Web Enabled Analysis Tool in the BRFFS. Results During the study period, 820 226 people (53.07% female) participated in the BRFSS survey, of whom 42 412 (5.17%) self-identified as "blind or having serious difficulty seeing, even while wearing glasses." Compared with White, non-Hispanic individuals, risk of SVI was increased among American Indian/Alaska Native (OR, 1.63; 95% CI, 1.38-1.91), Black/African American (OR, 1.50; 95% CI, 1.39-1.62), Hispanic (OR, 1.65; 95% CI, 1.53-1.79), and multiracial (OR, 1.33; 95% CI, 1.15-1.53) individuals. Lower annual household income and educational level (eg, not completing high school) were associated with greater risk of SVI. Individuals who were out of work for 1 year or longer (OR, 1.78; 95% CI, 1.54-2.07) or who reported being unable to work (OR, 2.90; 95% CI, 2.66-3.16) had higher odds of SVI compared with the other variables studied. Mental health diagnoses and 14 or more days per month with poor mental health were associated with increased risk of SVI (OR, 1.87; 95% CI, 1.73-2.02). Health care access factors associated with increased visual impairment risk included lack of health care coverage and inability to afford to see a physician. Conclusions and Relevance In this study, various SDOH were associated with SVI, including self-identification as being from a racial or ethnic minority group; low socioeconomic status and educational level; long-term unemployment and inability to work; divorced, separated, or widowed marital status; poor mental health; and lack of health care coverage. These disparities in care and barriers to health care access should guide targeted interventions.
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Patel S, Garner DC, Berkowitz ST, Sternberg P. Implications of the presence of private equity in ophthalmology: an academic perspective. Curr Opin Ophthalmol 2022; 33:377-380. [PMID: 35819904 DOI: 10.1097/icu.0000000000000856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Private equity acquisitions of ophthalmology private practices have been steadily increasing over the past decade with far-reaching implications. Ophthalmology departments at academic medical centers are not insulated from the impact of this trend. RECENT FINDINGS The limited data on this subject in the ophthalmology literature identify the growing number of practice acquisitions. However, the lack of transparency obfuscates a clear understanding of the effect on patients and practice patterns. SUMMARY Leaders at academic medical centers need to be aware of surrounding practice consolidation because of private equity as this could affect revenue streams and patient referral patterns, accelerating expansion. Trainees are entering an uncertain job marketplace that may create a compelling argument to practice in an academic medical center ophthalmology department.
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Patel S, Sternberg P. Is There a Cost Benefit to the Ranibizumab Port Delivery System? JAMA Ophthalmol 2022; 140:723-724. [PMID: 35708666 DOI: 10.1001/jamaophthalmol.2022.1820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Hatcher JB, de Castro-Abeger A, LaRue RW, Hingorani M, Mawn L, Donahue SP, Sternberg P, Shieh C. MRSA Decolonization and the Eye: A Potential New Tool for Ophthalmologists. Semin Ophthalmol 2022; 37:541-553. [DOI: 10.1080/08820538.2022.2039220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Berkowitz ST, Sternberg P, Patel S. Reply. Ophthalmol Retina 2021; 5:e10. [PMID: 34243972 DOI: 10.1016/j.oret.2021.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 10/21/2022]
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Tsai LM, Schroth HA, Schmidt GE, Sternberg P. The Impact of the American Academy of Ophthalmology's Leadership Development Program: Experience from the First 20 Years. JOURNAL OF ACADEMIC OPHTHALMOLOGY (2017) 2021; 13:e138-e143. [PMID: 37388843 PMCID: PMC9927980 DOI: 10.1055/s-0041-1735954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 06/22/2021] [Indexed: 10/19/2022]
Abstract
Objective This study aimed to analyze the effectiveness of the American Academy of Ophthalmology (AAO)'s Leadership Development Program (LDP), report the program's impact on participants in attaining ophthalmic leadership positions, and identify opportunities to improve future LDP programming. Design An open cohort study was performed on AAO LDP graduates by using an online questionnaire and retrospective monitoring. Participants and Methods AAO LDP graduates from 1999 to 2019 participated in the study. A Likert-scale survey was distributed via email. Online responses were submitted anonymously to a team at the Berkeley Haas School of Business for analysis. A separate review of gender demographics and ophthalmic leadership positions held by graduates was performed. Main Outcomes Measures Regression analysis was performed to determine whether survey results supported a meaningful relationship between the measured impact and the AAO LDP program's perceived effectiveness. Ascension into leadership positions of AAO-related organizations at the national, regional, state, and subspecialty level by AAO LDP graduates was collated. Results Of 381 potential respondents, 203 survey responses were returned (53.3%). 158 reported that they are currently holding a leadership position (77.8%). Statistical analyses indicated that the overall value of the program was seen as highly effective (M = 4.6), and that the development programs combined contributed significantly to AAO LDP being judged as effective overall, F (11,191) = 24.79; p < 0.001 with an R 2 of 0.59. Longitudinal tracking of the 383 graduates revealed that 268 (70.0%) have served as AAO committee/task force members, councilors, or representatives to outside organizations. A total of 242 (63.2%) graduates have served as president or chair of a state, subspecialty, or specialized interest ophthalmology society. 25 (6.5%) have served at the highest level of AAO leadership and two have been elected AAO President. A higher percentage of participants identifying as female was found in the LDP program compared with both U.S. overall and trainee ophthalmic populations. Conclusion The AAO LDP has fulfilled its initial goals of effectively developing a large cohort of ophthalmologists interested in and prepared to take on leadership roles across the profession. Development of more specific outcome measures to evaluate the program, as well as direct optimal programming, are needed to further the success of its aims.
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Siktberg J, Hamdan S, Liu Y, Chen Q, Donahue SP, Patel SN, Sternberg P, Robinson J, Kammer JA, Gangaputra SS. Validation of a Standardized Home Visual Acuity Test for Teleophthalmology. OPHTHALMOLOGY SCIENCE 2021; 1:100007. [PMID: 36246005 PMCID: PMC9560535 DOI: 10.1016/j.xops.2021.100007] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/20/2021] [Accepted: 03/04/2021] [Indexed: 11/25/2022]
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Berkowitz ST, Law JC, Sternberg P, Patel S. Leadership Development in Ophthalmology: Current Impact and Future Needs. JOURNAL OF ACADEMIC OPHTHALMOLOGY 2021. [DOI: 10.1055/s-0041-1723001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Abstract
Importance There is a lack of peer-reviewed literature on leadership development programs (LDP) in ophthalmology. Research into LDP demographics, outcomes, and methodology is needed.
Objective The aim of the study is to evaluate the extent to which LDPs targeting ophthalmologists meet the needs of emerging leaders.
Design The design type of the study is cross-sectional analysis.
Setting This study involves international setting.
Participants The participants involved were ophthalmologists at any career level.
Methods Routine internet search was used to identify LDPs targeting ophthalmologists. LDPs identified were categorized by the outcome data available into four levels based on prior literature. Participants were assessed using previously validated software for gender (Gender-API, 2020) and race or ethnicity (NamSor, 2020)
Results Nine programs were identified which were classified into LDP generations. The first LDP in ophthalmology was the American Academy of Ophthalmology (AAO) LDP, which served as the nidus for the formation of four multinational LDPs, together forming the Global LDP. These LDPs were similar in size and scope; program size ranging from nine to 30 participants; a length of 1 to 2 years; with similar curricular offerings; with funding primarily derived from cost-sharing with a nominating society. The second generation of ophthalmology LDPs in the United States has targeted female scientists or faculty (Women's LDP by ARVO) and academic ophthalmology leaders (Academic LDP by Association of University Professors of Ophthalmology).The AAO's LDP appears increasingly diverse with approximately 13% women at inception, gradually increasing from 40 to 65% women in the last 5 years (n = 389). There has also been a notable increase in ethnic diversity.
Conclusion and Relevance AAO LDP is the preeminent leadership training program for ophthalmologists, and it has influenced the creation of a new generation of LDP offerings. There remains a paucity of LDP evaluation metrics and reported outcomes. Newer iterations are successfully targeting academic leadership and attempting to address known disparities in gender and race or ethnicity. Further expansion of LDPs and related research can ensure equity and diversity in the pipeline.
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Berkowitz ST, Sternberg P, Patel S. Cost Analysis of Routine Vitrectomy Surgery. Ophthalmol Retina 2021; 5:496-502. [PMID: 33588067 DOI: 10.1016/j.oret.2021.02.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 01/24/2021] [Accepted: 02/08/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE To use electronic health record (EHR) time logs to calculate the complete cost profiles of routine pars plana vitrectomy surgery. DESIGN Economic analysis. PARTICIPANTS Patients undergoing elective vitrectomy procedures (Current Procedural Terminology codes 67040, 67041, and 67042) at Vanderbilt University Medical Center in fiscal year 2019. METHODS Process flow mapping for routine vitrectomy surgery was used to define the operative episode. De-identified time logs were sourced from an internal perioperative data warehouse to calculate procedure-level durations. The costs of materials and overhead were calculated from internal financial management software. Costs per minute for space, equipment, and personnel were based on internal figures. These inputs were used for a time-driven activity-based costing (TDABC) analysis. MAIN OUTCOME MEASURES Complete cost profile of routine pars plana vitrectomy surgery. RESULTS Cost analysis of routine vitrectomy surgery resulted in a total cost of $7169.79 per patient, which was $2053.85 more than the maximum Medicare reimbursement for the equivalent episode, $5115.93. Vitrectomy cases do not break even unless the case duration is fewer than 26.81 minutes, overhead is reduced by 53.78%, or reimbursement is increased by 40.15%. Reimbursement does not compensate for variable costs alone for cases lasting longer than 55.09 minutes. In the cohort used here, 68% of cases are completely unprofitable, with increasing losses directly proportional to the length of the case. CONCLUSIONS This analysis showed that true costs for routine vitrectomy procedures are significantly more than the maximum allowable Medicare reimbursement. Academic ophthalmology departments may benefit from more accurate costing approaches using existing EHR data. These approaches may be informative for policy discussion regarding appropriate reimbursement.
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De La Huerta I, Kim SJ, Sternberg P. Faricimab Combination Therapy for Sustained Efficacy in Neovascular Age-Related Macular Degeneration. JAMA Ophthalmol 2020; 138:972-973. [PMID: 32729885 DOI: 10.1001/jamaophthalmol.2020.2723] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Patel S, Sternberg P, Kim SJ. Publishing of Results from Ophthalmology Trials Registered on ClinicalTrials.gov. ACTA ACUST UNITED AC 2020; 4:754-755. [DOI: 10.1016/j.oret.2020.03.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 03/02/2020] [Accepted: 03/11/2020] [Indexed: 11/16/2022]
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