Eter N, Pauleikhoff D, Agostini H, Fleckenstein M, Ziemssen F. [Value and formats of quality assurance : Ophthalmology and intravitreal therapy between reality and wishful thinking].
Ophthalmologe 2020;
117:298-306. [PMID:
32170364 DOI:
10.1007/s00347-020-01064-y]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND
In view of the large number of patients and error-prone activities, legal requirements for quality assurance (QA) are of great importance for modern ophthalmology.
OBJECTIVE
This article discusses the need and formats of QA using the example of intravitreal operative medication injection therapy (IVOM).
MATERIAL AND METHODS
The legal framework conditions are briefly referenced and improvement potentials of the status quo are discussed.
RESULTS
The first quality control instruments were implemented for IVOM therapy; however, important quality indicators (number of treatments per patient/year, loss of follow-up, course of function) are not yet evaluated nationwide in Germany and cannot therefore be taken into account for continuous improvement and QA reports. To date, not all ophthalmologists involved have been under review in the field of basic diagnostics and follow-up. Limiting QA to ophthalmic surgeons alone does not improve quality and many statutory health insurances actively prevent scientific investigations within selective contracts.
CONCLUSION
For the QA of imaging diagnostics, similar proficiency measures (random samples, round robin testing) are required in ophthalmology as in radiological disciplines. The communication of transparent quality indicators can reduce the risk in the medium term. The quality of treatment and results must not be left to chance, cost pressure or convenience. The manufacturers of software and diagnostic equipment should be oriented towards radiology, where the exchange of voxel-oriented image formats is now less and less hindered by proprietary formats.
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