Knowledge of glaucoma and associated factors among primary glaucoma patients in Kunming, China

Xiaoqing: A Q&A model for glaucoma based on LLMs

Glaucoma is one of the leading cause of blindness worldwide. Individuals affected by glaucoma, including patients and their family members, frequently encounter a deficit in dependable support beyond the confines of clinical environments. Seeking advice via the internet can be a difficult task due to the vast amount of disorganized and unstructured material available on these sites, nevertheless. This research explores how Large Language Models (LLMs) can be leveraged to better serve medical research and benefit glaucoma patients. We introduce Xiaoqing, a Natural Language Processing (NLP) model specifically tailored for the glaucoma field, detailing its development and deployment. To evaluate its effectiveness, we conducted two forms of experiments: comparative and experiential. In the comparative analysis, we presented 22 glaucoma-related questions in simplified Chinese to three medical NLP models (Xiaoqing LLMs, HuaTuo, Ivy GPT) and two general models (ChatGPT-3.5 and ChatGPT-4), covering a range of topics from basic glaucoma knowledge to treatment, surgery, research, management standards, and patient lifestyle. Responses were assessed for informativeness and readability. The experiential experiment involved glaucoma patients and non-patients interacting with Xiaoqing, collecting and analyzing their questions and feedback on the same criteria. The findings demonstrated that Xiaoqing notably outperformed the other models in terms of informativeness and readability, suggesting that Xiaoqing is a significant advancement in the management and treatment of glaucoma in China. We also provide a Web-based version of Xiaoqing, allowing readers to directly experience its functionality. The Web-based Xiaoqing is available at https://qa.glaucoma-assistant.com//qa.

Knowledge about glaucoma among adults in Africa: a systematic review

BACKGROUND

Africa is one of the continents with a substantial burden of glaucoma, where it is approximately twice as common as it is worldwide. If left untreated, glaucoma can cause blindness and permanent vision loss if it is not addressed promptly. Good knowledge is essential for preventing glaucoma's irreversible blindness and ocular damage. However, no systematic review has been done to report the pooled percentage of adults in Africa who have good knowledge about glaucoma. This study aimed to estimate the level of knowledge about glaucoma in Africa and its determinants.

METHODS

The study followed the PRISMA guidelines for systematic review. Seven electronic databases which include PubMed/MEDLINE, Web of Science, PROQUEST (PQDT), CINAHL (EBSCO), Google Scholar, African Journal Online, and WHO HINARI databases were searched from January 1, 2013, to July 31, 2023for studies conducted with a focus on the knowledge about glaucoma among adults in Africa. The quality of the final articles was assessed using the Joanna Briggs Institute quality assessment tool for cross-sectional studies.

RESULTS

In the present systematic review, 2781 articles were initially identified and evaluated. Of these, eight studies that met the inclusion criteria were included in the final analysis. In this review, the proportion of knowledge about glaucoma among adults in Africa was low. Educational status, family history of glaucoma, occupation, being a male, and having a history of eye examination were the main determinants of good knowledge about glaucoma among adults in Africa.

CONCLUSION

The systematic review found that only a few had good knowledge about glaucoma. Education campaigns and eye exam promotions are recommended to enhance awareness.

TRAIL REGISTRATION

This systematic review was registered on 30/07/2023 with PROSPERO ID: CRD42023430723.

Factors associated with delayed first ophthalmological consultation for primary glaucoma: a qualitative interview study

Background

Glaucoma has an insidious onset with non-specific early symptoms, often leading patients to delay in seeking help. However, postponing the first ophthalmological consultation can result in delayed diagnosis and treatment, with adverse effects on vision. This study explored the factors associated with delayed first ophthalmological consultation in patients with primary glaucoma, with the overarching aim of informing measures to reduce delayed consultation and avoid the consequent adverse outcomes.

Methods

We adopted a phenomenological approach. Semi-structured interviews were conducted with patients admitted to a tertiary eye hospital in Tianjin, China, from January 2021 to April 2021. Data were analyzed by Colaizzi's seven-step method.

Results

We identified 46 patients with primary glaucoma who delayed their first ophthalmological consultation for various reasons. There were four major themes and 16 sub-themes. The major themes were as follows: (1) occult symptoms that are difficult to identify; (2) insufficient knowledge and understanding of glaucoma-related risks and harm; (3) perceived difficulties in accessing medical care; and (4) inadequate support system.

Conclusion

In order to avoid patient delay and consequent irreversible damage to the visual field in patients with primary glaucoma, it is essential that medical staff identify symptoms more effectively, change habitual medical behavior of the patients, adopt a medical union model, and promote the use of a social medical support system to address practical difficulties in delivering adequate care.

Predictors of glaucoma knowledge and its risk factors among Jordanian patients with primary open angle glaucoma at a tertiary teaching hospital: A cross-sectional survey

PURPOSE OF STUDY

To assess and compare glaucoma knowledge between Jordanian patients with glaucoma and non-glaucoma ophthalmic patients.

METHODS

A cross-sectional survey was developed after an extensive literature search to investigate glaucoma-related knowledge among participants with glaucoma visiting the Jordan University Hospital clinics from October 2021 to February 2022. Responses were compared to a sample of ophthalmic participants with eye conditions other than glaucoma visiting the ophthalmology clinics at the same time frame.

RESULTS

A total of 256 participants filled out the survey, of which 53.1% were diagnosed with glaucoma while 46.9% had ophthalmic conditions other than glaucoma. Our sample of participants is characterized by a mean age of 52.2 ± 17.8 years and a male-to-female ratio of 1.04:1. Overall, participants with glaucoma were more aware of their disease than participants with other ophthalmic conditions. Compared to their ophthalmic non-glaucoma counterparts, those diagnosed with glaucoma face significantly more daily life difficulties due to their ophthalmic disease (p <0.001). Results of the independent sample t-test demonstrate that participants with glaucoma have significantly higher knowledge scores (p <0.001) and were able to recognize more glaucoma symptoms than their non-glaucoma counterparts (p = 0.002). Similarly, those with a positive family history of glaucoma displayed higher knowledge (p = 0.005). Multivariate linear regression demonstrates that family history of glaucoma, higher symptom recognition score, reliance on ophthalmologists, and the internet for glaucoma-related information are positive predictors of higher knowledge scores.

CONCLUSION

We have demonstrated that both glaucoma and non-glaucoma ophthalmic patients display average levels of glaucoma knowledge. Raising awareness through various interventions may improve the lifestyles of patients with glaucoma and alleviate the economic burden associated with treating the disease.

Socio-Demographic, lifestyle and eye-related factors associated with quality of life Among people with glaucoma in Serbia

PURPOSE

The purpose of this study was to examine socio-demographic, lifestyle and ophthalmological factors associated with poorer Vision Related Quality of Life (VRQoL) in people with glaucoma.

METHODS

This cross-sectional study included 306 consecutive patients with glaucoma who presented for regular check-ups at the referral center in Belgrade (Serbia) from August 2015 to September 2016. The diagnosis of glaucoma was based on the glaucomatous disc cupping and reproducible visual field impairment on one or both eyes. Quality of life was examined using the validated Glaucoma Quality of Life-15 (GQL-15) and the National Eye Institute Visual Function Questionnaire 25 (NEI VFQ 25).

RESULTS

A series of adjusted linear regression models showed that glaucoma patients with higher educational attainment, who were employed and still driving had better VRQoL. Worse visual acuity and visual field defect, being in later glaucoma stages, having lower intraocular pressure, having two laser interventions as well as having pseudo-exfoliative glaucoma was associated with worse VRQoL. Intake of fewer medications and having had no trabeculectomies on better eye as well as taking less drops per day on worse eye were associated with better VRQoL.

CONCLUSIONS

Several socio-demographic, lifestyle and ocular factors can impact VRQoL in glaucoma patients. Identifying people who are at risk of having worse VRQoL could allow for earlier interventions, such as changes in therapy, undergoing surgery, use of mobility aids etc.