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Abstract
PURPOSE To identify female authorship trends in first author and last author positions in Cornea from 2007 to 2019. METHODS First and last authors of all Clinical Science and Basic Investigation publications in Cornea over 13 years were sorted by sex. Identification of sex was based on the author's institutional profile or a Google-based name identifier in cases of equivocal names. The proportion of female board-certified ophthalmologists between 2007 and 2019 was collected from the American Board of Ophthalmology total roster of certified diplomats. RESULTS First and last author sexes were collected from 2313 publications (1837 Clinical Science and 476 Basic Investigation). Between 2007 and 2019, the percentage of female first authors increased from 30.5% to 41.5%, although this change was not significant (P = 0.240). Female last author percentage increased significantly from 14.9% to 26.6% (P = 0.016). The percentage of female American Board of Ophthalmology-certified diplomats also increased significantly from 17.4% to 24.5% (P < 0.001). Similarly, when comparing 2007 and 2008 with 2018 and 2019, we noted a significant increase in the proportion of women in the last author (P < 0.001) but not in the first author (P = 0.208) position. We also identified a significantly higher proportion of female first authors than that of female board-certified ophthalmologists (P < 0.001). Finally, there was a strong association between first author sex and last author sex (P < 0.001) across manuscripts. CONCLUSIONS The proportion of women in last author positions increased over 13 years among manuscripts in Cornea. Despite these advances in academic female representation within the cornea subspecialty, a gender gap in authorship persists.
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Affiliation(s)
- Dilru C Amarasekera
- Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
| | - Sophia S Lam
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA; and
| | - Christopher J Rapuano
- Cornea Service, Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
| | - Zeba A Syed
- Cornea Service, Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
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Robertson AO, Tadić V, Rahi JS. Attitudes, experiences, and preferences of ophthalmic professionals regarding routine use of patient-reported outcome measures in clinical practice. PLoS One 2020; 15:e0243563. [PMID: 33275625 PMCID: PMC7717508 DOI: 10.1371/journal.pone.0243563] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 11/23/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND/OBJECTIVES Routine use of patient-reported outcome measures (PROMs) to assess quality of health care systems is mandated in many countries and has been implemented successfully in many specialities. Ophthalmology currently lags behind. To support and inform future implementation, we investigated paediatric ophthalmic clinicians' experience of, and future training needs for, using child-appropriate vision PROMs and their views about the barriers and enablers to future routine implementation in clinical practice. METHODS We conducted a pilot study, using an online survey to elicit the experience, attitudes, training needs and perceptions of barriers and enablers to routine PROMs use of ophthalmic health professionals in the Paediatric Ophthalmology Department at Great Ormond Street Hospital, London. A focus-group was undertaken to discuss survey results and preferences regarding presentation of PROM data. Analysis comprised descriptive statistics, presented alongside complementary qualitative data. RESULTS Eighteen clinicians in the department completed the survey. Twenty-seven took part in the focus group. Clinicians had limited experience of using PROMs but high confidence in the potential positive impact on communication with patients, monitoring chronic conditions and clinical decision-making. Clinicians identified operational issues (collection and analysis of data) and impact (interpretation and application of data) as the two key areas for consideration. Training and information requirements before implementation were clearly articulated, alongside the benefits of using digital/electronic data capture ahead of consultations to allow efficiency and automated analysis, and presentation in an appropriate visual format alongside clinical data to ensure meaningful use. CONCLUSION The findings of this pilot study of ophthalmic clinicians working in a specialist paediatric ophthalmology department, suggest that ophthalmic clinicians recognise the potential benefits of routine PROMs use in clinical practice. Together with existing literature outside ophthalmology relating to overcoming barriers and exploiting enablers to routine implementation, findings may be applicable in planning routine PROM implementation in paediatric ophthalmology.
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Affiliation(s)
- Alexandra O. Robertson
- Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street (GOS) Institute of Child Health, London, United Kingdom
| | - Valerija Tadić
- Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street (GOS) Institute of Child Health, London, United Kingdom
- School of Human Sciences, University of Greenwich, London, United Kingdom
| | - Jugnoo S. Rahi
- Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street (GOS) Institute of Child Health, London, United Kingdom
- Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
- National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
- Ulverscroft Vision Research Group, London, United Kingdom
- * E-mail:
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Feng PW, Ahluwalia A, Feng H, Adelman RA. National Trends in the United States Eye Care Workforce from 1995 to 2017. Am J Ophthalmol 2020; 218:128-135. [PMID: 32445703 DOI: 10.1016/j.ajo.2020.05.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 05/09/2020] [Accepted: 05/12/2020] [Indexed: 11/17/2022]
Abstract
PURPOSE To describe temporal and geographic trends in the US eye care workforce. DESIGN Cross-sectional study. METHODS We obtained data from the 2017 Area Health Resources File. The main outcomes were ophthalmologist and optometrist density, as defined as the number of providers per 100,000 individuals, the ratio of ophthalmologists ≥55 years of age to those <55 years of age, and county characteristics associated with the availability of an ophthalmologist. RESULTS From 1995 to 2017, the national ophthalmologist density decreased from 6.30 to 5.68 ophthalmologists per 100,000 individuals. Although rural counties experienced a mean annual increase in ophthalmologist density by 2.26%, they still had a lower mean ophthalmologist density (0.58/100,000 individuals) compared with nonmetropolitan (2.19/100,000 individuals) and metropolitan counties (6.29/100,000 individuals) in 2017. The ratio of older to younger ophthalmologists increased from 0.37 in 1995 to 0.82 in 2017, with the greatest ratio increase occurring in rural counties (0.29 to 1.90). The presence of an ophthalmologist was significantly associated with a greater proportion of individuals with a college degree and health insurance, and more developed health care infrastructure. From 1990 to 2017, the density of optometrists increased from 11.06 to 16.16 optometrists per 100,000 individuals. CONCLUSIONS Over the last 2 decades, the national density of ophthalmologists has decreased and the workforce has aged. In contrast, the density of optometrists has increased. Rural counties continue to have a disproportionately lower supply of eye care providers, although some growth has occurred. Given the rising ratio of optometrists to ophthalmologists, it is of interest for future work to determine how the optometrist workforce can best complement potential shortages of ophthalmologists.
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Affiliation(s)
- Paula W Feng
- Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, Connecticut
| | - Aneesha Ahluwalia
- Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, Connecticut
| | - Hao Feng
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut
| | - Ron A Adelman
- Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, Connecticut.
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Ahmad S, Ramulu P, Akpek E, Deobhakta A, Klawe J. Gender-Specific Trends in Ophthalmologist Medicare Collections. Am J Ophthalmol 2020; 214:32-39. [PMID: 31926887 DOI: 10.1016/j.ajo.2019.12.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 12/19/2019] [Accepted: 12/20/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE To assess the factors influencing the Medicare collections disparity between male and female ophthalmologists. DESIGN Retrospective cohort study. METHODS The Medicare Provider Utilization and Payment Data from 2012-2015 were combined with the 2015 Physician Compare National Downloadable file and US Census data. Three complementary regression models were generated for number of patients seen, number of services performed per patient, and the amount collected per service. Predictor variables included gender, calendar year, geography, years since medical school graduation, and subspecialty. RESULTS After adjusting for age, geography, and subspecialty, women ophthalmologists collected 42% less as compared to male ophthalmologists, with the median male ophthalmologist out-earning the 75th-percentile female ophthalmologist across almost all age groups, practice categories, and geographic regions. Although women are entering more lucrative subspecialties (cataract and retina) at a higher rate than before, the percentage of women pursuing these subspecialties remains lower than that of men. CONCLUSIONS Compared with men, women ophthalmologists see fewer patients and have lower Medicare collections. The observed gender gap in collections was highly persistent across years in practice, subspecialty, and geographic region. Future studies are warranted to examine whether the observed gender collections gap results from structural inequities, social circumstances, or personal choices.
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Affiliation(s)
- Sumayya Ahmad
- Icahn School of Medicine of Mount Sinai, New York, New York, USA.
| | - Pradeep Ramulu
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Esen Akpek
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Avnish Deobhakta
- Icahn School of Medicine of Mount Sinai, New York, New York, USA
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Patel SH, Truong T, Tsui I, Moon JY, Rosenberg JB. Gender of Presenters at Ophthalmology Conferences Between 2015 and 2017. Am J Ophthalmol 2020; 213:120-124. [PMID: 31982406 DOI: 10.1016/j.ajo.2020.01.018] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 01/09/2020] [Accepted: 01/13/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE To analyze the proportion of women presenting at 9 major ophthalmology conferences over 3 years. DESIGN Retrospective observational study. METHODS Conference brochures from 9 national ophthalmology conferences from 2015 to 2017 were analyzed. Genders of first author presenters of papers and non-papers (moderators, presenters at symposia, panel discussions, workshops/instructional courses) were recorded. Comparisons were made to the gender ratio of board-certified ophthalmologists. Student t test and Cochran-Armitage trend test was used for analysis, with significance at P < .05. RESULTS Of 14,214 speakers, 30.5% were female, statistically higher than the expected 25.4% (P < .001). Paper presenters were 33.1% female (P < .001) and non-paper presenters were 28.5% female (P < .001). When stratified to general or subspecialty conference, general conferences had a higher proportion of women compared to the American Board of Ophthalmology (ABO) expected rates (P < .001) for paper and non-paper presentations. The rates of female presenters increased over the 3 years only at the Association for Research in Vision and Ophthalmology (P = .009). Subgroup analysis showed that women presented 33.1% of papers but only 28.5% of non-paper presentations, which is lower than expected (P < .001). CONCLUSIONS Our results highlight positive trends: the overall proportions of female speakers exceed ABO estimates of female ophthalmologists. However, the gender gap remains at many subspecialty conferences, especially for non-papers, which are more likely to require invitations rather than being self-submitted. As demographics continue to change, further efforts are needed to assure equitable selection of conference presenters.
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Affiliation(s)
| | | | - Irena Tsui
- University of California, Los Angeles, Los Angeles, California, USA
| | - Jee-Young Moon
- Albert Einstein College of Medicine, Bronx, New York, USA
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Wibbelsman TD, Pandit RR, Xu D, Jenkins TL, Mellen PL, Soares RR, Obeid A, Levin H, Hsu J, Ho AC. Trends in Retina Specialist Imaging Utilization from 2012 to 2016 in the United States Medicare Fee-for-Service Population. Am J Ophthalmol 2019; 208:12-18. [PMID: 31265802 DOI: 10.1016/j.ajo.2019.06.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 06/21/2019] [Accepted: 06/21/2019] [Indexed: 11/19/2022]
Abstract
PURPOSE To characterize temporal trends and regional variance in retinal imaging utilization in the United States Medicare fee-for-service population from 2012-2016. DESIGN Cross-sectional, retrospective database analysis. METHODS This study addresses office or operating-room based retinal imaging. Our study population included retina specialists, defined as ophthalmologists performing either intravitreal anti-vascular endothelial growth factor injections or posterior segment laser photocoagulation and no neodymium-doped yttrium aluminum garnet laser capsulotomy. We recorded fundus photography, optical coherence tomography (OCT), intravenous fluorescein angiography (IVFA), indocyanine-green angiography, and ophthalmic ultrasound (B-scan) billed in the Medicare fee-for-service population from 2012-2016. Imaging obtained on any platform or device was eligible for inclusion (eg, posterior pole imaging vs ultrawidefield imaging). The main outcome measure was the relative utilization of retinal imaging modalities. RESULTS National relative utilization of OCT increased from 61.5% in 2012 to 70.5% in 2016 (P < .001), while IVFA fell from 20.9% to 15.1% over the same interval (P < .001). Fundus photography decreased from 14.6% in 2012 to 11.7% in 2016 (P < .001). By 2016, the Midwest region had the highest relative utilization of OCT (75.2%) and lowest of IVFA (12.0%), while the West region had the lowest OCT (68.4%) and highest IVFA (17.0%). CONCLUSIONS Among retina specialists, OCT usage increased while the utilization of fundus photography and IVFA has declined. The Midwest region had the highest utilization of OCT and lowest of IVFA.
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Affiliation(s)
| | - Ravi R Pandit
- Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA
| | - David Xu
- Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA
| | - Thomas L Jenkins
- Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA
| | - Phoebe L Mellen
- Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA
| | - Rebecca R Soares
- Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA
| | - Anthony Obeid
- Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA
| | - Hannah Levin
- Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA
| | - Jason Hsu
- Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA
| | - Allen C Ho
- Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA.
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Chaturvedi R, Wannamaker KW, Riviere PJ, Khanani AM, Wykoff CC, Chao DL. Real-World Trends in Intravitreal Injection Practices among American Retina Specialists. Ophthalmol Retina 2019; 3:656-662. [PMID: 31133544 PMCID: PMC6684447 DOI: 10.1016/j.oret.2019.03.023] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 03/23/2019] [Accepted: 03/25/2019] [Indexed: 04/25/2023]
Abstract
PURPOSE To analyze practice patterns used for intravitreal injections (IVIs) by retinal specialists in the United States. DESIGN Cross-sectional online survey. PARTICIPANTS Retina specialists in the United States who responded to a web-based survey. METHODS Retinal specialists in the United States were contacted via e-mail to complete a web-based, anonymous, 24-question survey. Multivariate analysis was performed on a selected question of interest focused on choice of anesthetic used for IVI. MAIN OUTCOME MEASURES Differences in IVI practices, such as antibiotic preferences, and different odds of anesthetic use by demographic variables with 95% confidence intervals. RESULTS A total of 281 retinal specialists responded to the survey (17% response rate). Respondents' average age was 53 years, with an average of 20 years in practice. Respondents practiced in 42 states, with 90% practicing in an urban or suburban area. For anesthesia, 14% used a topical anesthetic with cotton swab compression, 27% used a subconjunctival anesthetic, and 31% used an anesthetic gel. Age, gender, geographic location, and practice setting did not seem to impact choice of anesthetic for IVI significantly. Sixty-six percent of respondents always use a lid speculum, 21% administer topical antibiotics before injection, 36% wear a mask, 73% wear gloves, and 45% always dilate the eyes before injection. Most respondents use a 30-gauge needle and inject in the inferior temporal quadrant (70%). Forty-five percent always perform bilateral injections the same day if indicated. After the injection, 14% administer post operative nonsteroidal anti-inflammatory drugs, 28% administer postoperative antibiotics, and 31% routinely check intraocular pressure after injection. CONCLUSIONS This study provided real-world trends in practices for IVI among retina specialists in the United States. In addition, age, gender, practice type, and geographic location did not influence anesthetic choice for IVI.
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Affiliation(s)
- Rahul Chaturvedi
- School of Medicine, University of California, San Diego, La Jolla, California
| | | | - Paul J Riviere
- Department of Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla, California
| | | | - Charles C Wykoff
- Retina Consultants of Houston, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas
| | - Daniel L Chao
- Andrew Viterbi Department of Ophthalmology, Shiley Eye Institute, University of California, San Diego, La Jolla, California.
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Jiménez Benito J. A meditation on technique. Arch Soc Esp Oftalmol (Engl Ed) 2018; 93:313-314. [PMID: 29398238 DOI: 10.1016/j.oftal.2017.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 11/28/2017] [Indexed: 06/07/2023]
Affiliation(s)
- J Jiménez Benito
- Servicio de Oftalmología, Hospital Universitario de Burgos, Burgos, España.
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