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Using incognito standardised patients to evaluate quality of eye care in China
- Source :
- British Journal of Ophthalmology. 105:311-316
- Publication Year :
- 2020
- Publisher :
- BMJ, 2020.
-
Abstract
- Background/aimsFew studies have objectively examined the quality of eye care in China. We assessed refractive care using the incognito standardised patient (SP) approach, a gold standard for evaluating clinical practice.MethodsA total of 52 SPs were trained to provide standardised responses during eye examinations, and underwent automated and non-cycloplegic, subjective refraction by a senior ophthalmologist from Zhongshan Ophthalmologic Center, a national-level clinical and research centre. SPs subsequently received subjective refraction and eye exams at a randomly selected sample of 40 public hospitals and 93 private optical shops in Shaanxi, Northwestern China. Difference between expert and local refraction in the better-seeing eye was calculated by the vector diopteric method, and completeness of exams assessed against national standards. SP and provider demographic information and provider clinical experience were recorded.ResultsSPs (n=52, mean (range) age, 25.7 (22–31) years, 28.8% male) underwent 133 eye exams (mean total duration 15.0±11.7 min) by 133 local refractionists (24–60 years, 30.3% male). Only 93 (69.9%), 121 (91.0%) and 104 (78.2%) of local refractionists assessed vision, automated and subjective refraction, respectively. The median inaccuracy was −0.25 diopters (D), while 25.6% of results differed by an absolute value of ≥1.0 D and 6.0% by ≥2.0 D. Predictors of inaccurate refraction included spectacle power ConclusionInaccurate refractions are common in Northwestern China, particularly in public facilities. Important assessments, including subjective refraction, are frequently omitted.
- Subjects :
- Adult
Male
China
Visual Acuity
Eye care
Refraction, Ocular
Young Adult
03 medical and health sciences
Cellular and Molecular Neuroscience
0302 clinical medicine
Humans
Medicine
030212 general & internal medicine
Dioptre
Quality of Health Care
Retrospective Studies
business.industry
Standardised patient
Refractive Errors
Refraction
Subjective refraction
Sensory Systems
Clinical Practice
Ophthalmology
Research centre
030221 ophthalmology & optometry
Optometry
Female
Morbidity
business
Subjects
Details
- ISSN :
- 14682079 and 00071161
- Volume :
- 105
- Database :
- OpenAIRE
- Journal :
- British Journal of Ophthalmology
- Accession number :
- edsair.doi.dedup.....17b3206d7f493e942e5896c0af1d4e33