Background To compare individual ophthalmologists grouped as outliers or non-outliers based on the mean 12-month visual acuity (VA) outcomes for their patients with neovascular age-related macular degeneration (nAMD). Methods This prospectively designed database study included treatment-naïve eyes with nAMD starting vascular endothelial growth factor inhibitors between July 2018 and April 2023 in Australia. Ophthalmologists were classified into high outliers, non-outliers and low outliers with a funnel plot of the adjusted mean 12-month VA change. The number of injections, last injection interval and proportion of visits where choroidal neovascularisation was active were compared between the groups. Results 38 ophthalmologists who treated a total of 1266 eyes (male, 35%; mean age, 81 years old) were classified into 1 high outlier, 34 non-outliers and 3 low outliers (mean VA change, 7.5, 5.1 and 2.5 letters, respectively). The high outlier gave significantly more injections than the non-outliers (mean, 8.6 vs 7.7; p<0.001), while the low outliers administered significantly fewer injections than the non-outliers (mean, 7.1 vs 7.7; p=0.009). The last injection interval was shortest in the high outlier’s eyes (9.4 weeks), followed by non-outliers’ (10.8 weeks; p=0.04 (vs high outlier’s)) and low outliers’ (11.8 weeks; p=0.22 (vs non-outliers’)). The low outliers’ patients had more visits with intraretinal fluid (59%) than non-outliers’ (29%; p<0.001) and high outlier’s patients (31%; p<0.001). Conclusion The low outliers’ eyes had fewer injections, a longer treatment interval and more visits with intraretinal fluid. Building a system through which low outliers are anonymously notified of their performance would help improve general quality of care. No data are available.

中文翻译：

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异类眼科医生用玻璃体内治疗新生血管性年龄相关性黄斑变性


背景 根据新生血管性年龄相关性黄斑变性 （nAMD） 患者的平均 12 个月视力 （VA） 结果，比较分为异常值或非异常值的个体眼科医生。方法 这项前瞻性设计的数据库研究包括 2018 年 7 月至 2023 年 4 月期间在澳大利亚接受 nAMD 起始血管内皮生长因子抑制剂治疗的初治眼。眼科医生被分为高异常值、非异常值和低异常值，并带有调整后平均 12 个月 VA 变化的漏斗图。比较两组之间的注射次数、最后一次注射间隔和脉络膜新生血管活跃的就诊比例。结果 38 名眼科医生共治疗了 1266 只眼睛 （男性，35%;平均年龄，81 岁） 被分为 1 个高异常值、 34 个非异常值和 3 个低异常值 （平均 VA 变化，分别为 7.5 、 5.1 和 2.5 个字母）。高异常值比非异常值注射的注射次数明显多（平均值，8.6 vs 7.7;p<0.001），而低异常值的注射次数明显少于非异常值（平均值，7.1 vs 7.7;p=0.009）。在高异常值眼中，最后一次注射间隔最短（9.4 周），其次是非异常值（10.8 周;p=0.04（与高异常值相比））和低异常值（11.8 周;p=0.22（与非异常值相比））。低异常值患者使用视网膜内积液 （59%） 的次数多于非异常值患者 （29%;p<0.001） 和高异常值患者 （31%;p<0.001）。结论 低异常值眼的注射次数较少，治疗间隔较长，视网膜内积液就诊次数较多。建立一个系统，通过该系统匿名通知低异常值的表现，这将有助于提高总体护理质量。 没有可用的数据。