PredictCAT v1.1

• Research type

  Research Study

• Full title

  Predicting Self-Reported Benefit, Supporting Decision Making and Calibrating Health Utilities for Cataract Surgery Part of a NIHR Grant Funded Programme for Applied Research Cataract Surgery: Measuring and Predicting Patient Level Vision Related Health Benefits and Harms

• IRAS ID

  178787

• Contact name

  Jess Bisset

• Contact email

  R&Dsponsorship@uhbristol.nhs.uk

• Sponsor organisation

  University Hospitals Bristol NHS Foundation Trust

• Duration of Study in the UK

  2 years, 7 months, 21 days

• Research summary

  Cataract is an extremely common potentially blinding age related condition. Cataract surgery is the most frequently undertaken surgical procedure on the NHS (~330,000 annually in England). Before and after surgery vision testing is normally done one eye at a time using the (opticians) letter chart. Although useful, testing in this way does not capture people’s everyday experience of their vision. Asking patients about everyday vision, in a structured way, allows the patient’s perception of their eyesight to be ‘measured’.

  Our objective in this study is to quantify patient risk indicators of favourable and poor patient-reported cataract surgical outcomes, based on the Cat-PROM questionnaire developed within work package 1 of the research Programme, in a group of typical NHS cataract patients.

  Additionally we aim to develop an ‘Option Grid’ in which the likelihood of self-reported benefit is set alongside known risks of harm (surgical complications / VA loss) to provide an integrated decision-support tool for personalized prediction of outcomes.
  We will also compare the CatPROM questionnaire with existing health economic utilities and well being measures after cataract surgery alongside which CatPROM will be calibrated. The specific aims can be summarised as:

  1. Quantify specific indicators of self-reported benefit in patients undergoing cataract surgery.
  2. Develop personalised probability based information in ‘Option Grids’ as decision-support tools to assist shared decision making
  3. Investigate how cataract related visual disability should be calibrated against existing and emerging health economic indices

  Lay summary of study results: Decisions about whether to opt for cataract surgery right away, or to hold off, are mostly based on a patient’s ability to read a letter chart rather than on their real-world experience of their vision. This can mean that patients are sent for surgery before they really need it, or (more commonly) have to wait longer, until their vision is deemed poor enough. In order for the decision-making process to be more patient-friendly, we developed and tested a series of decision supporting ‘tools’ which give individual patients, and their doctors, a better understanding of how badly everyday vision is affected by their cataract(s). To enable patients to express how their vision affects them day-to-day, we developed a short questionnaire, Cat-PROM5, which has been shown to work well. Cat-PROM5 can be completed by patients before they see their eye doctor and considered alongside the letter chart results. Cat-PROM5 can also be completed after surgery, which is useful for doctors to measure how much a patient has benefitted from surgery. Furthermore, our analysis allows the eye doctor to predict how good a patient’s vision is likely to be after the surgery, should they decide to go ahead. People considering an operation usually also want to know what the risk is of things turning out badly. We have therefore developed a way to predict the risk of a complication occurring during the surgery and of loss of vision following the surgery, based on things like age and eye health. Using these predictions, we created a cataract decision aid which also includes general cataract surgery information and frequently asked questions. This was tested and most of the patients and doctors thought it was useful, though it, and the way it is used, could still be improved.

• REC name

  Yorkshire & The Humber - Leeds West Research Ethics Committee

• REC reference

  15/YH/0280

• Date of REC Opinion

  12 Jun 2015

• REC opinion

  Favourable Opinion