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Measures of multiple deprivation and visual field loss in glaucoma clinics in England: lessons from big data

BACKGROUND/OBJECTIVES: To examine the association between multiple deprivation with late diagnosis and rapid worsening of glaucoma in patients in English hospital eye services (HES). METHODS: 602,439 visual fields (VFs) were extracted from five regionally different glaucoma clinics in England. Mean...

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Autores principales: Rathore, Mehal, Shweikh, Yusrah, Kelly, Stephen R., Crabb, David P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10686257/
https://www.ncbi.nlm.nih.gov/pubmed/37165010
http://dx.doi.org/10.1038/s41433-023-02567-z
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author Rathore, Mehal
Shweikh, Yusrah
Kelly, Stephen R.
Crabb, David P.
author_facet Rathore, Mehal
Shweikh, Yusrah
Kelly, Stephen R.
Crabb, David P.
author_sort Rathore, Mehal
collection PubMed
description BACKGROUND/OBJECTIVES: To examine the association between multiple deprivation with late diagnosis and rapid worsening of glaucoma in patients in English hospital eye services (HES). METHODS: 602,439 visual fields (VFs) were extracted from five regionally different glaucoma clinics in England. Mean Deviation (MD) worse than −12 dB was used as a surrogate definition for advanced VF loss at diagnosis in patients with ≥2 reliable VF records. MD loss worse than -1 dB per year was used to define rapid VF progression in patients with ≥6 VFs. Patient data were stratified into deciles of the Index of Multiple Deprivation (IMD) from residential postcodes. RESULTS: There was an association between IMD and advanced VF loss at diagnosis in 44,956 patients with 18% (293/1608) and 11% (771/6929) in the most and least deprived IMD decile, respectively. Age-corrected odds ratio (OR) for having advanced VF loss at entry into HES was 1.42 (95% confidence interval [CI] 1.21–1.67) and 0.75 (95% CI: 0.66–0.85) in the most and least deprived IMD decile respectively (reference = fifth decile). In 15,094 patients with follow up data (median [interquartile range] of 6.9 [4.5, 10.0] years), the proportion having rapid VF progression did not differ across the IMD spectrum. CONCLUSION: Large-scale VF data from clinics indicates that glaucoma severity at presentation to English HES is associated with levels of multiple deprivation. We found no evidence to suggest likelihood of having rapid VF progression during follow-up is associated with IMD; this hints at equity of glaucoma care and outcomes once patients are in English HES.
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spelling pubmed-106862572023-11-30 Measures of multiple deprivation and visual field loss in glaucoma clinics in England: lessons from big data Rathore, Mehal Shweikh, Yusrah Kelly, Stephen R. Crabb, David P. Eye (Lond) Article BACKGROUND/OBJECTIVES: To examine the association between multiple deprivation with late diagnosis and rapid worsening of glaucoma in patients in English hospital eye services (HES). METHODS: 602,439 visual fields (VFs) were extracted from five regionally different glaucoma clinics in England. Mean Deviation (MD) worse than −12 dB was used as a surrogate definition for advanced VF loss at diagnosis in patients with ≥2 reliable VF records. MD loss worse than -1 dB per year was used to define rapid VF progression in patients with ≥6 VFs. Patient data were stratified into deciles of the Index of Multiple Deprivation (IMD) from residential postcodes. RESULTS: There was an association between IMD and advanced VF loss at diagnosis in 44,956 patients with 18% (293/1608) and 11% (771/6929) in the most and least deprived IMD decile, respectively. Age-corrected odds ratio (OR) for having advanced VF loss at entry into HES was 1.42 (95% confidence interval [CI] 1.21–1.67) and 0.75 (95% CI: 0.66–0.85) in the most and least deprived IMD decile respectively (reference = fifth decile). In 15,094 patients with follow up data (median [interquartile range] of 6.9 [4.5, 10.0] years), the proportion having rapid VF progression did not differ across the IMD spectrum. CONCLUSION: Large-scale VF data from clinics indicates that glaucoma severity at presentation to English HES is associated with levels of multiple deprivation. We found no evidence to suggest likelihood of having rapid VF progression during follow-up is associated with IMD; this hints at equity of glaucoma care and outcomes once patients are in English HES. Nature Publishing Group UK 2023-05-10 2023-12 /pmc/articles/PMC10686257/ /pubmed/37165010 http://dx.doi.org/10.1038/s41433-023-02567-z Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Rathore, Mehal
Shweikh, Yusrah
Kelly, Stephen R.
Crabb, David P.
Measures of multiple deprivation and visual field loss in glaucoma clinics in England: lessons from big data
title Measures of multiple deprivation and visual field loss in glaucoma clinics in England: lessons from big data
title_full Measures of multiple deprivation and visual field loss in glaucoma clinics in England: lessons from big data
title_fullStr Measures of multiple deprivation and visual field loss in glaucoma clinics in England: lessons from big data
title_full_unstemmed Measures of multiple deprivation and visual field loss in glaucoma clinics in England: lessons from big data
title_short Measures of multiple deprivation and visual field loss in glaucoma clinics in England: lessons from big data
title_sort measures of multiple deprivation and visual field loss in glaucoma clinics in england: lessons from big data
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10686257/
https://www.ncbi.nlm.nih.gov/pubmed/37165010
http://dx.doi.org/10.1038/s41433-023-02567-z
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