title: Potential for 2 priority systems to be used as  appropriateness of indication tools for cataract surgery.
abstract: OBJECTIVE
  To test 2 systems developed to prioritize patients on waiting lists for cataract surgery, the Western Canadian Waiting List (WCWL), and the Catalan Agency for Health Technology Assessment and Research Cataract Priority System (CCPS), as tools for judging the appropriateness of the intervention.
  
  
  METHODS
  Cross-sectional study with follow-up.
  
  
  METHODS
  A total of 1723 prospective patients awaiting cataract extraction in 5 hospitals were included in the study.
  
  
  METHODS
  Priority scores using the WCWL and the CCPS systems were calculated and compared with visual acuity (VA) and visual function, measured by the Visual Function-14 index, before and after surgery. The sensitivity of each priority system to different groups was evaluated using a validated appropriateness of indications tool for cataract extraction. One-way analysis of variance and the Jonckheere-Terpstra test were used to detect differences in group scores. Spearman correlation coefficients were also examined.
  
  
  RESULTS
  The WCWL and CCPS systems produced different mean values according to the preoperative levels of VA and visual function (p < 0.0001). Neither system showed a significant difference in mean scores based on gains in VA and visual function. Both systems produced different mean scores according to the different groups of appropriateness set by the appropriateness of indications tool for cataract (p < 0.0001).
  
  
  CONCLUSIONS
  Given that appropriateness tools should correlate with outcomes, we recommend using neither the WCWL nor the CCPS for appropriateness purposes. Incorporating new criteria into these systems may improve the correlation with important outcomes and their adequacy for use as appropriateness tools.
authors.affiliation: CIBER in Epidemiology and Public Health, Research Unit, Hospital Galdakao Usansolo, Vizcaya, Spain. carlota.lashayasrodriguez@osakidetza.net
authors.forename: Carlota
authors.initials: C
authors.lastname: Las Hayas
authors.forename: Jose María
authors.initials: JM
authors.lastname: Quintana
authors.forename: Mireia
authors.initials: M
authors.lastname: Espallargues
authors.forename: Kalliopi
authors.initials: K
authors.lastname: Vrotsou
authors.forename: Alejandro
authors.initials: A
authors.lastname: Allepuz
authors.forename: Antonio
authors.initials: A
authors.lastname: Escobar
authors.forename: Montse
authors.initials: M
authors.lastname: Moharra
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D002170:Canada; D002386:Cataract / Q000175:diagnosis*; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006292:Health Priorities / Q000592:standards*; D006801:Humans; D008297:Male; D018918:Phacoemulsification / Q000592:standards*; D011446:Prospective Studies; D018434:Sickness Impact Profile; D013030:Spain; D011795:Surveys and Questionnaires; D014786:Vision Disorders / Q000175:diagnosis*; D014792:Visual Acuity / Q000502:physiology; D014850:Waiting Lists