Potential for 2 priority systems to be used as  appropriateness of indication tools for cataract surgery.
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.
Las Hayas
Carlota
C
CIBER in Epidemiology and Public Health, Research Unit, Hospital Galdakao Usansolo, Vizcaya, Spain. carlota.lashayasrodriguez@osakidetza.net
Quintana
Jose María
JM
Espallargues
Mireia
M
Vrotsou
Kalliopi
K
Allepuz
Alejandro
A
Escobar
Antonio
A
Moharra
Montse
M
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