title: Retina specialists treating age-related macular degeneration recommend different approaches for patients than they would choose for themselves.
abstract: OBJECTIVE
  To evaluate the presence of cognitive biases among retina physicians when recommending treatment options for exudative age-related macular degeneration.
  
  
  METHODS
  Two random samples of retina specialists were surveyed regarding their treatment and dosing regimen choices among three anti-vascular endothelial growth factor biologics (aflibercept, bevacizumab, and ranibizumab). One group was asked to provide recommendations for a standardized hypothetical patient with exudative age-related macular degeneration, whereas the other group was asked to provide recommendations as if they themselves were the standardized hypothetical patient with exudative age-related macular degeneration.
  
  
  RESULTS
  Two hundred and twenty-six respondents (28.3%) completed the survey and were divided equally between the survey groups. For patients, most physicians recommended bevacizumab (52.2%), but when choosing for themselves, physicians were divided equally among all 3 biologics (P = 0.011). The results were influenced by geographical location of the physician but not by the gender or length of practice. Furthermore, physicians differed in dosing regimen selection with the majority (73%) choosing treat and extend for patients, whereas only 63% selected this regimen for themselves (P = 0.004).
  
  
  CONCLUSIONS
  When considering cases of exudative age-related macular degeneration, physicians would recommend different treatments for themselves than they would for a patient.
authors.affiliation: *Rutgers-Robert Wood Johnson Medical School, Piscataway, New Jersey; †Bascom Palmer Eye Institute, Miami, Florida; and ‡NJ Retina, New Brunswick, New Jersey.
authors.forename: Karen W
authors.initials: KW
authors.lastname: Jeng
authors.forename: John
authors.initials: J
authors.lastname: Wilgucki
authors.forename: Scott
authors.initials: S
authors.lastname: Halperin
authors.forename: William J
authors.initials: WJ
authors.lastname: Feuer
authors.forename: Howard F
authors.initials: HF
authors.lastname: Fine
authors.forename: Daniel
authors.initials: D
authors.lastname: Roth
authors.forename: Jonathan L
authors.initials: JL
authors.lastname: Prenner
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D000068258:Bevacizumab; D015982:Bias; D005260:Female; D005843:Geography; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D009885:Ophthalmology; D010820:Physicians / Q000523:psychology*; D010818:Practice Patterns, Physicians'; D000069579:Ranibizumab; D040262:Receptors, Vascular Endothelial Growth Factor / Q000627:therapeutic use; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use; D013038:Specialization; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D057135:Wet Macular Degeneration / Q000188:drug therapy*; D000078329:Workforce
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D011993:Recombinant Fusion Proteins; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; C533178:aflibercept; D000068258:Bevacizumab; D040262:Receptors, Vascular Endothelial Growth Factor; D000069579:Ranibizumab