title: Medical student and patient perceptions of quality of life associated with vision loss.
abstract: OBJECTIVE
  Because most medical schools in the United States and Canada require no formal ophthalmology training, the authors queried medical student and ophthalmic patients to compare their perceptions of the quality of life (QOL) associated with vision loss.
  
  
  METHODS
  Cross-sectional comparative study of consecutive medical students and patients with vision loss using a validated, reliable, time trade-off utility instrument.
  
  
  METHODS
  Consecutive Jefferson Medical College medical students (cohort 1: 145 second-year student; cohort 2: 112 third-year/fourth-year students) and 283 patients with vision loss (patient cohort).
  
  
  METHODS
  Time trade-off vision utilities with anchors of 0.0 (death) to 1.0 (normal vision permanently) were used to quantify the QOL associated with vision loss. Students were asked to assume they had: (i) mild vision loss (20/40 to 20/50 vision in the better-seeing eye), (ii) legal blindness (20/200 in the better-seeing eye), and (iii) absolute blindness (no light perception bilaterally).
  
  
  RESULTS
  Mean utilities for cohort 1/cohort 2 were 0.96/0.95 (p = 0.20) for mild vision loss, 0.88/0.84 for legal blindness (p = 0.009), and 0.80/0.67 (p < 0.0001) for absolute blindness. Medical student/patient mean utilities were 0.96/0.79 (p < 0.0001) for mild vision loss, 0.85/0.62 for legal blindness (p < 0.0001), and 0.74/0.26 (p < 0.0001) for absolute blindness. Overall, medical students underestimated the QOL associated with vision loss referent to patients with vision loss by 153%-425%.
  
  
  CONCLUSIONS
  Medical students dramatically underestimated the impact of vision loss on patient QOL. Clinical training slightly improved medical student perceptions. Trivialization of vision loss could result in systemic health harm, less ophthalmic research dollars, loss of the finest medical students entering ophthalmology, and overall adverse financial effects for the field.
authors.affiliation: Center for Value-Based Medicine, Flourtown; Department of Ophthalmology, Temple University School of Medicine.
authors.forename: Imtiaz
authors.initials: I
authors.lastname: Chaudry
authors.affiliation: Center for Value-Based Medicine, Flourtown; Retina Service, Wills Eye Institute, Jefferson Medical College; Eye Research Institute. Electronic address: gary0514@gmail.com.
authors.forename: Gary C
authors.initials: GC
authors.lastname: Brown
authors.affiliation: Center for Value-Based Medicine, Flourtown; Eye Research Institute; Research Unit, Wills Eye Hospital, Jefferson Medical College, Philadelphia, Pa.
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Brown
mesh_terms: D000328:Adult; D001766:Blindness / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology*; D011594:Psychometrics / Q000295:instrumentation; D011788:Quality of Life / Q000523:psychology*; D019057:Quality-Adjusted Life Years; D013337:Students, Medical / Q000523:psychology*; D015354:Vision, Low / Q000523:psychology*; D019987:Persons with Visual Disabilities / Q000523:psychology*; D055815:Young Adult