[Value and formats of quality assurance : Ophthalmology and intravitreal therapy between reality and wishful thinking]

Ophthalmologe. 2020 Apr;117(4):298-306. doi: 10.1007/s00347-020-01064-y.
[Article in German]

Abstract

Background: In view of the large number of patients and error-prone activities, legal requirements for quality assurance (QA) are of great importance for modern ophthalmology.

Objective: This article discusses the need and formats of QA using the example of intravitreal operative medication injection therapy (IVOM).

Material and methods: The legal framework conditions are briefly referenced and improvement potentials of the status quo are discussed.

Results: The first quality control instruments were implemented for IVOM therapy; however, important quality indicators (number of treatments per patient/year, loss of follow-up, course of function) are not yet evaluated nationwide in Germany and cannot therefore be taken into account for continuous improvement and QA reports. To date, not all ophthalmologists involved have been under review in the field of basic diagnostics and follow-up. Limiting QA to ophthalmic surgeons alone does not improve quality and many statutory health insurances actively prevent scientific investigations within selective contracts.

Conclusion: For the QA of imaging diagnostics, similar proficiency measures (random samples, round robin testing) are required in ophthalmology as in radiological disciplines. The communication of transparent quality indicators can reduce the risk in the medium term. The quality of treatment and results must not be left to chance, cost pressure or convenience. The manufacturers of software and diagnostic equipment should be oriented towards radiology, where the exchange of voxel-oriented image formats is now less and less hindered by proprietary formats.

Keywords: Automatic analysis; Benchmarking; Data transfer; Quality indicators; Statement certainty.

Publication types

  • Review

MeSH terms

  • Germany
  • Humans
  • Ophthalmology*
  • Quality Assurance, Health Care*
  • Radiography