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Some patients rate risk of complications not worth the wait for cataract operations

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Some older patients are theoretically willing to trade a higher risk of complications against shorter waiting times for cataract operations, a survey has disclosed. In a radical proposal, the finding might permit patients a choice between risk and waiting time by opting for a junior or consultant surgeon, say the investigators.

The interview survey of a sample of the general public in the UK aged 60–84 showed that the 146 respondents rated the risk of complications and waiting time as more important than surgeon grade (median importance score 46% , 41% v 13%, respectively). However, analysing the non-normally distributed responses on an individual basis showed that for some respondents risk of complications was more important than waiting time—and vice versa. The sample was typical of the general UK population for age, sex, cataract, and Jarman deprivation scores. The characteristics of the responders and non-responders were similar. Only length of education and being a driver or doing some other visually exacting tasks influenced preferences—making risk of complication more important.

The interviewees were systematically selected from GP registers in one health authority, those with difficulties in communicating or aged over 84 being excluded. They were presented with an array of 11 theoretical options around permutations of waiting time (4, 8, and 16 months), complication rate (1%, 5%, !0%), and surgeon grade (junior/consultant), which they had to choose between in order of preference. The data were analysed by conjoint analysis.

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