Survey on perception and knowledge of over-diagnosis and treatment in glaucoma among Spanish ophthalmologists.

Abstract

Purpose: To assess the perception and knowledge that Spanish ophthalmologists have of overdiagnosis (OD) and overtreatment (OT) in the field of glaucoma.

Methods: An anonymous, 26-item online survey was submitted to members of the Spanish Glaucoma Society and the Spanish Ophthalmology Society.

Results: Approximately 55% out of the 195 respondents were aware of the current definition of OD/OT. Only 13 (6.7%) believe OD/OT is not a clinically significant problem. There were no significant differences in terms of demographics, type of practice and treatment preferences between ophthalmologists who considered OD/OT important and those who considered OD/OT unimportant, except for a higher proportion of PhDs among the "not clinically relevant" group. No differences were found either across groups considering clinical findings/real-world scenarios. "Peace of mind" was considered a principal driver of OD/OT by both groups. Moderate OHT was considered the most common clinical scenario for OD/OT, which was estimated to affect 20% of medically treated patients and only 5% of those undergoing surgical procedures.

Conclusions: Spanish ophthalmologists reported being aware of the importance of OD and OT. However, only half were aware of the current definition of OD and OT. Most participants believe a White Paper should be produced to reduce the prevalence of OD/OT. The low participation rate and the non-response bias may limit the generalization of the results.