Survey on perception and knowledge of over-diagnosis and over 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.