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Comparing resident cataract surgery outcomes under novice versus experienced attending supervision

Overview of attention for article published in Clinical Ophthalmology, September 2015
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49 Mendeley
Title
Comparing resident cataract surgery outcomes under novice versus experienced attending supervision
Published in
Clinical Ophthalmology, September 2015
DOI 10.2147/opth.s85769
Pubmed ID
Authors

Shameema Sikder, Sidharth Puri, Amanda Kiely, Jiangxia Wang, Alonzo Woodfield, Saras Ramanathan

Abstract

To determine whether supervision by an attending who is new to surgical teaching, or an experienced attending measurably influences intraoperative complications rates or outcomes in phacoemulsification performed by ophthalmology residents. Single tertiary hospital. Retrospective cohort study. Resident-performed phacoemulsification cases supervised by one novice attending (N=189) and experienced attending (N=172) over 1 year were included. Data included: resident year, patient age, sex, preoperative risk factors (4+ on the four point scale for dense/white/brunescent cataracts, Flomax, zonular dialysis, pseudoexfoliation, glaucoma risk, post-vitrectomy), intraoperative risk factors (Trypan blue, iris hooks), and intraoperative complications (capsule tears, vitreous loss, zonular dialysis, zonular dehiscence, burns, nuclear fragment loss, Descemet's tear). Experienced attending data were compared against those of the novice attending. Regarding preoperative risks, experienced attending cases more likely involved 4+ cataract (P=0.005), Flomax (P<0.001), or glaucoma risk (P=0.001). For intraoperative risks, novice attending cases more likely involved Trypan blue (P<0.001). Regarding complications, novice attending cases were associated with vitreous loss (P=0.002) and anterior capsule tears (P<0.001). When comparing total complications, the novice attending was more likely to have both increased number of cases with complications and total complications than the experienced attending. The novice attending's overall complication rate trended downward (rate from 28% in first 25 cases to 6.67% in last 15). Early cases for the novice attending were accompanied by greater complications (vitreous loss and anterior capsule tear), likely due to a learning curve. Surgical judgment in the operating room likely develops with experience. Training programs may focus on these specific areas to aid new instructors.

Mendeley readers

The data shown below were compiled from readership statistics for 49 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 49 100%

Demographic breakdown

Readers by professional status Count As %
Student > Postgraduate 8 16%
Student > Doctoral Student 7 14%
Student > Master 5 10%
Student > Bachelor 4 8%
Professor > Associate Professor 4 8%
Other 12 24%
Unknown 9 18%
Readers by discipline Count As %
Medicine and Dentistry 31 63%
Nursing and Health Professions 2 4%
Engineering 2 4%
Psychology 1 2%
Biochemistry, Genetics and Molecular Biology 1 2%
Other 0 0%
Unknown 12 24%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 September 2015.
All research outputs
#11,106,108
of 12,488,808 outputs
Outputs from Clinical Ophthalmology
#1,432
of 1,597 outputs
Outputs of similar age
#205,917
of 250,137 outputs
Outputs of similar age from Clinical Ophthalmology
#82
of 83 outputs
Altmetric has tracked 12,488,808 research outputs across all sources so far. This one is in the 1st percentile – i.e., 1% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,597 research outputs from this source. They receive a mean Attention Score of 3.2. This one is in the 1st percentile – i.e., 1% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 250,137 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 83 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.