Abstract

Volume.128 Number.1

Original article : Clinical science

A Questionnaire on the Use of Clinical Guidelines for Anterior Segment Dysgenesis
Chika Shigeyasu1,2, Masakazu Yamada1, Nozomi Nishida3, Yoshinori Oie3, Ryo Kawasaki4, Kohji Nishida3
1 Department of Ophthalmology, Kyorin University School of Medicine
2 Department of Ophthalmology, Kosei Hospital
3 Department of Ophthalmology, Osaka University Graduate School of Medicine
4 Division of Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine

Purpose: A survey was conducted to assess the use of a clinical guideline (GL) for anterior segment dysgenesis (ASD), which was prepared by the research group of the Ministry of Health, Labor and Welfare, with the aim of establishing standardized diagnosis and treatment for intractable diseases/intractable anterior eye diseases.
Participants and methods: A questionnaire was sent by post to ophthalmologist training facilities certified by the Japanese Ophthalmological Society specialist system from August to October 2022, and responses were aggregated.
Results: Of 965 facilities, 195 (20.2%) provided responses. The survey revealed that 57.9% of the facilities did not attend any patients with ASD annually; 31.3% attended one to less than five cases; and 9.7% attended over five cases. Additionally, 88.7% reported not applying any cases of intractable disease annually, while 8.7% applied one or more cases. Of those surveyed, 64.1% were aware of the GL, 71.8% referred to it during examinations, 69.2% followed it during the treatment, and 23.1% did not follow it during the treatment. Among the reasons for not following the GL, 17.3% reported disagreement or the lack of understanding of the GL and 23.1% reported patients' requests. The purpose of the GL was to standardize treatment protocols in each institution, accounting for 81.2%. Regarding GL evaluation, 77.9% reported that the number of clinical questions (CQs) was sufficient, 75.8% reported that the CQs were clinically relevant, 81.1% reported that the recommendations were easy to understand, 89.6% reported that explanations were useful, and 65.4% reported that the GL reflected the current situation in Japan. In addition, the GL was useful for standardizing treatment and raising the recognition of intractable diseases, accounting for 84.7% and 61.2%, respectively.
Conclusion: The GL was generally used, although ASD is a rare disease among these facilities and there is still room for improvement in the recognition rate of the GL.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 128: 14-20,2024.

Key words
Anterior segment dysgenesis (ASD), Clinical guideline (GL), Survey, Diagnostic criteria, Intractable disease
Reprint requests to
Chika Shigeyasu, M. D.　Department of Ophthalmology, Kyorin University School of Medicine. Shinkawa, Mitaka-shi 6-20-2, 181-8611, Japan
Received: 2 August 2023. Accepted in revised form: 4 September 2023.
Nihon Ganka Gakkai Zasshi 128: 14-20,2024