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The Ocular Surface Apr 2019
Topics: Biomedical Research; Clinical Competence; Humans; Ophthalmologists; Ophthalmology
PubMed: 30954656
DOI: 10.1016/j.jtos.2019.04.005 -
Ophthalmology Oct 2022
Topics: Health Services Accessibility; Humans; Ophthalmologists; Ophthalmology
PubMed: 36058737
DOI: 10.1016/j.ophtha.2022.06.036 -
American Journal of Ophthalmology Jun 2020To assess the factors influencing the Medicare collections disparity between male and female ophthalmologists. (Comparative Study)
Comparative Study
PURPOSE
To assess the factors influencing the Medicare collections disparity between male and female ophthalmologists.
DESIGN
Retrospective cohort study.
METHODS
The Medicare Provider Utilization and Payment Data from 2012-2015 were combined with the 2015 Physician Compare National Downloadable file and US Census data. Three complementary regression models were generated for number of patients seen, number of services performed per patient, and the amount collected per service. Predictor variables included gender, calendar year, geography, years since medical school graduation, and subspecialty.
RESULTS
After adjusting for age, geography, and subspecialty, women ophthalmologists collected 42% less as compared to male ophthalmologists, with the median male ophthalmologist out-earning the 75th-percentile female ophthalmologist across almost all age groups, practice categories, and geographic regions. Although women are entering more lucrative subspecialties (cataract and retina) at a higher rate than before, the percentage of women pursuing these subspecialties remains lower than that of men.
CONCLUSIONS
Compared with men, women ophthalmologists see fewer patients and have lower Medicare collections. The observed gender gap in collections was highly persistent across years in practice, subspecialty, and geographic region. Future studies are warranted to examine whether the observed gender collections gap results from structural inequities, social circumstances, or personal choices.
Topics: Adult; Aged; Female; Humans; Insurance, Health, Reimbursement; Male; Medicare; Middle Aged; Ophthalmologists; Ophthalmology; Physicians, Women; Practice Patterns, Physicians'; Retrospective Studies; United States
PubMed: 31926887
DOI: 10.1016/j.ajo.2019.12.024 -
JAMA Ophthalmology Oct 2021Individuals with perceived experience and expertise are invited by editorial boards to provide commentary through editorials. Female representation among editorialists...
IMPORTANCE
Individuals with perceived experience and expertise are invited by editorial boards to provide commentary through editorials. Female representation among editorialists is not yet defined.
OBJECTIVE
To determine female representation as editorial authors in 3 high-impact general ophthalmology journals.
DESIGN, SETTING, AND PARTICIPANTS
This cross-sectional study investigates the proportion of female authorship in editorials published between 2005 to 2009 and 2015 to 2019 in 3 journals: Ophthalmology, JAMA Ophthalmology, and American Journal of Ophthalmology. Data were collected from April to June 2020.
MAIN OUTCOMES AND MEASURES
Proportions of female first and senior (last or solo) authors between 2005 to 2009 compared with 2015 to 2019. Secondary outcome measures include representation by sex across degree types and subspecialties. Comparisons were made for all editorialists and ophthalmologist editorialists.
RESULTS
Of 814 editorial articles, there were 1179 (first and senior) authors identified. Women held 301 (25.5%) of these authorships, including 116 of 365 first authorships (32.9%) and 185 of 814 senior authorships (23.9%). Overall, female first and senior authorships grew by 68.0% between 2005 to 2009 and 2015 to 2019 (85 of 469 [18.1%] vs 216 of 710 [30.4%]; difference, 12.3%; 95% CI, 7.4-317.2; P < .001). Between 2005 to 2009 and 2015 to 2019, first and senior authorships by women increased (first: 33 of 133 [24.8%] vs 83 of 232 [35.8%]; difference, 11.0%; 95% CI, 1.4-320.6; P = .03; senior: 52 of 336 [15.5%] vs 133 of 478 [27.8%]; difference, 12.3%; 95% CI, 6.8-317.9; P < .001). JAMA Ophthalmology most substantially contributed to the increase in female first and senior authorships (13.8% and 16%), although the test for homogeneity among the 3 journals was not significant. The proportion of female ophthalmologist first authors was greater than the proportion of American Board of Ophthalmology-certified female ophthalmologists (81 of 281 [28.9%] vs 123 of 672 [18.3%]; difference, 10.6%; 95% CI, 5.3-315.9; P < .001).
CONCLUSIONS AND RELEVANCE
The proportion of female senior authors increased by 68.0% between 2005 to 2009 and 2015 to 2019, but female authors represented only 25.5% of editorialists. Compared with male ophthalmologists, female ophthalmologists were more commonly first than senior authors. Additionally, female authors were more likely to be nonophthalmologists or to hold nonmedical, non-PhD degrees. While the swelling rank of female editorialists has paralleled the rising proportion of female ophthalmologists over time, parity by sex has yet to be attained. Greater awareness of disparities and strategies to mitigate them may help equalize representation.
Topics: Authorship; Cross-Sectional Studies; Female; Humans; Male; Ophthalmologists; Ophthalmology; Periodicals as Topic
PubMed: 34383002
DOI: 10.1001/jamaophthalmol.2021.3027 -
Ophthalmologist Turnover in the United States: Analysis of Workforce Changes from 2014 through 2021.Ophthalmology Sep 2023Physician turnover is costly to health care systems and affects patient experience due to discontinuity of care. This study aimed to assess the frequency of turnover by...
PURPOSE
Physician turnover is costly to health care systems and affects patient experience due to discontinuity of care. This study aimed to assess the frequency of turnover by ophthalmologists and identify physician and practice characteristics associated with turnover.
DESIGN
Retrospective cross-sectional study.
PARTICIPANTS
Actively practicing United States ophthalmologists included in the Centers for Medicare and Medicaid Services Physician Compare and Physician and Other Supplier Public Use File between 2014 and 2021.
METHODS
We collected data for each ophthalmologist that was associated with practice/institution and then calculated the rate of turnover both annually in each year window and cumulatively as the total proportion from 2014 to 2021. Multivariable logistic regression analysis was used to identify physician and practice characteristics associated with turnover. We also evaluated turnover characteristics surrounding the Coronavirus disease 2019 (COVID-19) pandemic.
MAIN OUTCOME MEASURES
Ophthalmologist turnover, defined as a change of an ophthalmologist's National Provider Identifier practice affiliation from one year to the next.
RESULTS
Of 13 264 ophthalmologists affiliated with 3306 unique practices, 34.1% separated from at least 1 practice between 2014 and 2021. Annual turnover ranged from 3.7% (2017) to 19.4% (2018), with an average rate of 9.4%. Factors associated with increased turnover included solo practice (adjusted odds ratio [aOR], 9.59), university affiliation (aOR, 1.55), practice location in the Northeast (aOR, 1.39), and practice size of 2 to 4 members (aOR, 1.21; P < 0.05 for all). Factors associated with decreased turnover included male gender (aOR, 0.87) and more than 5 years of practice: 6 to 10 years (aOR, 0.63), 11 to 19 years (aOR, 0.54), 20 to 29 years (aOR, 0.36), and ≥ 30 years (aOR, 0.18; P < 0.05 for all). In the initial year (2020) of the COVID-19 pandemic, annual turnover increased from 7.8% to 11.0%, then decreased to 8.7% in the postvaccine period (2021).
CONCLUSIONS
One-third of United States ophthalmologists separated from at least 1 practice from 2014 through 2021. Turnover patterns differed by various physician and practice characteristics, which may be used to develop future strategies for workforce stability. Because administrative data cannot solely determine reasons for turnover, further investigation is warranted given the potential clinical and financial implications.
FINANCIAL DISCLOSURE(S)
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Topics: Aged; Humans; Male; United States; Ophthalmologists; Retrospective Studies; Cross-Sectional Studies; Pandemics; Medicare; COVID-19; Workforce
PubMed: 37164243
DOI: 10.1016/j.ophtha.2023.05.003 -
Current Opinion in Ophthalmology May 2024Over the past decade, the number of studies published using network meta-analyses (NMAs) has rapidly increased, and there have been continued advancements to further... (Review)
Review
PURPOSE OF REVIEW
Over the past decade, the number of studies published using network meta-analyses (NMAs) has rapidly increased, and there have been continued advancements to further advance this analysis approach. Due to the fast moving and changing landscape in the infancy of NMA methodology, there is a lack of consistency and standardization for this approach. This article aims to summarize the crucial components of an NMA for both future readers, and for potential NMA authors.
RECENT FINDINGS
Key components of NMAs include, but are not limited to, reporting the proposed analysis methods, assessment of risk of bias within the included studies, reporting the overall quality of the available evidence, and defining the parameters in which the results will be presented. Although NMA allows for a comprehensive evaluation of all available treatment options for a given condition, we believe that there is importance in ensuring clear understanding and appropriate interpretation of results to inform clinical practice.
SUMMARY
While many components of NMA mirror those of traditional pairwise meta-analysis, there are many novel methodologies that are specific to this approach. It is imperative that future NMAs follow guidance from key methodology groups, as these provide valuable tools for conducting and reporting NMAs.
Topics: Humans; Forecasting; Network Meta-Analysis; Ophthalmologists
PubMed: 38484226
DOI: 10.1097/ICU.0000000000001048 -
Seminars in Ophthalmology Apr 2022Many diseases of the cornea and ocular surface are manifestations of an underlying autoimmune process and require systemic immunosuppression for their management. These... (Review)
Review
PURPOSE
Many diseases of the cornea and ocular surface are manifestations of an underlying autoimmune process and require systemic immunosuppression for their management. These cases often present to a general ophthalmologist before being referred to an ocular immunologist or rheumatologist. However, the patients do need to be followed by the ophthalmologist to assess disease progression or for management of ocular co-morbidities and for taking care of ocular complications of the disease. Undeniably, there is a certain hesitance to promptly initiate them on systemic therapy because the literature regarding the indications, dosages, and side effects of this group of drugs is vast and dispersed.The aim of this review is to provide a source of ready reference for the general ophthalmologist as well as trainees and residents, on systemic immunosuppression for corneal and ocular surface disease.
PURPOSE METHODS
This review included 153 studies which were published as randomized controlled trials, systematic reviews, or as nonrandomized comparative studies (cohort or case-control series) on the topic of systemic immunosuppression in cornea and ocular surface disorders.
RESULTS
This review provides a concise summary of both the types of drugs and the common indications where they would be indicated, along with treatment and monitoring algorithms for each specific disease condition. The most used group of drugs are corticosteroids, which have significant side effects, particularly when administered systemically or for longer periods of time. To overcome this, steroid-sparing immunosuppressants are recommended. The four main classes of immunosuppressants used today are antimetabolites, T-cell inhibitors, alkylating agents and biologic agents. This review details the use of these drugs in ocular surface inflammation, including the dosing schedule, side effects and monitoring in allergic conjunctivitis, mucous membrane pemphigoid, peripheral ulcerative keratitis, immunological rejection against corneal allografts, anterior scleritis and aqueous deficiency dry eyes.
CONCLUSIONS
This review provides an uncluttered and wholesome understanding of systemic immunosuppression in cornea and ocular surface diseases, with the hope that this will serve as a ready reckoner and help bridge the gap between ophthalmology and rheumatology for the betterment of our patients.
Topics: Cornea; Eye Diseases; Humans; Immunosuppression Therapy; Immunosuppressive Agents; Ophthalmologists; Pemphigoid, Benign Mucous Membrane
PubMed: 34423717
DOI: 10.1080/08820538.2021.1966059 -
Indian Journal of Ophthalmology Dec 2021This article aims at analyzing the impact of predatory publishing in ophthalmology, criteria to identify a legitimate journal, red flags of a predatory journal, sources,...
This article aims at analyzing the impact of predatory publishing in ophthalmology, criteria to identify a legitimate journal, red flags of a predatory journal, sources, and checkpoints available before publishing scientific work in a standard ophthalmology journal. A retrospective review was performed and a list of suspected Ophthalmology predatory journals was extracted through four major so-called blacklists: Beall's, Cabell's, Manca's, and Strinzel's list. This list of journals was then cross-referenced with the UGC CARE and vetted whitelist of vision science journals to remove the legitimate journals. Moreover, as all the predatory journals are supposed to be open access, all possible types of open-access journals on the Scimago webpage were also searched. A gross estimate in terms of publication cost was searched for, and a list of authentic links to find out a legitimate journal was prepared. Additionally, the methodology by which these predatory journals penetrate legitimate indexes such as PubMed was also evaluated. A total of 51 ophthalmology predatory journals were enlisted. Thirty-eight out of 124 Ophthalmology journals listed on Scimago were open access, and the cost of publishing in predatory journals ranged from USD50-500, which is substantially lower than that in legitimate journals (USD 50-3000). A total of 13 open-access platforms exist, with 10 characteristic red flags to identify a predatory journal. These journals have penetrated legitimate indexes such as PubMed by similar-sounding names to the legitimate journals and have published articles with external funding, which needs indexing. Predatory publishing impacts the quality of research in every field, including Ophthalmology, and must be discouraged.
Topics: Abstracting and Indexing; Humans; Ophthalmologists; Publishing; Retrospective Studies
PubMed: 34827029
DOI: 10.4103/ijo.IJO_1639_21 -
Eye (London, England) Apr 2022
Topics: Artificial Intelligence; Humans; Ophthalmologists; Ophthalmology
PubMed: 35001087
DOI: 10.1038/s41433-021-01891-6 -
American Journal of Ophthalmology Dec 2020
Topics: COVID-19; Humans; Internship and Residency; Ophthalmologists; Ophthalmology; Pandemics; SARS-CoV-2; Scholarly Communication; Stress, Psychological
PubMed: 32971027
DOI: 10.1016/j.ajo.2020.07.028