Physician and patient concordance in reporting of appropriateness and prioritization for cataract surgery

Determine the association between physician-deemed and patient-reported appropriateness and prioritization for cataract surgery. Two clinical factors (study eye and fellow eye best-corrected visual acuity (BCVA)), 2 eCAPS (night driving difficulty, ability to take care of local errands), and 2 Catquest-9SF PROMs (recognizing faces, seeing to walk on uneven ground) were associated with appropriateness. In multivariable regression, the rating physician, 2 clinical criteria (study eye BCVA, anticipated postoperative BCVA) and 1 eCAPS QoL (night driving difficulty) were associated with appropriateness. Prioritization was associated with low income, 8 clinical criteria, 9 eCAPS, 5 Catquest-9SF, and 1 EQ-5D PROMs. In multivariable regression, 1 clinical criterion (study eye BCVA), 2 eCAPS QoL (night driving difficulty, ability to take care of local errands), and 2 Catquest-9SF PROMs (seeing prices, seeing to walk on uneven ground) were significantly associated. The eCAPS and Catquest-9SF questionnaires show some concordance with physician-deemed appropriateness, and more with prioritization. Binary conversions of PROM scales provide similar modelling, with minimal loss of explanatory power. As physician-deemed appropriateness and prioritization do not completely capture the patient perspective, PROMs may have a role in cataract surgery decision-making frameworks.