Calculation of CSR and CSC and visual acuity thresholds
IAPB 9GA Hyderabad 2012 Calculation of CSR and CSC and visual acuity thresholds G V S Murthy Improving health worldwide www.iceh.org.uk www.lshtm.ac.uk
Institutional Affiliation Reader, International Centre for Eye Health, Department of Clinical Research, Faculty of Infectious and Tropical Diseases , London School of Hygiene and Tropical Medicine &
Director, Indian Institute of Public Health, Public Health Foundation of India, Hyderabad Improving health worldwide www.iceh.org.uk www.lshtm.ac.uk Acknowledgements
Dr Hans Limburg Dr B R Shamanna Their inputs were critical to this presentation Characteristics Cataract Surgical Rate (CSR) uses the population as the denominator
Cataract Surgical Coverage (CSC) uses operated persons in the community as the denominator. Both can be used in conjunction to compare performance and pending workload at regional/ national level. Cataract Surgical Rate (CSR) Number of cataract operations (eyes) conducted per million population per year
Indicator for output on cataract intervention Denominator is total population while cataract occurs mainly in people 50+ Who is operated? (age, sex, 1st or 2nd eye, VA?) Depends on accuracy of data collection Risk of over- or under-reporting What data is needed to calculate CSR?
Population of administrative area Quantum of cataract surgeries (operated eyes) Time period when above events occur i.e. specific year Usually obtained from secondary data sources. Cataract Surgical Rate No. of Cataract Surgeries/ Year x 106
Population in Defined Area Cataract Surgeries refers to Operated Eyes Cataract Surgical Coverage (CSC) Objective: coverage indicator measures accessibility & utilization of services measures actual community level situation independent of reporting system
Assumption: - VA at time of surgery not known: use VA threshold conforming to surgical practice in survey area Cataract Surgical coverage Sources of Data: Surveys RACSS/RAAB
What data is needed to calculate CSC? No. of cataract blind/visually impaired Quantum of cataract surgeries (eyes/persons) Time period when above events occur i.e. specific year Valid data generally possible only from primary sources in LMIC . i.e. RAAB
Defining CSC Can be calculated at person level or operated eye level Can be calculated at different visual acuity levels (based on a countrys needs/ surgical practices) VA<3/60: cataract blind eye or person VA<6/60: severely visually impaired cataract eye or person VA<6/18: visually impaired cataract eye or person
Calculating CSC CSC eyes: (a/a+b) x 100 Where: a = no. (pseudo)aphakic eyes b = no. eyes with operable cataract (BCVA<3/60; <6/60; <6/18) CSC persons: (x + y/x + y + z) x 100 Where:
x = persons with bilateral (pseudo)aphakia y = persons with 1 (pseudo)aphakic and 1 operable cataract z = persons with bilateral operable cataract (BCVA<3/60; <6/60; <6/18) THANK YOU
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