Visual Field Testing Frequency and Associations in Children With Glaucoma.

PRCIS: Children with glaucoma had an average of 1.3 visual field tests per year. Self-reported black and multiracial patients had lower visual field testing rates, whereas older children with better visual acuity had more frequent testing. PURPOSE: To evaluate frequency of visual field (VF) testing in children with glaucoma and identify characteristics associated with VF frequency. METHODS: A retrospective cohort study of 82 children 6-18 years of age with glaucoma seen between August 2018 and May 2023. Patients were divided into those who had ≥1 VF test (303 VF tests of 61 children) and 0 VFs (21 children). Eyes were excluded if best corrected visual acuity (BCVA) was counting fingers or worse. Characteristics obtained included age, self-reported race and ethnicity, sex, primary language, glaucoma diagnosis, distance to provider, office visit frequency, follow-up compliance, insurance type, and BCVA. The main outcome measure was VF testing frequency. RESULTS: Among children with ≥1 VF test, mean age at first VF was 11.8±2.8 years, mean number of VF/year was 1.3±0.8, and 44.9% of all VFs were reliable. Thirty nine percent of patients underwent <1 VF/year, 45.9% ≥1 to <2 VFs/year, and 14.8% ≥2 VF/year. Children who were black or multiracial had significantly lower VF testing frequency [estimated difference (ED) -1.2 (95% CI, -2.0 to -0.4, P =0.002) and ED -1.3 (95% CI, -2.2 to -0.3, P =0.008), respectively]. Better visual acuity and greater office visit frequency were significantly associated with higher VF testing frequency [ED 0.052 (95% CI, 0.001-0.103, P =0.045) and ED 0.2 (95% CI, 0.1-0.3, P <0.001), respectively]. CONCLUSIONS: Most children had between 1 and 2 VF/year, although less than half of all VFs were reliable. Ophthalmologists should consider barriers to care in glaucoma monitoring.

Ethical and Professional Decision-Making Capabilities of Artificial Intelligence Chatbots: Evaluating ChatGPT's Professional Competencies in Medicine.

Purpose: We examined the performance of artificial intelligence chatbots on the PREview Practice Exam, an online situational judgment test for professionalism and ethics. Methods: We used validated methodologies to calculate scores and descriptive statistics, χ2 tests, and Fisher's exact tests to compare scores by model and competency. Results: GPT-3.5 and GPT-4 scored 6/9 (76th percentile) and 7/9 (92nd percentile), respectively, higher than medical school applicant averages of 5/9 (56th percentile). Both models answered 95 + % of questions correctly. Conclusions: Chatbots outperformed the average applicant on PREview, suggesting their potential for healthcare training and decision-making and highlighting risks of online assessment delivery.

Regulatory and Informational Gaps in the Over-the-Counter Eye Care Product Industry-Over the Counter, Under the Radar.

This Viewpoint describes the limitations of regulatory oversight for over-the-counter eye care products and challenges in providing clinical recommendations.

Correlates of Price Transparency for Healthcare Services in United States Hospitals.

Purpose: The purpose of this study is to investigate demographic and hospital characteristics that predict hospital price transparency in the United States. Methods: We identified 6214 hospitals and extracted characteristics of each using the American Hospital Association Annual Survey, as well as cash prices for a representative selection of commonly performed procedures and visits from the Turquoise Health dataset. Descriptive statistics were used to determine compliance rates and price variation, and a Poisson regression model was used to calculate incidence rate ratios (IRR) and 95% confidence intervals (CI) for predictors of price transparency. Results: Price transparency compliance ranged from 13% to 49% of hospitals, and across-center ratios ranged from 244.8 to 4789.0. Number of hospital beds was marginally associated with price transparency for more services (IRR: 1.01 [95% CI: 1.01-1.02]); in contrast, location in the Southern (IRR: 0.91 [95% CI: 0.87-0.96]) or Western (IRR: 0.94 [95% CI: 0.90-0.99]) regions of the US was associated with transparency for fewer services. Conclusion: Smaller hospitals as well as those located in the South and West regions were less likely to be compliant with the CMS mandate for price transparency for hospital standard charges. Additionally, the poor usability of price transparency directories on hospital websites limits information access and undermines transparency efforts.