RESUMO
Visual field assessment is an important clinical evaluation for eye disease and neurological injury. We evaluated Octopus semi-automated kinetic peripheral perimetry (SKP) and Humphrey static automated central perimetry for detection of neurological visual field loss in patients with pituitary disease. We carried out a prospective cross-sectional diagnostic accuracy study comparing Humphrey central 30-2 SITA threshold programme with a screening protocol for SKP on Octopus perimetry. Humphrey 24-2 data were extracted from 30-2 results. Results were independently graded for presence/absence of field defect plus severity of defect. Fifty patients (100 eyes) were recruited (25 males and 25 females), with mean age of 52.4 years (SD = 15.7). Order of perimeter assessment (Humphrey/Octopus first) and order of eye tested (right/left first) were randomised. The 30-2 programme detected visual field loss in 85%, the 24-2 programme in 80%, and the Octopus combined kinetic/static strategy in 100% of eyes. Peripheral visual field loss was missed by central threshold assessment. Qualitative comparison of type of visual field defect demonstrated a match between Humphrey and Octopus results in 58%, with a match for severity of defect in 50%. Tests duration was 9.34 minutes (SD = 2.02) for Humphrey 30-2 versus 10.79 minutes (SD = 4.06) for Octopus perimetry. Octopus semi-automated kinetic perimetry was found to be superior to central static testing for detection of pituitary disease-related visual field loss. Where reliant on Humphrey central static perimetry, the 30-2 programme is recommended over the 24-2 programme. Where kinetic perimetry is available, this is preferable to central static programmes for increased detection of peripheral visual field loss.
RESUMO
INTRODUCTION: There is a serious debate over the involvement of the pharmaceutical industry in continuing education. Policies that govern the planning of continuing education for pharmacists center on the potential conflict of interest when there is commercial support for programs. The purpose of this study was to investigate the impact of commercial support on the provision and perceived outcomes of continuing pharmacy education. METHODS: A survey was administered online to a national sample of accredited providers of continuing pharmacy education, resulting in 134 responses. The 64-item survey was developed to measure the planning practices of these providers and their perceptions of the educational and noneducational consequences of commercial support for continuing education. RESULTS: One hundred thirty-four usable questionnaires (34%) were received from 386 leaders in pharmacy education. Approximately 86% of providers and 43% of programs received commercial support. Although the Accreditation Council for Pharmacy Education requires that providers review instructional content and materials for commercially supported programs before delivery, only 43% always did so. Commercial support was perceived to have consequences for provider organizations, pharmacists, and patients, such as increased cost and use of drugs and financial dependency of providers and participants on industry support. DISCUSSION: The results of our study lead to the conclusions that commercial support of continuing education is widespread, affects continuing education programs, and is perceived to have significant educational and noneducational consequences. The profession should ensure that continuing education guidelines are unambiguous related to specific practices that are allowable and unallowable when receiving commercial support. Future research should study the consequences of commercial support behaviorally by examining the effects on pharmacy professionals' practice and pharmaceutical care.
