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In This Issue of JAMA Ophthalmology |

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JAMA Ophthalmol. 2016;134(9):957. doi:10.1001/jamaophthalmol.2015.3256.
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Wiggins and Etz evaluate the American Board of Ophthalmology’s Maintenance of Certification Part 4 to consider its effects to assist diplomates with quality improvement in their practices. In a retrospective analysis of diplomates’ performance before and after 1408 performance improvement activities, performance improved on 80% of individual process measures and 38.9% of individual outcome measures. Positive comments outnumbered negative ones by a ratio of 5:1. While the study indicates that the program may help diplomates improve quality on both process and outcome measures, the analyses are limited to a self-report that has not been validated.

Rees and coauthors evaluate the association between clinical characteristics of diabetic retinopathy complications and symptoms of anxiety and depression. In a cross-sectional study of 519 participants with diabetes, the authors noted, as anticipated, a personal history of depression or anxiety was associated with symptoms of anxiety or depression. However, they also found that vision-threatening diabetic retinopathy and moderate or severe vision impairment were identified as independent risk factors for increased depressive symptoms in people with diabetes; an association of symptoms of anxiety with diabetic eye disease was not identified.

Deiner and coauthors assess whether internet-based data from social media and search engines provide novel sources of epidemiologic factors of infectious eye diseases that are associated with objective clinic-based diagnoses. Using data from encounters of 4143 patients diagnosed as having conjunctivitis, they found seasonality of clinical diagnoses of nonallergic conjunctivitis from electronic medical records correlated strongly with results of Google searches in the United States for the term pink eye and correlated moderately with Tweets about pink eye and with clinical diagnoses of influenza. Seasonality of clinical diagnoses of allergic conjunctivitis from electronic medical records correlated strongly with results of Google searches in the United States for the term eye allergy.

Vitale and coauthors seek to determine whether the Age-Related Eye Disease Study (AREDS) detailed and simple severity scales for age-related macular degeneration (AMD) were generalizable to studies other than the original AREDS. They included both AREDS (1992-2001) and AREDS2 (2006-2012) enrolled patients. In AREDS (n = 4519), participants with varying severity of AMD—from no AMD to late AMD in 1 eye—were enrolled and in AREDS2 (n = 4203), participants with bilateral large drusen or large drusen in the study eye and late AMD in the fellow eye were enrolled. The authors found that the 5-year incidence rates of late AMD between AREDS and AREDS2, stratifying by baseline AMD scale score, did not differ, suggesting the AMD severity scales are generalizable to studies other than AREDS.

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