Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jul 18, 2024
Date Accepted: Apr 28, 2025
Effectiveness of the Better Operative Software Outcomes Tool for Monitoring Cataract Surgery Outcomes in Inhambane Province, Mozambique: Pilot diagnostic accuracy study
ABSTRACT
Background:
The Better Operative Outcomes Software Tool (BOOST Cataract app) is an e-Health tool designed to address issues of measuring outcomes of cataract surgeries in low- and middle-income countries (LMICs) where postoperative follow-up is incomplete.
Objective:
The aim of this study is to evaluate the real-world utility of the BOOST Cataract app in the province of Inhambane and to describe the characteristics of a surgical campaign conducted there.
Methods:
Prospective study of diagnostic accuracy. The sample included patients over 50 years old who underwent cataract surgery during a surgical campaign in Inhambane province between April and May 2022. The BOOST Cataract app was used to assess surgical outcome. The sensitivity, specificity (with their 95% confidence intervals) and area under the curve (AUC) of the BOOST Cataract app were calculated to identify suboptimal outcomes (moderate and poor) compared to outcomes 6 weeks after surgery (reference standard).
Results:
A total of 141 patients were included in the study. The mean age was 70 years (SD 10.2) and 48% were women. The BOOST Cataract app had a sensitivity of 94.44% and a specificity of 59% for detecting suboptimal outcomes. The AUC was 0.825. The outcome of the campaign was good (VA ≥ 6/18) in 45.9% of cases, moderate (VA < 6/18 ≥ 6/60) in 33.8% of cases and poor in 20.3% of cases. The main cause of poor outcome was surgical complication.
Conclusions:
The BOOST Cataract app is a useful tool for analysing suboptimal outcomes of cataract surgery without waiting for completion of postoperative treatment in settings where postoperative follow-up is incomplete.
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