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Geographical variation in certification rates of blindness and sight impairment in England, 2008-2009

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Malik, Aeesha N. J., Bunce, Catey, Wormald, Richard, Suleman, Mehrunisha, Stratton, Irene and Gray, J. A. Muir (John Armstrong Muir) (2012) Geographical variation in certification rates of blindness and sight impairment in England, 2008-2009. BMJ Open, Vol.2 (No.6). Article no. e001496. doi:10.1136/bmjopen-2012-001496 ISSN 2044-6055.

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Official URL: http://dx.doi.org/10.1136/bmjopen-2012-001496

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Abstract

To examine and interpret the variation in the incidence of blindness and sight impairment in England by PCT, as reported by the Certificate of Vision Impairment (CVI).

Design:

Analysis of national certification data.

Setting:

All Primary Care Trusts, England.

Participants:

23 773 CVI certifications issued from 2008 to 2009.

Main Outcome measures:

Crude and Age standardised rates of CVI data for blindness and sight loss by PCT.

Methods:

The crude and age standardised CVI rates per 100 000 were calculated with Spearman's rank correlation used to assess whether there was any evidence of association between CVI rates with Index of Multiple Deprivation (IMD) and the Programme Spend for Vision.

Results:

There was high-level variation, almost 11-fold (coefficient of variation 38%) in standardised CVI blindness and sight impairment annual certification rates across PCTs. The mean rate was 43.7 and the SD 16.7. We found little evidence of an association between the rate of blindness and sight impairment with either the IMD or Programme Spend on Vision.

Conclusions:

The wide geographical variation we found raises questions about the quality of the data and whether there is genuine unmet need for prevention of sight loss. It is a concern for public health practitioners who will be interpreting these data locally and nationally as the CVI data will form the basis of the public health indicator ‘preventable sight loss’. Poor-quality data and inadequate interpretation will only create confusion if not addressed adequately from the outset. There is an urgent need to address the shortcomings of the current data collection system and to educate all public health practitioners.

Item Type: Journal Article
Subjects: R Medicine > RE Ophthalmology
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Blindness -- England -- Statistics
Journal or Publication Title: BMJ Open
Publisher: BMJ
ISSN: 2044-6055
Official Date: 2012
Dates:
DateEvent
2012Published
Volume: Vol.2
Number: No.6
Page Range: Article no. e001496
DOI: 10.1136/bmjopen-2012-001496
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons)
Date of first compliant deposit: 1 August 2016
Date of first compliant Open Access: 1 August 2016
Funder: National Institute for Health Research (Great Britain) (NIHR), University College, London. Institute of Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust

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