September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Retina specialists treating cystoid macular edema secondary to retinal vein occlusion recommend different treatments for patients than they would choose for themselves
Author Affiliations & Notes
  • Marlene D Wang
    Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, United States
  • Sumit P Shah
    Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, United States
    NJ Retina, New Brunswick, New Jersey, United States
  • Karen W Jeng
    Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, United States
  • Henry Feng
    Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, United States
  • Howard F. Fine
    Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, United States
    NJ Retina, New Brunswick, New Jersey, United States
  • Jonathan L. Prenner
    Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, United States
    NJ Retina, New Brunswick, New Jersey, United States
  • Footnotes
    Commercial Relationships   Marlene Wang, None; Sumit Shah, Allergan (F), Genentech (F), Regeneron (F); Karen Jeng, None; Henry Feng, None; Howard Fine, Allergan, Inc. (C), Allergan, Inc. (F), Allergan, Inc. (R), Auris Surgical Robotics (I), Auris Surgical Robotics (P), Auris Surgical Robotics (C), Auris Surgical Robotics (R), Genentech Inc. (C), Genentech Inc. (F), Genentech Inc. (R), Regeneron Pharmaceuticals Inc. (C), Regeneron Pharmaceuticals Inc. (F), Regeneron Pharmaceuticals Inc. (R); Jonathan Prenner, Allergan (F), Genentech (F), Genentech (C), Neurotech (S), Ophthotech (C), Ophthotech (I), Panoptica (C), Panoptica (I), Regeneron (F), Regeneron (C)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 4161. doi:
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    • Get Citation

      Marlene D Wang, Sumit P Shah, Karen W Jeng, Henry Feng, Howard F. Fine, Jonathan L. Prenner; Retina specialists treating cystoid macular edema secondary to retinal vein occlusion recommend different treatments for patients than they would choose for themselves. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4161.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Research suggests that cognitive bias may influence physician treatment recommendations. We performed a survey study to characterize and learn about the presence of cognitive bias among retinal specialists when recommending treatment options for cystoid macular edema (CME) secondary to retinal vein occlusion (RVO).

Methods : Two randomized groups of retina specialists in the United States were surveyed about their treatment and dosing regimen choices for the treatment of CME secondary to branch and central retinal vein occlusion. The first group was asked to make recommendations for a hypothetical patient, while the second group was asked to make recommendations assuming they were treating themselves as the hypothetical patient. The survey was completed by 492 total respondents (20.1%). Chi-squared tests and multivariable logistical regression were used for statistical analysis.

Results : When comparing anti-VEGF agents for patients with branch retinal vein occlusion (BRVO), a majority of physicians recommended bevacizumab (60.5%) over ranibizumab (37.8%) and aflibercept (1.7%) [p < 0.0001]. For themselves, physicians were more likely to recommend ranibizumab (44.9%) over bevacizumab (39.2%) and aflibercept (15.9%) [p < 0.0001]. When comparing among the anti-VEGF agents chosen for patients with CRVO, a majority of physicians recommended bevacizumab (56.7%) over ranibizumab (28.2%) and aflibercept (15.1%) [p < 0.0001] but when choosing for themselves, retina specialists were equally divided among the three biologics (aflibercept 30.6%, bevacizumab 36.5%, and ranibizumab 32.9 %) [p = 0.559]. The results were influenced by geographical location but not by the gender, the length of practice, or the type of practice.

Conclusions : Cognitive bias exists among retinal physicians in the treatment of CME secondary to RVO. Physicians should be aware of this potential bias when considering a treatment recommendation for their patients.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

 

Figure 1. The majority of physicians (57.4%) recommend bevacizumab for a hypothetical patient with CME secondary to BRVO, while only 36.9% recommend bevacizumab for themselves.

Figure 1. The majority of physicians (57.4%) recommend bevacizumab for a hypothetical patient with CME secondary to BRVO, while only 36.9% recommend bevacizumab for themselves.

 

Figure 2. The majority of physicians (53.8%) recommend bevacizumab for a hypothetical patient with CME secondary to CRVO, while only 33.6% recommend bevacizumab for themselves.

Figure 2. The majority of physicians (53.8%) recommend bevacizumab for a hypothetical patient with CME secondary to CRVO, while only 33.6% recommend bevacizumab for themselves.

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