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Biomedical subjects

S W Hatch

Publications and source records attributed to S W Hatch.

18 recordsLinked to original sources
PubMed1997

New England eye care survey.

BACKGROUND: Descriptive statistics on patient or consumer use of eye care are important for health care policy and professional development. Most survey research has been through doctors or doctors' offices. Some consumer surveys have been completed by direct mail, but information from direct mail surveys suffers from respondent self selection. This study joins a growing number of surveys designs that use random-digit telephone survey methods, which have less self-selection bias. METHODS: This study describes patient use and perceptions of eye care services in three New England areas using random-digit telephone survey. Nine hundred eighteen calls were attempted. A standardized interview and survey questionnaire was used for each phone contact. RESULTS: Of 163 respondents (18% response rate), it was found that most patients were satisfied with the care, time, discussion, and fees provided by their eye care practitioner. Most (78%) planned on returning to the same practitioner in the future. Sixty percent of participants saw an optometrist, 29% saw an ophthalmologist, and 11% were unsure. In a subsample, differences in perception between optometric and ophthalmologic care was investigated, and no statistically significant differences (p < 0.05) were found. CONCLUSIONS: The study findings are similar to others in terms of market share between optometric and ophthalmologic settings for primary eye care. Several new findings were measured and discussed, and the data may be helpful for policy decisions.

Adolescent↗
PubMed1995

Clinicolegal aspects of practice guidelines for pediatric eye and vision examination.

BACKGROUND: The American Optometric Association (AOA) recently joined a growing trend in the health care professions by adopting clinical practice guidelines. The goals of practice guidelines are to improve quality of care and to provide a more objective measure of standard of care for the legal system and the health insurance industry. Practice guidelines may eventually reduce the number and cost of malpractice actions. Historically, the standard of care for pediatric eye and vision examination has been the subject of controversy. Issues of disagreement include the amount of ocular health testing that should be performed and the determination of appropriate emphasis on functional vision. This paper summarizes the precedents that have established a legal standard of care for pediatric eye and vision examination. METHODS: A review of malpractice claims relevant to pediatric optometry was conducted. Public health policy, legal, and malpractice literature was also consulted for current views on practice guidelines. The recent AOA Optometric Clinical Practice Guidelines for Pediatric Eye and Vision Examination were compared to this review. RESULTS: Standards of care for pediatric eye examination should minimally include assessment of visual acuity, refractive error, binocular vision, functional vision, and eye health assessment including dilated funds examination with a binocular indirect ophthalmoscope. These standards are commensurate with the AOA Guidelines. CONCLUSIONS: The AOA Optometric Clinical Practice Guidelines for Pediatric Eye and Vision Examination is compared to the current standard of care for pediatric optometry. It is concluded that the Guidelines are appropriate. Optometrists should integrate these practices into patient care, and the optometric profession should seek to obtain wide spread acceptance of the Guidelines.

Adolescent↗
PubMed1994

Research and scholarship at the New England College of Optometry.

BACKGROUND: The development of the research and scholarly environment of the New England College of Optometry is recounted. We note three distinct phases in this development during the 1970s, 1980s, and 1990s. Unique interests of the faculty are discussed as well as affiliations with other institutions. An emphasis is placed on the current building of a strong research and scholarship program.

Fellowships and Scholarships↗
PubMed1994

Stereopsis testing without polarized glasses: a comparison study on five new stereoacuity tests.

BACKGROUND: Stereopsis testing is commonly used to assess the presence and level of binocular vision. A new series of stereopsis tests requiring no polarized goggles are available in the form of the Titmus Stereo Test, the Stereo Reindeer Test, the Random Dot Butterfly, the Random Dot Figures, and the Random E, Circle, Square. These polarized-free tests employ a special prismatic printing process creating a panagraphic presentation, i.e., a separate image is presented to each eye without the need for polarization. The purpose of this study was to compare the polarized-free stereo tests with their traditional polarized counterparts. METHODS: Thirty four subjects, including several persons with strabismus, ages 10-35 years, were each tested with the polarized and polarized-free versions of the Titmus, Reindeer, Butterfly, and Figures. Twenty nine of these subjects were tested with the Random Dot E. Half the subjects were tested first with polarized-free and half were tested first with polarized tests. Tests were performed according to manufacturer instructions by the same examiner in clinical settings. RESULTS: The results (matched pair ranked correlation coefficients) indicate that the polarized-free tests were highly correlated (r = 0.997, r = 0.998, r = 0.997, r = 1.00, and r = 1.00 respectively) with the polarized comparison tests. No significant difference (Wilcoxon Ranked Sign) in the stereopsis level was obtained between the two versions of the tests. CONCLUSIONS: We conclude that these five polarized-free tests were just as valid in measuring the subjects' stereopsis as their traditional polarized version. The use of goggle-free testing has potential clinical advantages, e.g., testing of young children who will not wear the glasses or the improved observation of the ocular alignment during stereopsis testing.

Adolescent↗
PubMed1994

Eye movement dysfunction vs. language delays in migrant children.

BACKGROUND: The Developmental Eye Movement Test (DEM) is a popular visual-verbal saccade test. An advantage of the DEM is that patients with below-average verbalization or automaticity can be distinguished from patients with eye movement coordination problems. The standardized norms for the DEM were previously determined in a sample of suburban and urban children with expected age to grade levels. We hypothesize that language difficulties common in some minority groups would be reflected by subnormal DEM automaticity but not eye movement dysfunction. METHODS: A group of children in the U.S. Department of Education's Massachusetts Migrant Summer Education Program were prospectively studied with the DEM. The sample included 84 subjects (age 7-12) from various ethnic and educational backgrounds. RESULTS: Significant difference was found for most age levels in automaticity in migrant children compared to the DEM norms (independent t tests p < 0.05 DEM vertical and horizontal). However, few differences in eye movement coordination was found (p > 0.05 DEM ratios and errors). CONCLUSIONS: The data supports the hypothesis that language barriers inherent in this population are reflected by lower automaticity, but not eye movement dysfunction, as measured by the DEM. The results are important for optometrists because they demonstrate the importance of taking language and cognitive development into account before diagnosing eye movement dysfunction in culturally different children.

Child↗
PubMed1993

Sensitive period in stereopsis: random dot stereopsis after long-standing strabismus.

Bifoveal fixation is a requirement for random dot stereopsis. It is believed that random dot stereopsis is not possible after treatment of long-standing strabismus because binocular cortical cells are permanently damaged when strabismus is present during the sensitive period. Although the sensitive period for amblyopia has been clearly documented, the sensitive period for stereopsis is uncertain. We present a case we have followed from age 22 months to 10 years. This patient had intermittent esotropia until approximately age 3 years 4 months; he then had constant esotropia from about age 3 years 4 months to age 9 years 7 months. After orthoptic treatment at age 9 years, the patient returned to intermittent esotropia. He subsequently developed bifoveal fixation as measured by 30 sec arc of contour stereopsis and 250 to 500 sec arc of random dot stereopsis. This patient demonstrates that bifoveal fixation can be obtained after long-standing strabismus. We suggest that the sensitive period for stereopsis development, for this patient, was from birth to age 3 years.

Aging↗
PubMed1992

Work with area employers to improve cost-efficiency.

Employers are becoming more active in affecting health care delivery systems and developing new health care coalitions and systems. Hospitals will benefit from building a dialog with the employers and industry groups in their service areas. By sharing information and working together, hospitals and employers have the opportunity to check rising costs, avoid duplication of services and maximize utilization of health care resources.

Catchment Area, Health↗
PubMed1990

Visual acuity in a prison population.

I determined the best corrected acuity of 90 prisoners. The data were compared to available published visual acuity data for the general population and to 6/6 (20/20) as the assumed normal. The prison population differed significantly from the population analyzed in one reported study but not from that in another (p less than 0.05). Comparison to the assumed normal of 6/6 showed no statistical difference. The differences among the studies are discussed. The data suggest that for this population corrected visual acuity may not be dissimilar from that of the general population.

Humans↗
PubMed1979

Hospitals should finance medical office buildings.

After the decision to build a medical office building on the hospital campus has been made, a new set of considerations must come to the fore. Although the best decision may be for the hospital to undertake financing of the building, this decision must be made in light of a number of important financial and legal considerations.

Certificate of Need↗