A problem with analyzing outcomes after cataract surgery is the loss of patients to follow-up for various personal reasons, Dr. Coleman said, possibly indicating successful outcomes because of the absence of a postoperative problem requiring medical attention, but this result is missing follow-up data.
One caveat attached to the use of Big Data, she advised, is that it can only show associations.
“By itself, Big Data cannot establish causation,” she said. “In addition, if surgeons do not measure or record an observation, it cannot be analyzed or controlled for.”
Further, she said, clinical insight is needed to interpret data and any findings.
“Without the clinical insight into my own patients’ reluctance to return for follow-up after cataract surgery, I might have a hard time interpreting the poor follow-up of cataract surgery patients,” she said.
Dr. Coleman underscored the importance of ophthalmologists recognizing the impact of Big Data.
Dr. Coleman said ophthalmologists can use Big Data to improve care and compare their practices and surgeries with national benchmarks.
“This knowledge can lead to our becoming better and better, which is desired. Data breaches are problematic,” she said. “In the Iris Registry, the vendor is HIPPA compliant and the data are encrypted to minimize security breaches.”
Big Data is an analytic tool that should be complemented with other large cohort studies and randomized clinical trials, she said. It can also give new ideas for future research while helping to find subjects for those trials, she said.
“Big Data will continue to get bigger and bigger,” she said. “The discoveries made with the Iris Registry will help improve care and decrease the rate of endophthalmitis in the future. Knowledge is power and Big Data will give us knowledge.”