Why Big Data Is a Big Deal

During Sunday’s Opening Session, the 2015 Jackson Memorial Lecturer—Anne L. Coleman, MD, PhD—provided some historical perspective on cataract surgery, before describing why Big Data would play a critical role in its future.

Underlining how far procedures have evolved, Dr. Coleman cited an early 20th century study that compared cataract couching with cataract extraction. A successful outcome was defined as vision of at least 20/200—“not great by today’s standards.”

Since then, “we have made huge advances in the techniques of cataract surgery and in the types of antibiotics we use, but we still have those people who get endophthalmitis.” The rarity of this complication poses a challenge for researchers. “Enter Big Data,” said Dr. Coleman.

After referencing several studies of endophthalmitis drawn from large data sets—including U.S. Medicare claims, electronic health records, and the Swedish National Cataract Surgery Registry—Dr. Coleman reported some results from her own research.

She analyzed a 5% sample of Medicare claims data for 4 successive years (2010-2013; 216,703 individuals) and 2 years of data from the IRIS Registry (2013-2014; 511,182 individuals), which includes clinical information, such as visual acuity (VA), unavailable in the Medicare data set.

The endophthalmitis rates were 0.14% and 0.08% based on the Medicare and IRIS Registry data, respectively. Why the difference? First, the IRIS Registry patients are younger. Second, some patients might have undergone cataract surgery by an IRIS Registry participant and later followed up with a nonparticipant. Third, the Medicare claims data set doesn’t indicate laterality, which means the endophthalmitis isn’t necessarily in the same eye that had surgery.

“Big Data is a tool, and it’s really up to us how to use it,” said Dr. Coleman. “The discoveries made with the IRIS Registry will help improve care and decrease the rate of endophthalmitis in the future.”—Chris McDonagh

Learn more about the IRIS Registry while you’re at AAO 2015.

Financial disclosures. Dr. Coleman—First Five: S; Reichert: C.

Disclosure key. C = Consultant/Advisor; E = Employee; L = Speakers bureau; O = Equity owner; P = Patents/Royalty; S = Grant support.