|24 September 2009||Fran�ais|
Jennifer Brunet-Colvey Appointed Executive Director and C.E.O. of the Canadian Ophthalmological Society
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As part of an ongoing effort to provide high quality continuing professional development (CPD) activities, an online evaluation and credit tracking tool was piloted at COS 2009 in Toronto. More than 380 ophthalmologists used this tool, for a 57% response rate. This is a significant increase from the 10�15% response rate to traditional paper evaluations.
Thank you to everyone who tried the tool and took the time to send in comments and suggestions. The pilot results indicate that most COS delegates appreciate an online, paperless evaluation. However, the evaluation could be improved by ensuring that delegates only log in once, providing plenty of on-site evaluation stations, and considering a PDA-friendly format. Several respondents also indicated that evaluating each individual session was tedious and time consuming. COS will be revising the tool and addressing most of these concerns for the 2010 meeting. However, the guidelines for continuing professional development from the Royal College of Physicians and Surgeons of Canada (RCPSC) do require participants of an accredited activity to evaluate each session in order to reflect upon their own learning.
Highlights of the meeting included the Glaucoma Drainage Devices Wet Lab and the Communications Rounds on Informed Consent. The Glaucoma Wet Lab was hands-on, instructing participants on the indications, techniques and postoperative management of glaucoma drainage devices, and gave participants the opportunity to practice their surgical techniques. One delegate reported: �[The] Glaucoma Wet Lab was [an] excellent opportunity to learn about implants and its management.� Another said, �This was the best course I have ever attended.� The Communications Rounds used a standardized patient and role playing to illustrate best practices for ensuring informed consent. Comments included �Outstanding session...one of the best.�
Overall, 96% of evaluation respondents felt that their learning objectives for the COS 2009 were met. General comments about COS 2009 include: �Excellent guest speakers. Invaluable opportunities for meeting with colleagues� and �I picked up several �pearls� per day and noted several alterations I will make in my practice.�
Learning needs identified for next year�s meeting include more information on Electronic Medical Records, AMD updates, and more information on emerging trends and new technologies.
Qu�bec City will be the host city for COS 2010, June 26�29.
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COS reintroduces a registration fee for its Annual Scientific Meeting
A registration fee of $325 for active members has been set for the 2010 meeting in Quebec City.
Proportional fees will be set for other membership categories. Details will be finalized and sent out with the program later this year.
In 1994, COS hosted the International Council of Ophthalmology (ICO) meeting with 3500 participants, resulting in a significant budget surplus. Consequently, the COS board of directors decided to waive registration fees temporarily and to freeze membership fees for the foreseeable future. In 2000, a corporate sponsorship program was initiated as part of a strategy to continue extending this benefit to members. While this program has worked well over the past 14 years, rising costs have necessitated the reintroduction of a registration fee for the Annual Meeting.
The continued growth and resulting success of the COS Annual Meeting has led to increased costs, influencing the need for additional revenue:
In addition, corporate sponsorship is on the decline, as companies tighten their belts in a difficult economy and must distribute funds to a growing number of regional ophthalmology meetings across the country. This downward adjustment by industry is also being felt by the Canadian Journal of Ophthalmology (CJO), which has seen a significant drop in advertising revenue since 2006.
With the advent of the Maintenance of Certification (MOC) program, all national specialty societies (NSS) have been requested by the Royal College of Physicians and Surgeons of Canada to adopt more strict criteria and move towards less dependence on industry for ongoing professional development. The Annual Meeting registration fee will allow us to move in this direction. Compared with other NSS across Canada, the $325 registration fee is well below the national average of $800 for a three-day meeting.
Finally, it is important to note that the membership fee of $525 has remained the same for the past eight years, and will not be increased for 2010. Membership fees will continue to support ongoing programs such as the CJO, MOC, clinical practice guidelines, the Perspectives newsletter and other important initiatives. With respect to the Annual Meeting, COS is committed to continuing to deliver the highest quality and accredited educational program to its members and affiliated societies.
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Update on Bevacizumab (Avastin)-associated Post-Operative Inflammation (TASS, Sterile Endophthalmitis)
The Canadian outbreaks of Bevacizumab (Avastin)-associated Post-Operative Inflammation (TASS, Sterile Endophthalmitis), also described as �Avastin TASS/SE,� were first reported in October 2008 and all had resolved by January 2009 with continued surveillance since. A total of 102 cases from 13 sites in 8 Canadian cities during the 4 months were reported to the COS TASS Task Force.
Investigations were done by Health Canada, BC Centre for Disease Control, Hoffman La Roche, and individual hospital infection control committees. The COS TASS committee has worked closely with all investigators, and although final reports are yet to published, we are able to share the following summary.
The Canadian outbreaks of Bevacizumab (Avastin) Post-Operative Inflammation were nationwide. Two centres were evaluated in cohort studies involving 42 cases.
Patients who received Avastin from Lot #B3002B028 (Vial#B30028) had a 33 times greater chance of developing postoperative inflammation. An additional risk that approached significance was repeated injection. Clinical outcomes were favourable, with no patient losing final vision attributed to the inflammation, although several underwent additional procedures (tap-inject/vitrectomy). A further 3 cases have been reported since January 1, 2009, which is consistent with the published experience of sporadic cases.
Our national experience of Bevacizumab (Avastin) Post-Operative Inflammation has attracted national and international attention (1) due to the importance of the anti-VEGF agents. Fortunately, the incidence of adverse reactions has dropped to the expected level after discontinuation of Avastin from a specific lot and packaging number. Laboratory investigations by Health Canada and Hoffman La Roche have to date not reported any deviation of the implicated lot from the approved formulation for intravenous, not intraocular, use of Avastin.
We would like to thank the many individuals, companies, and agencies who have contributed to resolving and investigating this national outbreak, and please continue to report any cases to the COS TASS Task Force. The issue of Post-Operative Inflammation after anti-VEGF agents is an important one and may affect further accessibility, with recent outbreaks reported from Europe.
Chong NV. Should Avastin be used to treat age-related macular degeneration in the NHS? No. Eye 2009; 23(6): 1250-53.
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