I read with great interest the article by Sidath Wijetilleka and Gwyn Williams titled “Are patients with poorer vision more polite? A study examining door closing tendencies in patients with poor vision” [1]. The authors performed a prospective cohort study of clinic room door closing on two groups of patients, with the group inclusion criteria being based on a visual acuity of more or less than 0.3 logMAR. The authors observed that patients with poor vision had higher rates of door closing and therefore concluded that poor vision is a risk factor for politeness.
I have identified a number of potential confounders that the authors did not report matching for. For instance, women have higher levels of politeness, conscientiousness and orderliness on measures of personality traits [2]. Furthermore, women demonstrate higher rates of visual impairment, therefore the low-VA group may have demonstrated a higher rate of door closing because there were more women in this group [3]. Age is another important confounder as it has been shown that there is a positive correlation between levels of empathy and kindness with advanced age [4]. As there is an increased risk of poor vision with advancing age, this could be another potential confounder [4]. I suggest 12 potential confounding variables, which should be appropriately matched for (Table 1).
Recruiting a cohort large enough to match for these confounders may be challenging, and so I propose the first UK wide multicentre study of door closing outcomes. Furthermore, sub-group analysis could investigate whether being from the south of England has a beneficial effect on politeness as appears to be the case in studies elsewhere [5]. Being a young man with a visual acuity greater than 0.3 logMAR, I am particularly susceptible to low-levels of politeness, and so I am interested to know if living in London is protective.
References
Wijetilleka S, Williams G. Are patients with poorer vision more polite? A study examining door closing tendencies in patients with poor vision. Eye. 2018;32:1539.
Weisberg YJ, Deyoung CG, Hirsh JB. Gender differences in personality across the ten aspects of the big five. Front Psychol. 2011;2:178.
Varma R, Vajaranant TS, Burkemper B, Wu S, Torres M, Hsu C et al. Visual impairment and blindness in adults in the united states: demographic and geographic variations from 2015 to 2050. JAMA Ophthalmol. 2016;134:802–9.
Venter E. Bridging the communication gap between Generation Y and the Baby Boomer generation. Int J Adolesc Youth. 2017;22:497–507.
Culpeper J, Gillings M. Politeness Variation in England: A North-South Divide? In: Brezina V, Love, R, Aijmer K, editors.Corpus Approaches to Contemporary British Speech. Taylor & Francis: Routledge; 2018. pp 123–8.
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Harvey, J.P. Comment on: 'Are patients with poorer vision more polite? A study examining door closing tendencies in patients with poor vision'. Eye 33, 683–692 (2019). https://doi.org/10.1038/s41433-018-0274-1
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DOI: https://doi.org/10.1038/s41433-018-0274-1