Choosing appropriate patient-reported outcomes instrument for glaucoma research: a systematic review of vision instruments

Hamzah, Jemaima Che; Burr, Jennifer; Ramsay, Craig R; Azuara‐Blanco, Augusto; Prior, Maria

doi:10.1007/s11136-010-9831-1

Cited by 37 publications

(44 citation statements)

References 79 publications

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“…According to recent systematic reviews of available vision instruments for glaucoma research, the NEI-VFQ-25 had the highest number of positive ratings in the content validity assessment and is a validated QoL measuring instrument [30,31]. NEI-VFQ-25 captures 11 vision-targeted subscales: global vision rating, difficulty with near-vision activities, difficulty with distance-vision activities, limitations in social functioning, role difficulties, dependency on others, mental health symptoms, driving difficulties, limitations with peripheral and color vision, and ocular pain symptoms [29].…”

Section: Methodsmentioning

confidence: 99%

Health- and Vision-Related Quality of Life in Patients with Ocular Hypertension or Primary Open-Angle Glaucoma

et al. 2013

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Background: The main objective of this analysis was to assess the impact of severity of disease on the quality of life (QoL) of patients with ocular hypertension (OHT) and early, moderate, or advanced primary open-angle glaucoma (POAG). Methods: This multicenter study was conducted at 2 university hospitals and 13 ophthalmology practices in Germany. QoL data were assessed by the Health Utility Index (HUI3) and the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). Results: 154 patients (17.5% OHT, 27.9% early, 22.7% moderate, and 31.8% advanced POAG) were included. The HUI3 scores for OHT, early, moderate, and advanced POAG were 0.87 ± 0.09, 0.85 ± 0.15, 0.75 ± 0.23, and 0.58 ± 0.32, respectively. Compared to a normal population matched by age and gender, for moderate and severe POAG a difference of -0.06 ± 0.24 and -0.19 ± 0.28, respectively, was observed. NEI-VFQ-25 scores illustrate different dimensions of the impact on QoL; reduced peripheral vision or difficulties to drive a car were more crucial to glaucoma patients than social factors. Conclusions: The key difference for QoL impairment in glaucoma lies between OHT/early POAG versus moderate/severe POAG, hence every possible effort needs to be made to prevent disease progression over this threshold.

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Section: Methodsmentioning

confidence: 99%

Health- and Vision-Related Quality of Life in Patients with Ocular Hypertension or Primary Open-Angle Glaucoma

et al. 2013

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“…Some work has been undertaken to identify and validate the different patient-reported outcome measures used in glaucoma trials. This previous effort provided a framework (and critique of existing tools) for selecting the core patient reported outcomes in glaucoma studies 7. However, no attempt has been undertaken on the standardisation of the clinical outcome measures in glaucoma RCTs.…”

Section: Introductionmentioning

confidence: 99%

Variation of clinical outcomes used in glaucoma randomised controlled trials: a systematic review

2014

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“…The decision whether to develop a new patient reported outcome (PRO) instrument or use an existing validated measure should be based on a thorough review of PRO instruments used in a population of interest [1,2]. If a new instrument is required, robust and transparent methods should be used at every stage of its development.…”

Section: Introductionmentioning

confidence: 99%

Theoretical and empirical dimensions of the Aberdeen Glaucoma Questionnaire: a cross sectional survey and principal component analysis

et al. 2013

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BackgroundTo develop patient-reported outcome instruments, statistical techniques (e.g., principal components analysis; PCA) are used to examine correlations among items and identify interrelated item subsets (empirical factors). However, interpretation and labelling of empirical factors is a subjective process, lacking precision or conceptual basis. We report a novel and reproducible method for mapping between theoretical and empirical factor structures. We illustrate the method using the pilot Aberdeen Glaucoma Questionnaire (AGQ), a new measure of glaucoma-related disability developed using the International Classification of Functioning and Disability (ICF) as a theoretical framework and tested in a sample representing the spectrum of glaucoma severity.MethodsWe used the ICF to code AGQ item content before mailing the AGQ to a UK sample (N = 1349) selected to represent people with a risk factor for glaucoma and people with glaucoma across a range of severity. Reflecting uncertainty in the theoretical framework (items with multiple ICF codes), an exploratory PCA was conducted. The theoretical structure informed our interpretation of the empirical structure and guided the selection of theoretically-derived factor labels. We also explored the discrimination of the AGQ across glaucoma severity groups.Results656 (49%) completed questionnaires were returned. The data yielded a 7-factor solution with a simple structure (using cut-off point of a loading of 0.5) that together accounted for 63% of variance in the scores. The mapping process resulted in allocation of the following theoretically-derived factor labels: 1) Seeing Functions: Participation; 2) Moving Around & Communication; 3) Emotional Functions; 4) Walking Around Obstacles; 5) Light; 6) Seeing Functions: Domestic & Social Life; 7) Mobility. Using the seven factor scores as independent variables in a discriminant function analysis, the AGQ scores resulted in correct glaucoma severity grading of 32.5% of participants (p < 0.001).ConclusionsThis paper addresses a methodological gap in the application of classical test theory (CTT) techniques, such as PCA, in instrument development. Labels for empirically-derived factors are often selected intuitively whereas they can inform existing bodies of knowledge if selected on the basis of theoretical construct labels, which are more explicitly defined and which relate to each other in ways that are evidence based.

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Choosing appropriate patient-reported outcomes instrument for glaucoma research: a systematic review of vision instruments

Cited by 37 publications

References 79 publications

Health- and Vision-Related Quality of Life in Patients with Ocular Hypertension or Primary Open-Angle Glaucoma

Health- and Vision-Related Quality of Life in Patients with Ocular Hypertension or Primary Open-Angle Glaucoma

Variation of clinical outcomes used in glaucoma randomised controlled trials: a systematic review

Theoretical and empirical dimensions of the Aberdeen Glaucoma Questionnaire: a cross sectional survey and principal component analysis

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