Measuring Outcomes of Vision Rehabilitation with the Veterans Affairs Low Vision Visual Functioning Questionnaire

Abstract

In addition to being a valid and reliable measure of visual ability, the VA LV VFQ-48 is a sensitive measure of changes that occur in visual ability as a result of vision rehabilitation. Patients' self-reports of the difficulty they experience performing daily activities measured with this instrument can be used to compute a single number, the person measure that can serve as an outcome measure in clinical studies. The VA LV VFQ-48 can be used to compare programs that offer different levels of intervention and serve patients across the continuum of vision loss.

How Effective is Low Vision Service Provision? A Systematic Review

“…88,137 ) suggest that outcome measures targeting visual function may be more sensitive to the benefits of this type of service. Although these findings indicate that the VA LV VFQ-48 outcome measure is sensitive to the effects of the Veterans' Affairs services, 138,141,143 which tend to be intensive, multidisciplinary services whose patient base is almost exclusively male, it is less clear whether similar effect sizes will be found using this tool to assess the outcomes of other types of service.…”

“…43,70,91,115 Instruments assessing functional status may be scored entirely based on a patient's judgment of their own ability (self-report/patient-rated assessment), e.g. the Veterans Affairs LV VFQ-48, 141 or may be completed by a single clinician, or group of professionals (provider/clinician-rated assessment), e.g.…”

“…Previous studies by Stelmack et al, looking at the effectiveness of other Veterans' Affairs service models, have similarly found a marked functional improvement post-intervention using the VA LV VFQ-48 tool. 138,141 Stelmack et al demonstrated that the positive effects of an intensive inpatient Veteran's Affairs rehabilitation programme on functional ability were reduced, but still large at 12 months (VA LV VFQ-48 effect sizes were 2.035 and 1.405 at 3 and 12 months respectively; N=95). 138 The greater effect sizes found in comparison to those reported by studies using vision related quality-of-life tools to assess the same type of Veterans' Affairs low vision service (e.g.…”

“…141 In contrast to the studies using self-report outcome measures, Stephens et al looked at the clinicianrated Independent Living Pre-Programme assessment and Post-Programme assessment outcomes of low vision service provision (across 6 services, providing 4 different models of intervention) in a large sample of 1194 people, 144 and found a significant pre-to post-rehabilitation improvement for all age groups studied (over 65 yrs) in all 4 parameters, with medium effect sizes for all ages. The potential bias introduced by using a clinician-rated measure of functional outcomes was investigated by McKnight and Babcock-Parziale, who compared the change in the Functional Assessment of Self-Reliance in Tasks (FAST) clinician-rated and self-rated scores between a preand post-rehabilitation assessment on the basis of complete data from 81 individuals.…”

“…However, several studies evaluated the effectiveness of different service models side by side, either in RCTs, 115 or at least using the same outcome measures. 41,43,48,49,60,102,115,141,149 Several studies have looked at the differential effect of optometric and multidisciplinary service models and found little difference in outcomes. 43,89,115,149 Reeves et al conducted an RCT to compare the effectiveness of three different models for low vision service provision.…”