Rasch Analysis of the Adult Strabismus Quality of Life Questionnaire (AS-20) among Chinese Adult Patients with Strabismus

Wang, Zonghua; Zhou, Jia-Rong; Luo, Xingli; Xu, Yan; She, Xi; Ling, Chen; Yin, Honghua; Wang, Xianyuan

doi:10.1371/journal.pone.0142188

Cited by 10 publications

(17 citation statements)

References 24 publications

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“…Correction of strabismus offers improvement in psychosocial functioning. [ 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 ] In a study by Menon et al .,[ 21 ] 95% of participants reported positive changes in appearance, self-confidence, self-esteem, and relationship with friends after being treated for strabismus. However, they found no influence of the type of strabismus on the problems perceived by their study participants.…”

Section: Discussionmentioning

confidence: 99%

To assess knowledge and attitude of parents toward children suffering from strabismus in Indian subcontinent

Singh

Rana

Patyal

et al. 2017

Indian J Ophthalmol

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Purpose:Strabismus and anisometropia are the most common causes of amblyopia. It can be easily prevented or treated if detected early. With the changing socio-cultural-economic milieu of the society, the perspectives of strabismus in society are gradually changing but still adequate knowledge, awareness, and attitude of parents toward strabismus will help in preventing amblyopia and aid in the proper psychosocial adaptation of such children. This study aimed to assess knowledge and attitude of parents toward children suffering from strabismus.Methods:A prospective study was carried out from January 1 to February 29, 2016, through a structured questionnaire to assess the level of knowledge and attitude of parents of children suffering from strabismus.Results:One hundred and twenty parents of children with strabismus were interviewed through a questionnaire. Education level of 78 parents was less than graduation (60%) and of 42 parents (40%) was graduation or higher. The majority of the parents, i.e., 116 (96.67%) were bothered due to strabismus. One hundred and one (84.17%) parents felt that their child's strabismus was noticed by others during interaction. Seventy-four (61.67%) parents felt that their children will have difficulty in making friends. Ninety (75%) parents felt uncomfortable if someone asked something about their child's strabismus. One hundred and ten (91.67%) parents considered strabismus as cosmetic stigma.Conclusion:Some parents, especially from the lower educated segment, had poor understanding of strabismus, thus resulting in late presentation and ineffective countermeasures. The key to prevent strabismic amblyopia and its psychosocial impacts is to provide health education regarding strabismus.

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Section: Discussionmentioning

confidence: 99%

To assess knowledge and attitude of parents toward children suffering from strabismus in Indian subcontinent

Singh

Rana

Patyal

et al. 2017

Indian J Ophthalmol

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“…Adult Strabismus‐20 (AS‐20) questionnaire (Original [n = 24], Adapted [n = 1], Chinese [n = 4], Danish [n = 1])…”

Section: Resultsmentioning

confidence: 99%

Patient‐reported outcome measures in amblyopia and strabismus: a systematic review

Kumaran

Khadka

Baker

et al. 2018

Clinical and Experimental Optometry

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Background: Many patient-reported outcome measures (PROMs) have been developed and/or used to measure the impact of amblyopia and strabismus on quality of life (QoL). Identifying the one with superior quality is important for evaluating the effectiveness of novel therapy for amblyopia and for directing improved clinical decision-making in adults considering strabismic surgery. Therefore, the aim of this review is to identify all PROMs previously developed/used to study the impact of amblyopia and/or strabismus on QoL and to appraise the quality and comprehensiveness of content of the disease-specific instruments. Methods: A systematic search was carried out in the electronic databases of PubMed, Cochrane, Web of Science and PsycINFO. The quality of content and measurement properties of all the disease-specific instruments were assessed using established quality standards. Further, the content of the instruments were examined for comprehensiveness by categorising each item across the eight ophthalmic QoL domains (activity limitation, concerns, emotional well-being, social well-being, economic, convenience, symptoms and mobility). Results: Seventy-one PROMs were identified, out of which 32 were amblyopia-and/or strabismus-specific. Out of all the disease-specific instruments, just four have been subjected to modern psychometric tests and only the adult strabismus questionnaire demonstrated good measurement properties. Most of the amblyopia-specific instruments measured the impact of the treatment of amblyopia on children, while most of the strabismus-specific instruments measured concerns related to appearance and treatment outcome in adults. All instruments have gaps in their content and failed to address QoL comprehensively. Conclusion: All the existing amblyopia-and/or strabismus-specific instruments fall short of desired quality and/or comprehensiveness of content. The review identifies the need for developing an instrument with superior quality and discusses potential directions of future research.Key words: amblyopia, patient reported outcome, quality assessment, quality of life, questionnaire, strabismus Amblyopia and strabismus are common developmental conditions of childhood and are known to cause functional deficits like impaired stereoscopic depth perception and defective sensory, motor, visual cognition and prehension skills.1-3 These functional deficits manifest in the individual as imprecise or inefficient performance of real-life activities like reading, grasping and driving and affect quality of life (QoL). 4,5 Apart from the implications of these functional deficits, socially noticeable strabismus also affects the psychosocial and emotional well-being of individuals. [6][7][8][9][10] Analysis of the cost-effectiveness of screening for amblyopia and its utility are limited by the lack of evidence about the long-term impact, the degree of disability and the impact of amblyopia on QoL. 11-13Incorporating patient-reported outcome measures (PROMs) as one of the treatment outcomes is considered importa...

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“…Wang et al 25 translated the AS-20 into Chinese and then performed Rasch analysis on responses from a cohort of 247 adult patients with strabismus. 26 In both Rasch studies, the AS-20 was found to be unidimensional when analyzing the two original constructs (psychosocial and function) separately, although there were some slight differences in misfitting items and category response when compared to the Rasch analysis of the English version. Such differences are not unexpected given different cultural backgrounds and clinical characteristics (e.g., 70% of subjects with exotropia in the Chinese study 26 ).…”

Section: Discussionmentioning

confidence: 98%

“… 26 In both Rasch studies, the AS-20 was found to be unidimensional when analyzing the two original constructs (psychosocial and function) separately, although there were some slight differences in misfitting items and category response when compared to the Rasch analysis of the English version. Such differences are not unexpected given different cultural backgrounds and clinical characteristics (e.g., 70% of subjects with exotropia in the Chinese study 26 ). Different lookup tables for non-English versions of the AS-20, such as those provided by Gothwal et al 24 , may be needed, particularly any time significant differences in performance are highlighted by Rasch analysis in different cultures.…”

Section: Discussionmentioning

confidence: 98%

Lookup Tables Versus Stacked Rasch Analysis in Comparing Pre- and Postintervention Adult Strabismus-20 Data

Hatt

Liebermann

Holmes

2016

Trans. Vis. Sci. Tech.

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PurposeWe compare two methods of analysis for Rasch scoring pre- to postintervention data: Rasch lookup table versus de novo stacked Rasch analysis using the Adult Strabismus-20 (AS-20).MethodsOne hundred forty-seven subjects completed the AS-20 questionnaire prior to surgery and 6 weeks postoperatively. Subjects were classified 6 weeks postoperatively as “success,” “partial success,” or “failure” based on angle and diplopia status. Postoperative change in AS-20 scores was compared for all four AS-20 domains (self-perception, interactions, reading function, and general function) overall and by success status using two methods: (1) applying historical Rasch threshold measures from lookup tables and (2) performing a stacked de novo Rasch analysis. Change was assessed by analyzing effect size, improvement exceeding 95% limits of agreement (LOA), and score distributions.ResultsEffect sizes were similar for all AS-20 domains whether obtained from lookup tables or stacked analysis. Similar proportions exceeded 95% LOAs using lookup tables versus stacked analysis. Improvement in median score was observed for all AS-20 domains using lookup tables and stacked analysis (P < 0.0001 for all comparisons).ConclusionsThe Rasch-scored AS-20 is a responsive and valid instrument designed to measure strabismus-specific health-related quality of life. When analyzing pre- to postoperative change in AS-20 scores, Rasch lookup tables and de novo stacked Rasch analysis yield essentially the same results.Translational RelevanceWe describe a practical application of lookup tables, allowing the clinician or researcher to score the Rasch-calibrated AS-20 questionnaire without specialized software.

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Rasch Analysis of the Adult Strabismus Quality of Life Questionnaire (AS-20) among Chinese Adult Patients with Strabismus

Cited by 10 publications

References 24 publications

To assess knowledge and attitude of parents toward children suffering from strabismus in Indian subcontinent

To assess knowledge and attitude of parents toward children suffering from strabismus in Indian subcontinent

Patient‐reported outcome measures in amblyopia and strabismus: a systematic review

Lookup Tables Versus Stacked Rasch Analysis in Comparing Pre- and Postintervention Adult Strabismus-20 Data

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