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Fernandes S, Brousse Y, Zendjidjian X, Cano D, Riedberger J, Llorca PM, Samalin L, Dassa D, Trichard C, Laprevote V, Sauvaget A, Abbar M, Misdrahi D, Berna F, Lancon C, Coulon N, El-Hage W, Rozier PE, Benoit M, Giordana B, Caqueo-Urízar A, Yon DK, Tran B, Auquier P, Fond G, Boyer L. Psychometric Assessment of an Item Bank for Adaptive Testing on Patient-Reported Experience of Care Environment for Severe Mental Illness: Validation Study. JMIR Ment Health 2024; 11:e49916. [PMID: 38753416 PMCID: PMC11140279 DOI: 10.2196/49916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/15/2023] [Accepted: 01/21/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND The care environment significantly influences the experiences of patients with severe mental illness and the quality of their care. While a welcoming and stimulating environment enhances patient satisfaction and health outcomes, psychiatric facilities often prioritize staff workflow over patient needs. Addressing these challenges is crucial to improving patient experiences and outcomes in mental health care. OBJECTIVE This study is part of the Patient-Reported Experience Measure for Improving Quality of Care in Mental Health (PREMIUM) project and aims to establish an item bank (PREMIUM-CE) and to develop computerized adaptive tests (CATs) to measure the experience of the care environment of adult patients with schizophrenia, bipolar disorder, or major depressive disorder. METHODS We performed psychometric analyses including assessments of item response theory (IRT) model assumptions, IRT model fit, differential item functioning (DIF), item bank validity, and CAT simulations. RESULTS In this multicenter cross-sectional study, 498 patients were recruited from outpatient and inpatient settings. The final PREMIUM-CE 13-item bank was sufficiently unidimensional (root mean square error of approximation=0.082, 95% CI 0.067-0.097; comparative fit index=0.974; Tucker-Lewis index=0.968) and showed an adequate fit to the IRT model (infit mean square statistic ranging between 0.7 and 1.0). DIF analysis revealed no item biases according to gender, health care settings, diagnosis, or mode of study participation. PREMIUM-CE scores correlated strongly with satisfaction measures (r=0.69-0.78; P<.001) and weakly with quality-of-life measures (r=0.11-0.21; P<.001). CAT simulations showed a strong correlation (r=0.98) between CAT scores and those of the full item bank, and around 79.5% (396/498) of the participants obtained a reliable score with the administration of an average of 7 items. CONCLUSIONS The PREMIUM-CE item bank and its CAT version have shown excellent psychometric properties, making them reliable measures for evaluating the patient experience of the care environment among adults with severe mental illness in both outpatient and inpatient settings. These measures are a valuable addition to the existing landscape of patient experience assessment, capturing what truly matters to patients and enhancing the understanding of their care experiences. TRIAL REGISTRATION ClinicalTrials.gov NCT02491866; https://clinicaltrials.gov/study/NCT02491866.
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Affiliation(s)
- Sara Fernandes
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
| | - Yann Brousse
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
| | - Xavier Zendjidjian
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
| | - Delphine Cano
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
| | - Jérémie Riedberger
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
| | - Pierre-Michel Llorca
- Department of Psychiatry, Centre Hospitalier Universitaire de Clermont-Ferrand, University of Clermont Auvergne, Centre national de la recherche scientifique, Institut national polytechnique de Clermont Auvergne, Institut Pascal UMR 6602, Clermont-Ferrand, France
| | - Ludovic Samalin
- Department of Psychiatry, Centre Hospitalier Universitaire de Clermont-Ferrand, University of Clermont Auvergne, Centre national de la recherche scientifique, Institut national polytechnique de Clermont Auvergne, Institut Pascal UMR 6602, Clermont-Ferrand, France
| | - Daniel Dassa
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
| | | | - Vincent Laprevote
- Department of Addictology and Psychiatry, Centre Psychothérapique de Nancy, Laxou, France
- Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Université de Strasbourg, Institut national de la santé et de la recherche médicale U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Anne Sauvaget
- Nantes Université, Centre Hospitalier Régional Universitaire de Nantes, Movement - Interactions - Performance - MIP UR 4334, Nantes, France
| | - Mocrane Abbar
- Department of Psychiatry, Centre Hospitalier Universitaire de Nîmes, University of Montpellier, Nîmes, France
| | - David Misdrahi
- National Centre for Scientific Research UMR 5287 - Institut de Neurosciences Cognitives et Intégratives d'Aquitaine, University of Bordeaux, Centre Hospitalier Charles Perrens, Bordeaux, France
| | - Fabrice Berna
- Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Université de Strasbourg, Institut national de la santé et de la recherche médicale U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Christophe Lancon
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
| | - Nathalie Coulon
- Centre Expert Schizophrénie, Centre Expert TSA-SDI et Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive - C3R, Centre Hospitalier Alpes Isère, Grenoble, France
| | - Wissam El-Hage
- Centre Hospitalier Régional Universitaire de Tours, Clinique Psychiatrique Universitaire, Tours, France
| | | | - Michel Benoit
- Department of Psychiatry, Hopital Pasteur, University Hospital of Nice, Nice, France
| | - Bruno Giordana
- Department of Psychiatry, Hopital Pasteur, University Hospital of Nice, Nice, France
| | | | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Department of Pediatrics, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Bach Tran
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
- Institute of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Pascal Auquier
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
| | - Guillaume Fond
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
| | - Laurent Boyer
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
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Markoulli M, Fricke TR, Arvind A, Frick KD, Hart KM, Joshi MR, Kandel H, Filipe Macedo A, Makrynioti D, Retallic N, Garcia-Porta N, Shrestha G, Wolffsohn JS. BCLA CLEAR Presbyopia: Epidemiology and impact. Cont Lens Anterior Eye 2024:102157. [PMID: 38594155 DOI: 10.1016/j.clae.2024.102157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
The global all-ages prevalence of epidemiologically-measured 'functional' presbyopia was estimated at 24.9% in 2015, affecting 1.8 billion people. This prevalence was projected to stabilise at 24.1% in 2030 due to increasing myopia, but to affect more people (2.1 billion) due to population dynamics. Factors affecting the prevalence of presbyopia include age, geographic location, urban versus rural location, sex, and, to a lesser extent, socioeconomic status, literacy and education, health literacy and inequality. Risk factors for early onset of presbyopia included environmental factors, nutrition, near demands, refractive error, accommodative dysfunction, medications, certain health conditions and sleep. Presbyopia was found to impact on quality-of-life, in particular quality of vision, labour force participation, work productivity and financial burden, mental health, social wellbeing and physical health. Current understanding makes it clear that presbyopia is a very common age-related condition that has significant impacts on both patient-reported outcome measures and economics. However, there are complexities in defining presbyopia for epidemiological and impact studies. Standardisation of definitions will assist future synthesis, pattern analysis and sense-making between studies.
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Affiliation(s)
- Maria Markoulli
- School of Optometry and Vision Science, UNSW Sydney, Australia.
| | - Timothy R Fricke
- School of Optometry and Vision Science, UNSW Sydney, Australia; Department of Optometry and Vision Science, University of Melbourne, Australia; National Vision Research Institute, Australian College of Optometry, Melbourne, Australia
| | - Anitha Arvind
- Department of Optometry, School of Medical and Allied Sciences, GD Goenka University, India
| | - Kevin D Frick
- Johns Hopkins Carey Business School, USA; Johns Hopkins Bloomberg School of Public Health Departments of International Health and Health Policy and Management, USA; Johns Hopkins School of Medicine, Department of Ophthalmology, USA
| | - Kerryn M Hart
- School of Medicine, Faculty of Health, Deakin University, Australia; Member Support and Optometry Advancement, Optometry Australia, Australia
| | - Mahesh R Joshi
- School of Health Professions, University of Plymouth, United Kingdom
| | - Himal Kandel
- Save Sight Institute, Faculty of Medicine and Health, The University of Sydney, Australia; Sydney Eye Hospital, Australia
| | - Antonio Filipe Macedo
- Department of Medicine and Optometry, Faculty of Health and Life Sciences, Linnaeus University, Sweden; Centre of Physics of Minho and Porto Universities, School of Sciences, University of Minho, Braga, Portugal
| | | | - Neil Retallic
- Specsavers Optical Group, La Villiaze, St. Andrew's, Guernsey, United Kingdom
| | - Nery Garcia-Porta
- Applied Physics Department, Optics and Optometry Faculty, University of Santiago de Compostela, Spain; Institute of Materials (iMATUS) of the University of Santiago de Compostela, Spain
| | - Gauri Shrestha
- Optometry Department, BPK Centre for Ophthalmic Studies, Institute of Medicine, Nepal
| | - James S Wolffsohn
- School of Optometry, Health and Life Sciences, Aston University, Birmingham, United Kingdom
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Albero-Ros E, Lorente-Velázquez A, González-Pérez M. Content development for a new item-bank for measuring multifocal contact lens performance. J Patient Rep Outcomes 2024; 8:16. [PMID: 38329635 PMCID: PMC10853121 DOI: 10.1186/s41687-024-00689-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 01/18/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Presbyopia is an age-related condition that causes a decreased ability to focus on nearby objects. Multifocal contact lenses are commonly used to address this issue. However, there seems to be a notable dissatisfaction among multifocal contact lens wearers. The absence of a reliable instrument to measure the patient's perspective, despite the widespread use of this method, highlights the need for further research in this area. OBJECTIVE The objective of this study is to develop an item-bank integrating all domains necessary to assess the patient's perspective on multifocal contact lens performance, offering a comprehensive measure. The item-bank will ensure a high level of content validity, be self-administered, and will initially be available in Spanish. The aim of this tool is to serve as a valuable resource for research and optometric clinics, facilitating the follow-up of patients with presbyopia who wear multifocal contact lenses or those who are newly starting to use them. METHODOLOGY The MCL-PRO item bank, followed a systematic and step-wise inductive approach to gather information, following the recommendations outlined in the COSMIN guidelines and similar studies. The process involved the following steps: (1) Literature review and relevant existing items identification (2) Social media review, (3) Semi-structured focus groups, (4) performing qualitative analysis, (5) refining and revising the items, and (6) generating the content of the item bank. RESULTS A total of 575 items were included in the item-bank hosted under 8 different domains that were found to be important for presbyopic population: visual symptoms (213), activity limitation (111), ocular symptoms (135), convenience (36), emotional well-being (33), general symptoms (16), cognitive issues (21) and economic issues (10). CONCLUSION The item-bank created has followed standardised methodology for its development and encloses all the aspects for MCL performance evaluation from patients perspective.
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Affiliation(s)
- Elsa Albero-Ros
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Arcos de Jalón, 118, 28037, Madrid, Spain.
- Alain Afflelou Óptico, Portugal, Av. António Augusto de Aguiar, 11, 1050-016, Lisbon, Portugal.
| | - Amalia Lorente-Velázquez
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Arcos de Jalón, 118, 28037, Madrid, Spain
- Clinical and Experimental Research Group (CEER), Faculty of Optics and Optometry, Universidad Complutense de Madrid, Arcos de Jalón, 118, 28037, Madrid, Spain
| | - Mariano González-Pérez
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Arcos de Jalón, 118, 28037, Madrid, Spain
- Clinical and Experimental Research Group (CEER), Faculty of Optics and Optometry, Universidad Complutense de Madrid, Arcos de Jalón, 118, 28037, Madrid, Spain
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Abdolalizadeh P, Mehrdad R, Saberzadeh-Ardestani B, Pouragha H, Alipour F, Esmaili M. Prevalence of uncorrected distance refractive errors and associated risk factors in employees of an academic centre. Clin Exp Optom 2023; 106:869-875. [PMID: 36372555 DOI: 10.1080/08164622.2022.2133988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 03/14/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Uncorrected refractive error (RE) may affect the work performance of adults in the workplace. The aim of current study was to determine the prevalence of corrected and uncorrected RE, and the determinants of uncorrected RE in adult employees of a university. METHODS This was a cross-sectional study of Tehran University Medical Sciences' staff. Besides demographic and some specific questionnaires, ophthalmic examinations including the measurement of uncorrected visual acuity (UCVA), best spectacles corrected visual acuity (BCVA), and presenting visual acuity were performed for all participants. The need for spectacles was defined as UCVA worse than 6/12 in the better eye that could be corrected to better than 6/12 with spectacles based on subjective refraction. RESULTS In total, 4460 individuals with mean age of 42.32 ± 8.80 were included in the study. The VA of the better eye was 0.01 ± 0.05 logMAR for BCVA, 0.13 ± 0.26 for UCVA, and 0.05 ± 0.12 for presenting VA. Prevalence of RE was 15.7%, including uncorrected RE of 5% and spectacles coverage (corrected RE) of 10.7%. The proportion of individuals with elementary education and poor-fair status of general health were 1.62 times higher in the uncorrected group. In the univariate analysis, type of occupation (office versus non-office workers), socioeconomic status, and insurance of employees were not related to uncorrected RE (all P > 0.4). Myopia was the only factor associated with uncorrected RE in logistic regression analysis (odds ratio = 2.73, 95%CI = 1.02-7.31, P = 0.04). CONCLUSION The prevalence of uncorrected RE and spectacle coverage were 5% and 10.7%, respectively. Myopia was almost three times more likely to be associated among employees with uncorrected RE.
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Affiliation(s)
- Parya Abdolalizadeh
- Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Ramin Mehrdad
- Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Hamidreza Pouragha
- Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran
| | - Fateme Alipour
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Esmaili
- Optometry Department, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Panthagani J, O'Donovan C, Aiyegbusi OL, Liu X, Bayliss S, Calvert M, Pesudovs K, Denniston AK, Moore DJ, Braithwaite T. Evaluating patient-reported outcome measures (PROMs) for future clinical trials in adult patients with optic neuritis. Eye (Lond) 2023; 37:3097-3107. [PMID: 36932161 PMCID: PMC10022552 DOI: 10.1038/s41433-023-02478-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 01/09/2023] [Accepted: 02/28/2023] [Indexed: 03/19/2023] Open
Abstract
OBJECTIVE To search for and critically appraise the psychometric quality of patient-reported outcome measures (PROMs) developed or validated in optic neuritis, in order to support high-quality research and care. METHODS We systematically searched MEDLINE(Ovid), Embase(Ovid), PsycINFO(Ovid) and CINAHLPlus(EBSCO), and additional grey literature to November 2021, to identify PROM development or validation studies applicable to optic neuritis associated with any systemic or neurologic disease in adults. We included instruments developed using classic test theory or Rasch analysis approaches. We used established quality criteria to assess content development, validity, reliability, and responsiveness, grading multiple domains from A (high quality) to C (low quality). RESULTS From 3142 screened abstracts we identified five PROM instruments potentially applicable to optic neuritis: three differing versions of the National Eye Institute (NEI)-Visual Function Questionnaire (VFQ): the 51-item VFQ; the 25-item VFQ and a 10-item neuro-ophthalmology supplement; and the Impact of Visual Impairment Scale (IVIS), a constituent of the Multiple Sclerosis Quality of Life Inventory (MSQLI) handbook, derived from the Functional Assessment of Multiple Sclerosis (FAMS). Psychometric appraisal revealed the NEI-VFQ-51 and 10-item neuro module had some relevant content development but weak psychometric development, and the FAMS had stronger psychometric development using Rasch Analysis, but was only somewhat relevant to optic neuritis. We identified no content or psychometric development for IVIS. CONCLUSION There is unmet need for a PROM with strong content and psychometric development applicable to optic neuritis for use in virtual care pathways and clinical trials to support drug marketing authorisation.
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Affiliation(s)
| | - Charles O'Donovan
- School of Immunology and Microbiology, King's College London, London, UK.
| | - Olalekan Lee Aiyegbusi
- Centre for Patient Reported Outcomes Research (CPROR), Institute of Applied Health Research, Birmingham Health Partners for Regulatory Science and Innovation, NIHR Birmingham Biomedical Research Centre, NIHR Applied Research Collaboration West Midlands, and NIHR Birmingham-Oxford Blood and Transplant Research Unit (BTRU) in Precision Transplant and Cellular Therapeutics, University of Birmingham, Birmingham, B15 2TT, UK
| | - Xiaoxuan Liu
- Institute of Inflammation and Ageing, University of Birmingham, University Hospitals Birmingham, Health Data Research UK, London, UK
| | - Susan Bayliss
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Melanie Calvert
- Centre for Patient Reported Outcomes Research (CPROR), Institute of Applied Health Research, Birmingham Health Partners for Regulatory Science and Innovation, NIHR, Birmingham Biomedical Research Centre, NIHR Surgical Reconstruction and Microbiology Centre, NIHR Applied Research Collaboration West Midlands, and NIHR Birmingham-Oxford Blood and Transplant Research Unit (BTRU) in Precision Transplant and Cellular Therapeutics, University of Birmingham, Birmingham, B15 2TT, UK
| | | | - Alastair K Denniston
- Institute of Inflammation and Ageing, and Centre for Patient Reported Outcomes Research (CPROR), Institute of Applied Health Research, Birmingham Health Partners for Regulatory Science and Innovation, NIHR Birmingham-Oxford Blood and Transplant Research Unit (BTRU) in Precision Transplant and Cellular Therapeutics, University of Birmingham, University Hospitals Birmingham, Health Data Research UK, London, UK
| | - David J Moore
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Tasanee Braithwaite
- School of Immunology and Microbiology, King's College London, and The Medical Eye Unit, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
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Erøy ÅA, Utheim TP, Sundling V. Cross-sectional Study Exploring Vision-related Quality of Life in Dry Eye Disease in a Norwegian Optometric Practice. Optom Vis Sci 2023; 100:679-687. [PMID: 37751404 PMCID: PMC10662625 DOI: 10.1097/opx.0000000000002058] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 07/22/2023] [Indexed: 09/28/2023] Open
Abstract
SIGNIFICANCE Dry eye disease causes ocular pain, blurred vision, reduced visual quality of life, and reduced workplace performance. This disease is underreported and underdiagnosed despite being highly prevalent in optometric care. PURPOSE This study aimed to explore the vision-related quality of life of patients with dry eye disease and the potential benefits of screening for dry eye disease in Norwegian optometric practice. METHODS This study adopted an observational, prospective, cross-sectional design. All patients between 18 and 70 years of age who were examined between June 8 and July 5, 2018, at Erøy Optikk, Kristiansand, Norway, were invited to participate. Dry eye disease was assessed according to Tear Film & Ocular Surface Society International Dry Eye Workshop II report recommendations. Vision-related quality of life was assessed with the National Eye Institute 25-item Visual Function Questionnaire. RESULTS Forty-nine patients participated in the study; 29 (59%) were female, and 29 (59%) had dry eye disease. The patients with dry eye disease reported significantly more ocular pain and (vision-specific) role difficulties than the patients without dry eye disease. After adjusting for age, sex, and habitual visual acuity, dry eye disease was found to be an independent predictor of both ocular pain ( r2 = 0.328, P = .001) and (vision-specific) role difficulties ( r2 = 0.240, P = .02). Both habitual visual acuity and dry eye disease were predictors of reduced general vision, a reduced score for near activity and reduced (vision-specific) mental health. CONCLUSIONS Dry eye disease was an independent predictor of ocular pain (vision-specific), role difficulties, and reduced general vision, near vision, and (vision-specific) mental health. Optometrists should consider dry eye disease as a cause of reduced vision and quality of vision. Furthermore, we propose that screening for dry eye disease in Norwegian optometric practice can promote better vision and health among patients.
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Affiliation(s)
- Åsmund André Erøy
- National Centre for Optics, Vision and Eye Care, Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University of South-Eastern Norway, Norway
- Erøy Optikk, Kristiansand, Norway
| | - Tor Paaske Utheim
- National Centre for Optics, Vision and Eye Care, Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University of South-Eastern Norway, Norway
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Vibeke Sundling
- National Centre for Optics, Vision and Eye Care, Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University of South-Eastern Norway, Norway
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Kandel H, Pesudovs K, Nguyen V, Chen JY, Poon A, Mills R, Watson SL. Patient-Reported Outcomes in Keratoconus: A Save Sight Keratoconus Registry Study. Cornea 2023; 42:590-597. [PMID: 36036705 DOI: 10.1097/ico.0000000000003119] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 07/07/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of this study was to evaluate the quality-of-life (QoL) status in keratoconus severity subgroups using the Keratoconus Outcomes Research Questionnaire (KORQ) and to determine the relationship between the QoL scores and the standard clinical variables. METHODS A cross-sectional study was conducted using prospective, web-based Save Sight Keratoconus Registry data. Rasch analysis was conducted on the KORQ data using the Andrich Rating Scale Model. Comparative analysis included Welch t test and 1-way ANOVA. Associations between visual acuity, corneal curvature, and minimum corneal thickness with KORQ scores were evaluated with Pearson correlation and multiple regression adjusted for age and sex. RESULTS The KORQ was completed by 542 patients with keratoconus (male, 67.7%; mean age, 31.6 years). Keratoconus severity, based on Kmax, was mild [<48 diopter (D)], moderate (48-55 D), and severe (>55 D) in 26.3%, 45.0%, and 28.7% of patients, respectively. Activity limitation (AL) and symptoms (SY) scales of the KORQ had robust psychometric properties including well-functioning response categories, unidimensionality, excellent measurement precision, and satisfactory fit statistics. In a group-wise analysis, the female patients had significantly lower AL and SY scores. Similarly, the severe keratoconus group had the worst AL and SY scores. Contact lens wearers had worse KORQ scores than the spectacles wearers. Overall, statistically significant but weak correlations between KORQ scores and visual acuity and corneal curvature (Kmax and K2) (Pearson r, 0.11-0.35) were observed. The correlations for SY were weaker than for AL scores. CONCLUSIONS Female sex, contact lens wear, reduced visual acuity, and higher disease severity were associated with worse AL and SY scores in keratoconus. Although the correlations between clinical and QoL scores were statistically significant, the low magnitudes suggested a complex relationship between clinical parameters and patient-reported outcomes.
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Affiliation(s)
- Himal Kandel
- The University of Sydney, Save Sight Institute, Sydney Medical School, Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | | | - Vuong Nguyen
- The University of Sydney, Save Sight Institute, Sydney Medical School, Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Jern Yee Chen
- Flinders Medical Centre, Flinders University, Adelaide, Australia; and
| | - Alexander Poon
- The Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
| | - Richard Mills
- Flinders Medical Centre, Flinders University, Adelaide, Australia; and
| | - Stephanie L Watson
- The University of Sydney, Save Sight Institute, Sydney Medical School, Faculty of Medicine and Health, Sydney, New South Wales, Australia
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Zhang J, Wu Y, Sharma B, Gupta R, Jawla S, Bullimore MA. Epidemiology and Burden of Astigmatism: A Systematic Literature Review. Optom Vis Sci 2023; 100:218-231. [PMID: 36749017 PMCID: PMC10045990 DOI: 10.1097/opx.0000000000001998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 01/15/2023] [Indexed: 02/08/2023] Open
Abstract
SIGNIFICANCE This is the first literature review to report the epidemiology, patient burden, and economic burden of astigmatism in the general adult population. The unmet needs of astigmatism patients with coexisting ocular conditions (cataract, glaucoma, dry eye, presbyopia, or macular degeneration) and risks associated with untreated astigmatism are also reviewed and reported. PURPOSE This study aimed to identify, report, and summarize the published literature on epidemiology, patient burden, and economic burden of astigmatism using a systematic literature review. METHODS MEDLINE, EMBASE, and Cochrane Library databases were searched (January 1996 to May 2021). Search results were limited to the English language. Proceedings (2018 to 2021) from ophthalmology congresses were searched along with gray literature using the Google Scholar platform. RESULTS The literature search yielded 6804 citations, of which 125 met the inclusion criteria (epidemiology, 68; patient burden, 60; economic burden, 6). Astigmatism prevalence in the general population varied from 8 to 62%, with higher rates in individuals 70 years or older. The prevalence of with-the-rule astigmatism was higher in individuals 40 years or younger, whereas rates of against-the-rule and oblique astigmatism increased with age. Astigmatic patients experienced decreased vision quality, increased glare (53 to 77%), haloes (28 to 80%), night-time driving difficulties (66%), falls, and spectacle dependence (45 to 85%). Astigmatic patients performed vision-related tasks slower (1 D, 9% slower; 2 D, 29% slower) and made more errors (1 D, 38% more errors; 2 D, 370% more errors) compared with fully corrected individuals. In cataract patients with astigmatism, the annual mean per-patient productivity loss costs ranged from €55 ($71) to €84 ($108), and mean informal care costs ranged from €30 ($39) to €55 ($71) with a mean of 2.3 to 4.1 hours spent on informal care. CONCLUSIONS Uncorrected astigmatism decreases patients' vision-related quality of life, decreases productivity among working-age adults, and poses an economic burden on patients and their families.
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Affiliation(s)
| | - Yifei Wu
- Alcon Vision LLC, Fort Worth, Texas
| | - Bhavna Sharma
- Skyward Analytics Pvt. Ltd., Gurugram, Haryana, India
| | - Ritu Gupta
- Skyward Analytics Pvt. Ltd., Gurugram, Haryana, India
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9
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Mohd-Ali B, Low YC, Mohamad Shahimin M, Arif N, Abdul-Hamid H, Wan Abdul-Halim WH, Mohidin N. Comparison of vision-related quality of life between wearing Orthokeratology lenses and spectacles in myopic children living in Kuala Lumpur. Cont Lens Anterior Eye 2023; 46:101774. [PMID: 36319519 DOI: 10.1016/j.clae.2022.101774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 10/08/2022] [Accepted: 10/18/2022] [Indexed: 01/18/2023]
Abstract
PURPOSE There are limited reports available on the impact of wearing Orthokeratology (ortho-K) lenses on the quality of life of Asian children. This study evaluated and compared vision-related quality of life (VRQoL) between myopic children wearing ortho-K lenses and single-vision spectacles (SVSs), living in Kuala Lumpur, using Paediatric Refractive Error Profile (PREP) questionnaires. METHODS This is a cross sectional study. Myopic children who had been wearing ortho-K and SVSs for 12 months were recruited, and the questionnaires were distributed online. The PREP scores were obtained using a summary scoring method. The Shapiro-Wilk test was used to determine data normality. Unpaired t-test was performed for normally distributed data, and the Mann-Whitney test for non-normally distributed data. P < 0.05 was considered significant. RESULTS A total of 70 subjects participated in this study (45 ortho-K and 25 SVSs), with a mean age of 10.86 ± 0.73 years. The mean scores for all the items were higher in ortho-K than SVS wearers (p < 0.05). With regard to symptoms during ortho-K lens wear at night, <10 % of the subjects reported difficulty falling asleep, itch/burning/dry eyes and foreign body sensation after lens insertion. CONCLUSION Ortho-K improves the vision-related quality of life of myopic school children in Kuala Lumpur. Thus, it should be considered by more local optometrists when managing myopic children.
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Affiliation(s)
- Bariah Mohd-Ali
- Optometry and Vision Science Program & Research Centre for Community Health (REACH), Faculty of Health Sciences, Universiti Kebangsaan, Malaysia.
| | - Yu Chen Low
- Optometry and Vision Science Program & Research Centre for Community Health (REACH), Faculty of Health Sciences, Universiti Kebangsaan, Malaysia
| | - Mizhanim Mohamad Shahimin
- Optometry and Vision Science Program & Research Centre for Community Health (REACH), Faculty of Health Sciences, Universiti Kebangsaan, Malaysia
| | - Norlaili Arif
- Optometry and Vision Science Program & Research Centre for Community Health (REACH), Faculty of Health Sciences, Universiti Kebangsaan, Malaysia
| | | | | | - Norhani Mohidin
- Optometry Centre, Faculty of Health Science, Universiti Teknologi MARA
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10
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Balparda K, Herrera-Chalarca T, Cano-Bustamante M. Standardizing the measurement and classification of quality of life using the Keratoconus End-Points Assessment Questionnaire (KEPAQ): the ABCDEF keratoconus classification. EYE AND VISION 2022; 9:17. [PMID: 35526027 PMCID: PMC9080176 DOI: 10.1186/s40662-022-00288-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 04/17/2022] [Indexed: 12/02/2022]
Abstract
Background Measuring quality of life is of importance in keratoconus. So far, the Keratoconus End-Points Assessment Questionnaire (KEPAQ) is the only keratoconus-specific scale to measure emotional well-being along with functional compromise in this population. Nevertheless, there is still a lack of clarity and standardization as to how KEPAQ scores should be computed and reported. There are also no guidelines for interpretation of classification of quality of life when using this instrument. The purpose of this study is to provide a specific framework on how to grade and classify keratoconus by using the KEPAQ and propose an extension of current classification to encompass subjective compromise. Methods A group of patients with a confirmed diagnosis of keratoconus underwent application of the KEPAQ. First, a Rasch modeling was performed to evaluate the psychometric characteristics of both sub-scales of the instrument. Then, a linear transformation was performed to turn data into a more relatable scale ranging from 0 to 100. Finally, by using Tukey’s Hinges, scores of the KEPAQ were divided in a 1-to-4 scale, allowing for an easy E&F classification system. Results A total of 386 applications of the KEPAQ were included. Analysis provided evidence of the KEPAQ being unidimensional, well-fitted to the Rasch Model, and provided adequate interval-level scores. Linear transformation resulted in a user-friendly final score ranging from 0 to 100, where a higher score translates to having a better quality of life. Two methods of easily computing final score, one by hand and the other one by an Excel file, were constructed. An E&F 1-to-4 classification was proposed, which may work well with the current ABCD classification of keratoconus. Conclusions The KEPAQ is a psychometrically robust scale, which confidently measures both emotional-related and functional-related quality of life in patients with keratoconus. It can be easily computed, and the results are interpretable and classified in a manner similar to that used in the ABCD keratoconus classification, by adding letters ‘E’ for emotional and ‘F’ for functional compromise.
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11
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O'Donovan C, Panthagani J, Aiyegbusi OL, Liu X, Bayliss S, Calvert M, Pesudovs K, Denniston A, Moore D, Braithwaite T. Evaluating patient-reported outcome measures (PROMs) for clinical trials and clinical practice in adult patients with uveitis or scleritis: a systematic review. J Ophthalmic Inflamm Infect 2022; 12:29. [PMID: 36063293 PMCID: PMC9443634 DOI: 10.1186/s12348-022-00304-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 07/09/2022] [Indexed: 12/01/2022] Open
Abstract
Patient reported outcome measures (PROMs) capture impact of disease and treatment on quality of life, and have an emerging role in clinical trial outcome measurement. This study included a systematic review and quality appraisal of PROMs developed or validated for use in adults with uveitis or scleritis. We searched MEDLINE, EMBASE, PsycINFO, CINAHL and grey literature sources, to 5 November 2021. We used established quality criteria to grade each PROM instrument in multiple domains from A (high quality) to C (low quality), and assessed content development, validity, reliability and responsiveness. For instruments developed using classic test theory-based psychometric approaches, we assessed acceptability, item targeting and internal consistency. For instruments developed using Item Response Theory (IRT) (e.g. Rasch analysis), we assessed response categories, dimensionality, measurement precision, item fit statistics, differential item functioning and targeting. We identified and appraised four instruments applicable to certain uveitis types, but none for scleritis. Specifically, the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ), a 3-part PROM for Birdshot retinochoroiditis (Birdshot Disease & Medication Symptoms Questionnaire [BD&MSQ], the quality of life (QoL) impact of Birdshot Chorioretinopathy [QoL BCR], and the QoL impact of BCR medication [QoL Meds], the Kings Sarcoidosis Questionnaire (KSQ), and a PROM for cytomegalovirus retinitis. These instruments had limited coverage for these heterogeneous conditions, with a focus on very rare subtypes. Psychometric appraisal revealed considerable variability between instruments, limited content development, and only one developed using Item Response Theory. In conclusion, there are few validated PROMs for patients with uveitis and none for scleritis, and existing instruments have suboptimal psychometric performance. We articulate why we do not recommend their inclusion as clinical trial outcome measures for drug licensing purposes, and highlight an unmet need for PROMs applicable to uveitis and scleritis.
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Affiliation(s)
- Charles O'Donovan
- School of Immunology and Microbiology, King's College London, London, England.
| | | | - Olalekan Lee Aiyegbusi
- Centre for Patient Reported Outcomes Research (CPROR), Institute of Applied Health Research, Birmingham Health Partners for Regulatory Science and Innovation, and NIHR, Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, B15 2TT, UK
| | - Xiaoxuan Liu
- Institute of Inflammation and Ageing, University of Birmingham, University Hospitals Birmingham, Birmingham, England.,Health Data Research UK, London, England
| | - Susan Bayliss
- Institute of Applied Health Research, University of Birmingham, Birmingham, England
| | - Melanie Calvert
- Centre for Patient Reported Outcomes Research (CPROR), Institute of Applied Health Research, Birmingham Health Partners for Regulatory Science and Innovation, NIHR, Birmingham Biomedical Research Centre, NIHR Surgical Reconstruction and Microbiology Centre and NIHR Applied Research Collaboration West Midlands, University of Birmingham, Birmingham, B15 2TT, UK
| | - Konrad Pesudovs
- University of New South Wales, Kensington, Australia.,Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, UK
| | - Alastair Denniston
- Institute of Inflammation and Ageing, University of Birmingham, University Hospitals Birmingham, Birmingham, England.,Health Data Research UK, London, England
| | - David Moore
- Institute of Applied Health Research, University of Birmingham, Birmingham, England
| | - Tasanee Braithwaite
- School of Immunology and Microbiology, King's College London, London, England.,Institute of Applied Health Research, University of Birmingham, Birmingham, England.,The Medical Eye Unit, Guy's and St Thomas' Hospital NHS Foundation Trust, London, England
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12
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Gothwal VK, Gujar R, Sharma S, Begum N, Pesudovs K. Factors affecting quality of life in keratoconus. Ophthalmic Physiol Opt 2022; 42:986-997. [PMID: 35638140 DOI: 10.1111/opo.13010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 04/30/2022] [Accepted: 05/02/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE To identify the factors affecting the quality of life (QoL) in adults with keratoconus, using the disease-specific Keratoconus Outcomes Research Questionnaire (KORQ). METHODS In this cross-sectional study, 574 patients with keratoconus completed the 29-item KORQ (18-item activity limitations and 11-item symptoms subscales) and demographic information. Based on mean corneal curvature to grade keratoconus severity, participants were categorised into four groups: mild <48 dioptres [D]; moderate: 48 to 53 D; advanced: 54 to 55 D and severe: >55D. Rasch analysis was used to assess the psychometric properties and to score the KORQ. Multivariable regression was performed to determine the independent impact of age, sex, laterality, severity and duration of keratoconus, education, employment status and mode of treatment for keratoconus on activity limitations and symptoms. RESULTS Mean (SD) age was 24.5 (5.1) years. 304 (53%), 160 (28%), 26 (4%) and 84 (15%) belonged to keratoconus groups 1, 2, 3 and 4, respectively. Rasch analysis demonstrated the 'activity limitations' and 'symptoms' KORQ subscales to possess good psychometric properties. Statistically significant associations were found between activity limitation score and the following measures: visual acuity (VA) in the better-seeing eye (r = -0.10, p = 0.01); VA in the worse-seeing eye (r = -0.09, p = 0.04) and ocular aberrations (r = -0.13, p = 0.008) in the worse-seeing eye. Statistically significant associations were also found between symptoms score and mean corneal curvature in the better-seeing eye (r = -0.10, p = 0.02). In regression models, female sex was associated with 21% worse symptom score than male (β = -0.33, 95% CI, -0.09, -0.59, p = 0.01) and working people experienced clinically and statistically significantly greater trouble from symptoms compared to those not working (β =0.44, 95% CI, 0.17, 0.70, p = 0.001). CONCLUSIONS People with keratoconus have poorer QoL in terms of activity limitations if they have poorer VA and greater wavefront aberrations, and in terms of symptoms if they are female and employed.
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Affiliation(s)
- Vijaya K Gothwal
- Patient Reported Outcomes Unit, Brien Holden Eye Research Centre, LV Prasad Eye Institute, Hyderabad, India
| | - Ramkailash Gujar
- Patient Reported Outcomes Unit, Brien Holden Eye Research Centre, LV Prasad Eye Institute, Hyderabad, India
| | - Sujata Sharma
- Patient Reported Outcomes Unit, Brien Holden Eye Research Centre, LV Prasad Eye Institute, Hyderabad, India
| | - Nazia Begum
- Centre for Ocular Regeneration, LV Prasad Eye Institute, Hyderabad, India
| | - Konrad Pesudovs
- The University of New South Wales, Sydney, New South Wales, Australia
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13
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Kandel H, Nguyen V, Piermarocchi S, Ceklic L, Teo K, Arnalich‐Montiel F, Miotto S, Daien V, Gillies MC, Watson SL. Quality of life impact of eye diseases: a Save Sight Registries study. Clin Exp Ophthalmol 2022; 50:386-397. [PMID: 35080803 PMCID: PMC9303885 DOI: 10.1111/ceo.14050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND The objectives of this study were to evaluate the quality-of-life (QoL) impact of eye diseases (keratoconus; neovascular age-related macular degeneration, AMD; retinal vein occlusion, RVO; and diabetic macular edema, DME) using the Impact of Vision Impairment (IVI) questionnaire, and to determine the relationship between the IVI scores and visual acuity. METHODS This cross-sectional, multicentre, real-world study utilised the prospective, web-based Save Sight Registries. The IVI was completed by 1557 patients: 307 with keratoconus, 1049 with AMD, 148 with RVO and 53 with DME. Statistical analysis included Rasch analysis, Welch t-test, one-way ANOVA, Tukey's test, Pearson correlation, and multiple regression. RESULTS The IVI scales (Overall; Visual Function, VF; Emotional, EM) had robust psychometric properties. The keratoconus patients had the worst Overall (adjusted mean: 48.2 vs. DME 58.8, RVO 64.6, AMD 67.6 units), VF (47.7 vs. DME 59.4, RVO 65.9, AMD 68.9 units) and EM (50.8 vs. DME 63.1, RVO 69.2, AMD 71.8 units) scores (all p < 0.05). The IVI scales scores weakly correlated with better and worse eye visual acuity (Pearson's r 0.24-0.39, all p < 0.05). The correlations were similar in the better eye (Overall 0.35, VF 0.39, EM 0.24) and the worse eye (Overall 0.31, VF 0.33, EM 0.25) visual acuity. Correlations with visual acuity were stronger for VF than for the EM scores. CONCLUSIONS The IVI was a psychometrically robust QoL questionnaire. Keratoconus patients had worse IVI scores than patients with retinal diseases. The low strength of correlations between visual acuity and QoL scores, although statistically significant, suggested that a complex relationship exists.
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Affiliation(s)
- Himal Kandel
- Save Sight Institute, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Vuong Nguyen
- Save Sight Institute, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | | | - Lala Ceklic
- Centar za zastitu vida" PaleEastern SarajevoBosnia and Herzegovina
| | - Kelvin Teo
- Singapore National Eye CentreSingapore Eye Research InstituteSingaporeSingapore
| | | | - Stefania Miotto
- Department of OphthalmologyPadua‐Camposampiero HospitalPaduaItaly
| | - Vincent Daien
- OphthalmologyUniversity Hospital MontpellierMontpellierFrance
| | - Mark C. Gillies
- Save Sight Institute, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Stephanie L. Watson
- Save Sight Institute, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
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14
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Beesley J, Davey CJ, Elliott DB. What are the causes of non‐tolerance to new spectacles and how can they be avoided? Ophthalmic Physiol Opt 2022; 42:619-632. [PMID: 35156719 PMCID: PMC9303957 DOI: 10.1111/opo.12961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 01/17/2022] [Accepted: 01/17/2022] [Indexed: 11/26/2022]
Abstract
Purpose To investigate non‐tolerance cases from several UK practices to determine their likely causes and how they might have been avoided. Methods Patient complaint and refraction data were collected from non‐tolerance recheck examinations. For one practice, clinical data were also collected retrospectively to investigate the quality of the eye examinations. Results Data for 279 rechecks were gathered from 10 practices and a recheck frequency of 2.3% was found. The mean patient age was 60 (SD 16) years, with cylinder changes responsible for 38% of prescription‐related causes of rechecks, overplusing or underminusing 26%, and underplusing or overminusing just 11%. An assessment of 242 recheck corrections found that 40% were unsatisfactory (e.g., failed to address initial or recheck symptoms, N = 45) and retrospective analysis of 217 case records showed many limitations (e.g., 61% or 28% recorded no uncorrected or habitual visual acuity (VA) at either initial examination or recheck). Conclusions Given that overplus‐underminus was a much bigger proportion of prescription‐related cases than overminus‐underplus (26% vs. 11%), the refraction mantra of “maximum plus for maximum VA” should be balanced by increased teaching of the problems of overplusing and underminusing, and the use of prescribing guidelines. In addition, continuing professional development regarding the basics of the recheck examination, refraction, visual acuity and prism determination is needed. Changes of oblique cylinders should be carefully considered in older patients as this is a common cause of non‐tolerance. In addition, if the “if it ain't broke, don't fix it” and related maxims had been applied to all patients who were asymptomatic at the original examination, one third of all non‐tolerance cases could have been avoided. Finally, it would seem appropriate for practices to develop a system to deal better with non‐tolerance cases. Perhaps an experienced clinician should examine all patients with non‐tolerance and provide feedback to the original clinician.
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Affiliation(s)
- Jeremy Beesley
- Bradford School of Optometry and Vision Science University of Bradford Bradford UK
| | - Christopher J Davey
- Bradford School of Optometry and Vision Science University of Bradford Bradford UK
| | - David B Elliott
- Bradford School of Optometry and Vision Science University of Bradford Bradford UK
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Hutchinson C, Ratcliffe J, Cleland J, Walker R, Milte R, McBain C, Corlis M, Cornell V, Khadka J. The integration of mixed methods data to develop the quality of life - aged care consumers (QOL-ACC) instrument. BMC Geriatr 2021; 21:702. [PMID: 34911445 PMCID: PMC8672336 DOI: 10.1186/s12877-021-02614-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 11/02/2021] [Indexed: 01/01/2023] Open
Abstract
Background This paper describes the collection and integration of mixed methods data to facilitate the final selection of items for the Quality of Life – Aged Care Consumers (QOL-ACC) instrument. The aim of the wider project is to develop a preference-based quality of life instrument that can be used for quality assessment and economic evaluation. Older people have been involved at every stage of the development of the QOL-ACC to ensure that the final instrument captures their perspectives and preferences. Methods Mixed methods data was collected on draft items for the QOL-ACC instrument across six key quality of life dimensions (mobility, pain management, emotional well-being, independence, social connections, and activities). Qualitative face validity data was collected from older people (aged 66 to 100 years) living in the community and in residential aged care via semi-structured interviews (n = 59). Quantitative data was collected from older people (aged 65 to 91 years) receiving aged care services in the community via an online survey (n = 313). A traffic light pictorial approach was adopted as a practical and systematic way to categorise and present data in a meaningful way that was easy for non-academic workshop members to understand and to be able to discuss the relative merits of each draft item. Results The traffic light approach supported the involvement of consumer and aged care provider representatives in the selection of the final items. Six items were selected for the QOL-ACC instrument with one item representing each of the six dimensions. Conclusions This methodological approach has ensured that the final instrument is psychometrically robust as well as meaningful, relevant and acceptable to aged care consumers and providers. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02614-y.
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Affiliation(s)
- Claire Hutchinson
- Caring Futures Institute, Flinders University, Adelaide, Australia. .,College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.
| | - Julie Ratcliffe
- Caring Futures Institute, Flinders University, Adelaide, Australia.,College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Jenny Cleland
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Ruth Walker
- Caring Futures Institute, Flinders University, Adelaide, Australia.,College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Rachel Milte
- Caring Futures Institute, Flinders University, Adelaide, Australia.,College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Candice McBain
- John Walsh Centre for Rehabilitation Research, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Megan Corlis
- Australian Nursing and Midwifery Federation (SA Branch), Adelaide, Australia
| | | | - Jyoti Khadka
- Caring Futures Institute, Flinders University, Adelaide, Australia.,College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.,Registry of Senior Australians (ROSA), South Australian Health and Medical Research Institute, Adelaide, Australia
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16
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Kandel H. Quality-of-life outcomes of long-term contact lens wear: A systematic review. Cont Lens Anterior Eye 2021; 45:101521. [PMID: 34656447 DOI: 10.1016/j.clae.2021.101521] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 09/28/2021] [Accepted: 09/28/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE The aim of this review was to evaluate the evidence on quality-of-life outcomes of long-term contact lens wear. METHODS A search for original articles that used validated measures to evaluate patient-reported outcomes (PROs) in long-term (≥2 years) contact lens wearers was conducted in Medline Ovid, PubMed, Scopus, Web of Science, Cochrane, CINAHL, and PsycInfo databases. The information including PRO measure (name, type, content) and key quality-of-life outcomes findings were extracted. RESULTS Seven articles that used 4 PRO measures to evaluate quality of life outcomes of long-term contact lens wear met the inclusion criteria. The median (range) number of contact lens wearers in these studies was 116 (31-247). The studies were conducted in 4 countries: USA, Spain, China, and Russia. All studies were conducted in myopic populations. None of the studies provided information on psychometric properties, validity and reliability of the PRO measures used. Five studies were conducted in children of which 3 studies evaluated PROs of myopia control contact lens wear. The studies reported that contact lens wear, including myopia control lens wear, was an effective method of refractive correction in children and adults in the long term in PRO-perspective, and resulted in a better quality of life status than with glasses. However, long-term dry eye and discomfort related symptoms were reported. CONCLUSION Overall, contact lens use improved quality of life status in children and adults. More research is required to better understand the long-term quality-of-life outcomes of contact lens wear.
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Affiliation(s)
- Himal Kandel
- Save Sight Institute, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
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17
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Makateb A, Nabavi A, Naghash Tabrizi M, Hashemian H, Shirzadi K. Reliability and Validity of the Persian Version of Quality of Life Impact of Refractive Correction Questionnaire. J Curr Ophthalmol 2021; 33:431-436. [PMID: 35128190 PMCID: PMC8772492 DOI: 10.4103/joco.joco_56_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 11/04/2022] Open
Abstract
PURPOSE To evaluate the psychometric properties of the Persian version of quality of life impact of refractive correction (QIRC) questionnaire and its utility in assessment of refractive error-related quality of life (QoL) following photorefractive keratectomy (PRK). METHODS Patients with low-to-moderate myopia (-0.75 to - 6.0) were enrolled in this study. Standard alcohol-assisted PRK was performed in all patients. The QIRC questionnaire was translated into a Persian version using the standard method. Patients completed QIRC questionnaire preoperatively and 3-month postoperatively. A group of patients completed the questionnaire twice preoperatively. Psychometric properties were evaluated by internal consistency (Cronbach's α), item-total correlation, and known group construct validity. Intraclass correlation coefficient (ICC) were used to examine the repeatability. RESULTS One hundred forty-seven patients (60 males and 87 females) with a mean age of 26.3 ± 5.5 (range, 18-39) years were enrolled. Cronbach's α for total score was 0.923. Item-total correlation was above 0.3 for all items. ICC was 0.978 for total score. Preoperatively, predominantly contact lens wearers showed significantly better total QIRC score than predominantly spectacle wearers (P = 0.017), which showed good known group validity. Total QIRC score significantly increased from 41.31 ± 6.69 preoperatively to 50.47 ± 7.26 postoperatively (P < 0.0001). Improvement in total QIRC score was observed both in contact lens wearers and spectacle wearers. CONCLUSION The Persian version of QIRC questionnaire is a valid and reliable tool. Refractive error-related QoL assess by QIRC was significantly improved after PRK in an Iranian population.
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Affiliation(s)
- Ali Makateb
- Department of Ophthalomolgy, AJA University of Medical Sciences, Tehran, Iran
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amin Nabavi
- Department of Ophthalomolgy, AJA University of Medical Sciences, Tehran, Iran
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Eye Research Center, Amir Almomenin Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Hesam Hashemian
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Keyvan Shirzadi
- Department of Ophthalomolgy, AJA University of Medical Sciences, Tehran, Iran
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Sankaridurg P, Tahhan N, Kandel H, Naduvilath T, Zou H, Frick KD, Marmamula S, Friedman DS, Lamoureux E, Keeffe J, Walline JJ, Fricke TR, Kovai V, Resnikoff S. IMI Impact of Myopia. Invest Ophthalmol Vis Sci 2021; 62:2. [PMID: 33909036 PMCID: PMC8083082 DOI: 10.1167/iovs.62.5.2] [Citation(s) in RCA: 123] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 12/26/2020] [Indexed: 01/15/2023] Open
Abstract
The global burden of myopia is growing. Myopia affected nearly 30% of the world population in 2020 and this number is expected to rise to 50% by 2050. This review aims to analyze the impact of myopia on individuals and society; summarizing the evidence for recent research on the prevalence of myopia and high myopia, lifetime pathological manifestations of myopia, direct health expenditure, and indirect costs such as lost productivity and reduced quality of life (QOL). The principal trends are a rising prevalence of myopia and high myopia, with a disproportionately greater increase in the prevalence of high myopia. This forecasts a future increase in vision loss due to uncorrected myopia as well as high myopia-related complications such as myopic macular degeneration. QOL is affected for those with uncorrected myopia, high myopia, or complications of high myopia. Overall the current global cost estimates related to direct health expenditure and lost productivity are in the billions. Health expenditure is greater in adults, reflecting the added costs due to myopia-related complications. Unless the current trajectory for the rising prevalence of myopia and high myopia change, the costs will continue to grow. The past few decades have seen the emergence of several novel approaches to prevent and slow myopia. Further work is needed to understand the life-long impact of myopia on an individual and the cost-effectiveness of the various novel approaches in reducing the burden.
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Affiliation(s)
- Padmaja Sankaridurg
- Brien Holden Vision Institute, Sydney, Australia
- School of Optometry and Vision Science, University of New South Wales, New South Wales, Australia
| | - Nina Tahhan
- Brien Holden Vision Institute, Sydney, Australia
- School of Optometry and Vision Science, University of New South Wales, New South Wales, Australia
| | - Himal Kandel
- Save Sight Institute, Sydney Medical School, The University of Sydney, New South Wales, Australia
| | - Thomas Naduvilath
- Brien Holden Vision Institute, Sydney, Australia
- School of Optometry and Vision Science, University of New South Wales, New South Wales, Australia
| | - Haidong Zou
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China
| | - Kevin D. Frick
- Johns Hopkins Carey Business School, Baltimore, Maryland, United States
| | - Srinivas Marmamula
- Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
| | - David S. Friedman
- Glaucoma Center of Excellence, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
| | - Ecosse Lamoureux
- Duke - NUS Medical School, Singapore; Singapore Eye Research Institute, Singapore
| | - Jill Keeffe
- Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
| | - Jeffrey J. Walline
- The Ohio State University College of Optometry, Columbus, Ohio, United States
| | | | - Vilas Kovai
- Health Promotion Service, Population Health, Liverpool Hospital, SWSLHD, Health - New South Wales, New South Wales, Australia
| | - Serge Resnikoff
- Brien Holden Vision Institute, Sydney, Australia
- School of Optometry and Vision Science, University of New South Wales, New South Wales, Australia
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Yang A, Lim SY, Wong YL, Yeo A, Rajeev N, Drobe B. Quality of Life in Presbyopes with Low and High Myopia Using Single-Vision and Progressive-Lens Correction. J Clin Med 2021; 10:1589. [PMID: 33918687 PMCID: PMC8069619 DOI: 10.3390/jcm10081589] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/30/2021] [Accepted: 04/04/2021] [Indexed: 11/26/2022] Open
Abstract
This study evaluates the impact of the severity of myopia and the type of visual correction in presbyopia on vision-related quality of life (QOL), using the refractive status and vision profile (RSVP) questionnaire. A total of 149 subjects aged 41-75 years with myopic presbyopia were recruited: 108 had low myopia and 41 had high myopia. The RSVP questionnaire was administered. Rasch analysis was performed on five subscales: perception, expectation, functionality, symptoms, and problems with glasses. Highly myopic subjects had a significantly lower mean QOL score (51.65), compared to low myopes (65.24) (p < 0.001). They also had a significantly lower functionality score with glasses (49.38), compared to low myopes (57.00) (p = 0.018), and they had a worse functionality score without glasses (29.12), compared to low myopes (36.24) (p = 0.045). Those who wore progressive addition lenses (PAL) in the high-myope group (n = 25) scored significantly better, compared to those who wore single-vision distance (SVD) lenses (n = 14), with perception scores of 61.19 and 46.94, respectively (p = 0.029). Highly myopic presbyopes had worse overall QOL and functionality, both with and without glasses, compared to presbyopes with low myopia. High-myopic PAL users had a better perception outcome than SVD lens wearers. Low-myopic PAL wearers had a better QOL than SVD wearers.
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Affiliation(s)
- Adeline Yang
- Essilor R&D AMERA, Essilor International, Singapore 339346, Singapore; (Y.L.W.); (B.D.)
| | - Si Ying Lim
- School of Chemical & Life Sciences, Singapore Polytechnic, Singapore 139651, Singapore; (S.Y.L.); (N.R.)
| | - Yee Ling Wong
- Essilor R&D AMERA, Essilor International, Singapore 339346, Singapore; (Y.L.W.); (B.D.)
| | - Anna Yeo
- Education & Professional Services, Essilor AMERA, Singapore 339338, Singapore;
| | - Narayanan Rajeev
- School of Chemical & Life Sciences, Singapore Polytechnic, Singapore 139651, Singapore; (S.Y.L.); (N.R.)
| | - Björn Drobe
- Essilor R&D AMERA, Essilor International, Singapore 339346, Singapore; (Y.L.W.); (B.D.)
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Richdale K, Cox I, Kollbaum P, Bullimore MA, Bakaraju RC, Gifford P, Plainis S, McKenney C, Newman S, Tomiyama ES, Morgan PB. CLEAR – Contact lens optics. Cont Lens Anterior Eye 2021; 44:220-239. [DOI: 10.1016/j.clae.2021.02.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 02/01/2021] [Indexed: 12/27/2022]
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Kandel H, Khadka J, Watson SL, Fenwick EK, Pesudovs K. Item banks for measurement of refractive error-specific quality of life. Ophthalmic Physiol Opt 2021; 41:591-602. [PMID: 33650713 DOI: 10.1111/opo.12792] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 11/23/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate the psychometric properties of refractive error-specific quality of life (QoL) item banks and assess their performance using computerised adaptive testing (CAT) simulations. METHODS In this cross-sectional study a 392-item questionnaire, grouped under 11 QoL domains, was interviewer-administered to 305 people with refractive error [mean age ± S.D., 30.5 ± 14.1 (range (18 to 83) years; male, 50.5%; mean ± S.D. spherical equivalent refractive error -2.4 ± 2.9 (range: -15.0 to +11.0) Dioptres; spectacles (n = 257), contact lens (n = 37), refractive surgery (n = 25), uncorrected refractive error (n = 57)]. Rasch analysis was conducted on each QoL domain using the Andrich rating scale model to investigate parameters including response category functioning, person- and item-reliability, infit and outfit statistics, unidimensionality, targeting, differential item functioning and local item dependency. The resulting item banks underwent CAT simulations in 1,000 cases with 'high' and 'moderate' precision stopping rules. RESULTS Rasch analysis iterations resulted in 13 refractive error-specific item banks (Convenience, Health concerns, Economic, Activity limitation, Mobility, Emotional, Social, Visual symptoms frequency, Visual symptoms severity, Visual symptoms bothersome, Comfort symptoms frequency, Comfort symptoms severity and Comfort symptoms bothersome), containing a total of 366 items. The item banks had good psychometric properties including satisfactory measurement precision, infit and outfit statistics and unidimensionality. In CAT simulations, the mean number of items required to achieve high and moderate measurement precision was 9.4 and 4.7, respectively. CONCLUSION Overall, refractive error-specific QoL item banks show promise in their ability to comprehensively and precisely evaluate a range of quality of life parameters. These items banks when administered using a CAT system offer unique outcome tools for implementation in clinical trials, healthcare and research.
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Affiliation(s)
- Himal Kandel
- Save Sight Institute, Discipline of Ophthalmology, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Jyoti Khadka
- Health and Social Care Economics Group, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia.,Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.,Business School, University of South Australia, Adelaide, South Australia, Australia
| | - Stephanie L Watson
- Save Sight Institute, Discipline of Ophthalmology, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Eva K Fenwick
- Centre for Eye Research Australia, The Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Victoria, Australia.,Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Duke-National University of Singapore Medical School, Singapore
| | - Konrad Pesudovs
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
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Abstract
Myopia, also known as short-sightedness or near-sightedness, is a very common condition that typically starts in childhood. Severe forms of myopia (pathologic myopia) are associated with a risk of other associated ophthalmic problems. This disorder affects all populations and is reaching epidemic proportions in East Asia, although there are differences in prevalence between countries. Myopia is caused by both environmental and genetic risk factors. A range of myopia management and control strategies are available that can treat this condition, but it is clear that understanding the factors involved in delaying myopia onset and slowing its progression will be key to reducing the rapid rise in its global prevalence. To achieve this goal, improved data collection using wearable technology, in combination with collection and assessment of data on demographic, genetic and environmental risk factors and with artificial intelligence are needed. Improved public health strategies focusing on early detection or prevention combined with additional effective therapeutic interventions to limit myopia progression are also needed.
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Wisse RPL, Simons RWP, van der Vossen MJB, Muijzer MB, Soeters N, Nuijts RMMA, Godefrooij DA. Clinical Evaluation and Validation of the Dutch Crosslinking for Keratoconus Score. JAMA Ophthalmol 2020; 137:610-616. [PMID: 30920597 DOI: 10.1001/jamaophthalmol.2019.0415] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Importance Defining keratoconus progression is fundamental in clinical decision making because crosslinking treatments are indicated when the disease is considered progressive. Currently, there is no consensus which parameters should be used to define progression. Objective To assess and validate a novel clinical scoring system as an easy-to-use assessment tool for crosslinking treatment in patients with keratoconus. Design, Setting, and Participants Prospective cohort study at 2 academic treatment centers. Patients with keratoconus referred between January 1, 2012, and June 30, 2014, with 2-year follow-up were included. Analysis began March 2017. Interventions The Dutch Crosslinking for Keratoconus (DUCK) score is based on changes in 5 clinical parameters that are routinely assessed: age, visual acuity, refraction error, keratometry, and subjective patient experience. The DUCK score is derived by scoring 0 to 2 points per item, and cutoffs were determined by clinical experience. We compared the DUCK scores to the conventional 1.0-diopter increase in maximum keratometry criterion, within the last 12 months, in a longitudinal discovery and a validation cohort. Sensitivity analyses and intraitem correlations were performed. Main Outcomes and Measures Overall treatment rate reduction and the duly withheld treatment rate. Results A total of 504 eyes of 388 patients were available for analysis on disease progression in the course of 12 and 24 months. Baseline patient characteristics of the discovery cohort and the validation cohort were comparable in terms of age (mean [SD], 26.8 [8.3] years vs 26.3 [9.1]), sex (216 of 332 [65%] vs 123 of 172 [72%] men), and maximum keratometry (mean [SD], 53.5 [7.1] vs 52.7 [6.3]). Adhering to the DUCK score, rather than maximum keratometry, was associated with a reduction in overall treatment rate by 23% (95% CI, 18%-30%), without increasing the risk of disease progression (ie, the rate of progression for both groups was equal; ±0%). The DUCK score appears to better identify eyes that were duly withheld treatment by 35% (95% CI, 22%-49%). Conclusions and Relevance These results provide validation of the DUCK score as a tool to determine whether a crosslinking treatment might be warranted. Compared with the conventional maximum keratometry criterion of more than 1.0 diopter, the DUCK score may better select patients who might benefit from crosslinking treatment. Potentially, it may prevent unnecessary treatments, reduce exposure to treatment risks, and improve the cost effectiveness of crosslinking.
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Affiliation(s)
- Robert P L Wisse
- Department of Ophthalmology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Rob W P Simons
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, Limburg, the Netherlands
| | | | - Marc B Muijzer
- Department of Ophthalmology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Nienke Soeters
- Department of Ophthalmology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Rudy M M A Nuijts
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, Limburg, the Netherlands
| | - Daniel A Godefrooij
- Department of Ophthalmology, University Medical Center Utrecht, Utrecht, the Netherlands
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Petrov SY, Antonov AA, Avetisov KS, Volzhanin AV, Agadzhanyan TM, Aslamazova AE. [Refractive shift after glaucoma surgery]. Vestn Oftalmol 2019; 135:278-285. [PMID: 31691673 DOI: 10.17116/oftalma2019135052278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Filtering glaucoma surgery can affect certain biometric features of the eye: it can change the axial length and anterior chamber depth, while redistribution of mechanical tensions in the fibrous tunic can alter the shape of the cornea. Among these changes that affect refraction, reshaping of corneal curvature is the principle one. Contrary to the expectations, and in contrast to changes associated with cataract surgery, glaucoma surgery led to decrease in vertical corneal radius (steepening) and development of the with-the-rule astigmatism. A number of studies helped reveal the features of corneal astigmatism that appears after glaucoma surgery: its power, duration, possibility of horizontal meridian flattening, influence of topical cytostatic drugs and drainage devices, etc. Potential reasons of astigmatism development were suggested: conjunctival incisions and sutures in the limbal area, quantity and strength of flap sutures, intraocular pressure level, shift of fistula edges, tissue contraction after cauterization, etc. The key role in pathogenesis of the refractive shift due to change of corneal curvature may belong to particularities of wound healing in the cornea and sclera: healing in sclera is similar to one of connective tissue - its ultrastructure undergoes aging process followed by change of rigidity. At the same time, the main reason for the development of corneal astigmatism after glaucoma surgery remains unclear.
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Affiliation(s)
- S Yu Petrov
- Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021
| | - A A Antonov
- Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021
| | - K S Avetisov
- Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021
| | - A V Volzhanin
- Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021
| | - T M Agadzhanyan
- Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021
| | - A E Aslamazova
- I.M. Sechenov First Moscow State Medical University, 8-2 Trubetskaya St., Moscow, Russian Federation, 119991
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Psychometric Properties of the Keratoconus Outcomes Research Questionnaire: A Save Sight Keratoconus Registry Study. Cornea 2019; 39:303-310. [DOI: 10.1097/ico.0000000000002169] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Abstract
SIGNIFICANCE Existing patient-reported outcome instruments in refractive error are paper-based questionnaires. They are not comprehensive and psychometrically robust. This study has identified the content of the refractive error-specific item banks that aim to provide comprehensive and scientific measurement of refractive error-specific quality of life. PURPOSE The purpose of this study was to identify minimally representative, optimally informative, and efficient sets of items for measuring quality of life in people with refractive error. METHODS First, items were identified from existing patient-reported outcome instruments. Second, items were developed from qualitative studies with people with refractive error (48 and 101 in-depth interviews in Australia and Nepal, respectively). Third, classification and selection of items were done based on a set of systematic criteria using an iterative process of binning and winnowing. The resulting items underwent cognitive testing with people with refractive error in Australia and in Nepal. Each step was guided by an expert panel consensus. RESULTS We retrieved 792 items from the existing patient-reported outcome instruments. From the interviews conducted in Australia, a total of 2367 comments were coded into 807 initial items. Similarly, from the interviews conducted in Nepal, 3477 comments were coded into 914 initial items. After binning and winnowing, followed by cognitive testing, a final set of items comprising 337 items for the Item-pool (Australia) and 308 items for the Item-pool (Nepal), both spanning 12 domains, was obtained. Forty-seven percent of items were common across the two item pools. In the Item-pool (Nepal), 65% items were common for corrected and uncorrected refractive error. CONCLUSIONS We identified the content of two different sets of item banks to comprehensively measure the impact of refractive error on quality of life for people in Australia and Nepal, which may be applicable to high-income country settings and low- and middle-income country settings, respectively. Future work aims to develop computer-adaptive testing system to administer the item banks, resulting in useful measurement tools for researchers, clinicians, and policy planners.
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Chiam NP, Mehta JS. Comparing Patient-Reported Outcomes of Laser In Situ Keratomileusis and Small-Incision Lenticule Extraction: A Review. Asia Pac J Ophthalmol (Phila) 2019; 8:377-384. [PMID: 31478935 PMCID: PMC6784778 DOI: 10.1097/apo.0000000000000258] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 07/30/2019] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Laser in situ keratomileusis (LASIK) and small-incision lenticule extraction (SMILE) are popular refractive surgeries. The objective refractive outcomes of LASIK and SMILE have been studied extensively; both procedures have comparable safety, efficacy, and predictability. However, owing to various psychosocial factors, refractive patients may report dissatisfaction despite good postoperative vision. Hence the importance of studies on subjective patient-reported outcomes. This review discusses the role of psychometric-technique-based validated questionnaires when evaluating subjective outcomes. It also summarizes the literature on patient-reported outcomes for LASIK and SMILE. DESIGN A literature search was performed on PubMed database to identify studies that have assessed patient-reported outcomes for LASIK and SMILE. RESULTS Several studies have looked into patient-reported outcome measures for LASIK, but the number of equivalent studies for SMILE is limited. Questionnaires (validated and non-validated) are used to evaluate patient-reported outcomes. Validated questionnaires are designed based on psychometric techniques, such as Classic Test Theory, Item Response Theory, and Rasch analysis. The Quality of Life Impact of Refractive Correction (QIRC) questionnaire, a validated questionnaire administered to both LASIK and SMILE patients, suggests that both groups have comparable vision-related quality of life in the first few months postoperatively; but SMILE might confer a slight advantage in the later postoperative period (postoperative month 6). CONCLUSIONS Future LASIK-SMILE comparative studies utilizing standardized validated questionnaires for patient-reported outcome measures with longer follow-up durations would be a welcome contribution to this important aspect of refractive surgery.
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Affiliation(s)
| | - Jodhbir S. Mehta
- Singapore National Eye Centre, Singapore
- Singapore Eye Research Institute, Singapore
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Sencanic I, Gazibara T, Dotlic J, Stamenkovic M, Jaksic V, Bozic M, Grgurevic A. Glaucoma Symptom Scale: Psychometric properties of the Serbian version. PLoS One 2019; 14:e0216920. [PMID: 31107903 PMCID: PMC6527221 DOI: 10.1371/journal.pone.0216920] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Accepted: 05/01/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose The study aim was to translate and validate the Glaucoma Symptom Scale (GSS) in Serbian language. Methods Clinical parameters and socio-demographic data were collected for each of the 177 enrolled glaucoma patients. Each eye was classified according to the Glaucoma staging system by Mills into 6 stages. Patients filled out the GSS and National Eye Institute Visual Function Questionnaire (NEI-VFQ 25). The GSS comprises 10 complaints common for glaucoma patients on a topical treatment, grouped into two subscales: SYMP-6 (non-visual) and FUNC-4 (visual problems). The GSS was translated following the customary methodology and its psychometric properties were assessed by using both Classical Test Theory (CTT) and Rasch analysis. Results The internal consistency of the Serbian GSS for the whole scale was very good (Cronbach’s alpha = 0.81). On factor analysis items were clustered into 2 factors (48.92% of variance) which corresponded to the original scale. The total and subscale GSS scores correlated significantly with measures of disease severity and also with total score and analogous NEI-VFQ 25 subscale scores. In Rasch analysis we obtained adequate item reliability index (0.90). Almost all items had infit and outfit mean squares in the accepted range. However, measurement precision was poor (low person separation reliability) and targeting revealed a ceiling effect. Conclusion When analyzed with CTT the Serbian version of the GSS seems to be a valid instrument, but Rasch analysis revealed some serious measurement flaws, therefore it should not be used in its current format. Further studies to modify and improve GSS are needed prior to its application for Serbian glaucoma patients.
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Affiliation(s)
- Ivan Sencanic
- Clinic for Eye Disease “Prof. dr Ivan Stankovic”, University Medical Center “Zvezdara”, Belgrade, Serbia
| | - Tatjana Gazibara
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Jelena Dotlic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic of Obstetrics and Gynecology Clinical Center of Serbia, Belgrade, Serbia
| | - Miroslav Stamenkovic
- Clinic for Eye Disease “Prof. dr Ivan Stankovic”, University Medical Center “Zvezdara”, Belgrade, Serbia
- Faculty of Special Education and rehabilitation, University of Belgrade, Belgrade, Serbia
| | - Vesna Jaksic
- Clinic for Eye Disease “Prof. dr Ivan Stankovic”, University Medical Center “Zvezdara”, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Marija Bozic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Eye Disease “Prof. dr Djordje Nesic”, Clinical Center of Serbia, Belgrade, Serbia
| | - Anita Grgurevic
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- * E-mail:
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Grzybowski A, Kanclerz P, Muzyka-Woźniak M. Methods for evaluating quality of life and vision in patients undergoing lens refractive surgery. Graefes Arch Clin Exp Ophthalmol 2019; 257:1091-1099. [PMID: 30824995 DOI: 10.1007/s00417-019-04270-w] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 01/16/2019] [Accepted: 02/11/2019] [Indexed: 10/27/2022] Open
Abstract
PURPOSE Cataract surgery has evolved into a procedure that generally yields the best postoperative refractive result attainable. Patients with multifocal intraocular lenses (IOLs) present higher rates of spectacle independence, although reduced intermediate vision, dysphotopsias, and a loss of image quality might also be experienced. The aim of the study was to review the methods for assessing quality of life and vision in patients undergoing lens refractive surgery in randomized controlled trials. METHODS We reviewed the PubMed web platform to identify relevant studies using the following keywords: quality of life, quality of vision, lens surgery, lens exchange, refractive lens exchange, cataract, cataract surgery, intraocular lens, IOL, multifocal, and monovision. RESULTS An increasing number of studies have focused on patient-reported outcomes (PROs). Only a few of the available visual function questionnaires can be regarded as useful in lens refractive surgery with multifocal IOL implantation. Many self-developed questionnaires have emerged that have not been adequately validated or found to feature properly evaluated repeatability, hampering the possibility of comparing outcomes. CONCLUSIONS This review describes the existing PROs instruments and informs the choice of an appropriate measure in lens refractive surgery. Rasch-developed tools should be utilized for measuring quality of life and vision in patients undergoing lens refractive surgery and there is a number of highly robust tools available.
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Affiliation(s)
- Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland. .,Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Gorczyczewskiego 2/3, 60-554, Poznan, Poland.
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Kandel H, Khadka J, Shrestha MK, Sharma S, Neupane Kandel S, Dhungana P, Pradhan K, Nepal BP, Thapa S, Pesudovs K. Uncorrected and corrected refractive error experiences of Nepalese adults: a qualitative study. Ophthalmic Epidemiol 2017; 25:147-161. [PMID: 28985110 DOI: 10.1080/09286586.2017.1376338] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE The aim of this study was to explore the impact of corrected and uncorrected refractive error (URE) on Nepalese people's quality of life (QoL), and to compare the QoL status between refractive error subgroups. METHODS Participants were recruited from Tilganga Institute of Ophthalmology and Dhulikhel Hospital, Nepal. Semi-structured in-depth interviews were conducted with 101 people with refractive error. Thematic analysis was used with matrices produced to compare the occurrence of themes and categories across participants. Themes were identified using an inductive approach. RESULTS Seven major themes emerged that determined refractive error-specific QoL: activity limitation, inconvenience, health concerns, psycho-social impact, economic impact, general and ocular comfort symptoms, and visual symptoms. Activity limitation, economic impact, and symptoms were the most important themes for the participants with URE, whereas inconvenience associated with wearing glasses was the most important issue in glasses wearers. Similarly, possibilities of having side effects or complications were the major concerns for participants wearing contact lens. In general, refractive surgery addressed socio-emotional impact of wearing glasses or contact lens. However, the surgery participants had concerns such as possibility of having to wear glasses again due to relapse of refractive error. CONCLUSION Impact of refractive error on people's QoL is multifaceted. Significance of the identified themes varies by refractive error subgroups. Refractive correction may not always address QoL impact of URE but often add unique QoL issues. This study findings also provide content for developing an item-bank for quantitatively measuring refractive error-specific QoL in developing country setting.
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Affiliation(s)
- Himal Kandel
- a NHMRC Centre for Clinical Eye Research , Flinders University , Adelaide , Australia
| | - Jyoti Khadka
- a NHMRC Centre for Clinical Eye Research , Flinders University , Adelaide , Australia
| | | | | | | | | | | | - Bhagavat P Nepal
- e Department of Ophthalmology, Dhulikhel Hospital , Kathmandu University , Kavre , Nepal
| | - Suman Thapa
- b Tilganga Institute of Ophthalmology , Kathmandu , Nepal
| | - Konrad Pesudovs
- a NHMRC Centre for Clinical Eye Research , Flinders University , Adelaide , Australia
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