Abstract
The Visual Functioning-14 (VF-14) scale is the most widely employed index of vision-related functional impairment and serves as a patient-reported outcome measure in vision-specific quality of life. The purpose of this study is to rigorously examine and validate the VF-14 scale on a Greek population of ophthalmic patients employing Rasch measurement techniques. Two cohorts of patients were sampled in two waves. The first cohort included 150 cataract patients and the second 150 patients with other ophthalmic diseases. The patients were sampled first while pending surgical or other corrective therapy and two months after receiving therapy. The original 14-item VF-14 demonstrated poor measurement precision and disordered response category thresholds. A revised eight-item version, the VF-8G (‘G’ for ‘Greek’), was tested and confirmed for validity in the cataract research population. No differential functioning was reported for gender, age, and underlying disorder. Improvement in the revised scale correlated with improvement in the mental and physical component of the general health scale SF-36. In conclusion, our findings support the use of the revised form of the VF-14 for assessment of vision-specific functioning and quality of life improvement in populations with cataracts and other visual diseases than cataracts, a result that has not been statistically confirmed previously.
Highlights
The principal aim of this study is to assess a Greek version of the Visual Functioning-14 (VF-14) using Rasch analysis and test its applicability in patients suffering from ophthalmic disease, including cataracts and other causes
The VF-14 showed a poor result in the fit statistics with a large number of items exhibiting MSNQ higher than 1.5
The principal component analysis (PCA) of the revised VF-8G had 64.6% of raw variance explained by the measures while the unexplained variance by the first contrast of the residuals was 1.99 eigenvalue units, demonstrating better unidimensionality than the VF-14
Summary
Patient-reported outcomes measures (PROMs) are the means of assessment that collect any information on patient-reported health, without external interpretation by a clinician or researcher and have gained a significant place in the assessment of treatment for ophthalmic diseases during the last two decades [2]. The reason for their proliferation is that they offer an unbiased indication of the real-life impact of the treatment on the patient’s life, a measure that can be weighed against the cost and burden of the treatment. Its widespread adoption made it a perfect candidate for validity testing with sophisticated psychometric assessment methods such as Rasch analysis [3,4,5,6,7]
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