Objective: To develop a Rasch-based item bank for the assessment of Cataract-specific patient-reported outcomes (PROs) that can be evaluated precisely, comprehensively and dynamically. Methods: In this cross-sectional study, patients diagnosed with cataract in the Eye Hospital of Wenzhou Medical University
were enrolled. Cataract patients answered an item pool of cataract PROs that was established by following the guidelines of the intemational PRO development process. Rasch analysis was used to test the category probability curve (CPC), measure precision, infit/outfit MNSQ, unidimensionality, targeting and differential
item functioning (DIF). The items were refined until reliable characteristics were developed for the item bank. A Pearson correlation analysis was used to test each dimension for its correlation with visual acuity.Results: A total of 296 patients (130 males) were recruited for this study. Of those, 60.1% were illiterate
with a median age of 70 years, an interquartile range of 63 t0 77 years, and a preoperative binocular visual acuity (LogMAR) range from 0.0 t0 3.0 (median 0.6). The conceptual framework of the item bank consisted of three domains. The Rasch analysis led to the following item banks: "Vision-related activity limitation" (23
items), "Visual symptoms" (14 items) and "Emotional well-being" (11 items). A11 items had four response options. The vision-related activity limitation domain had a category threshold order of -1.84, 0.04, 1.79,a person separation reliability/person separation index (PSR/PSD of 0.93/3.59. an eigenvalue of principal
component analysis of 2.61, and targeting of -0.81 none of the items had a DIF. This domain had a moderate correlation with better visual acuity (r-0.619, P<O.OI) and binocular visual acuity (r-0.622, P<O.OI). The vision symptoms domain had a category threshold order of -1.83. -0.18, 2.00, a PSR/PSI of 0.88/2.68, an
eigenvalue of principal components analysis of 2.53, and targeting of -1.35. Two items showing a DIF of ocular comorbidities. This domain had a moderate correlation with better visual acuity (r-0.482, P<O.OI)and binocular visual acuity (,-0.492, P<O.OI). The emotional well-being domain had a category threshold
order of 2.83, 0.03, 2.80, a PSR/PSI of 0.88/2.68, an eigenvalue of principal components analysis of 2.79,targeting of 0.34. None of the items had a DIF. This domain showed moderate correlation with better visual acuity (r-0.425, P<O.01) and binocular visual acuity (F=0.426, P<O.01). A11 items were trimmed to meet the
goodness of fit statistic criteria of 0.50-1.50. Conclusions: This study, which is based on the Rasch analysis,developed a cataract item bank that covers all three common concern domains of cataract patients. It is a comprehensive assessment denoting the PROs of cataract patients and is easy to understand and administer.It not only shows perfect psychometric properties but is also appropriate f'or measuring PROs in Chinese cataract patients.
黄锦海,朱森淼,涂瑞雪,章思芳,刘艳华,赵陈培,彭芳丽,曹思,王勤,高蓉蓉. 白内障患者报告结局条目库的研制[J]. 中华眼视光学与视觉科学杂志, 2017, 19(9): 518-527.
Jinhai Huang,Senmiao Zhu,Ruixue Tu,Sifang Zhang,Yanhua Liu,Chenpei Zhao,Fangli Peng,Si Cao,Qinmei Wang,Rongrong Gao. The Development of a Cataract-specific Item Bank to Measure Patient-reported Outcomes. Chinese Journal of Optometry Ophthalmology and Visual science, 2017, 19(9): 518-527. DOI: 10.3760/cma.j .issn. 1674-845X.2017.09.002
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