ORCID Profile
0000-0003-1012-2119
Current Organisations
Flinders University
,
University of South Australia
,
South Australian Health and Medical Research Institute
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Publisher: Informa UK Limited
Date: 11-2017
DOI: 10.1111/CXO.12495
Abstract: The aim was to develop and validate an instrument to measure job satisfaction in eye-care personnel and assess the job satisfaction of one-year trained vision technicians in India. A pilot instrument for assessing job satisfaction was developed, based on a literature review and input from a public health expert panel. Rasch analysis was used to assess psychometric properties and to undertake an iterative item reduction. The instrument was then administered to vision technicians in vision centres of Andhra Pradesh in India. Associations between vision technicians' job satisfaction and factors such as age, gender and experience were analysed using t-test and one-way analysis of variance. Rasch analysis confirmed that the 15-item job satisfaction in eye-care personnel (JSEP) was a unidimensional instrument with good fit statistics, measurement precisions and absence of differential item functioning. Overall, vision technicians reported high rates of job satisfaction (0.46 logits). Age, gender and experience were not associated with high job satisfaction score. Item score analysis showed non-financial incentives, salary and workload were the most important determinants of job satisfaction. The 15-item JSEP instrument is a valid instrument for assessing job satisfaction among eye-care personnel. Overall, vision technicians in India demonstrated high rates of job satisfaction.
Publisher: Wiley
Date: 13-08-2012
Publisher: Sissa Medialab
Date: 27-06-2019
DOI: 10.22323/1.352.0135
Publisher: BMJ
Date: 11-2022
DOI: 10.1136/BMJOPEN-2022-066390
Abstract: The Registry of Senior Australians (ROSA) was established to evaluate aged care experiences in Australia. In this manuscript, we describe the ROSA framework, the two ROSA cohorts, highlights from research findings, and future plans. The South Australian ROSA Prospective Cohort (August 2018–June 2020) enrolled 26 605 participants, of which 59.2% (N=15 745) are women, with a median age of 83 (interquartile range (IQR) 77–88). The National ROSA Historical Cohort (January 2002–June 2020) includes 1 694 206 participants with an aged care eligibility assessment, of which 59.1% (N=1 001 705) are women and the median age is 78 (IQR 72–83). Most research using the ROSA has focused on dementia, service accessibility, quality and safety of care, falls and injuries and quality use of medicines. The ROSA has also examined the experience of in iduals with highly prevalent and understudied conditions in aged care settings (eg, eye and mental health) and aspects of services (eg, built environment) and innovation (eg, mobile radiological services) that can affect older people’s health. Important learnings from the ROSA’s development include the significant resources and multidisciplinary expertise required for establishing this platform. Between 2018 and 2022, 43 academic publications, eight reports of the Australian Government Royal Commission into Aged Care Quality and Safety, and several reports to state health authorities and professional societies have used the ROSA. Our plans include to: (1) continue delivering high-quality evidence to support the improvement of ageing and aged care services (2) influence and improve the quality of research in and for the aged care sector (3) expand scope to facilitate examining aims in more depth (4) include future aged care sector data collections within the ROSA (5) inform best practices and innovate how consumer engagement occurs in research (6) monitor and evaluate the impact of the 2021 Australian Aged Care Reforms.
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 17-07-2014
Abstract: To translate, culturally adapt, and validate the original and previously validated shorter versions of the Visual Function Index (VF-14) questionnaire in a Chinese population. The VF-14 was completed by patients with cataract. The analysis was carried out in three phases: phase I, testing whether the VF-14 and its valid shorter versions,VF-8R and VF-11R, form valid scales in Chinese settings using Rasch analysis phase II, developing completely new Chinese versions of the VF-14 phase III, testing whether the previously validated shorter versions of the VF-14 could be applied in a Chinese population. This was tested by assessing the agreement between the new Chinese (developed in phase II) and the previously validated shorter versions of the VF-14 using Bland-Altman plots. A total of 456 patients (median age, 70 years range, 40-92 years females, 58%) completed the Chinese translated version of the VF-14. The VF-14 and the VF-11R demonstrated good Rasch based psychometric properties when a grossly misfitting item was removed. The VF-8R formed a valid scale without any modification. The scores of the VF-11R and the Chinese shorter version (VF-11RChin) showed very good agreement, with a mean difference of -0.18 logits and 95% limits of agreement between 0.11 and -0.47. The Chinese translated VF-14, VF-11R, and VF-8R were valid and could be applied to assess cataract outcomes in Chinese settings. The existing shorter version had good agreement with the new Chinese version, which signifies that there was no need to develop a different version of the VF-14 in China.
Publisher: Informa UK Limited
Date: 20-12-2021
Publisher: Springer Science and Business Media LLC
Date: 03-2018
Publisher: Elsevier BV
Date: 08-2018
Publisher: Elsevier BV
Date: 08-2012
Publisher: Oxford University Press (OUP)
Date: 02-07-2021
Abstract: (i) to describe the general practitioner utilisation of health assessments, management plans, coordination of team care arrangements and medication review item numbers within 6 months of an aged care eligibility assessment for home care packages (HCP) and (ii) investigate the impact of health assessments on the risk of mortality and entry into permanent residential aged care (PRAC) of in iduals accessing HCP. retrospective cohort study utilising data from the Registry of Senior Australians (ROSA) was conducted. 75,172 in iduals aged ≥75 years who received HCP between 2011 and 2015. for objective 1: the use of comprehensive assessments (Medicare Benefits Schedule (MBS) items 705 or 707), management plans (MBS 721), coordination of team care arrangements (MBS 723), and medication reviews (MBS 900). For objective 2: time to death and entry into PRAC. of the 75,172 in iduals, 28.2% (95% confidence interval (CI): 27.8–8.5%) had comprehensive assessments, 36.7% (95% CI: 36.3–37.0%) had management plans, 33.0% (95% CI: 32.7–33.3%) received coordination of team care arrangements and 5.4% (95% CI: 5.2–5.5%) had medication reviews. In iduals with a comprehensive assessment had a 5% lower risk of mortality (adjusted hazard ratio (aHR), 95% CI = 0.95, 0.92–0.98) but 5% higher risk of transition to PRAC (adjusted subdistribution HRs, 95% CI = 1.05, 1.02–1.08) compared to those who did not have these services. the utilisation of health assessments was associated with a lower risk of mortality. There is an opportunity for increased use of item numbers in frailer in iduals.
Publisher: Elsevier BV
Date: 11-2021
Publisher: BMJ
Date: 27-05-2010
Abstract: To develop and validate a short questionnaire to assess self-reported visual ability in children and young people with a visual impairment. A list of 121 items was generated from 13 focus groups with children and young people with and without a visual impairment. A long 89-item questionnaire was piloted with 45 visually impaired children and young people using face-to-face interviews. Rasch analysis was used to analyse the response category function and to facilitate item removal ensuring a valid unidimensional scale. The validity and reliability of the short questionnaire were assessed on a group of 109 visually impaired children (58.7% boys median age 13 years) using Rasch analysis and intraclass correlation coefficient (ICC). The final 25-item questionnaire has good validity and reliability as demonstrated by a person separation index of 2.28 and reliability coefficient of 0.84. The items are well targeted to the subjects with a mean difference of -0.40 logit between item and person means, and an ICC of 0.89 demonstrates good temporal stability. The Cardiff Visual Ability Questionnaire for Children (CVAQC) is a short, psychometrically robust and a self-reported instrument that works to form a unidimensional scale for the assessment of the visual ability in children and young people with a visual impairment.
Publisher: Research Square Platform LLC
Date: 04-08-2020
DOI: 10.21203/RS.3.RS-50156/V1
Abstract: Background To develop and validate an item bank using existing items from both preference and non-preference-based health-related quality of life (HRQoL) instruments targeted for application with adolescent populations. Methods Australian adolescents completed the Child Health Utility 9D (CHU9D), demographic details, self-rated health status, disability and one other instrument (either preference-based: Health Utilities Index (HUI) or EuroQoL-5 Dimension-Youth (EQ-5D-Y) or Assessment of Quality of Life (AQoL)-6D Adolescent or non-preference-based: Pediatric Quality of Life Inventory (PedsQL) Short Form 15 or KIDSCREEN-10) using online survey portals. Data from all the instruments were pooled together to create an item bank, which was then subjected to Rasch analysis to tests its psychometric properties. Validity of the item bank was assessed by testing its ability to discriminate varying levels of self-reported health, disability and socio-economic status (as approximated by the Family Affluence Scale). Results A total of 4,352 Australian adolescents aged 11–17 years from the general population participated. The CHU9D (common instrument) items were used as anchor items to create the item bank. Rasch analysis demonstrated that 2 of the 75 items (2.7%) misfit and were removed from the item bank. The 73-item item bank had adequate precision, no misfitting items, no item bias and demonstrated sufficient unidimensionality. In general boys exhibited higher HRQoL scores than girls (p = 0.001). More severe health status/disability and lower socio-economic status being associated with lower HRQoL (p 0.0001). Conclusions The item bank demonstrated adequate Rasch-based psychometric properties and validity demonstrating the feasibility of the construction of an item bank in this context. The addition of more targeted items for adolescents in the general population and the addition of participants with more health impairments may improve the general applicability of the item bank for both general population and patient cohorts.
Publisher: Elsevier BV
Date: 05-2011
DOI: 10.1053/J.AJKD.2010.12.018
Abstract: Planned early initiation of dialysis therapy based on estimated kidney function does not influence mortality and major comorbid conditions, but amelioration of symptoms may improve quality of life and decrease costs. Patients with progressive chronic kidney disease and a Cockcroft-Gault estimated glomerular filtration rate of 10-15 mL/min/1.73 m(2) were randomly assigned to start dialysis therapy at a glomerular filtration rate of either 10-14 (early start) or 5-7 mL/min/1.73 m(2) (late start). Of the original 828 patients in the IDEAL (Initiation of Dialysis Early or Late) Trial in renal units in Australia and New Zealand, 642 agreed to participate in this cost-effectiveness study. STUDY PERSPECTIVE & TIMEFRAME: A societal perspective was taken for costs. Patients were enrolled between July 1, 2000, and November 14, 2008, and followed up until November 14, 2009. Planned earlier start of maintenance dialysis therapy. Difference in quality of life and costs. Median follow-up of patients (307 early start, 335 late start) was 4.15 years, with a 6-month difference in median duration of dialysis therapy. Mean direct dialysis costs were significantly higher in the early-start group ($10,777 95% CI, $313 to $22,801). Total costs, including costs for resources used to manage adverse events, were higher in the early-start group ($18,715 95% CI, -$3,162 to $43,021), although not statistically different. Adjusted for differences in baseline quality of life, the difference in quality-adjusted survival between groups over the time horizon of the trial was not statistically different (0.02 full health equivalent years 95% CI, -0.09 to 0.14). Missing quality-of-life questionnaires and skewed cost data, although similar in each group, decrease the precision of results. Planned early initiation of dialysis therapy in patients with progressive chronic kidney disease has higher dialysis costs and is not associated with improved quality of life.
Publisher: Springer Science and Business Media LLC
Date: 11-2020
DOI: 10.1140/EPJC/S10052-020-08509-3
Abstract: A search is presented for four-top-quark production using an integrated luminosity of 139 fb $$^{-1}$$ - 1 of proton–proton collision data at a centre-of-mass energy of $$13~\\text {TeV}$$ 13 TeV collected by the ATLAS detector at the LHC. Events are selected if they contain a same-sign lepton pair or at least three leptons (electrons or muons). Jet multiplicity, jet flavour and event kinematics are used to separate signal from the background through a multivariate discriminant, and dedicated control regions are used to constrain the dominant backgrounds. The four-top-quark production cross section is measured to be $$24^{+7}_{-6}$$ 24 - 6 + 7 fb. This corresponds to an observed (expected) significance with respect to the background-only hypothesis of 4.3 (2.4) standard deviations and provides evidence for this process.
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 19-12-2017
Abstract: The purpose of this study was to assess the psychometric properties of diabetic retinopathy (DR) and diabetic macular edema (DME) quality-of-life (QoL) item banks and determine the utility of the final calibrated item banks by simulating a computerized adaptive testing (CAT) application. In this clinical, cross-sectional study, 514 participants with DR/DME (mean age ± SD, 60.4 ± 12.6 years 64% male) answered 314 items grouped under nine QoL item pools: Visual Symptoms (SY) Ocular Comfort Symptoms (OS) Activity Limitation (AL) Mobility (MB) Emotional (EM) Health Concerns (HC) Social (SC) Convenience (CV) and Economic (EC). The psychometric properties of the item pools were assessed using Rasch analysis, and CAT simulations determined the average number of items administered at high and moderate precision levels. The SY, MB, EM, and HC item pools required minor amendments, mainly involving removal of six poorly worded, highly misfitting items. AL and CV required substantial modification to resolve multidimensionality, which resulted in two new item banks: Driving (DV) and Lighting (LT). Due to unresolvable psychometric issues, the OS, SC, and EC item pools were not pursued further. This iterative process resulted in eight operational item banks that underwent CAT simulations. Correlations between CAT and the full item banks were high (range, 0.88-0.99). On average, only 3.6 and 7.2 items were required to gain measurement at moderate and high precision, respectively. Our eight psychometrically robust and efficient DR/DME item banks will enable researchers and clinicians to accurately assess the impact and effectiveness of treatment therapies for DR/DME in all areas of QoL.
Publisher: Elsevier BV
Date: 11-2021
Publisher: Wiley
Date: 02-10-2014
DOI: 10.1111/CEO.12413
Abstract: The aim of this study was to develop and validate a new vision-specific quality of life (VS QoL) instrument and to assess the impact of vision impairment and eye disease on the quality of life of adults in Papua New Guinea (PNG). This study was designed as community based cross-sectional. Six hundred fourteen adults aged 18 and above were included in this study. Focus groups and interviews guided development of a 41-item instrument. Two valid subscales of the instrument were obtained using pilot data after an iterative item reduction process guided by Rasch-based parameters. The person measures (in logits) of 614 participants were used to assess quality of life using univariate and multivariate regression analysis. Rasch logits. Rasch analysis confirmed a 17-item instrument containing an 8-item activity limitation subscale and a 9-item well-being subscale. Both subscales were unidimensional and demonstrated good fit statistics, measurement precisions and absence of significant differential item functioning. A consistent deterioration in vision-specific quality of life was independently and significantly associated with levels of vision. Severity of vision impairment and ocular morbidity were independently associated with activity limitation and emotional well-being. Participants with refractive error had lower quality of life score than those with no ocular abnormality but higher score than those with cataract and other eye diseases. The 17-item PNG-VS QoL instrument is a valid and reliable instrument for the assessment of impact of impaired vision on quality of life in PNG. Vision-specific quality of life was significantly worse among participants who were older and less-educated, had lower income and have had ocular morbidities.
Publisher: Springer Science and Business Media LLC
Date: 13-01-2017
DOI: 10.1038/EYE.2016.315
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2014
DOI: 10.1016/J.JCRS.2013.10.040
Abstract: To assess the native and the previously Rasch-modified National Eye Institute Visual Function Questionnaire (NEI VFQ) scales in a Chinese population. Eye Hospital of Wenzhou Medical University, Wenzhou, China. Questionnaire development. Patients on the waiting list for cataract surgery completed the 39-item NEI VFQ (NEI VFQ-39). Rasch analysis was performed in 3 steps as follows: (1) Assess the psychometric properties of the original NEI VFQ. (2) Reassess the previously proposed Rasch-modified NEI VFQ scales by Pesudovs et al. (2010) in Chinese populations. (3) Compare the scores of previously recommended scales of the NEI VFQ with new Rasch-modified scales of the same questionnaire using Bland-Altman plots. Four hundred thirty-five patients (median age 70 years range 35 to 90 years) completed the NEI VFQ-39. Response categories for 4 question types were dysfunctional and therefore repaired. The original NEI VFQ-39 and NEI VFQ-25 showed good measurement precision. However, both versions showed multidimensionality, misfitting items, suboptimum targeting, and nonfunctioning subscales. Using the previously proposed Rasch-modified scales of the NEI VFQ yielded valid measurement of each construct in the 39-item and 25-item questionnaire. Comparison between the earlier proposed NEI VFQ scales and the new versions developed in this population showed good agreement. The original NEI VFQ was once again found to be flawed. The previously proposed Rasch-analyzed versions of the NEI VFQ and the new Chinese versions showed good agreement.
Publisher: Public Library of Science (PLoS)
Date: 13-10-2016
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2020
DOI: 10.1097/J.JCRS.0000000000000084
Abstract: To evaluate the precision of elevation and wavefront aberration measurements with the Pentacam HR (Oculus Optikgeräte GmbH). Flinders University, Australia. Instrument evaluation study. A randomly selected eye of 100 participants was scanned twice with the Pentacam HR by 1 observer on the 3 measurement modes: 25-picture, 50-picture, and cornea fine. A second observer performed 2 scans on the same random eye with the 25-picture mode. Repeatability and reproducibility were assessed using the within-subject SD (S w ) statistic from a 1-way analysis of variance. From the 100 scanned eyes, the higher-order aberration root mean square (RMS) repeatability limit for both elevation and wavefront, and anterior and posterior measurements was 0.03 μm for all 3 measurement modes. Anterior, posterior, and total corneal wavefront Zernike terms were highly precise, with most Zernike terms displaying a repeatability limit of 0.03 μm. The least repeatable measurement was the posterior elevation Zernike term with the 25-picture scan (repeatability limit 1.50 μm). The cornea fine measurement mode provided the most precise measurements. Reproducibility limits (second observer) were similar to repeatability limits with the 25-picture scan mode. The Pentacam HR provided highly precise aberration outputs. The most precise measurements are achievable with the cornea fine measurement mode and wavefront aberrations. One should be cognizant of posterior elevation aberration precision, particularly for lower radial order and higher azimuthal frequency terms. Accounting for tilt and misalignment of aberrations, all RMS and Zernike aberrations were extremely precise (repeatability and reproducibility limit less than 0.000001 μm).
Publisher: Springer Science and Business Media LLC
Date: 12-2021
DOI: 10.1186/S12877-021-02614-Y
Abstract: 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. 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. 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. 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.
Publisher: Wiley
Date: 26-05-2011
DOI: 10.1111/J.1475-1313.2011.00851.X
Abstract: The ever-expanding choice of ocular metrology and imaging equipment has driven research into the validity of their measurements. Consequently, studies of the agreement between two instruments or clinical tests have proliferated in the ophthalmic literature. It is important that researchers apply the appropriate statistical tests in agreement studies. Correlation coefficients are hazardous and should be avoided. The 'limits of agreement' method originally proposed by Altman and Bland in 1983 is the statistical procedure of choice. Its step-by-step use and practical considerations in relation to optometry and ophthalmology are detailed in addition to s le size considerations and statistical approaches to precision (repeatability or reproducibility) estimates.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2019
DOI: 10.1097/OPX.0000000000001459
Abstract: The Indian translated and culturally adapted version of the vision-related activity limitation (VRAL) item bank is a validated instrument to assess the difficulty in performing daily activities by cataract patients and can also be used to capture self-reported changes in ability to perform daily activities after cataract surgery. The purpose of this study was to document ( a ) translation, cross-cultural adaptation of VRAL item bank into an Indian language, and ( b ) its validation using Rasch analysis in a South Indian cataract population. At the first stage, a translated Indian version of VRAL item bank was produced using recommended procedures. At the second stage, Rasch analysis was performed to investigate its psychometric properties in 787 cataract patients (mean age, 58.2 years mean ± SD visual acuity [logMAR], 1.19 ± 0.96 at baseline in eye for surgery) including comparison with the original version. Post-translation equivalence of meaning was achieved, but some English phrases required cross-cultural adaptation. Subsequently, all items were appropriate for the Indian culture, and VRAL item bank demonstrated excellent measurement precision (7.39). Dimensionality assessment suggested that VRAL construct may contain other dimensions such as self-care and visual search, and mobility. Self-care and visual search formed a unidimensional measure but was highly correlated with main VRAL dimension, and the removal of its items weakened precision of the main VRAL dimension measurement. Taken together, evidence favored retaining self-care and visual search items in a larger VRAL item bank. Mobility subscale lacked adequate measurement precision, so it was not examined further again, items were retained in VRAL scale because they strengthened its measurement properties. Majority of items (99%) did not demonstrate notable differential item functioning ( .0 logit) by presenting visual acuity (median, 0.20 logMAR) in the better-seeing eye. Items in the translated Indian VRAL item bank measure the same construct as the English version and fulfilled the psychometric requirements for use in cataract patients.
Publisher: Springer Science and Business Media LLC
Date: 12-09-2019
DOI: 10.1007/S40258-019-00512-4
Abstract: Older people (aged 65 years and over) are the fastest growing age cohort in the majority of developed countries, and the proportion of in iduals defined as the oldest old (aged 80 years and over) living with physical frailty and cognitive impairment is rising. These population changes put increasing pressure on health and aged care services, thus it is important to assess the cost effectiveness of interventions targeted for older people across health and aged care sectors to identify interventions with the strongest capacity to enhance older peoples' quality of life and provide value for money. Cost-utility analysis (CUA) is a form of economic evaluation that typically uses preference-based instruments to measure and value health-related quality of life for the calculation of quality-adjusted life-years (QALYS) to enable comparisons of the cost effectiveness of different interventions. A variety of generic preference-based instruments have been used to measure older people's quality of life, including the Adult Social Care Outcomes Toolkit (ASCOT) Health Utility Index Mark 2 (HUI2) Health Utility Index Mark 3 (HUI3) Short-Form-6 Dimensions (SF-6D) Assessment of Quality of Life-6 dimensions (AQoL-6D) Assessment of Quality of Life-8 dimensions (AQoL-8D) Quality of Wellbeing Scale-Self-Administered (QWB-SA) 15 Dimensions (15D) EuroQol-5 dimensions (EQ-5D) and an older person specific preference-based instrument-the Investigating Choice Experiments Capability Measure for older people (ICECAP-O). This article reviews the development and application of these instruments within the older population and discusses the issues surrounding their use with this population. Areas for further research relating to the development and application of generic preference-based instruments with populations of older people are also highlighted.
Publisher: Elsevier BV
Date: 12-2011
DOI: 10.1016/J.OPHTHA.2011.06.008
Abstract: To investigate the responsiveness of 16 questionnaires used in cataract surgery outcomes. Prospective, observational study. Patients at the Ophthalmology Eye Clinic, Flinders Medical Centre, Adelaide, Australia, and 1 matched eye clinic in Sweden. Sixteen Rasch-scaled cataract surgery questionnaires were completed before and 6 months after surgery. These were: the Cataract Symptom Scale, 6 versions of the National Eye Institute Visual Function Questionnaire, the Quality of Life and Vision Function Questionnaire, the Cataract TyPE Specification, the Visual Activities Questionnaire, the Visual Disability Assessment (VDA), the Visual Function and Quality of Life questionnaire, the Visual Function Index, Catquest-9SF, the Visual Symptoms and Quality of Life questionnaire, and the Cataract Outcomes Questionnaire. Responsiveness was calculated with the effect size (ES) statistic (change in questionnaire score ided by pooled standard deviation of the preoperative and postoperative scores). Questionnaire responsiveness to cataract surgery (ability to detect clinically important change). All 16 questionnaires and their subscales were responsive to cataract surgery, with visual functioning scales being more responsive than socioemotional scales and some subscales being less responsive. The largest ES was for the Catquest-9SF (1.45 95% confidence interval [CI], 1.22-1.67), which was the only instrument with a mean and 95% CI of more than 1.0 (very large ES). Three measures had very large ESs and 95% CIs of more than 0.80 (large ES): the VDA (activity limitations and subscale) and the Cataract Outcomes Questionnaire, although their 95% CIs overlapped with a number of other instruments. The Catquest-9SF is short and highly responsive to cataract surgery, and so is ideal for measuring visual functioning outcomes. Other instruments may be preferred to measure different constructs. The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Publisher: Informa UK Limited
Date: 07-2019
DOI: 10.1111/CXO.12875
Abstract: Although being the second most common sight-threatening retinal vascular disease after diabetic retinopathy, the patient-centred impact of retinal vein occlusion has not been well studied. This study aims to understand the quality of life issues in people with retinal vein occlusion using a qualitative methodology. In-depth semi-structured interviews were conducted with 17 patients with retinal vein occlusion. All the interviews were digitally recorded and transcribed verbatim. An inductive analytic approach based on the constant comparative method was used for coding, aggregation, and theme development. The qualitative analysis was done using the software NVivo. Participants had a median age of 73 years (range 34-85 years females, 71 per cent). Six quality of life themes were identified: concerns about the disease progression and treatment outcome (health concerns), emotional responses to the disease (emotional), experiencing a range of symptoms (symptoms), inability to do things as before (activity limitation), adapting to the visual loss (coping), and inconveniences due to the eye condition (convenience). Participants often felt that lasers and injections did not improve their vision. They feared that their eye condition may come back, or the other eye may be affected. They experienced a range of visual symptoms that affected their day-to-day performance, particularly reading small print, and driving at night. Having multiple treatments and frequent eye appointments were major sources of inconvenience. Patients adopted several coping strategies to manage the stress associated with visual loss. This study shows that several aspects of quality of life are compromised in people with retinal vein occlusion. The findings of this study will be used to identify the item content for a vitreoretinal disease-specific quality of life item bank.
Publisher: Springer Science and Business Media LLC
Date: 31-03-2012
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 03-2012
DOI: 10.1167/IOVS.11-8102
Abstract: To develop a model for establishing indications for cataract surgery that incorporates clinical and questionnaire data on a single linear scale using Rasch analysis. In this prospective study, 293 preoperative cataract surgery patients (mean age, 72.8±10 years age range, 33-98 years 174 female, 119 male 49% with ocular comorbidity) completed two questionnaires, and visual acuity was measured in each eye. A cataract impact model was developed using Rasch analysis incorporating questionnaire scores and visual acuity. Participants were ranked from 1 to 293 based on the order in which they presented (first in first out [FIFO]) and then were ranked based on the cataract impact model. The main outcome measure was the number of participants moving 49 (16.7% change) rank positions, which represented a likelihood to change priority category. The cataract impact model was unidimensional (fit statistics within 0.66-1.68) and had adequate precision (person separation of 2.58), and the components were well targeted to the population (0.05 logits between the mean item difficulty and person ability). Two hundred twenty-seven (77.5%) patients moved by at least 49 rank positions. It is possible to combine clinical and questionnaire data and rank patients on a single linear scale. This approach modifies the ranking that occurs with the FIFO model and can be used for prioritizing patients for surgical intervention. More sophisticated models incorporating more clinical information may provide a better measure of the cataract impact latent trait.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-2013
Publisher: Springer Science and Business Media LLC
Date: 09-06-2022
DOI: 10.1007/S11136-022-03142-X
Abstract: To evaluate the construct (convergent and known group) validity of the Quality-of-Life-Aged Care Consumer (QOL-ACC), an older-person-specific quality-of-life measure designed for application in quality assessment and economic evaluation in aged care. Convergent validity was assessed by examining relationships with other validated preference-based measures (EQ-5D-5L, ASCOT), quality of aged care experience (QCE-ACC) and life satisfaction (PWI) through an online survey. Known-group validity was assessed by testing the ability to discriminate varying levels of care needs, self-reported health and quality of life. Older people (aged ≥ 65 years) receiving community-aged care ( N = 313) responded 54.6% were female, 41.8% were living alone and 56.8% were receiving higher-level care. The QOL-ACC and its six dimensions were low to moderately and significantly correlated with the EQ-5D-5L (correlation co-efficient range, ρ = 0.39–0.56). The QOL-ACC demonstrated moderate and statistically significant correlations with ASCOT ( ρ = 0.61), the QCE-ACC ( ρ = 0.51) and the PWI ( ρ = 0.70). Respondents with poorer self-reported health status, quality of life and/or higher-level care needs demonstrated lower QOL-ACC scores ( P 0.001), providing evidence of known-group validity. The study provides evidence of the construct validity of the QOL-ACC descriptive system. A preference-weighted value set is currently being developed for the QOL-ACC, which when finalised will be subjected to further validation assessments.
Publisher: Springer Science and Business Media LLC
Date: 29-09-2021
DOI: 10.1007/S11136-020-02649-5
Abstract: To identify the salient quality of life characteristics relevant to older people in receipt of community aged care services in order to develop dimensions for a draft descriptive system for a new preference-based quality of life instrument. Forty-one in-depth semi-structured interviews were undertaken with older people (65 years and over) receiving community aged care services across three Australian states to explore quality of life characteristics of importance to them. The data were analysed using framework analysis to extract broader themes which were organised into a conceptual framework. The data were then summarised into a thematic chart to develop a framework matrix which was used to interpret and synthesise the data. Care was taken throughout to retain the language that older people had adopted during the interviews to ensure that appropriate language was used when identifying and developing the quality of life dimensions. The analysis resulted in the identification of five salient quality of life dimensions: independence, social connections, emotional well-being, mobility, and activities. This research finds that quality of life for older people accessing aged care services goes beyond health-related quality of life and incorporates broader aspects that transcend health. The findings represent the first stage in a multiphase project working in partnership with older people to develop a new preference-based instrument of quality of life for informing quality assessment and economic evaluation in community aged care. In future work, draft items will be developed from these dimensions and tested in face validity interviews before progressing to further psychometric testing.
Publisher: Oxford University Press (OUP)
Date: 17-01-2020
DOI: 10.1093/JAMIA/OCZ210
Abstract: To (1) use an elastic net (EN) algorithm to derive a frailty measure from a national aged care eligibility assessment program (2) compare the ability of EN-based and a traditional cumulative deficit (CD) based frailty measures to predict mortality and entry into permanent residential care (3) assess if the predictive ability can be improved by using weighted frailty measures. A Cox proportional hazard model based EN algorithm was applied to the 2003–2013 cohort of 903 996 participants for selecting items to enter an EN based frailty measure. The out-of-s le predictive accuracy was measured by the area under the curve (AUC) from Cox models fitted to 80% training and validated on 20% testing s les. The EN approach resulted in a 178-item frailty measure including items excluded from the 44-item CD-based measure. The EN based measure was not statistically significantly different from the CD-based approach in terms of predicting mortality (AUC 0.641, 95% CI: 0.637–0.644 vs AUC 0.637, 95% CI: 0.634–0.641) and permanent care entry (AUC 0.626, 95% CI: 0.624–0.629 vs AUC 0.627, 95% CI: 0.625–0.63). However, the weighted EN based measure statistically outperforms the weighted CD measure for predicting mortality (AUC 0.774, 95% CI: 0.771–0.777 vs AUC 0.757, 95% CI: 0.754–0.760) and permanent care entry (AUC 0.676, 95% CI: 0.673–0.678 vs AUC 0.671, 95% CI: 0.668–0.674). The weighted EN and CD-based measures demonstrated similar prediction performance. The CD-based measure items are relevant to frailty measurement and easier to interpret. We recommend using the weighted and unweighted CD-based frailty measures.
Publisher: Informa UK Limited
Date: 07-2018
DOI: 10.1111/CXO.12553
Abstract: Many patient-reported outcome measures (PROMs) have been developed and/or used to measure the impact of amblyopia and strabismus on quality of life (QoL). Identifying the one with superior quality is important for evaluating the effectiveness of novel therapy for amblyopia and for directing improved clinical decision-making in adults considering strabismic surgery. Therefore, the aim of this review is to identify all PROMs previously developed/used to study the impact of amblyopia and/or strabismus on QoL and to appraise the quality and comprehensiveness of content of the disease-specific instruments. A systematic search was carried out in the electronic databases of PubMed, Cochrane, Web of Science and PsycINFO. The quality of content and measurement properties of all the disease-specific instruments were assessed using established quality standards. Further, the content of the instruments were examined for comprehensiveness by categorising each item across the eight ophthalmic QoL domains (activity limitation, concerns, emotional well-being, social well-being, economic, convenience, symptoms and mobility). Seventy-one PROMs were identified, out of which 32 were amblyopia- and/or strabismus-specific. Out of all the disease-specific instruments, just four have been subjected to modern psychometric tests and only the adult strabismus questionnaire (AS-20) demonstrated good measurement properties. Most of the amblyopia-specific instruments measured the impact of the treatment of amblyopia on children, while most of the strabismus-specific instruments measured concerns related to appearance and treatment outcome in adults. All instruments have gaps in their content and failed to address QoL comprehensively. All the existing amblyopia- and/or strabismus-specific instruments fall short of desired quality and/or comprehensiveness of content. The review identifies the need for developing an instrument with superior quality and discusses potential directions of future research.
Publisher: Elsevier BV
Date: 04-2012
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2013
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2015
Publisher: SAGE Publications
Date: 09-2012
Abstract: The purpose of the study was to identify the educational, social and leisure activities and issues that matter to school children and young people with a visual impairment and to compare their lifestyle with fully sighted counterparts. Thirteen focus groups were conducted and the groups were stratified by age, gender, visual status and school location (urban and non-urban). The sessions were audio taped, transcribed verbatim, coded using NVivo software and a qualitative data analysis was carried out to identify the main themes. Eighty-one children and young people aged between 5–18 years participated in the focus groups 34 were visually impaired (22 boys) and 47 were fully sighted (24 boys). In total, 121 different daily living activities important to children and young people were discussed in the focus groups. Results suggested that children and young people with a visual impairment have similar lifestyles to their fully sighted counterparts but are more restricted in some specific activities. The children and young people also reported that sometimes these restrictions were imposed by those supporting them rather than their own abilities. This information provided an in-depth understanding of the impact of visual impairment in school-aged children and young people.
Publisher: Elsevier BV
Date: 06-2018
Publisher: Elsevier BV
Date: 07-2017
DOI: 10.1016/J.SURVOPHTHAL.2016.12.011
Abstract: Advances in the understanding of the genetic, molecular, and cellular biology of retinal diseases have led to the development of new treatments. These expanding treatment options demand appropriate outcome measures for studies of treatment benefit including patient-reported outcomes (PROs). A plethora of PRO instruments assess impacts of retinal diseases from the patients' perspectives. We review all the studies that implemented PRO assessment in retinal diseases and also discuss quality assessment of the PRO instruments. We also include qualitative studies that explored quality of life impact on people with retinal diseases. Most studies used PRO instruments not specifically developed for retinal diseases (non-disease specific), nor have they undergone comprehensive validation in this disease group. A few retina-specific PRO instruments are available, but they suffer from limited content coverage of quality of life. Finally, we discuss the need for a new comprehensive and technologically advanced PRO instrument to assess quality of life impacts in retinal diseases.
Publisher: Wiley
Date: 17-04-2023
DOI: 10.1111/AJAG.13199
Abstract: To examine the incidence and trends in primary care, allied health, geriatric, pain and palliative care service use by permanent residential aged care (PRAC) residents and the older Australian population. Repeated cross‐sectional analyses on PRAC residents ( N = 318,484) and the older (≥65 years) Australian population ( N ~ 3.5 million). Outcomes were Medicare Benefits Schedule (MBS) subsidised primary care, allied health, geriatric, pain and palliative services between 2012–13 and 2016–17. GEE Poisson models estimated incidence rates and incidence rate ratios (IRR). In 2016–17, PRAC residents had a median of 13 (interquartile range [IQR] 5–19) regular general medical practitioner (GP) attendances, 3 (IQR 1–6) after‐hours attendances and 5% saw a geriatrician. Highlights of utilisation changes from 2012–13 to 2016–17 include the following: GP attendances increased by 5%/year (IRR = 1.05, 95% confidence interval [CI] 1.05–1.05) for residents compared to 1%/year (IRR = 1.01, 95%CI 1.01–1.01) for the general population. GP after‐hours attendances increased by 15%/year (IRR = 1.15, 95%CI 1.14–1.15) for residents and 9%/year (IRR = 1.08, 95%CI 1.07–1.20) for the general population. GP management plans increased by 12%/year (IRR = 1.12, 95%CI 1.11–1.12) for residents and 10%/year (IRR = 1.10, 95%CI 1.09–1.11) for the general population. Geriatrician consultations increased by 28%/year (IRR = 1.28, 95%CI 1.27–1.29) for residents compared to 14%/year (IRR = 1.14, 95%CI 1.14–1.15) in the general population. The utilisation of most examined services increased in both cohorts over time. Preventive and management care, by primary care and allied health care providers, was low and likely influences the utilisation of other attendances. PRAC residents' access to pain, palliative and geriatric medicine services is low and may not address the residents' needs.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2015
Publisher: Elsevier BV
Date: 09-2018
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 03-06-2020
DOI: 10.1167/TVST.9.7.3
Publisher: Springer Science and Business Media LLC
Date: 11-2020
Abstract: In this paper, a new technique for reconstructing and identifying hadronically decaying τ + τ − pairs with a large Lorentz boost, referred to as the di- τ tagger, is developed and used for the first time in the ATLAS experiment at the Large Hadron Collider. A benchmark di- τ tagging selection is employed in the search for resonant Higgs boson pair production, where one Higgs boson decays into a boosted $$ b\\overline{b} $$ b b ¯ pair and the other into a boosted τ + τ − pair, with two hadronically decaying τ -leptons in the final state. Using 139 fb − 1 of proton-proton collision data recorded at a centre-of-mass energy of 13 TeV, the efficiency of the di- τ tagger is determined and the background with quark- or gluon-initiated jets misidentified as di- τ objects is estimated. The search for a heavy, narrow, scalar resonance produced via gluon-gluon fusion and decaying into two Higgs bosons is carried out in the mass range 1–3 TeV using the same dataset. No deviations from the Standard Model predictions are observed, and 95% confidence-level exclusion limits are set on this model.
Publisher: BMJ
Date: 28-07-2016
DOI: 10.1136/BJOPHTHALMOL-2016-308866
Abstract: To validate a visual ability instrument for school-aged children with visual impairment in China by translating, culturally adopting and Rasch scaling the Cardiff Visual Ability Questionnaire for Children (CVAQC). The 25-item CVAQC was translated into Mandarin using a standard protocol. The translated version (CVAQC-CN) was subjected to cognitive testing to ensure a proper cultural adaptation of its content. Then, the CVAQC-CN was interviewer-administered to 114 school-aged children and young people with visual impairment. Rasch analysis was carried out to assess its psychometric properties. The correlation between the CVAQC-CN visual ability scores and clinical measure of vision (visual acuity VA and contrast sensitivity, CS) were assessed using Spearman's r. Based on cultural adaptation exercise, cognitive testing, missing data and Rasch metrics-based iterative item removal, three items were removed from the original 25. The 22-item CVAQC-CN demonstrated excellent measurement precision (person separation index, 3.08), content validity (item separation, 10.09) and item reliability (0.99). Moreover, the CVAQC-CN was unidimensional and had no item bias. The person-item map indicated good targeting of item difficulty to person ability. The CVAQC-CN had moderate correlations between CS (-0.53, p<0.00001) and VA (0.726, p<0.00001), respectively, indicating its validity. The 22-item CVAQC-CN is a psychometrically robust and valid instrument to measure visual ability in children with visual impairment in China. The instrument can be used as a clinical and research outcome measure to assess the change in visual ability after low vision rehabilitation intervention.
Publisher: Wiley
Date: 21-06-2021
DOI: 10.1111/JGS.17317
Abstract: To examine in idual , medication, system, and healthcare related predictors of hospitalization and emergency department (ED) presentation within 90 days of entering the aged care sector, and to create risk‐profiles associated with these outcomes. Retrospective population‐based cohort study using data from the Registry of Senior Australians. Older people (aged 65 and older) with an aged care eligibility assessment in South Australia between January 1, 2013 and May 31, 2016 ( N = 22,130). Primary outcomes were unplanned hospitalization and ED presentation within 90 days of assessment. In idual, medication, system, and healthcare related predictors of the outcomes at the time of assessment, within 90 days or 1‐year prior. Fine–Gray models were used to calculate subdistribution hazard ratios (sHR) and 95% confidence intervals (CI). Harrell's C ‐index assessed predictive ability. Four thousand nine‐hundred and six (22.2%) in iduals were hospitalized and 5028 (22.7%) had an ED presentation within 90 days. Predictors of hospitalization included: being a man (hospitalization sHR = 1.33, 95% CI 1.26–1.42), ≥3 urgent after‐hours attendances (hospitalization sHR = 1.21, 95% CI 1.06–1.39), increasing frailty index score (hospitalization sHR = 1.19, 95% CI 1.11–1.28), in iduals using glucocorticoids (hospitalization sHR = 1.11, 95% CI 1.02–1.20), sulfonamides (hospitalization sHR = 1.18, 95% CI 1.10–1.27), trimethoprim antibiotics (hospitalization sHR = 1.15, 95% CI 1.03–1.29), unplanned hospitalizations 30 days prior (hospitalization sHR = 1.13, 95% CI 1.04–1.23), and ED presentations 1 year prior (hospitalization sHR = 1.07, 95% CI 1.04–1.10). Similar predictors and hazard estimates were also observed for ED presentations. The hospitalization models out‐of‐s le predictive ability ( C ‐index = 0.653, 95% CI 0.635–0.670) and ED presentations ( C ‐index = 0.647, 95% CI 0.630–0.663) were moderate. One in five in iduals with aged care eligibility assessments had unplanned hospitalizations and/or ED presentation within 90 days with several predictors identified at the time of aged care eligibility assessment. This is an actionable period for targeting at‐risk in iduals to reduce hospitalizations.
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 31-08-2011
DOI: 10.1167/IOVS.11-7423
Abstract: To investigate, using Rasch analysis, whether the 15-item Glaucoma Quality of Life-15 (GQL-15) forms a valid scale and to optimize its psychometric properties. One hundred eighteen glaucoma patients (mean age, 65.7 years) completed the German-version of the GQL-15. Rasch analysis was performed to assess category function (how respondents differentiated between the response options), measurement precision (discriminative ability), unidimensionality (whether items measure a single construct), targeting (whether items are of appropriate difficulty for the s le), and differential item functioning (whether comparable subgroups respond differently to an in idual item). Where any of these attributes were outside acceptable ranges, steps were taken to improve the instrument. The five-response categories of the GQL-15 were well differentiated by respondents, as demonstrated by ordered and well-spaced category thresholds. The GQL-15 had an excellent measurement precision but demonstrated poor targeting of item difficulty to person ability and multidimensionality, indicating that it was measuring more than one construct. Removal of six misfitting items created a nine-item unidimensional instrument with good measurement precision and no differential item functioning but poor targeting. A new name, the Glaucoma Activity Limitation (GAL-9) questionnaire, is proposed for the short version, which better reflects the construct under measurement. The GAL-9 has superior psychometric properties over the GQL-15. Its only limitation is poor targeting of item difficulty to person ability, which is an inevitable attribute of a vision-related activity limitation instrument for glaucoma patients, most of whom have only peripheral visual field defects and little difficulty with daily activities.
Publisher: Emerald
Date: 15-02-2023
DOI: 10.1108/QAOA-07-2022-0046
Abstract: This paper aims to assess the face validity to inform content validity of the Quality of Life – Aged Care Consumers (QOL-ACC), a new measure for quality assessment and economic evaluation in aged care. Semi-structured interviews were conducted with older adults (66–100 years) receiving aged care services at home ( n = 31) and in residential care ( n = 28). Participants provided feedback on draft items to take forward to the next stage of psychometric assessment. Items were removed according to several decision criteria: ambiguity, sensitive wording, not easy to answer and/or least preferred by participants. The initial candidate set was reduced from 34 items to 15 items to include in the next stage of the QOL-ACC development alongside the preferred response category. The reduced set reflected the views of older adults, increasing the measure’s acceptability, reliability and relevance. Quality of life is a key person-centred quality indicator recommended by the recent Royal Commission into Aged Care Quality and Safety. Responding to this policy reform objective, this study documents a key stage in the development of the QOL-ACC measure, a new measure designed to assess aged care specific quality of life.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2016
DOI: 10.1097/OPX.0000000000000992
Abstract: There is an increasing demand for high-standard, comprehensive, and reliable patient-reported outcome (PRO) instruments in all the disciplines of health care including in ophthalmology and optometry. Over the past two decades, a plethora of PRO instruments have been developed to assess the impact of eye diseases and their treatments. Despite this large number of instruments, significant shortcomings exist for the measurement of ophthalmic quality of life (QoL). Most PRO instruments are short-form instruments designed for clinical use, but this limits their content coverage often poorly targeting any study population other than that which they were developed for. Also, existing instruments are static paper and pencil based and unable to be updated easily leading to outdated and irrelevant item content. Scores obtained from different PRO instruments may not be directly comparable. These shortcomings can be addressed using item banking implemented with computer-adaptive testing (CAT). Therefore, we designed a multicenter project (The Eye-tem Bank project) to develop and validate such PROs to enable comprehensive measurement of ophthalmic QoL in eye diseases. Development of the Eye-tem Bank follows four phases: Phase I, Content Development Phase II, Pilot Testing and Item Calibration Phase III, Validation and Phase IV, Evaluation. This project will deliver technologically advanced comprehensive QoL PROs in the form of item banking implemented via a CAT system in eye diseases. Here, we present a detailed methodological framework of this project.
Publisher: Springer Science and Business Media LLC
Date: 2012
Publisher: Informa UK Limited
Date: 06-10-2018
DOI: 10.1080/09286586.2017.1376338
Abstract: 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. 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. 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. 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.
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 02-12-2021
DOI: 10.1167/TVST.10.14.3
Publisher: The Beryl Institute
Date: 04-08-2021
Publisher: Springer Science and Business Media LLC
Date: 20-07-2023
DOI: 10.1007/S11136-023-03488-W
Abstract: Increasingly there are calls to routinely assess the health-related quality of life (HRQoL) of older people receiving aged care services, however the high prevalence of dementia and cognitive impairment remains a challenge to implementation. Eye-tracking technology facilitates detailed assessment of engagement and comprehension of visual stimuli, and may be useful in flagging in iduals and populations who cannot reliably self-complete HRQoL instruments. The aim of this study was to apply eye-tracking technology to provide insights into self-reporting of HRQoL among older people in residential care with and without cognitive impairment. Residents ( n = 41), recruited based on one of three cognition subgroups (no, mild, or moderate cognitive impairment), completed the EQ-5D-5L on a computer with eye tracking technology embedded. Number and length of fixations (i.e., eye gaze in seconds) for key components of the EQ-5D-5L descriptive system were calculated. For all dimensions, participants with no cognitive impairment fixated for longer on the Area of Interest (AOI) for the response option they finally chose, relative to those with mild or moderate cognitive impairment. Participants with cognitive impairment followed similar fixation patterns to those without. There was some evidence that participants with cognitive impairment took longer to complete and spent relatively less time attending to the relevant AOIs, but these differences did not reach statistical significance generally. This exploratory study applying eye tracking technology provides novel insights and evidence of the feasibility of self-reported HRQoL assessments in older people in aged care settings where cognitive impairment and dementia are highly prevalent.
Publisher: Wiley
Date: 15-05-2017
DOI: 10.1111/CEO.12954
Abstract: This study qualitatively explores the impact of refractive error on adults, particularly after correction. The study aimed to explore the impact of refractive error on quality of life. Cross-sectional in-depth telephone and face-to-face semistructured interviews qualitative study with inductive and deductive processes. Forty-eight adults with refractive error (including presbyopia) were recruited from the Flinders Vision, the Ashford Advanced Eye Care and among Flinders University staff and students, in South Australia. The interviews were audio-recorded, transcribed verbatim, coded and analysed using thematic analysis. Themes and categories RESULTS: The median age of the participants was 49 years (min: 22 years max: 76 years). Most of them were female: (29 59%). Most of them (36 75.0%) had myopia followed by hyperopia (12 25.0%). Twenty-two (45.8%) participants had astigmatism. Similarly, 23 (47.9%) of them were presbyopes. Most of the participants (39 81.3%) wore glasses 17 (35.4%) used contact lenses, and 17 (35.4%) had undergone refractive surgery. A total of 2367 comments were coded. Thematic analysis resulted into six themes that informed about quality of life issues in people with refractive error. Concerns about cosmetic appearance, personal health and safety, difficulties in day-to-day activities and inconveniences rendered in daily life were identified as the most important themes. The findings of this study enrich the understanding on the issues important in people with refractive error. The quality of life issues identified will be used to develop a refractive error-specific item bank.
Publisher: Copernicus GmbH
Date: 03-07-2017
Abstract: Abstract. Extratropical cyclones of type Vb, which develop over the western Mediterranean and move northeastward, are major natural hazards that are responsible for heavy precipitation over central Europe. To gain further understanding in the governing processes of these Vb cyclones, the study explores the role of soil moisture and sea surface temperature (SST) and their contribution to the atmospheric moisture content. Thereby, recent Vb events identified in the ERA-Interim reanalysis are dynamically downscaled with the Weather Research and Forecasting (WRF) model. Results indicate that a mean high-impact summer Vb event is mostly sensitive to an increase in the Mediterranean SSTs and rather insensitive to Atlantic SSTs and soil moisture changes. Hence, an increase of +5 K in Mediterranean SSTs leads to an average increase of 24 % in precipitation over central Europe. This increase in precipitation is mainly induced by larger mean upward moisture flux over the Mediterranean with increasing Mediterranean SSTs. This further invokes an increase in latent energy release, which leads to an increase in atmospheric instability, i.e. in convective available potential energy. Both the increased availability of atmospheric moisture and the increased instability of the atmosphere, which is able to remove extra moisture from the atmosphere due to convective processes, are responsible for the strong increase in precipitation over the entire region influenced by Vb events. Precipitation patterns further indicate that a strong increase in precipitation is found at the eastern coast of the Adriatic Sea for increased Mediterranean SSTs. This premature loss in atmospheric moisture leads to a significant decrease in atmospheric moisture transport to central Europe and the northeastern flanks of the Alpine mountain chain. This leads to a reduction in precipitation in this high-impact region of the Vb event for an increase in Mediterranean SSTs of +5 K. Furthermore, the intensity of the Vb cyclones, measured as a gradient in the 850 hPa geopotential height field around the cyclone centre, indicates that an upper bound for intensity might be reached for the most intense Vb event.
Publisher: Springer Science and Business Media LLC
Date: 21-09-2017
Publisher: Wiley
Date: 16-11-2022
DOI: 10.1111/OPO.12917
Abstract: Utilising Rasch analysis on the Keratoconus Outcome Research Questionnaire (KORQ) data, we explored the hypothesis that the KORQ with discrete verbal rating scale (VRS) would demonstrate better psychometric properties and provide less noise in measurement than with a visual analogue scale (VAS). The KORQ is a keratoconus‐specific patient‐reported outcome measure it has activity limitation and symptoms scales. The KORQ scales with two different rating scales (VAS and a discrete 4‐response VRS) were completed by self‐administration by people with keratoconus. For each KORQ scale, Rasch analysis‐based psychometric properties were compared between the two versions. Rasch analysis was also used to optimise rating scale functioning when disordered thresholds were observed. 118 (mean age ± SD, 46.4 ± 0.4 years) and 169 (45.4 ± 14.7 years) people completed the KORQ with VAS and VRS, respectively. Both scales demonstrated high measurement precision. However, the VAS rating scale was disordered (6 out of 11 categories dysfunctional) and had two misfitting items. Conversely, the VRS had ordered categories and no misfitting items. For the disordered VAS, ordering was achieved only after collapsing 11 categories into four categories. In comparison to the KORQ with VRS, the repaired VAS had lower measurement precision, test information, variance explained by the measure, poor targeting, and reduced measurement range. The KORQ demonstrated superior psychometric properties when measured using a VRS than with a VAS. This illustrates the advantages of verbal rating scales for a patient‐reported outcome measurement over a visual analogue scale.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2013
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2019
DOI: 10.1097/OPX.0000000000001317
Abstract: This study develops psychometrically valid item banks across 10 areas of quality of life (QoL) specific to people with hereditary retinal diseases, which will enable clinicians and researchers to explore the impact of hereditary retinal diseases across all aspects of QoL. The purpose of this study was to assess the psychometric properties of hereditary retinal disease QoL item banks using Rasch analysis and demonstrate the effectiveness of a computerized adaptive testing (CAT) system in obtaining precise measurement of QoL using only a few items. The hereditary retinal disease item banks were answered by 233 participants (median age, 58 years range, 18 to 94 years female participants, 59%). The hereditary retinal disease item banks cover 10 QoL domains: activity limitation, mobility, emotional, social, convenience, economic, health concerns, visual symptoms, ocular comfort symptoms, and general symptoms. Rasch analysis assessed the psychometric properties of the 10 item banks and provided item calibrations for the development of CAT. Computerized adaptive testing simulations were performed to calculate the average number of items required to gain precise measurement of each QoL domain. The convenience, economic, visual symptoms, and the social domains formed unidimensional scales. However, the activity limitation and health concerns domains demonstrated multidimensionality and required major modifications to resolve this, which resulted in four new QoL domains, namely, reading, driving, lighting, and concerns about the disease progression. In total, 10 item banks underwent CAT simulation testing, which indicated that 8 to 12 items were required to gain precise measurement of each QoL domain. We have developed 10 psychometrically valid item banks to measure the QoL domains relevant to people with hereditary retinal diseases. On average, only 5 and 10 items were required to gain measurement at moderate and high precision, respectively.
Publisher: SLACK, Inc.
Date: 06-2017
DOI: 10.3928/1081597X-20170310-01
Abstract: To identify the questionnaires used to assess refractive surgery outcomes, assess the available questionnaires in regard to their psychometric properties, validity, and reliability, and evaluate the performance of the available questionnaires in measuring refractive surgery outcomes. An extensive literature search was done on PubMed, MEDLINE, Scopus, CINAHL, Cochrane, and Web of Science databases to identify articles that described or used at least one questionnaire to assess refractive surgery outcomes. The information on content quality, validity, reliability, responsiveness, and psychometric properties was extracted and analyzed based on an extensive set of quality criteria. Eighty-one articles describing 27 questionnaires (12 refractive error–specific, including 4 refractive surgery–specific, 7 vision-but-non-refractive, and 8 generic) were included in the review. Most articles (56, 69.1%) described refractive error–specific questionnaires. The Quality of Life Impact of Refractive Correction (QIRC), the Quality of Vision (QoV), and the Near Activity Visual Questionnaire (NAVQ) were originally constructed using Rasch analysis others were developed using the Classical Test Theory. The National Eye Institute Refractive Quality of Life questionnaire was the most frequently used questionnaire, but it does not provide a valid measurement. The QoV, QIRC, and NAVQ are the three best existing questionnaires to assess visual symptoms, quality of life, and activity limitations, respectively. This review identified three superior quality questionnaires for measuring different aspects of quality of life in refractive surgery. Clinicians and researchers should choose a questionnaire based on the concept being measured with superior psychometric properties. [ J Refract Surg. 2017 (6):416–424.]
Publisher: BMJ
Date: 14-02-2013
DOI: 10.1136/BJOPHTHALMOL-2012-302416
Abstract: To evaluate the long-term effectiveness of the community-based Low Vision Service Wales (LVSW). A long-term observational study of the Government-funded, community-based, low-vision rehabilitation service which operates in over 180 optometry practices in Wales. Participants were recruited from the LVSW (n=342 246 women median age 82 years) at baseline (before the Low Vision intervention). The primary outcome measure was change in visual disability as evaluated by the seven-item National Eye Institute Visual Function Questionnaire (NEI-VFQ). Change was measured on the same cohort at three separate time points, and comparisons were made between these: baseline-3 months 3-18 months baseline-18 months. Secondary outcome measures included: use of low-vision aids (LVAs) and satisfaction with the service provided. Questionnaires were sent to 281 participants (whose visual disability had been measured at baseline and 3 months) at 18 months postintervention. Responses were received from 190 (67.6%) people 24 were deceased. Self-reported visual disability was significantly reduced (Wilcoxon Signed Rank (WSR) test: p<0.001) between baseline and 18 months by -0.28 logits (-1.24 to 0.52). This was less than that found between baseline and 3 months -0.61 logits (-1.81 to 0.02). At 18 months, 79% patients used their LVAs at least once a week which was not significantly different to that found at 3 months (WSR: p=0.127). This study provides evidence that the effect of the LVSW persists over a period of 18 months disability is reduced from baseline, and use of LVAs remains high.
Publisher: Springer Science and Business Media LLC
Date: 12-2020
DOI: 10.1140/EPJC/S10052-020-08477-8
Abstract: The jet energy scale, jet energy resolution, and their systematic uncertainties are measured for jets reconstructed with the ATLAS detector in 2012 using proton–proton data produced at a centre-of-mass energy of 8 TeV with an integrated luminosity of $$20 \\, \\hbox {fb}^{-1}$$ 20 fb - 1 . Jets are reconstructed from clusters of energy depositions in the ATLAS calorimeters using the anti- $$k_t$$ k t algorithm. A jet calibration scheme is applied in multiple steps, each addressing specific effects including mitigation of contributions from additional proton–proton collisions, loss of energy in dead material, calorimeter non-compensation, angular biases and other global jet effects. The final calibration step uses several in situ techniques and corrects for residual effects not captured by the initial calibration. These analyses measure both the jet energy scale and resolution by exploiting the transverse momentum balance in $$\\gamma $$ γ + jet, Z + jet, dijet, and multijet events. A statistical combination of these measurements is performed. In the central detector region, the derived calibration has a precision better than 1% for jets with transverse momentum $$150 \\, \\hbox {GeV} p_{{\\mathrm {T}}} $$ 150 GeV p T 1500 GeV, and the relative energy resolution is $$(8.4\\pm 0.6)\\%$$ ( 8.4 ± 0.6 ) % for $$p_{{\\mathrm {T}}}= 100 \\, \\hbox {GeV}$$ p T = 100 GeV and $$(23\\pm 2)\\%$$ ( 23 ± 2 ) % for $$p_{{\\mathrm {T}}}= 20 \\, \\hbox {GeV}$$ p T = 20 GeV . The calibration scheme for jets with radius parameter $$R=1.0$$ R = 1.0 , for which jets receive a dedicated calibration of the jet mass, is also discussed.
Publisher: Elsevier BV
Date: 07-2022
DOI: 10.1016/J.SOCSCIMED.2022.115046
Abstract: Quality of life is an important person-centred outcome in health and aged care settings. Due to an increasing prevalence of cognitive decline and dementia in ageing populations, a proportion of older people receiving health and aged care services may not be able to reliably assess their own quality of life, highlighting the need for proxy assessment. This systematic review sought to investigate the level of agreement between self and proxy-report of older people's quality of life using established preference-based instruments of quality of life suitable for economic evaluation. A systematic review was conducted following PRISMA guidelines. Eight databases were searched: Web of Science, Scopus, Medline, Econlit, PsychINFO, CINAHL, Ageline and Cochrane Library. Information was extracted on the instruments, population s les (including any cognitive thresholds applied), mean scores, type of proxy, and measures of inter-rater agreement. A total of 50 studies using eight different preference-based quality of life instruments were identified. Most studies were cross-sectional (72%) with a wide variety of cognitive assessments and thresholds applied to define older participants with cognitive impairment. The most common proxies were family members, mostly spouses. The level of agreement between self and proxy-report was generally poor - irrespective of the instrument applied or type of proxy - with proxy-report generally indicating lower levels of quality of life than self-report. There was some evidence of stronger agreement on more observable quality of life domains e.g., physical health and mobility, relative to less observable domains e.g. emotional well-being. Few studies tracked self and/or proxy-report of quality of life longitudinally. More research is needed to develop evidence to inform guidance on self-report versus proxy-report of quality of life for older people receiving health and aged care services. Until then, the collection of both self and proxy reports as complementary measures is indicated.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2016
DOI: 10.1097/OPX.0000000000001035
Abstract: To develop and validate a keratoconus-specific quality of life (QoL) questionnaire: the Keratoconus Outcomes Research Questionnaire (KORQ). The study was carried out in three phases. Phase I: content identifications: items were identified based on an extensive literature review, open-ended patient mail survey, and expert consultations. Each item was scored on a visual analog scale (VAS). Phase II: pilot testing using Rasch analysis. Phase III: testing psychometric properties of the final version of the KORQ. Phase I identified 44 items across 3 different content areas: activity limitation (26), symptoms (20), and convenience (8). The 44-item KORQ was self-administered to 158 people with keratoconus. The 44-item KORQ was multidimensional. Unidimensionality was restored by separating items across three content areas (subscales) as identified in phase I. The activity limitation and symptoms subscales demonstrated adequate measurement precision, but convenience (precision, 1.01) did not. Hence, the convenience subscale was discarded. Rasch analysis revealed that the VAS was disordered. The ordering of the VAS was restored by collapsing categories into 4. An iterative Rasch analysis guided item-removal resulted into a 29-item KORQ (18-item activity limitation and 11-item symptoms). The VAS was replaced by a discrete 4-option labeled categorical rating scale, and it was self-administered by 169 people with keratoconus. Both the subscales demonstrated good psychometric properties. The KORQ scores strongly correlated with visual acuity and contrast sensitivity demonstrating its construct validity. The 29-item KORQ was a psychometrically robust and valid instrument to assess the impact of keratoconus on activity limitation and symptoms.
Publisher: Elsevier BV
Date: 2019
Publisher: American Medical Association (AMA)
Date: 11-2012
DOI: 10.1001/ARCHOPHTHALMOL.2012.1603
Abstract: To investigate the effect of cataract surgery on subjective quality of vision. The Quality of Vision (QoV) questionnaire (Italian translation) was completed before and 3 months after cataract surgery in 4 groups of patients recruited from September through December 2010: first eye with ocular comorbidity, first eye without ocular comorbidity, second eye with ocular comorbidity, and second eye without ocular comorbidity. The questionnaire measures 3 aspects of quality of vision: frequency, severity, and bothersome nature of symptoms. The Lens Opacities Classification System (LOCS) III was used for cataract grading. Friedman and Kruskal-Wallis H tests were performed to compare QoV scores within and between groups. Spearman rank correlations (rs) were calculated to investigate the correlation between LOCS III and QoV symptoms. Two hundred twelve patients (mean [SD] age, 74.2 [8.7] years) were recruited, and 212 eyes were included in the study. Improvements in QoV scores were found in all 4 groups (P .05) differences among the 4 groups in the improvement in QoV scores or in the preoperative or postoperative scores. Blurred vision was correlated with posterior subcapsular cataract (rs = 0.420, P = .04). Cataract in one or both eyes causes a similar loss in subjective quality of vision, which is also irrespective of the presence of ocular comorbidity. Posterior subcapsular cataract causes the specific symptom "blurred vision." Cataract surgery resulted in a large and comparable improvement in subjective quality of vision, regardless of ocular comorbidity and first or second eye surgery.
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 09-03-2012
DOI: 10.1167/IOVS.12-9541
Publisher: Springer Science and Business Media LLC
Date: 12-2022
DOI: 10.1186/S12955-022-02065-Y
Abstract: Quality of Life-Aged Care Consumers (QOL-ACC) is a new older-person-specific quality of life instrument designed for application in quality assessment and economic evaluation in aged care. The QOL-ACC was designed from its inception with older people receiving aged care services ensuring its strong content validity. Given that the QOL-ACC has already been validated in home care settings and a preference-weighted value set developed, we aimed to assess feasibility, construct validity and reliability of the QOL-ACC in residential aged care settings. In iduals living in residential aged care facilities participated in an interviewer-facilitated survey. The survey included the QOL-ACC, QCE-ACC (quality of aged care experience measure) and two other preference-based quality of life instruments (ASCOT and EQ-5D-5L). Feasibility was assessed using missing data and ceiling/floor effects. Construct validity was assessed by exploring the relationship between the QOL-ACC and other instruments (convergent validity) and the QOL-ACC’s ability to discriminate varying levels of self-rated health and quality of life. Internal consistency reliability was assessed using Cronbach’s alpha (α). Of the 200 residents (mean age, 85 ± 7.7 years) who completed the survey, 60% were female and 69% were born in Australia. One in three participating residents self-rated their health as fair oor. The QOL-ACC had no missing data but had small floor effects (0.5%) and acceptable ceiling effects (7.5%). It demonstrated moderate correlation with ASCOT ( r = 0.51, p 0.001) and EQ-5D-5L ( r = 0.52, p 0.001) and a stronger correlation with the QCE-ACC ( r = 0.57, p 0.001). Residents with poor self-rated health and quality of life had significantly lower scores on the QOL-ACC. The internal consistency reliability of the QOL-ACC and its dimensions was good (α = 0.70–0.77). The QOL-ACC demonstrated good feasibility, construct validity and internal consistency reliability to assess aged care-related quality of life. Moderate correlations of the QOL-ACC and other instruments provide evidence of its construct validity and signifies that the QOL-ACC adds non-redundant and non-interchangeable information beyond the existing instruments. A stronger correlation with the QCE-ACC than other instruments may indicate that quality of life is more intimately connected with the care experience than either health- or social-related quality of life in residential aged care settings.
Publisher: Springer Science and Business Media LLC
Date: 02-2018
Publisher: Wiley
Date: 12-08-2021
DOI: 10.1111/OPO.12864
Abstract: While much is known about the psychosocial impacts of strabismus, little is known about the effects of non‐strabismic amblyopia on quality of life (QoL). The aim of this study was to explore the long‐term impacts of anisometropic amblyopia. A phenomenological qualitative investigation was carried out on a s le of adults with anisometropic amblyopia. Subjects participated in in‐depth telephone interviews and described how their eye condition affected different aspects of their life. The interviews were audio‐recorded, transcribed verbatim and analysed iteratively to form emergent themes. Sixteen participants took part in the study (median age: 21.5 years range: 18–36 years 11 male and 5 female). Six themes emerged: (1) symptoms experienced by participants, (2) concerns and apprehensions, (3) emotional impacts, (4) activity limitations, (5) hassle and inconveniences and (6) economic and career implications. Symptoms reported by participants ranged from glare to difficulty concentrating. They were extremely concerned about the safety of their better eye and lived with several doubts and anxieties. Negative emotions such as grief and disappointment due to eye care negligence in childhood was apparent. Guilt and regretful feelings were present in those who did not comply with past treatment. Participants expressed several limitations in driving, reading, mobility (e.g., using stairs) and tasks requiring high resolution. Reported inconveniences associated with coping with their eye condition included having to travel across the country in search of a cure for their amblyopia. Economic impacts ranged from costs associated with accessing eye care and management to career choices being compromised. Lived experiences of people with anisometropic amblyopia indicate that the QoL impacts are multifaceted and substantial, even in the absence of strabismus. The results have the potential to influence patient‐practitioner relationship by opening newer horizons to communication and care while managing adult amblyopes.
Publisher: Springer Science and Business Media LLC
Date: 23-08-2022
Publisher: Wiley
Date: 07-09-2022
DOI: 10.1111/JOCN.15462
Abstract: To generate content for a new questionnaire, based on the 10 Principles of Dignity in Care. Older people in hospital are vulnerable and at risk of harm, including indignity. The 10 Principles of Dignity in Care, which undergird the United Kingdom's Dignity in Care C aign, have been used to promote dignified care for older people in hospital. A 2006 recommendation of the c aign was to survey people on their experiences of dignity in care. To undertake such a survey, a questionnaire based on the 10 Principles of Dignity is required. Qualitative methods based on a modified Delphi technique, assessed against the CREDES checklist. A Delphi panel of experts was convened that included: consumers, carers, clinicians, academics, policy experts and representatives from the National Dignity Council in the UK, Aboriginal people and people from culturally and linguistically erse backgrounds. Fifty-seven experts consented to participate, over the three rounds of Delphi panel deliberations (response rate: R1 n = 49, R2 n = 47 and R3 n = 44). The Delphi panellists were asked to rank, rewrite, relocate or remove items and suggest additional items, under each of the 10 Principles of Dignity in Care. The initial list of 93 items, generated from a review of the literature, existing questionnaires and drafted by the authors, was reduced to 87 items in Round 2 and 69 items in Round 3. A panel of experts were able to determine, based on their own judgement, and through consensus, the 69-items and response categories to be included in the patient and carer versions of the Dignity in Care questionnaire, to progress to a pilot study.
Publisher: Wiley
Date: 13-07-2021
DOI: 10.1111/GGI.14231
Abstract: The quality of the care provided to frail older people in aged care is a concern for all Australians and for the citizens of many other countries internationally. This paper summarizes the methods and findings from an Australian study commissioned by the Royal Commission into Aged Care Quality and Safety to identify and synthesize international literature relating to the quality of care in aged care. A comprehensive literature review was undertaken to search and identify the literature (grey and peer reviewed) relating to quality of care and/or person‐centered care in aged care. The review identified nine key themes as salient to the quality of care experience, which include treating the older person with respect and dignity acknowledging and supporting their spiritual, cultural, religious and sexual identity the skills and training of the aged care staff providing care relationships between the older person and the aged care staff social relationships and the community supporting the older person to make informed choices supporting the older person's health and well‐being ensuring the delivery of safe care in a comfortable service environment and the ability to make complaints and provide feedback to the aged care organization. In practice, particularly in the context of residential care, quality of care has traditionally been measured using clinical indicators of care quality. These findings highlight the central importance of person‐centered care and care experience as fundamental tenets of the quality of aged care service delivery in Australia and internationally. Geriatr Gerontol Int 2021 21: 765–778 .
Publisher: Massachusetts Medical Society
Date: 23-11-2017
DOI: 10.1056/NEJMC1712573
Publisher: Elsevier BV
Date: 09-2005
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2017
DOI: 10.1097/OPX.0000000000001143
Abstract: This review has identified the best existing patient-reported outcome (PRO) instruments in refractive error. The article highlights the limitations of the existing instruments and discusses the way forward. A systematic review was conducted to identify the types of PROs used in refractive error, to determine the quality of the existing PRO instruments in terms of their psychometric properties, and to determine the limitations in the content of the existing PRO instruments. Articles describing a PRO instrument measuring 1 or more domains of quality of life in people with refractive error were identified by electronic searches on the MEDLINE, PubMed, Scopus, Web of Science, and Cochrane databases. The information on content development, psychometric properties, validity, reliability, and responsiveness of those PRO instruments was extracted from the selected articles. The analysis was done based on a comprehensive set of assessment criteria. One hundred forty-eight articles describing 47 PRO instruments in refractive error were included in the review. Most of the articles (99 [66.9%]) used refractive error–specific PRO instruments. The PRO instruments comprised 19 refractive, 12 vision but nonrefractive, and 16 generic PRO instruments. Only 17 PRO instruments were validated in refractive error populations six of them were developed using Rasch analysis. None of the PRO instruments has items across all domains of quality of life. The Quality of Life Impact of Refractive Correction, the Quality of Vision, and the Contact Lens Impact on Quality of Life have comparatively better quality with some limitations, compared with the other PRO instruments. This review describes the PRO instruments and informs the choice of an appropriate measure in refractive error. We identified need of a comprehensive and scientifically robust refractive error–specific PRO instrument. Item banking and computer-adaptive testing system can be the way to provide such an instrument.
Publisher: African Journals Online (AJOL)
Date: 30-06-2020
DOI: 10.4314/MMJ.V32I2.2
Abstract: Background To assess the psychometric properties of the QIRC questionnaire and use it as an outcome measure in spectacle wearers attending an eye clinic in Malawi. MethodsParticipants who had uncorrected distance visual acuity of below 6/18 and improved to 6/9 or better with spectacles on both eyes were included in the study. The participants self-administered the Chichewa version of the QIRC questionnaire that was translated and culturally adapted for Malawian settings. Psychometric evaluation of the QIRC responses was carried out using the WinSteps software (Version 3.92.1 Winsteps, Chicago, IL) by applying the Andrich rating scale model of the Rasch analysis.Results One hundred and forty-three participants (mean age ± standard deviation, 27.64 ± 2.91 age range 16 to 39 years male, 51.7%) completed the QIRC. The Chichewa QIRC had satisfactory psychometric properties (Ordered response categories, Person separation index, 1.93 Item separation index, 3.42 Targeting 0.70) including excellent Rasch-model fit statistics (Infit and Outfit MnSq 1.30 for all items). The QIRC score was not significantly associated with sex, age, magnitude of refractive error, occupation and status of previous spectacle wear (p 0.05 for all). The QIRC scores negatively correlated with uncorrected visual acuity (in logMAR) in the better eye (spearman’s rho=-0.34, p 0.001).ConclusionsThe translated and culturally adapted version of the QIRC Questionnaire had satisfactory psychometric properties to measure the refractive error-specific quality of life in Malawi. It performed well as an outcome measure of spectacle wear. Key words: validation, quality of life, Rasch analysis, spectacles, Malawi
Publisher: Wiley
Date: 20-08-2020
DOI: 10.1111/AJAG.12833
Abstract: To examine the one‐year mortality of Australians entering aged care services compared with the general population. A population‐based analysis evaluating one‐year mortality among people who received first ever aged care services in 2013 compared with the general population was conducted. In 2013, 3.3 million Australians were ≥ 65 years and 34 919 (1%) entered permanent residential care, 23 288 (0.7%) respite care, 20 265 (0.6%) commenced home care packages, and 15 387 (0.5%) transition care. In iduals receiving aged care services had higher mortality than the general population, with those entering permanent residential care (age and sex direct standardised mortality rate ratio = 10.1, 95% CI: 9.8‐10.5) having the greatest difference, followed by people accessing respite (7.2, 95% CI: 6.9‐7.6), transition (4.6, 95% CI: 4.4‐4.9) and home care (4.1, 95% CI: 3.9‐4.4). Significant variation by sex and age was observed. Our study has identified significant variations in mortality rates that highlight which cohorts entering aged care are the most vulnerable.
Publisher: Massachusetts Medical Society
Date: 20-09-2012
DOI: 10.1056/NEJMC1209366
Publisher: BMJ
Date: 20-04-2011
DOI: 10.1136/BMJ.D2345
Publisher: AMPCo
Date: 09-08-2020
DOI: 10.5694/MJA2.50720
Publisher: Wiley
Date: 07-04-2019
DOI: 10.1111/OPO.12610
Abstract: Patients’ perceptions about the functional impact of amblyopia and strabismus in daily life have not been explored extensively. Therefore, this study aimed to explore the lived experiences of adults with these conditions and understand the functional limitations they face in their day‐to‐day life. A qualitative study design was adopted. Participants over 18 years of age, with a primary diagnosis of amblyopia (with or without strabismus) were recruited from the community and various eye care practices in South Australia and Victoria, Australia. Participants took part in either focus group discussions or in idual interviews and described the functional limitations they experienced in their daily life due to their eye condition. These sessions were audio recorded, transcribed verbatim, coded inductively, and analysed iteratively to form emergent themes. Thirty‐seven adult participants took part in the study: 23 (62%) had strabismic amblyopia 5 (14%) anisometropic amblyopia , 7 (19%) combined‐mechanism amblyopia and 2 (5%) deprivational amblyopia. Their median age was 54 years (range: 21–82 years) and 19 (51%) were female. Participants reported several challenges in performing everyday tasks such as driving (e.g. judging distances, changing lanes), reading (e.g. fine print, reading for prolonged time) and sports (e.g. catching a ball). They also articulated trouble in navigating safely (e.g. using stairs, bumping into objects), performing work‐tasks (e.g. taking longer than peers to complete tasks) and other routine tasks (e.g. chopping vegetables with care). Several functional limitations were encountered by adults living with amblyopia and strabismus. Participants recognised these limitations in their normal day‐to‐day life and related the challenges they faced to symptoms associated with their eye condition. By presenting rich in‐depth qualitative data, the paper demonstrates qualitative evidence of the functional impacts associated with amblyopia and strabismus.
Publisher: Informa UK Limited
Date: 15-10-2019
Publisher: Informa UK Limited
Date: 28-08-2019
DOI: 10.1080/09638288.2019.1652703
Abstract: A population-based epidemiological study was conducted using publicly available datasets from the Australian Institute of Health and Welfare and Australian Bureau of Statistics. The incidence of service utilization by younger people (<65 year) and per 10,000 citizens 0-49, 50-54, 55-59, and 60-64 years old per year was estimated. Negative binomial regression models were used to estimate incidence rate ratios. Between 2008-2009 and 2015-2016 the number of younger people accessing services increased for home care services by 103.2% and transition care by 131.9% but decreased for permanent residential care by 0.4%, and respite care by 2.4%. Permanent residential care incidence use decreased for the overall population (incidence rate ratio = 0.98, The overall use of permanent residential care has decreased along with the use of respite in the youngest people, and the use of home and transition care services have increased. Efforts to keep young people out of residential aged care may have redirected them to home care services.Implications for rehabilitationThe number of young people (<65 years old) with disability using aged cares services in Australia has increased significantly between 2008-2009 and 2015-2016.The overall use of permanent residential care has decreased along with the use of respite care, and the use of home and transition care services have increased, which should be encouraged.Development of targeted rehabilitation support programs to support young people with disability housed in residential aged care may help to better cater their care needs.Development of transition pathways to shift young people with disability to appropriate support programs may help to reduce the number of younger people with disability in aged care services.
Publisher: Frontiers Media SA
Date: 20-01-2023
DOI: 10.3389/FNEUR.2022.1006221
Abstract: People with neurological disorders (ND) are less physically active than the general population due to physical, sensory, and/or cognitive impairments. These in iduals often feel intimidated to join mainstream health and wellness centers due to lack of specialized support for people with ND. The Brain and Body Fitness Studio (BBFS) is one of the first Accredited Exercise Physiologist-led interprofessional services in Adelaide South Australia to provide in idualized evidence-based multimodal exercise prescription and social support for this population. This comprehensive retrospective study evaluated the impact of BBFS on functional capacity (FC) determined as the 6-min walk distance (6 MWD) achieved during a 6-min walk test (6 MWT), of its members with ND. Sixty-two BBFS members (age, 66 ± 10 years 60% male) with ND (85% Parkinson's Disease average time since diagnosis, 4 years [IQR, 2 to 12 years]) and complete pre- and post-6-month clinical assessment of the primary outcome of the study, the 6 MWD, were included in this retrospective analysis. A series of sub-analyses were also performed to investigate the effects of adherence to the recommended prescription of at least twice a week in the program (≥80 vs. & 80% adherence), and disease stage (time since diagnosis ≥6 vs. & 6 years) on FC. Although there was no statistically significant change in 6 MWD from pre- to post-6-month BBFS program (+15 ± 90 m, p = 0.19), a clinically meaningful improvement of & m was evident. Improvement in 6 MWD was significantly greater in members who attended at least 80% of the recommended visits (≥80% visits, +37 ± 58 m ≤ 80% visits,−1 ± 105 m, p = 0.046). We also found a 6 MWD improvement from pre- to post-6 months in those in the early years of their ND (& 6 years since diagnosis, +39 ± 76 m), but not in those in the later years of their ND (≥6 years since diagnosis, −36 ± 123 m, between group difference, p = 0.029). A clinically meaningful 6 MWD improvement may be elicited by services provided by BBFS in people with ND. Overall, the benefits appear to be more evident in members who attended the BBFS for at least 80% of the recommended visits and those who were in the early stage of their ND diagnosis.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2011
DOI: 10.1016/J.JCRS.2011.01.028
Abstract: To determine whether the Visual Symptoms and Quality of Life Questionnaire (VSQ), which was developed to be sensitive to second-eye cataract surgery, has satisfactory psychometric properties and, if so, to examine first-eye, second-eye, and bilateral cataract surgery outcomes. Ophthalmology Clinic, Flinders Medical Centre, Adelaide, Australia. Cohort study. The 26-item VSQ was self-administered by cataract patients before and after cataract surgery and by those on the cataract surgery waiting list. The VSQ was revised by Rasch analysis using preoperative questionnaire data. The surgical outcome measures were logMAR visual acuities and the Rasch-refined VSQ. The VSQ was self-administered by 92 patients before and after surgery (25 first eye, 38 second eye, and 29 bilateral) and by 147 on the waiting list. The preoperative visual acuity (surgical eye) was similar across groups. Cataract surgery improved visual acuities in all groups the mean better-seeing eye visual acuity was significantly better (by 2 lines) in second and bilateral surgery patients than in first-eye surgery patients. Preoperative visual disability was significantly higher in patients awaiting cataract surgery in both eyes than in those awaiting second-eye surgery. Postoperatively, visual disability decreased significantly in all groups (first eye, 1.66 logits second eye, 1.52 logits bilateral, 2.58 logits). However, a floor effect limited the measurement of visual disability after cataract surgery. The revised visual disability scale of the VSQ measured a reduction in visual disability after first, second, and bilateral cataract surgery. However, the VSQ could not measure lower levels of visual disability, suggesting better questionnaires are required. No author has a financial or proprietary interest in any material or method mentioned.
Publisher: Springer Science and Business Media LLC
Date: 09-11-2019
DOI: 10.1007/S11136-019-02354-Y
Abstract: To compare the results from a simulated computerized adaptive test (CAT) for the 28-item Impact of Vision Impairment (IVI) questionnaire and the original paper-pencil version in terms of efficiency (main outcome), defined as percentage item reduction. Using paper-pencil IVI data from 832 participants across the spectrum of vision impairment, item calibrations of the 28-item IVI instrument and its associated 20-item vision-specific functioning (VSF) and 8-item emotional well-being (EWB) subscales were generated with Rasch analysis. Based on these calibrations, CAT simulations were conducted on 1000 cases, with 'high' and 'moderate' precision stopping rules (standard error of measurement [SEM] 0.387 and 0.521, respectively). We examined the average number of items needed to satisfy the stopping rules and the corresponding percentage item reduction, level of agreement between person measures estimated from the full IVI item bank and from the CAT simulations, and item exposure rates (IER). For the overall IVI-CAT, 5 or 9.7 items were required, on average, to obtain moderate or high precision estimates of vision-related quality of life, corresponding to 82.1 and 65.4% item reductions compared to the paper-pencil IVI. Agreement was high between the person measures generated from the full IVI item bank and the IVI-CAT for both the high precision simulation (mean bias, - 0.004 logits 95% LOA - 0.594 to 0.587) and moderate precision simulation (mean bias, 0.014 logits 95% LOA - 0.828 to 0.855). The IER for the IVI-CAT in the moderate precision simulation was skewed, with six EWB items used > 40% of the time. Compared to the paper-pencil IVI instrument, the IVI-CATs required fewer items without loss of measurement precision, making them potentially attractive outcome instruments for implementation into clinical trials, healthcare, and research. Final versions of the IVI-CATs are available.
Publisher: Springer Science and Business Media LLC
Date: 04-08-2022
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-2014
Publisher: Elsevier BV
Date: 03-2023
Publisher: Springer Science and Business Media LLC
Date: 29-09-2023
Publisher: Wiley
Date: 16-09-2021
DOI: 10.5694/MJA2.51242
Publisher: Elsevier BV
Date: 04-2018
Publisher: SLACK, Inc.
Date: 06-2018
DOI: 10.3928/1081597X-20180326-01
Abstract: To assess psychometric properties of the Hong Kong Quality of Life Questionnaire (HKQ) using Rasch analysis and use it to assess cataract surgery outcomes. The HKQ was interviewer administered to participants at baseline (preoperative) and 12 months of follow-up (postoperative). Rasch analysis was used to assess and improve psychometric properties of the HKQ using the preoperative data. The responsiveness of the HKQ was assessed on the stacked preoperative and postoperative data, reported with the effect size. One hundred ninety-nine participants (median age: 72 years interquartile range: 65 to 78 years) with cataract completed the HKQ at the preoperative assessment. There were more women (58%) and most of the participants had bilateral cataract (83.9%). Nearly half of the participants had undergone surgery in one eye (45.2%) followed by bilateral surgery (38.7%). Psychometric assessment guided by Rasch analysis resulted into a 15-item HKQ with promising psychometric properties including adequate measurement precision (2.09), no misfitting items, near perfect targeting (−0.05), unidimensionality, and with no evidence of item bias. For those who completed the HKQ (n = 82, 41.2%) at the 12-month follow-up visit, all groups demonstrated statistically significant gains in the HKQ scores, with the highest gain in participants who had undergone bilateral surgery (effect size: 2.61). The 15-item HKQ was valid and psychometrically sound and might be a highly responsive instrument to measure cataract surgery outcomes in China. This study demonstrated that cataract surgery significantly improves quality of life in the Chinese population. [ J Refract Surg. 2018 (6):413–418.]
Publisher: BMJ
Date: 19-09-2017
DOI: 10.1136/BJOPHTHALMOL-2017-310915
Abstract: We explored the direct and indirect impact of restrictions in daily living activities on the relationship between perceived visual symptoms associated with diabetic retinopathy (DR) and psychological functioning. In this prospective, cross-sectional study, 514 tertiary patients with DR (mean age±SD, 60.4±12.6 years 64% male) answered questions related to nine domains of DR-specific quality of life. These were classified into the following predictor, mediating and outcome variables: visual symptoms (predictor variable) activity limitation, driving, lighting, social restriction, inconvenience, mobility (mediating variables) and emotional distress and concerns (outcome variables). Direct and indirect relationships between study variables were assessed using path analysis, using interval-level person measures derived from Rasch analyses of the study questionnaires. We found no direct effect of DR-related visual symptoms on emotional distress or concerns. Rather, the association between visual symptoms and emotional distress was mediated (all p .05) by mobility (indirect effect=0.07), inconvenience (indirect effect=0.28), activity limitation (indirect effect=0.13) and social restriction (indirect effect=0.11). Similarly, the relationship between DR-related visual symptoms and concerns was mediated by inconvenience (indirect effect=0.36) and social restriction (indirect effect=0.11). Lighting and driving did not have a mediating role. The link between vision and psychological functioning outcomes such as emotional distress and concern is complex in patients with DR and mediated by limitations in daily living activities and social factors. Interventions to enhance daily functioning and social interaction may be effective in reducing emotional distress associated with DR-related vision impairment.
Publisher: Springer Science and Business Media LLC
Date: 06-2018
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 10-06-2022
DOI: 10.1167/TVST.11.6.9
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2016
DOI: 10.1097/OPX.0000000000000958
Abstract: To explore whether large item sets, as used in item banking, enable important latent traits, such as driving, to form stand-alone measures. The 88-item activity limitation (AL) domain of the glaucoma module of the Eye-tem Bank was interviewer-administered to patients with glaucoma. Rasch analysis was used to calibrate all items in AL domain on the same interval-level scale and test its psychometric properties. Based on Rasch dimensionality metrics, the AL scale was separated into subscales. These subscales underwent separate Rasch analyses to test whether they could form stand-alone measures. Independence of these measures was tested with Bland and Altman (B& A) Limit of Agreement (LOA). The AL scale was completed by 293 patients (median age, 71 years). It demonstrated excellent precision (3.12). However, Rasch analysis dimensionality metrics indicated that the domain arguably had other dimensions which were driving, luminance, and reading. Once separated, the remaining AL items, driving and luminance subscales, were unidimensional and had excellent precision of 4.25, 2.94, and 2.22, respectively. The reading subscale showed poor precision (1.66), so it was not examined further. The luminance subscale demonstrated excellent agreement (mean bias, 0.2 logit 95% LOA, −2.2 to 3.3 logit) however, the driving subscale demonstrated poor agreement (mean bias, 1.1 logit 95% LOA, −4.8 to 7.0 logit) with the AL scale. These findings indicate that driving items in the AL domain of the glaucoma module were perceived and responded to differently from the other AL items, but the reading and luminance items were not. Therefore, item banking enables stand-alone measurement of driving ability in glaucoma.
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 28-09-2011
DOI: 10.1167/IOVS.10-7093
Abstract: To evaluate the precision (repeatability and reproducibility) of the Pentacam HR (high-resolution) tomographer (Oculus, Wetzlar, Germany) across a large range of measurement parameters. A randomly selected healthy eye of 100 subjects was scanned twice with the Pentacam HR by one observer for each of the three measurement modes: 25-picture (1 second) scan, 50-picture (2 second) scan, and cornea fine scan (50 pictures in 1 second). The repeatability of each scan mode was assessed. One additional 25-picture scan was acquired by a second observer to test reproducibility. Overall, the Pentacam HR had good precision, with the cornea fine scan returning the most precise results: The 25- and 50-picture scans showed similar precision. The repeatability limits, expressed as the within-subject SD × 1.96√2 of the anterior keratometry (K)1 and K2 readings with the standard 25-picture scan, were 0.25 and 0.36 D, respectively. Pachymetry maps, corneal maps, anterior chamber depth maps, corneal volume, topometric Q values and indices were also found to be precise. Poor precision was found for estimates of axis (astigmatic and progression index), pupil center pachymetry, single points on corneal maps, refractive power maps, and equivalent K readings. Measurements taken with the Pentacam HR are repeatable and reproducible, especially those obtained with the cornea fine scan. Although the Pentacam HR is clearly a very useful clinical and research tool, the measurement of corneal axes, pupil center pachymetry, front meridional and axial maps, refractive power maps, and equivalent K readings should be interpreted with caution.
Publisher: Springer Science and Business Media LLC
Date: 31-01-2012
DOI: 10.1007/S11136-012-0110-1
Abstract: Assessing the efficacy of treatment modalities for diabetic retinopathy (DR) from the patient's perspective is restricted due to a lack of a comprehensive patient-reported outcome measure. We are developing a DR-specific quality of life (QoL) item bank, and we report here on the qualitative results from the first phase of this project. Eight focus groups and 18 semi-structured interviews were conducted with 57 patients with DR. The sessions were transcribed verbatim and iteratively analysed using the constant comparative method and NVIVO software. Participants had a median age of 58 years (range 27-83 years). Twenty-seven (47%) participants had proliferative DR in the better eye, and 14 (25%) had clinically significant macular oedema. Nine QoL domains were identified, namely visual symptoms, ocular surface symptoms, vision-related activity limitation, mobility, emotional well-being, health concerns, convenience, social, and economic. Participants described many vision-related activity limitations, particularly under challenging lighting conditions however, socioemotional issues were equally important. Participants felt frustrated due to their visual restrictions, concerned about further vision loss and had difficulty coping with this uncertainty. Restrictions on driving were pervasive, affecting transport, social life, relationships, responsibilities, work and independence. Patients with DR experience many socioemotional issues in addition to vision-related activity limitations. Data from this study will be used to generate data for a DR-specific QoL item bank.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2018
DOI: 10.1097/OPX.0000000000001246
Abstract: 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. 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. 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. 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. 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.
Publisher: Informa UK Limited
Date: 2014
DOI: 10.1111/CXO.12069
Abstract: Significant levels of non-compliance and poor hygiene among contact lens wearers have been reported previously from different parts of the world. This survey aimed at identifying the scope of hygiene and non-compliant behaviour of soft contact lens wearers in the Mal es. Established soft lens wearers attending two eye clinics in Male' city, were interviewed in office or via telephone. A set of interviewer-administered questions was used to access the subjective response on compliance and hygiene behaviour (hand and lens case hygiene, water exposure, adherence to lens replacement schedule, dozing and overnight wear, awareness of aftercare visits and reuse of disinfecting solution). Participants were also asked to rate themselves as a contact lens user based on their perceived compliance and hygiene practices. Out of 107 participants, 79 (74.8 per cent) were interviewed in the office and the rest via telephone. The majority of lens wearers were female, office workers and students, with a mean age of 20.64 ± 4.4 years. Mean duration of lens wear was 28.04 ± 8.36 months. Most of them were using spherical lenses (86.9 per cent) on a daily wear basis (96.3 per cent). Major reported forms of non-compliance were poor hand hygiene (60.7 per cent), lack of aftercare awareness (39.3 per cent), water exposure (35.5 per cent) and over-use of lenses (24.3 per cent). While females were more likely to overuse their lenses than males (p < 0.005), other socio-demographic factors were not associated with reported non-compliance. Although around 90 per cent of the participants considered themselves average or good contact lens wearers, most exhibited some form of non-compliant and poor hygienic behaviour. A significant number of Mal ian contact lens wearers exhibited poor levels of hygiene and compliance with contact lenses and lens care systems. An effective educational reinforcement strategy needs to be developed to modify lens wearers' non-compliance.
Publisher: Cambridge University Press (CUP)
Date: 20-10-2021
DOI: 10.1017/S0144686X21001549
Abstract: The recent Royal Commission into Aged Care Quality and Safety in Australia has documented systemic failures and shocking incidences of abuse and neglect, a not uncommon story internationally. As aged care in many countries is predominantly publicly funded, it is important to understand the general public's attitudes towards aged care quality, what aspects of care quality they think are most important and their willingness to contribute to increased funding to the sector. This paper asks specifically whether self-reported aged care literacy impacts expectations and willingness to pay. More than 10,000 members of the general population were surveyed stratified by age, gender and state. Regardless of the level of aged care literacy, there was consensus about what constitutes quality care, and care priorities for the sector. However, aged care literacy affected willingness to pay to fund a better-quality aged care system. The current crisis facing Australia's aged care system and that of many other countries internationally demonstrates the central importance of general public support to drive quality improvements, recognising that increasing public expenditure on aged care is a necessary part of the solution. This study provides important baseline data from which to commence national and international conversations to consider all options for ensuring the quality, safety and sustainability of aged care now and into the future.
Publisher: Springer Science and Business Media LLC
Date: 03-2018
Publisher: Wiley
Date: 02-03-2021
DOI: 10.1111/OPO.12792
Abstract: 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. 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. 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. 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.
Publisher: Springer Science and Business Media LLC
Date: 05-05-2018
DOI: 10.1007/S00417-018-3998-5
Abstract: Our understanding of the coping strategies used by people with visual impairment to manage stress related to visual loss is limited. This study aims to develop a sophisticated coping instrument in the form of an item bank implemented via Computerised adaptive testing (CAT) for hereditary retinal diseases. Items on coping were extracted from qualitative interviews with patients which were supplemented by items from a literature review. A systematic multi-stage process of item refinement was carried out followed by expert panel discussion and cognitive interviews. The final coping item bank had 30 items. Rasch analysis was used to assess the psychometric properties. A CAT simulation was carried out to estimate an average number of items required to gain precise measurement of hereditary retinal disease-related coping. One hundred eighty-nine participants answered the coping item bank (median age = 58 years). The coping scale demonstrated good precision and targeting. The standardised residual loadings for items revealed six items grouped together. Removal of the six items reduced the precision of the main coping scale and worsened the variance explained by the measure. Therefore, the six items were retained within the main scale. Our CAT simulation indicated that, on average, less than 10 items are required to gain a precise measurement of coping. This is the first study to develop a psychometrically robust coping instrument for hereditary retinal diseases. CAT simulation indicated that on an average, only four and nine items were required to gain measurement at moderate and high precision, respectively.
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 08-06-2021
DOI: 10.1167/TVST.10.7.8
Publisher: Elsevier BV
Date: 11-2019
DOI: 10.1016/J.SOCSCIMED.2019.112543
Abstract: Evidence surrounding utilities for health states, derived either directly from the application of preference-based valuation methods or indirectly from the application of preference-based quality of life instruments, is increasingly being utilised to inform the cost-effectiveness of child health interventions. Proxy (parent or health professional) assessments are common in this area. This study sought to investigate the degree of convergence in childhood utilities generated directly or indirectly within dyad child and proxy assessments. A systematic literature review was conducted following PRISMA guidelines. A comprehensive literature search strategy conducted across six search engines (PubMed, Embase, Web of Science, PsychoINFO, EconLit, CINAHL and Cochrane Library). Original peer-reviewed articles that reported utilities derived directly or indirectly using simultaneous dyad child and proxy assessments were extracted. Mean and median utilities, correlation coefficients and levels of agreement were extracted, catalogued and assessed. A total of 35 studies that reported utilities for two or more respondent types were identified. Of these, 29 studies reported dyad childhood self-report and proxy utilities whilst six studies reported levels of agreement and/or correlations only without documenting overall utilities. Proxy assessment was most often conducted by parents with the HUI3 representing the most commonly applied instrument across a range of health conditions. The utilities derived from child and parent proxy assessment were bidirectional with parental proxies tending to underestimate and health professional proxies tending to overestimate relative to child self-reports. Inter-rater agreement between child self-reports and parent-proxy reports were poorer for more subjective attributes (cognition, emotion and pain), relative to physical attributes (mobility, self-care, speech, vision) of health-related quality of life. Childhood utilities derived from children or proxies are not interchangeable. The choice of self or proxy assessor may have potentially significant implications for economic evaluations of child health interventions.
Publisher: Oxford University Press (OUP)
Date: 10-2023
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 27-05-2020
DOI: 10.1167/IOVS.61.5.48
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 25-06-2012
DOI: 10.1167/IOVS.12-9728
Abstract: To investigate the effect of rating scale designs (question formats and response categories) on item difficulty calibrations and assess the impact that rating scale differences have on overall vision-related activity limitation (VRAL) scores. Sixteen existing patient-reported outcome instruments (PROs) suitable for cataract assessment, with different rating scales, were self-administered by patients on a cataract surgery waiting list. A total of 226 VRAL items from these PROs in their native rating scales were included in an item bank and calibrated using Rasch analysis. Fifteen item/content areas (e.g., reading newspapers) appearing in at least three different PROs were identified. Within each content area, item calibrations were compared and their range calculated. Similarly, five PROs having at least three items in common with the Visual Function (VF-14) were compared in terms of average item measures. A total of 614 patients (mean age ± SD, 74.1 ± 9.4 years) participated. Items with the same content varied in their calibration by as much as two logits "reading the small print" had the largest range (1.99 logits) followed by "watching TV" (1.60). Compared with the VF-14 (0.00 logits), the rating scale of the Visual Disability Assessment (1.13 logits) produced the most difficult items and the Cataract Symptom Scale (0.24 logits) produced the least difficult items. The VRAL item bank was suboptimally targeted to the ability level of the participants (2.00 logits). Rating scale designs have a significant effect on item calibrations. Therefore, constructing item banks from existing items in their native formats carries risks to face validity and transmission of problems inherent in existing instruments, such as poor targeting.
Publisher: Springer Science and Business Media LLC
Date: 06-08-2019
Publisher: Springer Science and Business Media LLC
Date: 08-11-2013
DOI: 10.1007/S11136-012-0307-3
Abstract: We are developing an item bank assessing the impact of diabetic retinopathy (DR) on quality of life (QoL) using a rigorous multi-staged process combining qualitative and quantitative methods. We describe here the first two qualitative phases: content development and item evaluation. After a comprehensive literature review, items were generated from four sources: (1) 34 previously validated patient-reported outcome measures (2) five published qualitative articles (3) eight focus groups and 18 semi-structured interviews with 57 DR patients and (4) seven semi-structured interviews with diabetes or ophthalmic experts. Items were then evaluated during 3 stages, namely binning (grouping) and winnowing (reduction) based on key criteria and panel consensus development of item stems and response options and pre-testing of items via cognitive interviews with patients. The content development phase yielded 1,165 unique items across 7 QoL domains. After 3 sessions of binning and winnowing, items were reduced to a minimally representative set (n = 312) across 9 domains of QoL: visual symptoms ocular surface symptoms activity limitation mobility emotional health concerns social convenience and economic. After 8 cognitive interviews, 42 items were amended resulting in a final set of 314 items. We have employed a systematic approach to develop items for a DR-specific QoL item bank. The psychometric properties of the nine QoL subscales will be assessed using Rasch analysis. The resulting validated item bank will allow clinicians and researchers to better understand the QoL impact of DR and DR therapies from the patient's perspective.
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Date: 25-10-2012
DOI: 10.1167/IOVS.12-9969
Abstract: To assess the psychometric properties of the National Eye Institute Refractive Error Quality of Life (NEI-RQL-42) questionnaire in keratoconus and compare these findings to patients with refractive error correction alone. The Portuguese version of the NEI-RQL-42 Quality of Life questionnaire was completed by 44 patients who had keratoconus before and after implantation of intracorneal ring segments. Rasch analysis was used to assess the use of response categories, success in measuring a single trait per subscale (unidimensionality), ability to discriminate person ability (precision), and targeting of questions to person quality of life (QoL). Rasch analysis was performed for the questionnaire subscales using stacked preoperative and postoperative data. Three subscales (Symptoms, Dependence on correction, and Suboptimal correction) contained response categories that were not used as intended. Six subscales contained misfitting items indicating multidimensionality. Eleven subscales exhibited inadequate measurement precision. Only the Near vision subscale demonstrated adequate precision with a person separation greater than 2.0. Targeting of items to person QoL was adequate in 11 of the 12 subscales with a mean item location of less than 1 logit. Only one NEI-RQL-42 subscale (Near vision) performed adequately in keratoconus. Targeting was better in patients with keratoconus than in patients with refractive error correction alone, but 11 of the 12 subscales remain manifestly inadequate. Better instruments exist for measuring patient-reported outcomes in keratoconus.
Publisher: Springer Science and Business Media LLC
Date: 11-2020
DOI: 10.1140/EPJC/S10052-020-08469-8
Abstract: This paper presents a search for direct top squark pair production in events with missing transverse momentum plus either a pair of jets consistent with Standard Model Higgs boson decay into b -quarks or a same-flavour opposite-sign dilepton pair with an invariant mass consistent with a Z boson. The analysis is performed using the proton–proton collision data at $$\\sqrt{s}=13$$ s = 13 TeV collected with the ATLAS detector during the LHC Run-2, corresponding to an integrated luminosity of 139 fb $$^{-1}$$ - 1 . No excess is observed in the data above the Standard Model predictions. The results are interpreted in simplified models featuring direct production of pairs of either the lighter top squark ( $$\\tilde{t}_1$$ t ~ 1 ) or the heavier top squark ( $$\\tilde{t}_2$$ t ~ 2 ), excluding at 95% confidence level $$\\tilde{t}_1$$ t ~ 1 and $$\\tilde{t}_2$$ t ~ 2 masses up to about 1220 and 875 GeV, respectively.
Location: United Kingdom of Great Britain and Northern Ireland
Location: Australia
Start Date: 2015
End Date: 2015
Funder: Flinders University
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