Development of a new Rasch-based scoring algorithm for the National Eye Institute Visual Functioning Questionnaire to improve its interpretability

Health and Quality of Life Outcomes

Research

Jennifer Petrillo¹  Ecosse Lamoureux²  Stefan Cano³  Alberto Ferreira⁴  Neil M. Bressler⁵ 

[1] Biogen, Boston, USA;Centre for Eye Research Australia, the Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, VIC, Australia;Singapore Eye Research Institute, Singapore, Singapore;Modus Outcomes, Letchworth Garden City, UK;Novartis Pharma AG, CH-4002, Basel, Switzerland;Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA;

关键词: National Eye Institute Visual Functioning Questionnaire;    Rasch Measurement Theory;    Vision-related quality of life;   

DOI  :  10.1186/s12955-017-0726-5

 received in 2016-09-28, accepted in 2017-07-20,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe NEI VFQ-25 has undergone psychometric evaluation in patients with varying ocular conditions and the general population. However, important limitations which may affect the interpretation of clinical trial results have been previously identified, such as concerns with reliability and validity. The purpose of this study was to evaluate the National Eye Institute Visual Functioning Questionnaire (NEI VFQ­25) and make recommendations for a revised scoring structure, with a view to improving its psychometric performance and interpretability.MethodsRasch Measurement Theory analyses were conducted in two stages using pooled baseline NEI VFQ­25 data for 2487 participants with retinal diseases enrolled in six clinical trials. In stage 1, we examined: scale-to-sample targeting; thresholds for item response options; item fit statistics; stability; local dependence; and reliability. In stage 2, a post-hoc revision of the scoring structure (VFQ-28R) was created and psychometrically re-evaluated.ResultsIn stage 1, we found that the NEI VFQ­25 was mis-targeted to the sample, and had disordered response thresholds (15/25 items) and mis-fitting items (8/25 items). However, items appeared to be stable (differential item functioning for three items), have minimal item dependency (one pair of items) and good reliability (person-separation index, 0.93). In stage 2, the modified Rasch-scored NEI VFQ­28­R was assessed. It comprised two broad domains: Activity Limitation (19 items) and Socio-Emotional Functioning (nine items). The NEI VFQ­28­R demonstrated improved performance with fewer disordered response thresholds (no items), less item misfit (three items) and improved population targeting (reduced ceiling effect) compared with the NEI VFQ­25.ConclusionsCompared with the original version, the proposed NEI VFQ­28­R, with Rasch-based scoring and a two-domain structure, appears to offer improved psychometric performance and interpretability of the vision-related quality of life scale for the population analysed.

【 授权许可】

CC BY   
© The Author(s). 2017