Validation of a novel diabetic retinopathy utility index using discrete choice experiments

2019 ◽  
Vol 104 (2) ◽  
pp. 188-193 ◽  
Author(s):  
Eva K Fenwick ◽  
Nick Bansback ◽  
Alfred Tau Liang Gan ◽  
Julie Ratcliffe ◽  
Leonie Burgess ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Diabetic Retinopathy ◽  
Discrete Choice ◽  
Convergent Validity ◽  
Severe Disease ◽  
Well Being ◽  
Vision Impairment ◽  
Discrete Choice Experiments ◽  
Utility Index

Background/aimsTo validate a preference-based Diabetic Retinopathy Utility Index (DRU-I) using discrete choice experiment (DCE) methods and assess disutilities associated with vision-threatening DR (VTDR: severe non-proliferative DR, proliferative DR and clinically significant macular oedema) and associated vision impairment.MethodsThe DRU-I comprises five quality-of-life dimensions, including Visual symptoms, Activity limitation/mobility, Lighting and glare, Socio-emotional well-being and Inconvenience, each rated as no, some, or a lot of difficulty. The DRU-I was developed using a DCE comprising six blocks of nine choice sets which, alongside the EuroQoL-5D (EQ-5D-3L) and Vision and Quality of Life (VisQoL) utility instruments, were interviewer-administered to participants. To ensure the DRU-I was sensitive to severe disease, we oversampled patients with VTDR. Data were analysed using conditional logit regression.ResultsOf the 220 participants (mean±SD age 60.1±11.3 years; 70.9% men), 57 (29.1%) and 139 (70.9%) had non-VTDR and VTDR, respectively, while 157 (71.4%), 20 (9.4%) and 37 (17.3%) had no, mild or moderate/severe vision impairment, respectively. Regression coefficients for all dimensions were ordered as expected, with worsening levels in each dimension being less preferred (theoretical validity). DRU-I utilities decreased as DR severity (non-VTDR=0.87; VTDR=0.80; p=0.021) and better eye vision impairment (none=0.84; mild=0.78; moderate/severe=0.72; p=0.012) increased. DRU-I utilities had low (r=0.39) and moderate (r=0.58) correlation with EQ-5D and VisQoL utilities, respectively (convergent validity).DiscussionThe DRU-I can estimate utilities associated with vision-threatening DR and associated vision impairment. It has the potential to assess the cost-effectiveness of DR interventions from a patient perspective and inform policies on resource allocation relating to DR.

scholarly journals Vision-related quality of life in adults with severe peripheral vision loss: a qualitative interview study

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Ryan Lange ◽  
Abigail Kumagai ◽  
Sara Weiss ◽  
Katherine B. Zaffke ◽  
Sherry Day ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Contrast Sensitivity ◽  
Qualitative Interviews ◽  
Well Being ◽  
Vision Impairment ◽  
Qualitative Interview Study ◽  
Patient Reported ◽  
Related Quality ◽  
The Impact

Abstract Background Existing patient-reported outcome (PRO) measures may not be relevant to the full range of functional and vision-related quality of life (VR-QOL) concerns of individuals with vision impairment due to severe peripheral field loss (PFL). Measurement of VR-QOL in severe PFL is important in order to determine the effectiveness of vision rehabilitation interventions for this population. The purpose of this study was to characterize the impact of severe PFL due to retinitis pigmentosa (RP) and glaucoma on VR-QOL as the initial phase in the development of a novel PRO measure. Methods Individuals with severe PFL due to RP or glaucoma were recruited from the Kellogg Eye Center and the Association for the Blind and Visually Impaired. Participants completed semi-structured qualitative interviews, the Impact of Vision Impairment (IVI) questionnaire and the RAND 36-Item Health Survey. Interviews were analyzed by two coders using thematic analysis. A matrix analysis was conducted to compare VR-QOL by cause of severe PFL. Sample size was determined by thematic saturation. Results The study included 37 participants (19 RP, 18 glaucoma). Median best-corrected visual acuity for those with RP and glaucoma was 20/40 and 20/27.5, while Pelli-Robson contrast sensitivity was 1.2 log contrast sensitivity (logCS) and 1.1 logCS, respectively. Median domain scores on the IVI (reading, mobility, well-being) ranged from a low of − 0.2 to a high of 0.7 logits in those with RP and from 0.5 to 1.2 logits in those with glaucoma. Qualitative interviews identified six VR-QOL themes relevant across participants with both RP and glaucoma, including activity limitations, driving, emotional well-being, reading, mobility, and social function. VR-QOL concerns were largely consistent among those with severe PFL due to RP and glaucoma. These overarching themes contained content relevant to specific challenges related to severe PFL. Conclusions There are commonly occurring VR-QOL concerns among individuals with severe PFL due to RP and glaucoma. The outlined themes will serve as the basis for development of the Low Vision Severely Constricted Peripheral Eyesight (LV-SCOPE) Questionnaire.

Beyond vision loss: the independent impact of diabetic retinopathy on vision-related quality of life in a Chinese Singaporean population

2018 ◽  
Vol 103 (9) ◽  
pp. 1314-1319 ◽  
Author(s):  
Eva K Fenwick ◽  
Ryan E K Man ◽  
Alfred Tau Liang Gan ◽  
Neelam Kumari ◽  
Charlene Wong ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Diabetic Retinopathy ◽  
Vision Loss ◽  
Well Being ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Significant Difference ◽  
Related Quality ◽  
The Impact

Background/aimsTo assess the independent impact of diabetic retinopathy (DR) on three domains of vision-related quality of life (VRQoL) in a Chinese Singapore population.MethodsThe Singapore Chinese Eye Study (n=3353; 2009–2011) was a population-based, prospective, cross-sectional study conducted at the Singapore Eye Research Institute. The study population included 292 adults with diabetes, with and without DR. DR (better eye) was categorised as presence and absence of any DR; severity of DR (no vision-threatening DR (VTDR); severe non-proliferative DR (NPDR); PDR and/or clinically significant macular oedema and VTDR). Our main outcome was VRQoL which was measured using Rasch-calibrated scores from the ‘Reading’, ‘Mobility’ and ‘Emotional’ domains of the Impact of Vision Impairment questionnaire. The relationship between DR and VRQoL was assessed using multiple linear regression models.ResultsOf the 292 individuals (mean age 61.35 ± 9.66 years; 55.8% male), 201 (68.8%), 49 (16.8%), 20 (6.8%), 22 (7.5%) and 27 (9.2%) had no DR, minimal-mild NPDR, moderate-severe NPDR, PDR and VTDR, respectively. Any DR and VTDR were independently associated with 6% and 12% worse Reading scores and 7% and 18% poorer Emotional well-being, respectively, compared with those without DR. These associations persisted after separate adjustment for visual impairment and presenting visual acuity. No significant difference was found in the Mobility domain between persons with and without DR.ConclusionsWe documented that DR, particularly VTDR, was independently associated with restrictions in Reading and Emotional well-being. Understanding factors underlying the detrimental DR-VRQoL relationship may optimise rehabilitation outcomes for individuals with DR.

scholarly journals Comparison of 2 Quality-of-Life Questionnaires in Women Treated for Breast Cancer: The RAND 36-Item Health Survey and the Functional Living Index–Cancer

2005 ◽  
Vol 85 (9) ◽  
pp. 851-860 ◽  
Author(s):  
Rick W Wilson ◽  
Lorraine M Hutson ◽  
Deborah VanStry
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Health Survey ◽  
Convergent Validity ◽  
Well Being ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Global Quality Of Life ◽  
Index Cancer

Abstract Background and Purpose. A variety of health status questionnaires have been used in physical rehabilitation studies involving women with breast cancer, but the usefulness of these questionnaires as measures of physical, mental, and social well-being has not been firmly established in this population. This study was conducted to assess the convergent and discriminative properties of the RAND 36-Item Health Survey and the Functional Living Index–Cancer (FLIC). Subjects Both questionnaires were administered concurrently to 110 outpatients treated surgically for breast cancer at a National Cancer Institute–designated Comprehensive Cancer Center. Methods Bivariate correlations and a multi-trait–multi-method matrix were used to evaluate convergent validity between summary and subscale scores from both questionnaires. Discriminative validity was assessed by testing for expected differences between women who were treated for breast cancer with and without secondary lymphedema. Results Correlations between overall quality-of-life scores produced by both questionnaires were modest, indicating that the instruments focus on somewhat different aspects of health-related quality of life. Global quality-of-life and physical well-being scores were lower among women with lymphedema secondary to breast cancer. The FLIC demonstrated greater sensitivity to group differences in emotional well-being. Discussion and Conclusion The results suggest that neither questionnaire can be replaced by the other in studies of women treated for breast cancer. Both questionnaires were able to distinguish physical functioning deficits in women with lymphedema secondary to breast cancer, but symptom- or treatment-specific measures may be required to assess more subtle difficulties related to the emotional aspects of health and functioning in this population.

scholarly journals Quality of Life (QOL) in Patients with Acromegaly Is Severely Impaired: Use of a Novel Measure of QOL: Acromegaly Quality of Life Questionnaire

2005 ◽  
Vol 90 (6) ◽  
pp. 3337-3341 ◽  
Author(s):  
Susannah V. Rowles ◽  
L. Prieto ◽  
X. Badia ◽  
Steven M. Shalet ◽  
Susan M. Webb ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Signs And Symptoms ◽  
Well Being ◽  
Cross Sectional Study ◽  
Life Questionnaire ◽  
Cross Sectional ◽  
Quality Of Life Questionnaire ◽  
Utility Index ◽  
Igf I

Acromegaly Quality of Life Questionnaire (AcroQoL) is a new disease-generated quality of life (QOL) questionnaire comprising 22 questions covering physical and psychological aspects of acromegaly and subdivided into “appearance” and “personal relations” categories. We have performed a cross-sectional study of QOL in 80 patients [43 male (mean age, 54.2 yr; range, 20–84); median GH, 0.93ng/ml (range, <0.3 to 23.7); IGF-I, 333.1 ng/ml (range, 47.7–899)] with acromegaly. In addition to AcroQoL, patients completed three generic QOL questionnaires: Psychological General Well-Being Schedule (PGWBS), EuroQol, and a signs and symptoms score (SSS). All three generic questionnaires confirmed impairment in QOL [mean scores: PGWBS, 69.6; EuroQol, visual analog scale, 66.4 (range, 20–100) and utility index, 0.7 (range, −0.07 to 0.92); and SSS, 12 (range, 0–27)]. There was no correlation between biochemical control and any measure of QOL. AcroQoL (57.3%; range, 18.2–93.2) correlated with PGWBS (r = 0.73; P < 0.0001); and in patients with active disease, AcroQoL-physical dimension correlated with SSS (r = −0.67; P < 0.0003). In all questionnaires, prior radiotherapy was associated with impaired QOL. In conclusion, these data underline the marked impact that acromegaly has on patients’ QOL and provide the first evidence validating AcroQoL against well-authenticated measures of QOL. This indicates the potential of AcroQoL as a patient-friendly measure of disease activity.

Development of the Sport Mental Health Continuum—Short Form (Sport MHC-SF)

2019 ◽  
Vol 13 (4) ◽  
pp. 593-608 ◽  
Author(s):  
Brian J. Foster ◽  
Graig M. Chow
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Convergent Validity ◽  
Short Form ◽  
Measurement Instrument ◽  
Collegiate Athletes ◽  
Well Being ◽  
Emotional Quality ◽  
Context Specific

Well-being research conducted in competitive athletics has been marred by the lack of a context-specific measurement instrument. The purpose of this study was to adapt the Mental Health Continuum – Short Form (MHC-SF) to create a sport-specific well-being instrument, the Sport Mental Health Continuum—Short Form (Sport MHC-SF), and test its initial psychometric properties. Participants were 287 collegiate athletes from a variety of sports. Confirmatory factor analysis (CFA) determined a three-factor structure of sport well-being, consisting of subjective, psychological, and social factors, as the model of best fit. Internal consistency reliabilities of the subscales exceeded .88. Moderate positive correlations were found between Sport MHC-SF subscales and quality of life indices, notably physical and emotional quality of life, demonstrating convergent validity. The Sport MHC-SF will facilitate empirical research by providing a more accurate and comprehensive measurement of well-being for an athletic population.

scholarly journals Development and Validation of the Short Multidimensional Well-Being Questionnaire (SMWQ)

2017 ◽  
Vol 10 (1) ◽  
pp. 25-31
Author(s):  
Lucile Bigot ◽  
Catherine Garncarzyk ◽  
Antoine Gauthier ◽  
Gaelle Quarck ◽  
Fabrice Dosseville
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Factor Analysis ◽  
Factor Structure ◽  
Convergent Validity ◽  
Well Being ◽  
Emotional Reactions ◽  
Self Report ◽  
Four Dimensions

Purpose: Psychological well-being and health are closely linked at older ages. It is widely recognized that adapted regular physical exercise improves drastically both the physical and emotional well-being and allows older adults to stay healthy longer, with a better quality of life. In the framework of a European project (MOTION) to increase the life expectancy, independence and quality of life of older adults, the aim of the current research was to develop and validate a brief, multi-faceted, self-report measure of well-being in older adults. Method: The aim of Study 1 was to establish the factor structure of the newly developed measure using Exploratory Factor Analysis (EFA). The aim of Study 2 was to replicate the measure's factor structure using Confirmatory Factor Analysis (CFA), and to evaluate test-retest reliability and convergent validity. Results: Analyses allowed generating a model of well-being comprising four dimensions: Perceived physical value, self-esteem and self-efficacy, socialization, and emotional reactions. Conclusion: The findings suggest that the SMWQ is appropriate for use with older adults and can help researchers and health professionals to assess the effects of APA programs.

scholarly journals Is the Kidscreen-27 a valid measure of health-related quality of life in 10-year-old Norwegian children?

2015 ◽  
Author(s):  
John Roger Andersen ◽  
Gerd Karin Natvig ◽  
Kristin Haraldstad ◽  
Turid Skrede ◽  
Eivind Aadland ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Convergent Validity ◽  
Reliability And Validity ◽  
Well Being ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
General Life Satisfaction ◽  
Over Time

The aim of this study was to investigate the reliability and validity of the Norwegian Kidscreen-27 questionnaire, a measure of generic health-related quality of life, in 10 year-old children. The Kidscreen-27 consists of five domains and was validated in a sample of 56 school children (29 boys). The children completed the questionnaire at three different time points during two consecutive school days. For convergent validity, the study was powered to detect a statistically significant correlation coefficient of 0.4. Cronbach's alpha values ranged from 0.73 to 0.83. Floor effects were all zero and ceiling effects ranged from 1.7% to 23.7%. Intraclass correlation values over time ranged from 0.71 to 0.81. However, some individual variability over time occurred and was illustrated by Bland Altman plots. The domains of physical well-being, psychological well-being and autonomy & parents improved over time (Ps < 0.05), while social support and school environment domains did not. We assessed convergent validity using general life satisfaction scores obtained by administering the Cantrils Ladder. All the Kidscreen-27 domains were significantly associated with general life satisfaction (Spearman rank correlations ranged from 0.29 to 0.59, Ps < 0.05). In conclusion, the Norwegian version of Kidscreen-27 has good reliability and validity.

scholarly journals Health-related quality of life and well-being in people over 75 years of age with end-stage kidney disease managed with dialysis or comprehensive conservative care: a cross-sectional study in the UK and Australia

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e027776 ◽  
Author(s):  
Karan K Shah ◽  
Fliss E M Murtagh ◽  
Kevin McGeechan ◽  
Su Crail ◽  
Aine Burns ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Kidney Disease ◽  
Older People ◽  
Convergent Validity ◽  
Well Being ◽  
Summary Score ◽  
Cross Sectional ◽  
Conservative Care ◽  
Treatment Type

ObjectiveTo measure health-related quality of life (HRQoL) and well-being in older people with end-stage kidney disease (ESKD) and to determine the association between treatment type and sociodemographic characteristics on these outcome measures. In addition, to assess the convergent validity between the HRQoL and well-being measure and their feasibility and acceptability in this population.DesignProspective cross-sectional study.SettingThree renal units in the UK and Australia.Participants129 patients with ESKD managed with dialysis or with an estimated glomerular filtration ≤10 mL/min/1.73 m2and managed with comprehensive conservative, non-dialytic care.Outcome measuresHRQoL and well-being were assessed using Short-Form six dimensions (SF-6D, 0–1 scale); Kidney Disease Quality of Life (KDQOL-36) (0–100 scale) and Investigating Choice Experiments Capability Measure-Older people (ICECAP-O, 0–1 scale). Linear regression assessed associations between treatment, HRQoL and well-being. Pearson’s correlation coefficient assessed convergent validity between instruments.ResultsMedian age of 81 years (IQR 78–85), 65% males; 83 (64%) were managed with dialysis and 46 (36%) with conservative care. When adjusted for treatment type and sociodemographic variables, those managed on dialysis reported lower mean SF-6D utility (−0.05, 95% CI −0.12 to 0.01); lower KDQOL Physical Component Summary score (−3.17, 95% CI −7.61 to 1.27); lower Mental Component Summary score (−2.41, 95% CI −7.66 to 2.84); lower quality of life due to burden (−28.59, 95% CI −41.77 to −15.42); symptoms (−5.93, 95% CI −14.61 to 2.73) and effects of kidney disease (−16.49, 95% CI −25.98 to −6.99) and lower overall ICECAP-O well-being (−0.07, 95% CI −0.16 to 0.02) than those managed conservatively. Correlation between ICECAP-O well-being and SF-6D utility scores was strong overall, 0.65 (p<0.001), but weak to moderate at domain level.ConclusionsOlder people on dialysis report significantly higher burden and effects of kidney disease than those on conservative care. Lower HRQoL and well-being may be associated with dialysis treatment and should inform shared decision-making about treatment options.Trial registration numberUK (IRAS project ID: 134360andREC reference 14/LO/0291) and Australia (R20140203 HREC/14/RAH/36).

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