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A. Azuara-Blanco, P.A. Aspinall, C. O'Brien, P. Nelson, L. McCloughan, A.R. Hill, R. Brice, S. Green, S. Steeds; Quality of Life in Patients With Glaucoma: A Conjoint Analysis Approach . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2204.
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Purpose: To study the quality of life (QOL) of patients with glaucoma using a conjoint analysis approach Methods: A group of 106 patients with chronic glaucoma and visual acuity better than 6/12 were given a battery of tests including visual function (binocular Easterman visual field, Pelli-Robson contrast sensitivity), and QOL questionnaires. Included within the latter was choice based conjoint analysis - a way of estimating patient utilities (i.e. values or part worths) associated with different visual outcomes, and the NEI-VFQ. The outcomes were structured into five attributes that emerged following principal component analysis of a vision-related QOL questionnaire given to glaucoma patients. The five attributes - aspects of central and near vision, peripheral vision, darkness and glare, household chores, and outdoor mobility were presented at different levels of difficulty in coping with a set of daily tasks. Results: There was a rank order of importance in which aspects of central vision and outdoor mobility were the highest rated priorities. Although peripheral visual loss characterises the disease, its associated behavioural problems were rated as less important by patients than tasks associated with central vision. While the attribute ‘darkness and glare' was the most frequently reported complaint suffered by the group of patients, its relative importance was much less than that assigned to the other attributes. In general, patient ratings were not linked to age, gender, or acuity level or the results from the NEI-VFQ questionnaire. The importance rating of central vision increased significantly with increasing visual field loss while that of outdoor mobility decreased significantly with increasing field loss. In addition there was evidence for increased priority for ‘glare' as contrast sensitivity decreased. The measure of visual field loss most closely related to these changes was pattern standard deviation. Conclusions: The concerns of a group of glaucoma patients were not primarily associated with the characteristic loss of peripheral visual field but with an increased awareness of the vulnerability of central vision as the disease progresses.
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