June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Development of a Concise Patient-Reported Outcome Measure for Cataract Surgery in South India
Author Affiliations & Notes
  • Charles Frank
    Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, United States
  • Josiah Smiley
    Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, United States
  • Hong-Gam Le
    Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, United States
  • Sanil Joseph
    Lions Aravind Institute of Community Ophthalmology, Aravind Eye Care System, Madurai, Tamil Nadu, India
  • Stephen Schilling
    Institute for Social Research, University of Michigan, Ann Arbor, Michigan, United States
    Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan, United States
  • Brian Stagg
    Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, United States
    Center for Eye Policy and Innovation, University of Michigan, Ann Arbor, Michigan, United States
  • RD Ravindran
    Aravind Eye Care System, Madurai, Tamil Nadu, India
  • Jonathan Trobe
    Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, United States
  • Joshua D Stein
    Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, United States
    Center for Eye Policy and Innovation, University of Michigan, Ann Arbor, Michigan, United States
  • Haripriya Aravind
    Aravind Eye Care System, Madurai, Tamil Nadu, India
  • Joshua R Ehrlich
    Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, United States
    Center for Eye Policy and Innovation, University of Michigan, Ann Arbor, Michigan, United States
  • Footnotes
    Commercial Relationships   Charles Frank, None; Josiah Smiley, None; Hong-Gam Le, None; Sanil Joseph, None; Stephen Schilling, None; Brian Stagg, None; RD Ravindran, None; Jonathan Trobe, None; Joshua Stein, None; Haripriya Aravind, None; Joshua Ehrlich, None
  • Footnotes
    Support  Heed Ophthalmic Foundation, Kellogg Eye Center for International Ophthalmology, Research to Prevent Blindness “Physician Scientist” Award (JDS), W.K. Kellogg Foundation (JDS), University of Michigan Medical School Summer Biomedical Research Program (CRF)
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 774. doi:
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      Charles Frank, Josiah Smiley, Hong-Gam Le, Sanil Joseph, Stephen Schilling, Brian Stagg, RD Ravindran, Jonathan Trobe, Joshua D Stein, Haripriya Aravind, Joshua R Ehrlich; Development of a Concise Patient-Reported Outcome Measure for Cataract Surgery in South India. Invest. Ophthalmol. Vis. Sci. 2017;58(8):774.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Existing patient-reported outcome measures (PROMs) for cataract surgery are too long to be employed in a busy clinical setting or are not culturally relevant to patients in South India. Consequently, we prospectively surveyed patients in order to develop and test the psychometric properties of a shortened version of the Indian Visual Functioning Questionnaire (IND-VFQ-SF) for patients undergoing cataract surgery in Tamil Nadu, India.

Methods : In Phase 1, using the full Rasch-modified IND-VFQ we prospectively surveyed patients undergoing cataract surgery preoperatively and 1 month postoperatively. We calculated the effect size of each of the 28 survey items (Cohen’s d) and correlations between item scores and preoperative visual acuity. An expert panel (AH, JDS, JRE) selected items from each subscale that were deemed relevant to patients with cataracts and that had: Cohen’s d >0.5; >35% of respondents affected; and correlation with vision in the better-seeing eye <-0.15. Selected items formed the IND-VFQ-SF. In Phase 2, the resulting IND-VFQ-SF was prospectively administered to a separate group of patients undergoing cataract surgery. Cronbach’s α and item-total correlations were calculated to evaluate the reliability of the IND-VFQ-SF. For both study phases patients were recruited in even proportions from Aravind’s private and charity hospitals.

Results : In Phase 1, 212 patients completed the full IND-VFQ questionnaire. Using predefined criteria and expert consensus, 12 survey items were selected to comprise the IND-VFQ-SF; these items were related to mobility, activity limitation, psychosocial impact, and visual symptoms. In Phase 2, the 12-item survey was completed by an additional 225 patients before and after cataract surgery. The mean age of patients in Phase 2 was 60.4 ± 8.6 years; they were 66.2% female; 36.4% had no formal schooling; 58.5% had a monthly income ≤ 5000 Rupees (US$73); and 53.9% underwent manual small-incision cataract surgery. Mean LogMAR visual acuity was 0.48 preoperatively and 0.06 post-operatively. Cronbach’s α was 0.85 and item-total correlations ranged from 0.47 to 0.74.

Conclusions : The IND-VFQ-SF we developed was found to have high internal consistency and its items had very good discriminating power. Thus, this instrument was found to be a reliable PROM to assess the success of cataract surgery in South India.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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