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Sharon A. Haymes, Alan W. Johnston, Anthony D. Heyes; The Development of the Melbourne Low-Vision ADL Index: A Measure of Vision Disability. Invest. Ophthalmol. Vis. Sci. 2001;42(6):1215-1225.
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© ARVO (1962-2015); The Authors (2016-present)
purpose. To develop a new test of activities of daily living (ADLs) appropriate
for the low-vision population: the Melbourne Low-Vision ADL Index
methods. The MLVAI was designed as a desk-based clinical assessment, comprising
18 observed items on complex ADLs in part (a) and 9 questions on broad
self-care ADLs in part (b). Each item was rated on a five-level
descriptive scale from 0 to 4, based on independence, speed, and
accuracy of performance. It was designed to be administered under
standardized conditions with regard to the instructions, illumination,
and working distances. The validity and reliability of the new MLVAI
was determined for 122 subjects who were representative of the general
low-vision population, in a cross-sectional study.
results. Two items were found to be redundant and were eliminated from the test.
Thus, the final test comprised 25 items, with 100 being the highest
possible score. Cronbach’s α indicated an internal reliability of
0.96, and an intraclass correlation coefficient indicated an overall
reliability of 0.95. The SE of measurement was 4.5. According to
Spearman’s correlation coefficient, the test–retest reliability was
0.94 (P < 0.001), and the interpractitioner
reliability for five different pairs of practitioners was 0.90 or
higher (P < 0.001). With regard to validity, there
was a moderately high correlation with vision impairment
(r = −0.68, P < 0.001). Using
Rasch analysis, content validity was also demonstrated by good
separation indexes (4.70 and 9.88) and high reliability scores (0.96
and 0.99) for the person and items parameters, respectively. Separate
calculation of indexes and reliability scores for parts (a) and (b)
indicated high content validity and reliability of each part. However,
the separation indexes and reliability scores were higher for part (a)
than for part (b). The correlation coefficient for part (a) and part
(b) was 0.68.
conclusions. The MLVAI is a highly valid and reliable standardized test of ADL
performance for the general low-vision population. It may be used to
assess patients with low vision and has the potential to be used as a
measure of low-vision rehabilitation outcomes.
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