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Paolo Scollo, Rathin Pujari, John Somner, Konrad Pesudovs, Peter Shah, Sajan Rajani, Lionel Dufour, Reema Pujari, Ali Hassan, Inderraj Hanspal, Tasneem Khatib, Ian Tapply, Rupert R A Bourne; Developing a Patient-Reported Outcome and Experience Measure for Glaucoma. Invest. Ophthalmol. Vis. Sci. 2020;61(7):51.
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© ARVO (1962-2015); The Authors (2016-present)
Patient reported outcomes (PROs) identify important information about glaucoma patients not revealed by conventional measures. Existing questionnaires are typically long and impractical for use in routine clinical care. Evidence demonstrates the need for a short, practical measure of a patient’s health-related quality of life as well as experience of their health care. Thus, a short 8-item patient-reported outcome and experience measure (POEM) was developed. The purpose of this study was to determine the feasibility, validity and reliability of the proposed Glaucoma POEM.
Glaucoma and ocular hypertension patients, undergoing all types of treatment were recruited in a multi-centre study encompassing 9 centres across the East of England and Moorfield’s Eye Hospital London. Glaucoma related clinical data was collected for all eligible participants who also completed a questionnaire comprising the new glaucoma POEM and a battery of pre-existing health, vision and experience related instruments. The POEM was then Rasch analysed to assess category function, measurement precision, dimensionality, targeting and differential item functioning.
Six-hundred and forty-eight patients were included. The POEM items demonstrated clear polarity with higher scores representing positive responses via its five step Likert scale. Analysis showed that the Glaucoma POEM’s 8 items did not produce interval level measurement. At this stage, the fundamental criterion of precision was not met due to a lack of variance in responses amongst the items. The exception was item 6, "I'm worried about losing vision from glaucoma" which was very discriminating. Regarding item fit, POEM items were of an appropriate difficulty for participants. Category probability curves showed the "not sure" category was not well utilised. Dimensionality analysis suggested that there are two dimensions, but on inspection these were represented by the 3 items with some variance in one cluster and the 5 items with no variance in another cluster.
Findings provide important insights into the glaucoma patient perspective in a large cohort with multiple measurements. Analysis of the proposed Glaucoma POEM and those of other established instruments will be discussed and used to further guide the development of a valid and reliable, yet practical instrument for day-to-day use in glaucoma care that accounts for both patient experiences and outcomes.
This is a 2020 ARVO Annual Meeting abstract.
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