Abstract
Purpose :
Current myopia quality-of-life (QoL) questionnaires are burdensome to administer, have complicated scoring systems, and primarily assess vision functioning deficits. To address these issues, we are developing a myopia-specific QoL item bank (IB) that will be operationalized using a computerized adaptive testing (CAT) system to optimize administration and scoring. We report on the content generation and item refinement phases of this myopia specific IB; and compare its content with published literature.
Methods :
Myopia-specific QoL domains and items were generated from: (1) existing visual and refractive-error specific questionnaires; (2) published articles; and (3) semi-structured interviews with patients with myopia (n=39); and healthcare practitioners (clinicians, optometrists, psychologists, and researchers; n=9) recruited from the Singapore National Eye Centre between 2020 and 2021. Following thematic analysis, items were systematically refined and subsequently tested using cognitive interviews with 24 additional patients across the myopia severity spectrum.
Results :
Of the 39 participants with myopia (mean ± standard deviation age: 41.4±16.3 years; 76.9% female), 16 (41.0%) were spectacle wearers, 10 (25.6%) wore contact lenses regularly, 18 (46.1%) had undergone myopic refractive surgery, and 1 (2.5%) was on atropine drops. Ten (25.6%) patients had clinically-diagnosed pathologic myopia (PM). Whilst some myopia-specific QoL issues identified have been reported previously, e.g., activity limitation and mobility, others like work anxiety, refractive surgery and PM-related issues were novel. Initially, 912 items within seven independent QoL domains were identified: Activity limitation, Concerns, Emotional, Mobility, Management Comfort, Management Convenience, Management Concern, and Work. Following refinement, 249 items were retained, of which 69 (27.7%) were novel. During cognitive interviews, 14 items underwent amendment to improve clarity.
Conclusions :
Our myopia specific IB comprises 7 QoL domains and 249 items, of which over a quarter are new. It will likely provide a comprehensive assessment of the broad impact of myopia and associated long-term complications, and the patient-centred effectiveness of myopia treatment. The IB will now undergo rigorous psychometric testing to generate item calibrations for the validation of a novel myopia CAT.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.