屈光手术患者报告结局的测量：屈光状态和视力概况。
The measurement of patient-reported outcomes of refractive surgery: the refractive status and vision profile.
作者信息
Schein O D
机构信息
Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
出版信息
Trans Am Ophthalmol Soc. 2000;98:439-69.
PURPOSE
To develop a questionnaire, the Refractive Status and Vision Profile (RSVP), to assess health-related quality of life associated with refractive error and its correction.
METHODS
The published literature on patient report of visual and overall function was reviewed, and the RSVP was self-administered by 550 participants with refractive error. Cross-sectional validation was performed using standard psychometric techniques. The responsiveness of the RSVP to surgical intervention was assessed prospectively in a subset of 176 patients. The principal outcomes measures were scores on the overall RSVP scale (S) and on 8 RSVP subscales (functioning, driving, concern, expectations, symptoms, glare, optical problems, problems with corrective lenses).
RESULTS
The RSVP (S) and its subscales demonstrated very good internal consistency (Cronbach's alpha, 0.70-0.93). S and several subscale scores were independently associated with satisfaction with vision and were more correlated with satisfaction with vision than with either visual acuity or refractive error. Higher refractive error was associated with lower scores on S and on 5 subscales. In the prospective surgical cohort, 15% of patients had some worsening in their total RSVP score; however, substantial variation was seen in the individual subscales where worsening ranged from 7% (problems with corrective lenses) to 41% (driving). The effect size (measure of responsiveness) of the RSVP and most of its subscales was very high. Approximately 14% of patients had significant worsening in 3 or more subscales, and this outcome was found to be independently associated with being dissatisfied with vision following surgery (OR, 5.84; 95% CI, 1.88, 8.13).
CONCLUSIONS
The RSVP has been validated as a questionnaire that measures patient-reported quality of life related to refractive error and its correction. It is responsive to surgical intervention and provides important information regarding patient outcomes not available from standard clinical measurements.
目的
开发一种问卷，即屈光状态与视力概况问卷（RSVP），以评估与屈光不正及其矫正相关的健康相关生活质量。
方法
回顾了已发表的关于患者视觉和整体功能报告的文献，550名屈光不正患者自行填写RSVP。使用标准心理测量技术进行横断面验证。在176名患者的子集中前瞻性评估RSVP对手术干预的反应性。主要结局指标是RSVP总评分量表（S）和8个RSVP子量表（功能、驾驶、担忧、期望、症状、眩光、光学问题、矫正镜片问题）的得分。
结果
RSVP（S）及其子量表显示出非常好的内部一致性（Cronbach's α系数，0.70 - 0.93）。S和几个子量表得分与视力满意度独立相关，并且与视力满意度的相关性高于与视力或屈光不正的相关性。更高的屈光不正与S和5个子量表的较低得分相关。在前瞻性手术队列中，15%的患者RSVP总分有一定程度的恶化；然而，在各个子量表中观察到了很大的差异，恶化范围从7%（矫正镜片问题）到41%（驾驶）。RSVP及其大多数子量表的效应量（反应性测量指标）非常高。约14%的患者在3个或更多子量表中有显著恶化，并且发现这一结果与术后对视力不满意独立相关（比值比，5.84；95%置信区间，1.88，8.13）。
结论
RSVP已被验证为一种测量患者报告的与屈光不正及其矫正相关生活质量的问卷。它对手术干预有反应，并提供了标准临床测量无法获得的关于患者结局的重要信息。
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