Neumann Guenter, Schaadt Anna-Katharina, Reinhart Stefan, Kerkhoff Georg
HELIOS Clinic, Kipfenberg, Germany.
Saarland University, Saarbruecken, Germany
Neurorehabil Neural Repair. 2016 Mar;30(3):187-98. doi: 10.1177/1545968315585355. Epub 2015 May 12.
Cerebral vision disorders (CVDs) are frequent after brain damage and impair the patient's outcome. Yet clinically and psychometrically validated procedures for the anamnesis of CVD are lacking.
To evaluate the clinical validity and psychometric qualities of the Cerebral Vision Screening Questionnaire (CVSQ) for the anamnesis of CVD in individuals poststroke.
Analysis of the patients' subjective visual complaints in the 10-item CVSQ in relation to objective visual perimetry, tests of reading, visual scanning, visual acuity, spatial contrast sensitivity, light/dark adaptation, and visual depth judgments. Psychometric analyses of concurrent validity, specificity, sensitivity, positive/negative predictive value, and interrater reliability were also done.
Four hundred sixty-one patients with unilateral (39.5% left, 47.5% right) or bilateral stroke (13.0%) were included. Most patients were assessed in the chronic stage, on average 36.7 (range = 1-620) weeks poststroke. The majority of all patients (96.4%) recognized their visual symptoms within 1 week poststroke when asked for specifically. Mean concurrent validity of the CVSQ with objective tests was 0.64 (0.54-0.79, P < .05). The mean positive predictive value was 80.1%, mean negative predictive value 82.9%, mean specificity 81.7%, and mean sensitivity 79.8%. The mean interrater reliability was 0.76 for a 1-week interval between both assessments (all P < .05).
The CVSQ is suitable for the anamnesis of CVD poststroke because of its brevity (10 minute), clinical validity, and good psychometric qualities. It, thus, improves neurovisual diagnosis and guides the clinician in the selection of necessary assessments and appropriate neurovisual therapies for the patient.
脑损伤后常出现脑性视觉障碍(CVD),并影响患者的预后。然而,目前缺乏针对CVD问诊的临床和心理测量学验证程序。
评估脑性视觉筛查问卷(CVSQ)在中风后个体CVD问诊中的临床有效性和心理测量学特性。
分析患者在10项CVSQ中的主观视觉主诉,并与客观视野检查、阅读测试、视觉扫描、视力、空间对比敏感度、明/暗适应及视觉深度判断进行关联。同时进行了效度、特异性、敏感性、阳性/阴性预测值及评分者间信度的心理测量学分析。
纳入461例单侧(左侧39.5%,右侧47.5%)或双侧中风(13.0%)患者。大多数患者在慢性期接受评估,平均中风后36.7周(范围1 - 620周)。当被专门询问时,所有患者中的大多数(96.4%)在中风后1周内就意识到了自己的视觉症状。CVSQ与客观测试的平均同时效度为0.64(0.54 - 0.79,P <.05)。平均阳性预测值为80.1%,平均阴性预测值为82.9%,平均特异性为81.7%,平均敏感性为79.8%。两次评估间隔1周时,评分者间平均信度为0.76(所有P <.05)。
CVSQ因其简短(10分钟)、临床有效性和良好的心理测量学特性,适用于中风后CVD的问诊。因此,它改善了神经视觉诊断,并指导临床医生为患者选择必要的评估和合适的神经视觉治疗方法。