Qazi Yureeda, Hurwitz Shelley, Khan Sarosh, Jurkunas Ula V, Dana Reza, Hamrah Pedram
Cornea Service, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.
Biostatistics Core, Brigham and Women's Hospital Center for Clinical Investigation, Harvard Medical School, Boston, Massachusetts.
Ophthalmology. 2016 Jul;123(7):1458-68. doi: 10.1016/j.ophtha.2016.03.006. Epub 2016 Apr 16.
To validate the Ocular Pain Assessment Survey (OPAS), specifically designed to measure ocular pain and quality of life for use by eye care practitioners and researchers.
A single-center cohort study was conducted among patients with and without corneal and ocular surface pain at initial and follow-up visits over a 6-month period. The content of the OPAS was guided by literature review, a body of experts, and incorporating conceptual frameworks from existing pain questionnaires. The Wong-Baker FACES Pain Rating Scale served as the gold standard for measuring the intensity of ocular pain.
A total of 102 patients aged 18 to 80 years completed the OPAS at the initial visit. A total of 21 patients were followed up after treatment.
Indices of validity and internal consistency (Spearman's rank-order, rs, or Pearson's correlation coefficients, rp), and coefficient of reliability (Cronbach's α) were determined in addition to equivalence testing, exploratory factor analysis (EFA), and diagnostic analysis.
Eye pain intensity was the primary outcome measure, and interference with quality of life (QoL), aggravating factors, associated factors, associated non-eye pain intensity, and self-reported symptomatic relief were the secondary outcome measures.
The OPAS had criterion validity at both initial (rs = 0.71; n = 102; P < 0.01) and follow-up visits (rs = 0.97; n = 21; P < 0.01). Equivalence tests yielded OPAS and gold standard equivalence for both the initial and follow-up visits. The EFA supported 6 subscales (eye pain intensity at 24 hours and 2 weeks, non-eye pain intensity, QoL, aggravating factors, and associated factors) confirming multidimensionality. Cronbach's α >0.83 for all subscales established strong internal consistency, which correlated with the gold standard, including 24-hour eye pain intensity and QoL interference scores (rp = 0.81, 0.64, respectively P < 0.001). At follow-up, reduction in pain scores was accompanied by improvement in all dimensions of the OPAS. Percentage change in QoL correlated to percentage change in the gold standard (rp = 0.53; P < 0.05). The OPAS was sensitive (94%), specific (81%), and accurate (91%), with a diagnostic odds ratio >50.
The OPAS is a valid, reliable, and responsive tool with strong psychometric and diagnostic properties in the multidimensional quantification of corneal and ocular surface pain intensity, and QoL.
验证专门设计用于测量眼痛及生活质量的眼痛评估调查问卷（OPAS），供眼科护理从业者和研究人员使用。
在6个月期间，对有角膜和眼表疼痛以及无角膜和眼表疼痛的患者进行了单中心队列研究，在初次就诊和随访时进行评估。OPAS的内容以文献综述、专家意见为指导，并纳入了现有疼痛问卷的概念框架。面部表情疼痛评分量表（Wong-Baker FACES Pain Rating Scale）作为测量眼痛强度的金标准。
共有102名年龄在18至80岁之间的患者在初次就诊时完成了OPAS。共有21名患者在治疗后进行了随访。
除了等效性测试、探索性因素分析（EFA）和诊断分析外，还确定了效度指标和内部一致性指标（斯皮尔曼等级相关系数，rs，或皮尔逊相关系数，rp）以及信度系数（克朗巴哈α系数）。
眼痛强度是主要结局指标，对生活质量（QoL）的干扰、加重因素、相关因素、相关的非眼痛强度以及自我报告的症状缓解是次要结局指标。
OPAS在初次就诊时（rs = 0.71；n = 102；P < 0.01）和随访时（rs = 0.97；n = 21；P < 0.01）均具有标准效度。等效性测试得出OPAS与初次就诊和随访时的金标准等效。探索性因素分析支持6个分量表（24小时和2周时的眼痛强度、非眼痛强度、生活质量、加重因素和相关因素），证实了多维性。所有分量表的克朗巴哈α系数>0.83，表明具有很强的内部一致性，与金标准相关，包括24小时眼痛强度和生活质量干扰评分（rp分别为0.81、0.64，P < 0.001）。在随访时，疼痛评分的降低伴随着OPAS所有维度的改善。生活质量的百分比变化与金标准的百分比变化相关（rp = 0.53；P < 0.05）。OPAS具有敏感性（94%）、特异性（81%）和准确性（91%），诊断比值比>50。
OPAS是一种有效、可靠且具有反应性的工具，在角膜和眼表疼痛强度及生活质量的多维度量化方面具有很强的心理测量和诊断特性。
