密歇根视觉相关焦虑问卷：遗传性视网膜变性的心理社会结局测量工具。
The Michigan Vision-Related Anxiety Questionnaire: A Psychosocial Outcomes Measure for Inherited Retinal Degenerations.
机构信息
Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor, Michigan, USA; Department of Ophthalmology and Otolaryngology, University of São Paulo Medical School, São Paulo, Brazil.
出版信息
Am J Ophthalmol. 2021 May;225:137-146. doi: 10.1016/j.ajo.2020.12.001. Epub 2020 Dec 9.
OBJECTIVE
We sought to construct and validate a patient-reported outcome measure for screening and monitoring vision-related anxiety in patients with inherited retinal degenerations.
DESIGN
Item-response theory and graded response modeling to quantitatively validate questionnaire items generated from qualitative interviews and patient feedback.
METHODS
Patients at the Kellogg Eye Center (University of Michigan, Ann Arbor, Michigan, USA) with a clinical diagnosis of an inherited retinal degeneration (n = 128) participated in an interviewer-administered questionnaire. The questionnaire consisted of 166 items, 26 of which pertained to concepts of "worry" and "anxiety." The subset of vision-related anxiety questions was analyzed by a graded response model using the Cai Metropolis-Hastings Robbins-Monro algorithm in the R software mirt package. Item reduction was performed based on item fit, item information, and item discriminability. To assess test-retest variability, 25 participants completed the questionnaire a second time 4 to 16 days later.
RESULTS
The final questionnaire consisted of 14 items divided into 2 unidimensional domains: rod function anxiety and cone function anxiety. The questionnaire exhibited convergent validity with the Patient Health Questionnaire for symptoms of depression and anxiety. This vision-related anxiety questionnaire has high marginal reliability (0.81 for rod-function anxiety, 0.83 for cone-function anxiety) and exhibits minimal test-retest variability (ρ = 0.81 [0.64-0.91] for rod-function anxiety and ρ = 0.83 [0.68-0.92] for cone-function anxiety).
CONCLUSIONS
The Michigan Vision-Related Anxiety Questionnaire is a psychometrically validated 14-item patient-reported outcome measure to be used as a psychosocial screening and monitoring tool for patients with inherited retinal degenerations. It can be used in therapeutic clinical trials for measuring the benefit of an investigational therapy on a patient's vision-related anxiety.
目的
我们旨在构建并验证一种用于遗传性视网膜变性患者视觉相关焦虑症筛查和监测的患者报告结局测量工具。
设计
采用项目反应理论和分级反应模型，对源自定性访谈和患者反馈的问卷项目进行定量验证。
方法
密歇根大学凯洛格眼科中心（美国密歇根州安娜堡）的遗传性视网膜变性患者（n=128）参与了一项访谈者管理的问卷调查。问卷包括 166 个项目，其中 26 个与“担忧”和“焦虑”概念有关。使用 Cai metropolis-Hastings Robbins-Monro 算法在 R 软件 mirt 包中，对与视觉相关的焦虑问题子集进行分级反应模型分析。根据项目拟合度、项目信息量和项目区分度进行项目删减。为评估测试-重测变异性，25 名参与者在 4 至 16 天后再次完成问卷。
结果
最终问卷包括 14 个项目，分为 2 个单一维度领域：杆状功能焦虑和锥状功能焦虑。该问卷与患者健康问卷（用于评估抑郁和焦虑症状）具有良好的聚合效度。该视觉相关焦虑问卷具有较高的边缘可靠性（杆状功能焦虑为 0.81，锥状功能焦虑为 0.83），并且具有最小的测试-重测变异性（杆状功能焦虑的ρ=0.81 [0.64-0.91]，锥状功能焦虑的ρ=0.83 [0.68-0.92]）。
结论
密歇根视觉相关焦虑问卷是一种经过心理测量学验证的 14 项患者报告结局测量工具，可作为遗传性视网膜变性患者的心理社会筛查和监测工具。它可用于治疗性临床试验，以衡量一种研究疗法对患者视觉相关焦虑的益处。
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