Department of Ophthalmology, University Hospital Bonn, Bonn, Germany.
Department of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany.
Br J Ophthalmol. 2023 Aug;107(8):1144-1150. doi: 10.1136/bjophthalmol-2021-320848. Epub 2022 Mar 30.
BACKGROUND/AIMS: To further validate the Vision Impairment in Low Luminance (VILL) questionnaire, which captures visual functioning and vision-related quality of life (VRQoL) under low luminance, low-contrast conditions relevant to age-related macular degeneration (AMD).
The VILL was translated from German into English (UK), Danish, Dutch, French, Italian and Portuguese. Rasch analysis was used to assess psychometric characteristics of 716 participants (65% female, mean age 72±7 years, 82% intermediate AMD) from the baseline visit of the MACUSTAR study. In a subset of participants (n=301), test-retest reliability (intraclass correlation coefficient (ICC) and coefficient of repeatability (CoR)) and construct validity were assessed.
Four items were removed from the VILL with 37 items due to misfit. The resulting Vision Impairment in Low Luminance with 33 items (VILL-33) has three subscales with no disordered thresholds and no misfitting items. No differential item functioning and no multidimensionality were observed. Person reliability and person separation index were 0.91 and 3.27 for the Vision Impairment in Low Luminance Reading Subscale (VILL-R), 0.87 and 2.58 for the Vision Impairment in Low Luminance Mobility Subscale (VILL-M), and 0.78 and 1.90 for the Vision Impairment in Low Luminance Emotional Subscale (VILL-E). ICC and CoR were 0.92 and 1.9 for VILL-R, 0.93 and 1.8 for VILL-M and 0.82 and 5.0 for VILL-E. Reported VRQoL decreased with advanced AMD stage (p<0.0001) and was lower in the intermediate AMD group than in the no AMD group (p≤0.0053).
The VILL is a psychometrically sound patient-reported outcome instrument, and the results further support its reliability and validity across all AMD stages. We recommend the shortened version of the questionnaire with three subscales (VILL-33) for future use.
NCT03349801.
背景/目的：进一步验证 Vision Impairment in Low Luminance (VILL) 问卷，该问卷可在与年龄相关性黄斑变性（AMD）相关的低亮度、低对比度条件下捕捉视觉功能和与视觉相关的生活质量（VRQoL）。
VILL 从德语翻译成英语（英国）、丹麦语、荷兰语、法语、意大利语和葡萄牙语。使用 Rasch 分析评估了 MACUSTAR 研究基线访视的 716 名参与者（65%为女性，平均年龄 72±7 岁，82%为中间型 AMD）的心理测量特征。在一组参与者（n=301）中，评估了测试-重测信度（组内相关系数（ICC）和可重复性系数（CoR））和结构效度。
由于拟合不良，从 VILL 中删除了 4 个项目，剩下 37 个项目。由此产生的 Vision Impairment in Low Luminance with 33 items (VILL-33) 有三个子量表，没有无序阈值和拟合不良的项目。没有观察到差异项目功能和多维性。Vision Impairment in Low Luminance Reading Subscale (VILL-R) 的个人可靠性和个人分离指数为 0.91 和 3.27，Vision Impairment in Low Luminance Mobility Subscale (VILL-M) 为 0.87 和 2.58，Vision Impairment in Low Luminance Emotional Subscale (VILL-E) 为 0.78 和 1.90。VILL-R 的 ICC 和 CoR 为 0.92 和 1.9，VILL-M 的 ICC 和 CoR 为 0.93 和 1.8，VILL-E 的 ICC 和 CoR 为 0.82 和 5.0。报告的 VRQoL 随 AMD 晚期的进展而降低（p<0.0001），并且在中间型 AMD 组中低于无 AMD 组（p≤0.0053）。
VILL 是一种具有良好心理测量特性的患者报告结局工具，其结果进一步支持其在所有 AMD 阶段的可靠性和有效性。我们建议在未来使用包含三个子量表的问卷缩短版（VILL-33）。
NCT03349801。
