Gittel Lisa, Li Jeany Q, Dell Jennifer, Wintergerst Maximilian W M, Heinz Carsten, Finger Robert P, Terheyden Jan Henrik
Department of Ophthalmology, University Hospital Bonn, Venusberg-Campus 1, Bonn, NRW, 53127, Germany.
Department of Ophthalmology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany.
J Ophthalmic Inflamm Infect. 2024 Apr 16;14(1):16. doi: 10.1186/s12348-024-00398-x.
The National Eye Institute Visual Function Questionnaire (NEI VFQ) is a common patient-reported outcome measure (PROM) in uveitis trials. Its psychometric properties using state-of-the-art scoring based on Rasch models, a latent trait model that improves accuracy of PROMs assessment, has not yet been investigated.
The study participants were recruited online from uveitis patient organizations, where individuals self-reported their uveitis diagnosis and visual acuity level. These participants then completed the NEI VFQ-25. The visual function (VF) and socioemotional (SE) subscales were psychometrically analysed in terms of item fit, targeting, internal consistency, dimensionality, and differential item functioning (DIF), using Rasch models. Criterion validity was examined based on associations between NEI VFQ person measures and recent visual acuity (VA) levels.
Ninety-nine participants recruited online from uveitis patient organizations (68 women, 31 men; mean age 50 ± 15 years; 46.5% self-reported receiving systematic therapy for uveitis, 0.6% NEI VFQ-25 missing data) were included. The mean difficulty of items was lower than the average person ability. None of the items demonstrated misfit to an extent that would induce noise into the measurement. The consistency metrics person reliability and person separation index of the subscales were 0.85 and 2.34 (NEI VFQ-VF), 0.86 and 2.52 (NEI VFQ-SE), respectively. There was no evidence of multidimensionality and none of the items showed DIF by gender. The differences between item and person measures were 1.44 (NEI VFQ-VF) and 1.03 (NEI VFQ-SE). NEI VFQ-25 person measures were significantly lower in participants with visual impairment (all p values ≤ 0.007).
Rasch model-based scoring of the re-engineered NEI VFQ-25 demonstrates acceptable internal consistency, item fit and construct validity for assessing two key domains of quality of life in individuals self-reporting uveitis. The PROM was targeted at a higher level of difficulty than present in our heterogeneous sample.
美国国立眼科研究所视觉功能问卷（NEI VFQ）是葡萄膜炎试验中常用的患者报告结局指标（PROM）。尚未对其基于拉施模型（一种可提高PROM评估准确性的潜在特质模型）的最新评分方法的心理测量特性进行研究。
研究参与者通过葡萄膜炎患者组织在线招募，参与者自行报告其葡萄膜炎诊断和视力水平。然后这些参与者完成NEI VFQ - 25问卷。使用拉施模型从项目拟合、目标定位、内部一致性、维度性和项目功能差异（DIF）方面对视觉功能（VF）和社会情感（SE）子量表进行心理测量分析。基于NEI VFQ个体测量值与近期视力（VA）水平之间的关联检验标准效度。
纳入了从葡萄膜炎患者组织在线招募的99名参与者（68名女性，31名男性；平均年龄50±15岁；46.5%的参与者自述接受过葡萄膜炎系统治疗，0.6%的NEI VFQ - 25问卷存在缺失数据）。项目的平均难度低于个体的平均能力。没有项目显示出会在测量中引入噪声的不拟合情况。子量表的一致性指标个体信度和个体分离指数分别为0.85和2.34（NEI VFQ - VF）、0.86和2.52（NEI VFQ - SE）。没有多维性的证据，且没有项目显示出按性别存在DIF。项目测量值与个体测量值之间的差异分别为1.44（NEI VFQ - VF）和1.03（NEI VFQ - SE）。视力受损参与者的NEI VFQ - 25个体测量值显著更低（所有p值≤0.007）。
重新设计的NEI VFQ - 25基于拉施模型的评分在评估自述葡萄膜炎个体生活质量的两个关键领域时，显示出可接受的内部一致性、项目拟合和结构效度。该PROM针对的难度水平高于我们异质性样本中的难度水平。
