Development of a new Rasch-based scoring algorithm for the National Eye Institute Visual Functioning Questionnaire to improve its interpretability
Abstract Background The NEI VFQ-25 has undergone psychometric evaluation in patients with varying ocular conditions and the general population. However, important limitations which may affect the interpretation of clinical trial results have been previously identified, such as concerns with reliabil...
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| Format: | Article |
| Language: | English |
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BMC
2017-08-01
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| Series: | Health and Quality of Life Outcomes |
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| Online Access: | http://link.springer.com/article/10.1186/s12955-017-0726-5 |
| _version_ | 1818416301981302784 |
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| author | Jennifer Petrillo Neil M. Bressler Ecosse Lamoureux Alberto Ferreira Stefan Cano |
| author_facet | Jennifer Petrillo Neil M. Bressler Ecosse Lamoureux Alberto Ferreira Stefan Cano |
| author_sort | Jennifer Petrillo |
| collection | DOAJ |
| description | Abstract Background The NEI VFQ-25 has undergone psychometric evaluation in patients with varying ocular conditions and the general population. However, important limitations which may affect the interpretation of clinical trial results have been previously identified, such as concerns with reliability and validity. The purpose of this study was to evaluate the National Eye Institute Visual Functioning Questionnaire (NEI VFQ25) and make recommendations for a revised scoring structure, with a view to improving its psychometric performance and interpretability. Methods Rasch Measurement Theory analyses were conducted in two stages using pooled baseline NEI VFQ25 data for 2487 participants with retinal diseases enrolled in six clinical trials. In stage 1, we examined: scale-to-sample targeting; thresholds for item response options; item fit statistics; stability; local dependence; and reliability. In stage 2, a post-hoc revision of the scoring structure (VFQ-28R) was created and psychometrically re-evaluated. Results In stage 1, we found that the NEI VFQ25 was mis-targeted to the sample, and had disordered response thresholds (15/25 items) and mis-fitting items (8/25 items). However, items appeared to be stable (differential item functioning for three items), have minimal item dependency (one pair of items) and good reliability (person-separation index, 0.93). In stage 2, the modified Rasch-scored NEI VFQ28R was assessed. It comprised two broad domains: Activity Limitation (19 items) and Socio-Emotional Functioning (nine items). The NEI VFQ28R demonstrated improved performance with fewer disordered response thresholds (no items), less item misfit (three items) and improved population targeting (reduced ceiling effect) compared with the NEI VFQ25. Conclusions Compared with the original version, the proposed NEI VFQ28R, with Rasch-based scoring and a two-domain structure, appears to offer improved psychometric performance and interpretability of the vision-related quality of life scale for the population analysed. |
| first_indexed | 2024-12-14T11:48:43Z |
| format | Article |
| id | doaj.art-794a04f9f9c5494ab68d1b0c12e4f3bb |
| institution | Directory Open Access Journal |
| issn | 1477-7525 |
| language | English |
| last_indexed | 2024-12-14T11:48:43Z |
| publishDate | 2017-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Health and Quality of Life Outcomes |
| spelling | doaj.art-794a04f9f9c5494ab68d1b0c12e4f3bb2022-12-21T23:02:28ZengBMCHealth and Quality of Life Outcomes1477-75252017-08-0115111010.1186/s12955-017-0726-5Development of a new Rasch-based scoring algorithm for the National Eye Institute Visual Functioning Questionnaire to improve its interpretabilityJennifer Petrillo0Neil M. Bressler1Ecosse Lamoureux2Alberto Ferreira3Stefan Cano4BiogenRetina Division, Wilmer Eye Institute, Johns Hopkins University School of MedicineCentre for Eye Research Australia, the Royal Victorian Eye and Ear Hospital, University of MelbourneNovartis Pharma AGModus OutcomesAbstract Background The NEI VFQ-25 has undergone psychometric evaluation in patients with varying ocular conditions and the general population. However, important limitations which may affect the interpretation of clinical trial results have been previously identified, such as concerns with reliability and validity. The purpose of this study was to evaluate the National Eye Institute Visual Functioning Questionnaire (NEI VFQ25) and make recommendations for a revised scoring structure, with a view to improving its psychometric performance and interpretability. Methods Rasch Measurement Theory analyses were conducted in two stages using pooled baseline NEI VFQ25 data for 2487 participants with retinal diseases enrolled in six clinical trials. In stage 1, we examined: scale-to-sample targeting; thresholds for item response options; item fit statistics; stability; local dependence; and reliability. In stage 2, a post-hoc revision of the scoring structure (VFQ-28R) was created and psychometrically re-evaluated. Results In stage 1, we found that the NEI VFQ25 was mis-targeted to the sample, and had disordered response thresholds (15/25 items) and mis-fitting items (8/25 items). However, items appeared to be stable (differential item functioning for three items), have minimal item dependency (one pair of items) and good reliability (person-separation index, 0.93). In stage 2, the modified Rasch-scored NEI VFQ28R was assessed. It comprised two broad domains: Activity Limitation (19 items) and Socio-Emotional Functioning (nine items). The NEI VFQ28R demonstrated improved performance with fewer disordered response thresholds (no items), less item misfit (three items) and improved population targeting (reduced ceiling effect) compared with the NEI VFQ25. Conclusions Compared with the original version, the proposed NEI VFQ28R, with Rasch-based scoring and a two-domain structure, appears to offer improved psychometric performance and interpretability of the vision-related quality of life scale for the population analysed.http://link.springer.com/article/10.1186/s12955-017-0726-5National Eye Institute Visual Functioning QuestionnaireRasch Measurement TheoryVision-related quality of life |
| spellingShingle | Jennifer Petrillo Neil M. Bressler Ecosse Lamoureux Alberto Ferreira Stefan Cano Development of a new Rasch-based scoring algorithm for the National Eye Institute Visual Functioning Questionnaire to improve its interpretability Health and Quality of Life Outcomes National Eye Institute Visual Functioning Questionnaire Rasch Measurement Theory Vision-related quality of life |
| title | Development of a new Rasch-based scoring algorithm for the National Eye Institute Visual Functioning Questionnaire to improve its interpretability |
| title_full | Development of a new Rasch-based scoring algorithm for the National Eye Institute Visual Functioning Questionnaire to improve its interpretability |
| title_fullStr | Development of a new Rasch-based scoring algorithm for the National Eye Institute Visual Functioning Questionnaire to improve its interpretability |
| title_full_unstemmed | Development of a new Rasch-based scoring algorithm for the National Eye Institute Visual Functioning Questionnaire to improve its interpretability |
| title_short | Development of a new Rasch-based scoring algorithm for the National Eye Institute Visual Functioning Questionnaire to improve its interpretability |
| title_sort | development of a new rasch based scoring algorithm for the national eye institute visual functioning questionnaire to improve its interpretability |
| topic | National Eye Institute Visual Functioning Questionnaire Rasch Measurement Theory Vision-related quality of life |
| url | http://link.springer.com/article/10.1186/s12955-017-0726-5 |
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