TY - JOUR
T1 - Responsiveness of health-related quality-of-life questionnaires in adults undergoing strabismus surgery
AU - Hatt, Sarah R.
AU - Leske, David A.
AU - Holmes, Jonathan M.
N1 - Funding Information:
Supported by National Institutes of Health Grant EY015799 (JMH), Research to Prevent Blindness , New York, NY (JMH as Olga Keith Weiss Scholar and an unrestricted grant to the Department of Ophthalmology, Mayo Clinic), and Mayo Foundation , Rochester, Minnesota. None of the funding organizations had any role in the design or conduct of this research.
PY - 2010/12
Y1 - 2010/12
N2 - Objective: To evaluate the responsiveness of 2 health-related quality-of-life (HRQOL) questionnaires, the Adult Strabismus-20 (AS-20) and National Eye Institute Visual Function Questionnaire-25 (VFQ-25), to changes in HRQOL after strabismus surgery. Design: Cohort study. Participants: We included 106 adults (aged 1884 years; median, 48.5) undergoing strabismus surgery, 80 (75%) with diplopia and 26 (25%) without diplopia. Methods: All participants completed AS-20 and VFQ-25 questionnaires preoperatively and a median of 7 weeks (range, 413) postoperatively. Using predefined clinical criteria, postoperative outcomes were graded as either "success" (n = 65), "partial success" (n = 32), or "failure" (n = 9). Main Outcome Measures: For each questionnaire, mean composite and subscale scores (range, 0100; worst to best HRQOL) were calculated for each patient. Median change in scores pre- to postoperatively was compared for successes, partial successes, and failures, and the proportion of patients whose scores exceeded 95% limits of agreement was calculated. Results: Successfully aligned diplopic patients (n = 46) showed greater improvement than failures (n = 7) using both the AS-20 questionnaire (21.3 [quartiles 12.535.0] vs. 8.8 [3.812.5]; P = 0.002) and the VFQ-25 questionnaire (18.3 [8.626.1] vs 8.3 [0.813.5]; P = 0.02). Successfully aligned nondiplopic patients (n = 19) also showed greater improvement than failures (n = 2; AS-20, 23.8 [10.032.5] vs -3.1 [-10.0 to 3.8]; P = 0.05). In nondiplopic patients, changes on VFQ-25 were small but significantly greater for successes than failures (5.0 [0.010.1] vs -15.4 [-19.4 to -11.4]; P = 0.03). More successfully aligned patients showed improvement exceeding the 95% limits of agreement for AS-20 scores than VFQ-25 scores (67% vs 65% [P = 0.8] for diplopic patients and 63% vs 21% [P = 0.005] for nondiplopic patients). Conclusions: The AS-20 and VFQ-25 questionnaires are responsive to improved HRQOL in adults undergoing successful strabismus surgery. Changes on VFQ-25 were smaller, particularly for nondiplopic strabismus. The AS-20 is more responsive than the VFQ-25 across the range of adult strabismus. Financial Disclosure(s): The authors have no proprietary or commercial interest in any of the materials discussed in this article.
AB - Objective: To evaluate the responsiveness of 2 health-related quality-of-life (HRQOL) questionnaires, the Adult Strabismus-20 (AS-20) and National Eye Institute Visual Function Questionnaire-25 (VFQ-25), to changes in HRQOL after strabismus surgery. Design: Cohort study. Participants: We included 106 adults (aged 1884 years; median, 48.5) undergoing strabismus surgery, 80 (75%) with diplopia and 26 (25%) without diplopia. Methods: All participants completed AS-20 and VFQ-25 questionnaires preoperatively and a median of 7 weeks (range, 413) postoperatively. Using predefined clinical criteria, postoperative outcomes were graded as either "success" (n = 65), "partial success" (n = 32), or "failure" (n = 9). Main Outcome Measures: For each questionnaire, mean composite and subscale scores (range, 0100; worst to best HRQOL) were calculated for each patient. Median change in scores pre- to postoperatively was compared for successes, partial successes, and failures, and the proportion of patients whose scores exceeded 95% limits of agreement was calculated. Results: Successfully aligned diplopic patients (n = 46) showed greater improvement than failures (n = 7) using both the AS-20 questionnaire (21.3 [quartiles 12.535.0] vs. 8.8 [3.812.5]; P = 0.002) and the VFQ-25 questionnaire (18.3 [8.626.1] vs 8.3 [0.813.5]; P = 0.02). Successfully aligned nondiplopic patients (n = 19) also showed greater improvement than failures (n = 2; AS-20, 23.8 [10.032.5] vs -3.1 [-10.0 to 3.8]; P = 0.05). In nondiplopic patients, changes on VFQ-25 were small but significantly greater for successes than failures (5.0 [0.010.1] vs -15.4 [-19.4 to -11.4]; P = 0.03). More successfully aligned patients showed improvement exceeding the 95% limits of agreement for AS-20 scores than VFQ-25 scores (67% vs 65% [P = 0.8] for diplopic patients and 63% vs 21% [P = 0.005] for nondiplopic patients). Conclusions: The AS-20 and VFQ-25 questionnaires are responsive to improved HRQOL in adults undergoing successful strabismus surgery. Changes on VFQ-25 were smaller, particularly for nondiplopic strabismus. The AS-20 is more responsive than the VFQ-25 across the range of adult strabismus. Financial Disclosure(s): The authors have no proprietary or commercial interest in any of the materials discussed in this article.
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U2 - 10.1016/j.ophtha.2010.03.042
DO - 10.1016/j.ophtha.2010.03.042
M3 - Article
C2 - 20832120
AN - SCOPUS:78649805268
SN - 0161-6420
VL - 117
SP - 2322-2328.e1
JO - Ophthalmology
JF - Ophthalmology
IS - 12
ER -