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Cui QN, Hays RD, Tarver ME, Spaeth GL, Paz SH, Weidmer B, Fellman RL, Vold SD, Eydelman M, Singh K. Vision-Targeted Health-Related Quality-of-Life Survey for Evaluating Minimally Invasive Glaucoma Surgery. Am J Ophthalmol 2021; 229:145-151. [PMID: 33852908 DOI: 10.1016/j.ajo.2021.03.064] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 03/26/2021] [Accepted: 03/28/2021] [Indexed: 11/15/2022]
Abstract
PURPOSE To develop a vision-targeted health-related quality-of-life instrument for patients with glaucoma who are candidates for minimally invasive glaucoma surgery (MIGS). DESIGN Development of a health-related quality-of-life instrument. PARTICIPANTS Twelve practicing ophthalmologists and 41 glaucoma patients. METHODS A questionnaire was constructed to assess functional limitations, vision-related symptoms, aesthetics, psychosocial issues, and surgical satisfaction for MIGS candidates. Questions were drafted after a review of the literature and subsequently refined based upon input from 1 physician and 4 patient focus groups. Nineteen cognitive interviews were used to ensure that questions were understandable to respondents. RESULTS The focus group identified the following key issues and concerns as being important to glaucoma patients: functional limitations (eg, driving), bodily discomfort (eg, stinging from drops), changes in appearance (eg, drooping eyelid), and psychosocial concerns (eg, mental burden associated with a diagnosis of glaucoma, financial burden of treatment). Cognitive interviews resulted in the following improvements to the questionnaire: changes in wording to clarify lighting conditions, and additional questions addressing psychosocial issues, such as job loss, severity of disease, and perception of MIGS. CONCLUSIONS A patient-reported outcomes instrument, the Glaucoma Outcomes Survey, was developed to evaluate MIGS for patients with mild to moderate glaucoma. Next steps include electronic administration to patients selected from the American Academy of Ophthalmology Intelligent Research in Sight (IRIS) registry. An electronic patient-reported outcomes platform will be used to administer the questionnaire before and after MIGS. The questionnaire will improve understanding of how surgical interventions such as MIGS impact vision-targeted health-related quality-of-life in glaucoma patients.
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Affiliation(s)
- Qi N Cui
- From the Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
| | - Ron D Hays
- Department of Medicine, University of California, Los Angeles, Los Angeles, California, USA; RAND Corporation, Santa Monica, California, USA
| | - Michelle E Tarver
- Office of Strategic Partnerships and Technology Innovation, Center for Devices and Radiological Health, U.S. Food and Drug Administration, White Oak, Maryland, USA
| | - George L Spaeth
- Wills Eye Hospital, Sidney Kimmel School of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Sylvia H Paz
- Department of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | | | | | | | - Malvina Eydelman
- Office of Ophthalmic, Anesthesia, Respiratory, ENT and Dental Devices, Center for Devices and Radiological Health United States Food and Drug Administration, White Oak, Maryland, USA
| | - Kuldev Singh
- Stanford University School of Medicine, Stanford, California, USA
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Paz SH, Jones L, Calderón JL, Hays RD. Readability and Comprehension of the Geriatric Depression Scale and PROMIS ® Physical Function Items in Older African Americans and Latinos. Patient 2017; 10:117-131. [PMID: 27599978 DOI: 10.1007/s40271-016-0191-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Depression and physical function are particularly important health domains for the elderly. The Geriatric Depression Scale (GDS) and the Patient-Reported Outcomes Measurement Information System (PROMIS®) physical function item bank are two surveys commonly used to measure these domains. It is unclear if these two instruments adequately measure these aspects of health in minority elderly. OBJECTIVE The aim of this study was to estimate the readability of the GDS and PROMIS® physical function items and to assess their comprehensibility using a sample of African American and Latino elderly. METHODS Readability was estimated using the Flesch-Kincaid and Flesch Reading Ease (FRE) formulae for English versions, and a Spanish adaptation of the FRE formula for the Spanish versions. Comprehension of the GDS and PROMIS® items by minority elderly was evaluated with 30 cognitive interviews. RESULTS Readability estimates of a number of items in English and Spanish of the GDS and PROMIS® physical functioning items exceed the U.S. recommended 5th-grade threshold for vulnerable populations, or were rated as 'fairly difficult', 'difficult', or 'very difficult' to read. Cognitive interviews revealed that many participants felt that more than the two (yes/no) GDS response options were needed to answer the questions. Wording of several PROMIS® items was considered confusing, and interpreting responses was problematic because they were based on using physical aids. CONCLUSIONS Problems with item wording and response options of the GDS and PROMIS® physical function items may reduce reliability and validity of measurement when used with minority elderly.
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Affiliation(s)
- Sylvia H Paz
- UCLA Division of General Internal Medicine and Health Services Research, Department of Medicine, UCLA, 911 Broxton Avenue, Los Angeles, CA, 90024-1736, USA.
| | - Loretta Jones
- Healthy African American Families, 4305 Degnan Blvd, Suite 105, Los Angeles, CA, 90008, USA
- Charles R. Drew University of Medicine and Science, 1731 E 120th St, Los Angeles, CA, 90059, USA
| | - José L Calderón
- UCLA Division of General Internal Medicine and Health Services Research, Department of Medicine, UCLA, 911 Broxton Avenue, Los Angeles, CA, 90024-1736, USA
| | - Ron D Hays
- UCLA Division of General Internal Medicine and Health Services Research, Department of Medicine, UCLA, 911 Broxton Avenue, Los Angeles, CA, 90024-1736, USA
- RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA
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Hays RD, Calderón JL, Spritzer KL, Reise SP, Paz SH. Differential item functioning by language on the PROMIS ® physical functioning items for children and adolescents. Qual Life Res 2017; 27:235-247. [PMID: 28875367 DOI: 10.1007/s11136-017-1691-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2017] [Indexed: 12/01/2022]
Abstract
PURPOSE To assess the equivalence of self-reports of physical functioning between pediatric respondents to the English- and Spanish-language patient-reported outcomes measurement information system (PROMIS®) physical functioning item banks. METHODS The PROMIS pediatric physical functioning item banks include 29 upper extremity items and 23 mobility items. A sample of 5091 children and adolescents (mean age = 12 years, range 8-17; 49% male) completed the English-language version of the items. A sample of 605 children and adolescents (mean age = 12 years, range 8-17; 55% male; 96% Hispanic) completed the Spanish-language version of the items. RESULTS We found language (English versus Spanish) differential item functioning (DIF) for 4 upper extremity items and 7 mobility items. Product-moment correlations between estimated upper extremity and mobility scores using the English versus the equated Spanish item parameters for Spanish-language respondents were 0.98 and 0.99, respectively. After excluding cases with significant person misfit, we found DIF for the same 4 upper extremity items that had DIF in the full sample and for 12 mobility items (including the same 7 mobility items that had DIF in the full sample). The identification of DIF items between English- and Spanish-language respondents was affected slightly by excluding respondents displaying person misfit. CONCLUSIONS The results of this study provide support for measurement equivalence of self-reports of physical functioning by children and adolescents who completed the English- and Spanish-language surveys. Future analyses are needed to replicate the results of this study in other samples.
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Affiliation(s)
- Ron D Hays
- Division of General Internal Medicine & Health Services Research, UCLA Department of Medicine, 911 Broxton Ave, Los Angeles, CA, 90024, USA.
| | - José Luis Calderón
- Division of General Internal Medicine & Health Services Research, UCLA Department of Medicine, 911 Broxton Ave, Los Angeles, CA, 90024, USA
| | - Karen L Spritzer
- Division of General Internal Medicine & Health Services Research, UCLA Department of Medicine, 911 Broxton Ave, Los Angeles, CA, 90024, USA
| | - Steve P Reise
- UCLA Department of Psychology, 3583 Franz Hall, Los Angeles, CA, 90095-1563, USA
| | - Sylvia H Paz
- Division of General Internal Medicine & Health Services Research, UCLA Department of Medicine, 911 Broxton Ave, Los Angeles, CA, 90024, USA
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Khanna D, Hays RD, Shreiner AB, Melmed GY, Chang L, Khanna PP, Bolus R, Whitman C, Paz SH, Hays T, Reise SP, Spiegel B. Responsiveness to Change and Minimally Important Differences of the Patient-Reported Outcomes Measurement Information System Gastrointestinal Symptoms Scales. Dig Dis Sci 2017; 62:1186-1192. [PMID: 28251500 PMCID: PMC5532518 DOI: 10.1007/s10620-017-4499-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 02/10/2017] [Indexed: 01/03/2023]
Abstract
BACKGROUND The NIH-sponsored Patient-Reported Outcomes Measurement Information System (PROMIS) Gastrointestinal (GI) Symptoms scales were developed to assess patients' GI symptoms in clinical settings. AIMS To assess responsiveness to change and provide minimally important difference (MID) estimates for the PROMIS GI Symptoms scales. METHODS A sample of 256 GI outpatients self-administered the eight PROMIS GI Symptoms scales (gastroesophageal reflux, disrupted swallowing, diarrhea, bowel incontinence/soilage, nausea and vomiting, constipation, belly pain, and gas/bloating/flatulence) at two visits. Patient self-reported and physician-reported assessments of the subjects' overall GI condition were employed as change anchors. In addition, we prospectively assessed change at both visits using a GI-symptom anchor, the Gastrointestinal Symptom Rating Scale (GSRS). Responsiveness to change was assessed using F-statistics. The minimally changed group was those somewhat better or somewhat worse on the retrospective anchors and changing by one category on the modified GSRS (e.g., from slight to mild discomfort to moderate to moderately severe discomfort). RESULTS Responsiveness to change was statistically significant for 6 of 8 PROMIS scales using the self-report GI anchor, 3 of 8 scales using the physician-reported anchor, and 5 of 5 scales using the corresponding GSRS scales as anchors. The MID estimates for scales for improvement and worsening were about 0.5-0.6 SD using the GSRS anchor and generally larger in magnitude than the change for the "about the same" group. CONCLUSIONS The responsiveness and MID estimates provided here for the PROMIS GI Symptoms scales can aid in scale score interpretation in clinical trials and observational studies.
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Affiliation(s)
- Dinesh Khanna
- Division of Rheumatology, University of Michigan, 1500 E. Medical Center Dr., SPC 5370, Ann Arbor, MI 48109, USA,Division of Rheumatology/Department of Internal Medicine, University of Michigan Scleroderma Program, 300 North Ingalls Street, Suite 7C27, Ann Arbor, MI 48109, USA
| | - Ron D. Hays
- Division of General Internal Medicine & Health Services Research, David Geffen School of Medicine at UCLA, 911 Broxton Avenue, Los Angeles, CA 90024, USA,Department of Health Policy and Management, UCLA Fielding School of Public Health, 911 Broxton Avenue, Los Angeles, CA 90024, USA
| | - Andrew B. Shreiner
- Division of Gastroenterology, University of Michigan, 1500 E. Medical Center Dr., SPC 5362, Ann Arbor, MI 48109-5362, USA
| | - Gil Y. Melmed
- Department of Gastroenterology, Cedars-Sinai Medical Center, 8730 Alden Dr., Los Angeles, CA 90048, USA
| | - Lin Chang
- Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA,G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, David Geffen School of Medicine at UCLA, 100 UCLA Medical Plaza, Los Angeles, CA 90095, USA
| | - Puja P. Khanna
- Division of Rheumatology, University of Michigan, 1500 E. Medical Center Dr., SPC 5370, Ann Arbor, MI 48109, USA
| | - Roger Bolus
- Department of Gastroenterology, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd., Los Angeles, CA 90073, USA,UCLA/VA Center for Outcomes Research and Education (CORE), 11301 Wilshire Blvd., Los Angeles, CA 90073, USA
| | - Cynthia Whitman
- UCLA/VA Center for Outcomes Research and Education (CORE), 11301 Wilshire Blvd., Los Angeles, CA 90073, USA
| | - Sylvia H. Paz
- Division of General Internal Medicine & Health Services Research, David Geffen School of Medicine at UCLA, 911 Broxton Avenue, Los Angeles, CA 90024, USA,Department of Health Policy and Management, UCLA Fielding School of Public Health, 911 Broxton Avenue, Los Angeles, CA 90024, USA
| | - Tonya Hays
- Division of General Internal Medicine & Health Services Research, David Geffen School of Medicine at UCLA, 911 Broxton Avenue, Los Angeles, CA 90024, USA,Department of Health Policy and Management, UCLA Fielding School of Public Health, 911 Broxton Avenue, Los Angeles, CA 90024, USA
| | - Steven P. Reise
- UCLA Department of Psychology, 3857 Franz Hall, Los Angeles, CA 90095, USA
| | - Brennan Spiegel
- Division of General Internal Medicine & Health Services Research, David Geffen School of Medicine at UCLA, 911 Broxton Avenue, Los Angeles, CA 90024, USA,Department of Health Policy and Management, UCLA Fielding School of Public Health, 911 Broxton Avenue, Los Angeles, CA 90024, USA,Department of Gastroenterology, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd., Los Angeles, CA 90073, USA,UCLA/VA Center for Outcomes Research and Education (CORE), 11301 Wilshire Blvd., Los Angeles, CA 90073, USA,Medicine and Public Health, Division of Health Services Research, Cedars-Sinai Health System, Cedars-Sinai and UCLA, 8723 W. Alden Drive, Steven Spielberg Building, Los Angeles, CA 90048, USA
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Paz SH, Spritzer KL, Reise SP, Hays RD. Differential item functioning of the patient-reported outcomes information system (PROMIS ®) pain interference item bank by language (Spanish versus English). Qual Life Res 2017; 26:1451-1462. [PMID: 28224257 DOI: 10.1007/s11136-017-1499-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND About 70% of Latinos, 5 years old or older, in the United States speak Spanish at home. Measurement equivalence of the PROMIS® pain interference (PI) item bank by language of administration (English versus Spanish) has not been evaluated. METHODS A sample of 527 adult Spanish-speaking Latinos completed the Spanish version of the 41-item PROMIS® pain interference item bank. We evaluate dimensionality, monotonicity and local independence of the Spanish-language items. Then we evaluate differential item functioning (DIF) using ordinal logistic regression with item response theory scores estimated from DIF-free "anchor" items. RESULTS One of the 41 items in the Spanish version of the PROMIS® PI item bank was identified as having significant uniform DIF. CONCLUSIONS English- and Spanish-speaking subjects with the same level of pain interference responded differently to 1 of the 41 items in the PROMIS® PI item bank. This item was not retained due to proprietary issues. The original English language item parameters can be used when estimating PROMIS® PI scores.
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Affiliation(s)
- Sylvia H Paz
- UCLA Division of General Internal Medicine and Health Services Research, Department of Medicine, 911 Broxton Avenue, Los Angeles, CA, 90095-1736, USA.
| | - Karen L Spritzer
- UCLA Division of General Internal Medicine and Health Services Research, Department of Medicine, 911 Broxton Avenue, Los Angeles, CA, 90095-1736, USA
| | - Steven P Reise
- UCLA Department of Psychology, Franz Hall, 502 Portola Plaza, Los Angeles, CA, 90095, USA
| | - Ron D Hays
- UCLA Division of General Internal Medicine and Health Services Research, Department of Medicine, 911 Broxton Avenue, Los Angeles, CA, 90095-1736, USA.,RAND, 1776 Main Street, Santa Monica, CA, 90407, USA
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Spiegel BMR, Hays RD, Bolus R, Melmed GY, Chang L, Whitman C, Khanna PP, Paz SH, Hays T, Reise S, Khanna D. Corrigendum: development of the NIH Patient-Reported Outcomes Measurement Information System (PROMIS) gastrointestinal symptom scales. Am J Gastroenterol 2015; 110:608. [PMID: 25853211 DOI: 10.1038/ajg.2015.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Spiegel BM, Hays RD, Bolus R, Melmed GY, Chang L, Whitman C, Khanna PP, Paz SH, Hays T, Reise S, Khanna D. Development of the NIH Patient-Reported Outcomes Measurement Information System (PROMIS) gastrointestinal symptom scales. Am J Gastroenterol 2014; 109:1804-14. [PMID: 25199473 PMCID: PMC4285435 DOI: 10.1038/ajg.2014.237] [Citation(s) in RCA: 138] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Accepted: 06/24/2014] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The National Institutes of Health (NIH) Patient-Reported Outcomes Measurement Information System (PROMIS(®)) is a standardized set of patient-reported outcomes (PROs) that cover physical, mental, and social health. The aim of this study was to develop the NIH PROMIS gastrointestinal (GI) symptom measures. METHODS We first conducted a systematic literature review to develop a broad conceptual model of GI symptoms. We complemented the review with 12 focus groups including 102 GI patients. We developed PROMIS items based on the literature and input from the focus groups followed by cognitive debriefing in 28 patients. We administered the items to diverse GI patients (irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), systemic sclerosis (SSc), and other common GI disorders) and a census-based US general population (GP) control sample. We created scales based on confirmatory factor analyses and item response theory modeling, and evaluated the scales for reliability and validity. RESULTS A total of 102 items were developed and administered to 865 patients with GI conditions and 1,177 GP participants. Factor analyses provided support for eight scales: gastroesophageal reflux (13 items), disrupted swallowing (7 items), diarrhea (5 items), bowel incontinence/soilage (4 items), nausea and vomiting (4 items), constipation (9 items), belly pain (6 items), and gas/bloat/flatulence (12 items). The scales correlated significantly with both generic and disease-targeted legacy instruments, and demonstrate evidence of reliability. CONCLUSIONS Using the NIH PROMIS framework, we developed eight GI symptom scales that can now be used for clinical care and research across the full range of GI disorders.
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Affiliation(s)
- Brennan M.R. Spiegel
- Department of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, California, USA,Cedars-Sinai Center for Outcomes Research and Education, Los Angeles, California, USA,Department of Gastroenterology, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA,Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Ron D. Hays
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California, USA,Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Roger Bolus
- Cedars-Sinai Center for Outcomes Research and Education, Los Angeles, California, USA
| | - Gil Y. Melmed
- Department of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Lin Chang
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA,Gail and Gerald Oppenheimer Family Center for Neurobiology of Stress, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Cynthia Whitman
- Cedars-Sinai Center for Outcomes Research and Education, Los Angeles, California, USA
| | - Puja P. Khanna
- Division of Rheumatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Sylvia H. Paz
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Tonya Hays
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Steve Reise
- Department of Psychology, UCLA, Los Angeles, California, USA
| | - Dinesh Khanna
- Division of Rheumatology, University of Michigan, Ann Arbor, Michigan, USA
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Paz SH, Slotkin J, McKean-Cowdin R, Lee P, Owsley C, Vitale S, Varma R, Gershon R, Hays RD. Development of a vision-targeted health-related quality of life item measure. Qual Life Res 2013; 22:2477-87. [PMID: 23475688 PMCID: PMC3722299 DOI: 10.1007/s11136-013-0365-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2013] [Indexed: 12/25/2022]
Abstract
PURPOSE To develop a vision-targeted health-related quality of life (HRQOL) measure for the NIH Toolbox for the Assessment of Neurological and Behavioral Function. METHODS We conducted a review of existing vision-targeted HRQOL surveys and identified color vision, low luminance vision, distance vision, general vision, near vision, ocular symptoms, psychosocial well-being, and role performance domains. Items in existing survey instruments were sorted into these domains. We selected non-redundant items and revised them to improve clarity and to limit the number of different response options. We conducted 10 cognitive interviews to evaluate the items. Finally, we revised the items and administered them to 819 individuals to calibrate the items and estimate the measure's reliability and validity. RESULTS The field test provided support for the 53-item vision-targeted HRQOL measure encompassing 6 domains: color vision, distance vision, near vision, ocular symptoms, psychosocial well-being, and role performance. The domain scores had high levels of reliability (coefficient alphas ranged from 0.848 to 0.940). Validity was supported by high correlations between National Eye Institute Visual Function Questionnaire scales and the new-vision-targeted scales (highest values were 0.771 between psychosocial well-being and mental health, and 0.729 between role performance and role difficulties), and by lower mean scores in those groups self-reporting eye disease (F statistic with p < 0.01 for all comparisons except cataract with ocular symptoms, psychosocial well-being, and role performance scales). CONCLUSIONS This vision-targeted HRQOL measure provides a basis for comprehensive assessment of the impact of eye diseases and treatments on daily functioning and well-being in adults.
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Affiliation(s)
- Sylvia H Paz
- Division of General Internal Medicine and Health Services Research, Department of Medicine, UCLA School of Medicine, 911 Broxton Avenue, Los Angeles, CA, 90095-1736, USA,
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Paz SH, Spritzer KL, Morales LS, Hays RD. Age-related Differential Item Functioning for the Patient-Reported Outcomes Information System (PROMIS®) Physical Functioning Items. ACTA ACUST UNITED AC 2013; 3. [PMID: 24052925 DOI: 10.4172/2167-1079.1000131] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE To evaluate the equivalence of the PROMIS® wave 1 physical functioning item bank, by age (50 years or older versus 18-49). MATERIALS AND METHODS A total of 114 physical functioning items with 5 response choices were administered to English- (n=1504) and Spanish-language (n=640) adults. Item frequencies, means and standard deviations, item-scale correlations, and internal consistency reliability were estimated. Differential Item Functioning (DIF) by age was evaluated. RESULTS Thirty of the 114 items were fagged for DIF based on an R-squared of 0.02 or above criterion. The expected total score was higher for those respondents who were 18-49 than those who were 50 or older. CONCLUSIONS Those who were 50 years or older versus 18-49 years old with the same level of physical functioning responded differently to 30 of the 114 items in the PROMIS® physical functioning item bank. This study yields essential information about the equivalence of the physical functioning items in older versus younger individuals.
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Affiliation(s)
- Sylvia H Paz
- UCLA Division of General Internal Medicine and Health Services Research, Department of Medicine, 911 Broxton Avenue, Los Angeles, CA 90095-1736, USA
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Paz SH, Spritzer KL, Morales LS, Hays RD. Evaluation of the Patient-Reported Outcomes Information System (PROMIS(®)) Spanish-language physical functioning items. Qual Life Res 2012; 22:1819-30. [PMID: 23124505 DOI: 10.1007/s11136-012-0292-6] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2012] [Indexed: 12/01/2022]
Abstract
PURPOSE To evaluate the equivalence of the PROMIS(®) physical functioning item bank by language of administration (English versus Spanish). METHODS The PROMIS(®) wave 1 English-language physical functioning bank consists of 124 items, and 114 of these were translated into Spanish. ANALYSIS Item frequencies, means and standard deviations, item-scale correlations, and internal consistency reliability were calculated. The IRT assumption of unidimensionality was evaluated by fitting a single-factor confirmatory factor analytic model. IRT threshold and discrimination parameters were estimated using Samejima's Graded Response Model. DIF by language of administration was evaluated. RESULTS Item means ranged from 2.53 (SD = 1.36) to 4.62 (SD = 0.82). Coefficient alpha was 0.99, and item-rest correlations ranged from 0.41 to 0.89. A one-factor model fits the data well (CFI = 0.971, TLI = 0.970, and RMSEA = 0.052). The slope parameters ranged from 0.45 ("Are you able to run 10 miles?") to 4.50 ("Are you able to put on a shirt or blouse?"). The threshold parameters ranged from -1.92 ("How much do physical health problems now limit your usual physical activities (such as walking or climbing stairs)?") to 6.06 ("Are you able to run 10 miles?"). Fifty of the 114 items were flagged for DIF based on an R(2) of 0.02 or above criterion. The expected total score was higher for Spanish- than English-language respondents. CONCLUSIONS English- and Spanish-speaking subjects with the same level of underlying physical function responded differently to 50 of 114 items. This study has important implications in the study of physical functioning among diverse populations.
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Affiliation(s)
- Sylvia H Paz
- Division of General Internal Medicine and Health Services Research, Department of Medicine, UCLA School of Medicine, 911 Broxton Avenue, Los Angeles, CA 90095-1736, USA.
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Paz SH, Liu H, Fongwa MN, Morales LS, Hays RD. Readability estimates for commonly used health-related quality of life surveys. Qual Life Res 2009; 18:889-900. [PMID: 19590979 PMCID: PMC2724639 DOI: 10.1007/s11136-009-9506-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2008] [Accepted: 06/14/2009] [Indexed: 10/31/2022]
Abstract
PURPOSE To estimate readability of seven commonly used health-related quality of life instruments: SF-36, HUI, EQ-5D, QWB-SA, HALex, Minnesota Living with Heart Failure Questionnaire (MLHFQ), and the NEI-VFQ-25. METHODS The Flesch-Kincaid (F-K) and Flesch Reading Ease (FRE) formulae were used to estimate readability for every item in each measure. RESULTS The percentage of items that require more than 5 years of formal schooling according to F-K was 50 for the EQ-5D, 53 for the SF-36, 80 for the VFQ-25, 85 for the QWB-SA, 100 for the HUI, HALex, and the MLHFQ. The percentage of items deemed harder than "easy" according to FRE was 50 for the SF-36, 67 for the EQ-5D, 79 for the QWB-SA, 80 for the VFQ-25, 100 for the HUI, HALex, and the MLHFQ. CONCLUSIONS All seven surveys have a substantial number of items with high readability levels that may not be appropriate for the general population.
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Affiliation(s)
- Sylvia H Paz
- Department of Health Services, UCLA School of Public Health, Los Angeles, CA 90095-1772, USA.
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Abstract
PURPOSE To summarize the study design of the Multi-Ethnic Pediatric Eye Disease Study (MEPEDS). METHODS The objectives of the MEPEDS are to: (1) estimate age- and ethnicity-specific prevalence of strabismus, amblyopia, and refractive error; (2) evaluate the association of selected risk factors with these ocular disorders; and (3) evaluate the association of ocular conditions on limitations in health-related functional status in a population-based sample of 12,000 children aged 6-72 months from four ethnic groups--African-American, Asian-American, Hispanics/Latinos and non-Hispanic White. Each eligible child undergoes an eye examination, which includes an interview with his/her parent. The interview includes an assessment of demographic, behavioral, biological, and ocular risk factors and health-related functional status. The examination includes fixation preference testing, visual acuity, stereoacuity, axial length measurement, cycloplegic refraction, keratometry, eye alignment, and anterior and posterior segment examination.
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Affiliation(s)
- Rohit Varma
- Doheny Eye Institute and the Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033-9224, USA.
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Paz SH, Varma R, Klein R, Wu J, Azen SP. Noncompliance with Vision Care Guidelines in Latinos with Type 2 Diabetes Mellitus. Ophthalmology 2006; 113:1372-7. [PMID: 16769120 DOI: 10.1016/j.ophtha.2006.04.018] [Citation(s) in RCA: 106] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2005] [Revised: 04/05/2006] [Accepted: 04/11/2006] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To determine the prevalence of and personal factors associated with noncompliance with American Diabetes Association (ADA) guidelines for vision care in a population-based sample of adult Latinos with type 2 diabetes mellitus (T2DM). DESIGN Population-based cross-sectional study. PARTICIPANTS Eight hundred twenty-one Los Angeles Latino Eye Study (LALES) participants with a history of T2DM and a history of treatment for T2DM. METHODS Detailed interviews, physical examinations, and dilated eye examinations were performed on all participants. Interviews assessed sociodemographic factors, history of diabetes and eye disease, and utilization of health and eye care services. All participants with a self-reported history and treatment of diabetes were asked about health and vision care utilization and diabetes self-care. MAIN OUTCOME MEASURE Compliance with ADA guidelines for vision care. Noncompliance was defined as having had no dilated eye examination in the previous 12 months. Logistic regression analyses were used to identify personal factors associated with noncompliance. RESULTS Of 821 individuals who self-reported having T2DM and being on treatment for T2DM, 535 (65%) had not complied with ADA vision guidelines for persons with T2DM. When compared with those with T2DM who complied with ADA guidelines, noncompliers were more likely to be less educated (odds ratio [OR], 1.5; 95% confidence interval [CI], 1.1-2.2), to lack health insurance (OR, 2.5; 95% CI, 1.7-3.7), to have had no routine physical examination in the 12 months before the LALES examination (OR, 1.8; 95% CI, 1.3-2.5), and to have a glycosylated hemoglobin level > or = 9.0% (OR, 1.7; 95% CI, 1.1-2.6). CONCLUSIONS Because timely and appropriate vision care can delay the onset of ocular morbidity, visual impairment, and blindness associated with diabetic retinopathy, our data suggest the need to evaluate intervention programs aimed at a targeted group of Latinos with T2DM--those who have less than a high school education, lack health insurance, have had no routine physical examination in the previous year, and have poorly controlled T2DM.
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Affiliation(s)
- Sylvia H Paz
- Doheny Eye Institute and Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California 90033-9224, USA
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Varma R, Paz SH, Azen SP, Klein R, Globe D, Torres M, Shufelt C, Preston-Martin S. The Los Angeles Latino Eye Study: design, methods, and baseline data. Ophthalmology 2004; 111:1121-31. [PMID: 15177962 DOI: 10.1016/j.ophtha.2004.02.001] [Citation(s) in RCA: 124] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2003] [Accepted: 02/02/2004] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To describe the study design, operational strategies, procedures, and baseline characteristics of the Los Angeles Latino Eye Study (LALES), a population-based assessment of the prevalence of visual impairment, ocular disease, and visual functioning in Latinos. DESIGN Population-based, cross-sectional study. PARTICIPANTS Six thousand three hundred fifty-seven Latinos 40 years and older from 6 census tracts in Los Angeles, California. METHODS A detailed interview and eye examination were performed on each eligible participant. The interview included an assessment of demographic, behavioral, and ocular risk factors and health-related and vision-related quality of life. The eye examination included a measurement of visual acuity, intraocular pressure, and visual fields; fundus and optic disc photography; a detailed anterior and posterior segment examination; and measurement of blood pressure, glycosylated hemoglobin levels, and blood glucose levels. MAIN OUTCOME MEASURES Prevalence of visual impairment, blindness, cataract, glaucoma, diabetic retinopathy, and age-related macular degeneration constitute the study's primary outcome variables. Secondary outcomes include odds ratios for risk factors associated with eye disease, health-related quality of life, and vision-related quality of life. Response rates and baseline characteristics are presented. RESULTS Of the 7789 individuals eligible for LALES, 6357 (82%) had a clinical examination; an additional 524 completed only an in-home interview. The majority of participants were female (58%), the average (+/- standard deviation) age was 54.9 (+/-10.8) years, and 80.0% were of Mexican origin and 0.4% self-identified as American Indian or Alaskan Native. The age distribution of LALES participants was similar to that of Latinos of Mexican origin in the rest of the United States. CONCLUSION The LALES has recruited Latinos 40 and older for an ophthalmic epidemiologic study. The LALES cohort will provide information about the prevalence and risk factors of ocular disease in the largest and fastest growing minority in the United States.
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Affiliation(s)
- Rohit Varma
- Doheny Eye Institute and the Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
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Abstract
OBJECTIVE To validate and assess the relationship between self-reported depression as measured by a single item on the Medical Outcomes Study Short-Form 12 (SF-12) and self-reported visual function. METHODS The Los Angeles Latino Eye Study is population-based and designed to assess the prevalence of visual impairment, ocular disease, and visual functioning in Latinos. Both the 25-item National Eye Institute-Visual Function Questionnaire (NEI VFQ-25) (self-reported visual function) and the SF-12 (health-related quality of life) were administered. A single item from the SF-12 was used to measure self-reported depression and validated against the Center for Epidemiologic Studies-Depression measure of depression. Covariate-adjusted NEI VFQ-25 subscale scores were contrasted across the 6 response choices of the SF-12, as well as across 3 combined response categories of the SF-12 using analysis of covariance. Covariate-adjusted regression analyses assessed the contribution of self-reported depression in explaining self-reported visual function. RESULTS The sensitivity and specificity of the SF-12 single item with the Center for Epidemiologic Studies-Depression measure was 0.96 and 0.50, respectively. Using the 3 combined response categories of the SF-12 single item, it was found that (1) all covariate-adjusted subscales of the NEI VFQ-25 were statistically significantly different across the self-reported depression categories (P<.001) and (2) covariate-adjusted self-reported depression was a significant predictor of self-reported visual function (P<.001). CONCLUSIONS A single SF-12 item may be used as a measure of self-reported depression. In addition, self-reported depression is an important covariate to consider when assessing self-reported visual function in Latinos.
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Affiliation(s)
- Sylvia H Paz
- Doheny Eye Institute, Department of Ophthalmology and Preventive Medicine, Keck School of Medicine, Los Angeles, CA 90033-9224, USA
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