Establishing levels of indications for cataract surgery: combining clinical and questionnaire data into a measure of cataract impact

Colm McAlinden, Marina Jonsson, Maria Kugelberg, Mats Lundström, Jyoti Khadka, Konrad Pesudovs

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

PURPOSE: To develop a model for establishing indications for cataract surgery that incorporates clinical and questionnaire data on a single linear scale using Rasch analysis.

METHODS: In this prospective study, 293 preoperative cataract surgery patients (mean age, 72.8±10 years; age range, 33-98 years; 174 female, 119 male; 49% with ocular comorbidity) completed two questionnaires, and visual acuity was measured in each eye. A cataract impact model was developed using Rasch analysis incorporating questionnaire scores and visual acuity. Participants were ranked from 1 to 293 based on the order in which they presented (first in first out [FIFO]) and then were ranked based on the cataract impact model. The main outcome measure was the number of participants moving 49 (16.7% change) rank positions, which represented a likelihood to change priority category.

RESULTS: The cataract impact model was unidimensional (fit statistics within 0.66-1.68) and had adequate precision (person separation of 2.58), and the components were well targeted to the population (0.05 logits between the mean item difficulty and person ability). Two hundred twenty-seven (77.5%) patients moved by at least 49 rank positions.

CONCLUSIONS: It is possible to combine clinical and questionnaire data and rank patients on a single linear scale. This approach modifies the ranking that occurs with the FIFO model and can be used for prioritizing patients for surgical intervention. More sophisticated models incorporating more clinical information may provide a better measure of the cataract impact latent trait.

LanguageEnglish
Pages1095-101
Number of pages7
JournalInvestigative Ophthalmology and Visual Science
Volume53
Issue number3
DOIs
Publication statusPublished - 1 Mar 2012
Externally publishedYes

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Cataract
  • Cataract Extraction
  • Disability Evaluation
  • Female
  • Humans
  • Male
  • Middle Aged
  • Models, Statistical
  • Prospective Studies
  • Psychometrics
  • Sickness Impact Profile
  • Surveys and Questionnaires
  • Sweden
  • Visual Acuity
  • Journal Article

Cite this

McAlinden, Colm ; Jonsson, Marina ; Kugelberg, Maria ; Lundström, Mats ; Khadka, Jyoti ; Pesudovs, Konrad. / Establishing levels of indications for cataract surgery : combining clinical and questionnaire data into a measure of cataract impact. In: Investigative Ophthalmology and Visual Science. 2012 ; Vol. 53, No. 3. pp. 1095-101.
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Establishing levels of indications for cataract surgery : combining clinical and questionnaire data into a measure of cataract impact. / McAlinden, Colm; Jonsson, Marina; Kugelberg, Maria; Lundström, Mats; Khadka, Jyoti; Pesudovs, Konrad.

In: Investigative Ophthalmology and Visual Science, Vol. 53, No. 3, 01.03.2012, p. 1095-101.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Establishing levels of indications for cataract surgery

T2 - Investigative Ophthalmology and Visual Science

AU - McAlinden, Colm

AU - Jonsson, Marina

AU - Kugelberg, Maria

AU - Lundström, Mats

AU - Khadka, Jyoti

AU - Pesudovs, Konrad

PY - 2012/3/1

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N2 - PURPOSE: To develop a model for establishing indications for cataract surgery that incorporates clinical and questionnaire data on a single linear scale using Rasch analysis.METHODS: In this prospective study, 293 preoperative cataract surgery patients (mean age, 72.8±10 years; age range, 33-98 years; 174 female, 119 male; 49% with ocular comorbidity) completed two questionnaires, and visual acuity was measured in each eye. A cataract impact model was developed using Rasch analysis incorporating questionnaire scores and visual acuity. Participants were ranked from 1 to 293 based on the order in which they presented (first in first out [FIFO]) and then were ranked based on the cataract impact model. The main outcome measure was the number of participants moving 49 (16.7% change) rank positions, which represented a likelihood to change priority category.RESULTS: The cataract impact model was unidimensional (fit statistics within 0.66-1.68) and had adequate precision (person separation of 2.58), and the components were well targeted to the population (0.05 logits between the mean item difficulty and person ability). Two hundred twenty-seven (77.5%) patients moved by at least 49 rank positions.CONCLUSIONS: It is possible to combine clinical and questionnaire data and rank patients on a single linear scale. This approach modifies the ranking that occurs with the FIFO model and can be used for prioritizing patients for surgical intervention. More sophisticated models incorporating more clinical information may provide a better measure of the cataract impact latent trait.

AB - PURPOSE: To develop a model for establishing indications for cataract surgery that incorporates clinical and questionnaire data on a single linear scale using Rasch analysis.METHODS: In this prospective study, 293 preoperative cataract surgery patients (mean age, 72.8±10 years; age range, 33-98 years; 174 female, 119 male; 49% with ocular comorbidity) completed two questionnaires, and visual acuity was measured in each eye. A cataract impact model was developed using Rasch analysis incorporating questionnaire scores and visual acuity. Participants were ranked from 1 to 293 based on the order in which they presented (first in first out [FIFO]) and then were ranked based on the cataract impact model. The main outcome measure was the number of participants moving 49 (16.7% change) rank positions, which represented a likelihood to change priority category.RESULTS: The cataract impact model was unidimensional (fit statistics within 0.66-1.68) and had adequate precision (person separation of 2.58), and the components were well targeted to the population (0.05 logits between the mean item difficulty and person ability). Two hundred twenty-seven (77.5%) patients moved by at least 49 rank positions.CONCLUSIONS: It is possible to combine clinical and questionnaire data and rank patients on a single linear scale. This approach modifies the ranking that occurs with the FIFO model and can be used for prioritizing patients for surgical intervention. More sophisticated models incorporating more clinical information may provide a better measure of the cataract impact latent trait.

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KW - Disability Evaluation

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Models, Statistical

KW - Prospective Studies

KW - Psychometrics

KW - Sickness Impact Profile

KW - Surveys and Questionnaires

KW - Sweden

KW - Visual Acuity

KW - Journal Article

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DO - 10.1167/iovs.11-8102

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JO - Investigative Ophthalmology and Visual Science

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SN - 0146-0404

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ER -