Skip to main content

Psychometric evaluation of the National Eye Institute Visual Function Questionnaire and Visual Function Questionnaire Utility Index in patients with non-infectious intermediate and posterior uveitis

Quality of Life Research volume 22, pages 2801–2808 (2013)Cite this article

Abstract

Objective

To evaluate the psychometric properties of the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25) and Visual Function Questionnaire Utility Index (VFQ-UI) in patients with non-infectious intermediate and posterior uveitis.

Methods

Secondary analysis of pooled data from a 26-week, multicenter, masked, randomized, sham-controlled Phase 3 clinical trial. Health-related quality of life was assessed using the NEI VFQ-25, the EQ-5D, and SF-36. Internal consistency reliability, reproducibility, convergent validity, and known groups of BCVA and vitreous haze severity were assessed. Clinically significant difference was assessed using anchor-based and distribution-based methods.

Results

The study included 224 subjects with non-infectious intermediate (80.4 %) or posterior uveitis (19.6 %). The NEI VFQ-25 and the VFQ-UI demonstrated good internal consistency (Cronbach’s alpha 0.87–0.94) and test–retest reliability (ICCs 0.58–0.88). Spearman’s product–moment rank correlations between the NEI VFQ-25 and VFQ-UI scores and the SF-6D, EQ-5D, and BCVA ranged from small to moderate. There was a significant association between visual functioning and known groups of visual acuity (p < 0.05). Clinical significance, using the anchor-based method (difference between visual acuity groups ≥10–<15 letter better and no change), was 10.2 for change from baseline to week 26 for the NEI VFQ-25 composite score and 0.05 for the VFQ-UI. Using the distribution-based method, the clinical significance was 3.86 for the composite score and 0.04 for the VFQ-UI.

Conclusion

The NEI VFQ-25 and the VFQ-UI are reliable and valid measures of vision-related functioning and preference-based status in patients with non-infectious intermediate and posterior uveitis.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  1. Durrani, O. M., Meads, C. A., & Murray, P. I. (2004). Uveitis: A potentially blinding disease. Ophthalmologica, 218(4), 223–236.

    PubMed  Article  CAS  Google Scholar 

  2. Markomichelakis, N. N., Halkiadakis, I., Pantelia, E., Peponis, V., Patelis, A., Theodossiadis, P., et al. (2004). Patterns of macular edema in patients with uveitis: Qualitative and quantitative assessment using optical coherence tomography. Ophthalmology, 111(5), 946–953.

    PubMed  Article  Google Scholar 

  3. Schiffman, R. M., Jacobsen, G., & Whitcup, S. M. (2001). Visual functioning and general health status in patients with uveitis. Archives of Ophthalmology, 119(6), 841–849.

    PubMed  Article  CAS  Google Scholar 

  4. Mangione, C. M., Lee, P. P., Gutierrez, P. R., Spritzer, K., Berry, S., & Hays, R. D. (2001). Development of the 25-item National Eye Institute Visual Function Questionnaire. Archives of Ophthalmology, 119(7), 1050–1058.

    PubMed  Article  CAS  Google Scholar 

  5. Lowder, C., Belfort, R, Jr, Lightman, S., Foster, C. S., Robinson, M. R., Schiffman, R. M., et al. (2011). Dexamethasone intravitreal implant for noninfectious intermediate or posterior uveitis. Archives of Ophthalmology, 129(5), 545–553.

    PubMed  Article  Google Scholar 

  6. Rentz, A. M., Kowalski, J. W., Walt, J., Hays, R. D., Brazier, J. E., Yu, R., Lee, P., Bressler, N. M., & Revicki, D. A. (submitted.). Developing a preference-based single index for the National Eye Institute Visual Function Questionnaire-25. Arch Opth.

  7. Kowalski, J. W., Rentz, A. M., Walt, J., Lloyd, A., Young, D., Chen, W. H., Bressler, N. M., Lee, P., Brazier, J. E., Hays, R. D., & Revicki, D. A. (2011). Development of a classification system for health states from the National Eye Institute Visual Function Questionnaire-25. Quality of life research. August 04, 2011. (Epub ahead of print).

  8. Ware, J. E., Kosinski, M., & Keller, S. D. (1994). SF-36 physical and mental health summary scales: A users manual. Boston: The Health Institute.

    Google Scholar 

  9. Brazier, J., Roberts, J., & Deverill, M. (2002). The estimation of a preference-based measure of health from the SF-36. Journal of Health Economics, 21(2), 271–292.

    PubMed  Article  Google Scholar 

  10. Walters, S. J., & Brazier, J. E. (2003). What is the relationship between the minimally important difference and health state utility values? The case of the SF-6D. Health Qual Life Outcomes, 1, 4.

    PubMed  Article  Google Scholar 

  11. Fryback, D. G., Dunham, N. C., Palta, M., Hanmer, J., Buechner, J., Cherepanov, D., et al. (2007). US norms for six generic health-related quality-of-life indexes from the National Health Measurement study. Medical Care, 45(12), 1162–1170.

    PubMed  Article  Google Scholar 

  12. Brooks, R., Rabin, R., & de Charro, F. (2003). The measurement and validation of health status suing EQ-5D: A European perspective. Dordrecht: Kluwer Academic Publishers.

    Book  Google Scholar 

  13. Ferris, F. L, 3rd, Kassoff, A., Bresnick, G. H., & Bailey, I. (1982). New visual acuity charts for clinical research. American Journal of Ophthalmology, 94(1), 91–96.

    PubMed  Google Scholar 

  14. Hays, R. D., & Revicki, D. (2005). Reliability and validity (including responsiveness). In P. Fayers & R. D. Hays (Eds.), Assessing quality of life in clinical trials (2nd ed., pp. 25–40). New York: Oxford University Press.

    Google Scholar 

  15. Gritz, D. C., & Wong, I. G. (2004). Incidence and prevalence of uveitis in northern California: The northern California epidemiology of uveitis study. Ophthalmology, 111, 491–500.

    PubMed  Article  Google Scholar 

  16. Kazis, L. E., Anderson, J. J., & Meenan, R. F. (1989). Effect sizes for interpreting changes in health status. Medical Care, 27, S178–S189.

    PubMed  Article  CAS  Google Scholar 

  17. Liang, M. J., Fossel, A. H., & Larson, M. G. (1990). Comparisons of five health status instruments for orthopedic evaluation. Medical Care, 28, 632–642.

    PubMed  Article  CAS  Google Scholar 

  18. Guyatt, G. H., Osoba, D., Wu, A. W., Wyrwich, K. W., & Norman, G. R. (2002). Methods to explain the clinical significance of health status measures. Mayo Clinic Proceedings, 77(4), 371.

    PubMed  Article  Google Scholar 

  19. Revicki, D., Hays, R. D., Cella, D., & Sloan, J. (2008). Recommended methods for determining responsiveness and minimally important differences for patient-reported outcomes. Journal of Clinical Epidemiology, 61(2), 102–109.

    PubMed  Article  Google Scholar 

  20. Chan, C. C., Inrig, T., Molloy, C. B., Stone, M. A., & Derzko-Dzulynsky, L. (2012). Prevalence of inflammatory back pain in a cohort of patients with anterior uveitis. American Journal of Ophthalmology, 153, 1025–1030.

    PubMed  Article  Google Scholar 

  21. Frick, K. D., Drye, L. T., Kempen, J. H., Dunn, J. P., Holland, G. N., Latkany, P., et al. (2012). Associations among visual acuity and vision- and health-related quality of life among patients in the multicenter uveitis steroid treatment trial. Investigative Ophthalmology and Visual Science, 53, 1169–1176.

    PubMed  Article  Google Scholar 

  22. Nussenblatt, R. B., & Whitcup, S. M. (2004). Uveitis: Fundamentals and clinical practice (3rd ed.). St. Louis: Mosby.

    Google Scholar 

Download references

Acknowledgments

The authors would like to thank Young Zhu and Rebecca Liu for their support in statistical analyses.

Author information

Affiliations

  1. Global Health Outcomes Strategy and Research, Allergan Inc., 2525 Dupont Drive, Irvine, CA, 92612, USA

    Rupali K. Naik & Jonathan W. Kowalski

  2. Outcomes Research, United BioSource Corporation, Bethesda, MD, USA

    Katharine S. Gries, Anne M. Rentz & Dennis A. Revicki

Authors
  1. Rupali K. Naik
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Katharine S. Gries
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anne M. Rentz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jonathan W. Kowalski
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Dennis A. Revicki
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jonathan W. Kowalski.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Naik, R.K., Gries, K.S., Rentz, A.M. et al. Psychometric evaluation of the National Eye Institute Visual Function Questionnaire and Visual Function Questionnaire Utility Index in patients with non-infectious intermediate and posterior uveitis. Qual Life Res 22, 2801–2808 (2013). https://doi.org/10.1007/s11136-013-0412-y

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-013-0412-y

Keywords

  • Ocular disease
  • Vision-related functioning
  • NEI VFQ-25
  • VFQ-UI
  • Uveitis
  • Psychometric evaluation