Rasch Analysis of the Quality of Life and Vision Function Questionnaire


Purpose: The Quality of life and Vision Function Questionnaire (QOL-VFQ) was developed using classical test theory to assess outcomes of cataract surgery. The aim of this study was to examine the psychometric properties of this questionnaire using Rasch analysis in a cataract population.

Methods: The 17-item QOL-VFQ was self-administered to 389 patients waiting to undergo cataract surgery. The QOL-VFQ and its five subscales were assessed for fit to the Rasch model. Rasch analysis was used to estimate interval level measures of “visual ability” from ordinal scores for the QOL-VFQ and its five subscales. Unidimensionality, item fit, response category performance, and targeting of items to patients were assessed.

Results: The QOL-VFQ and its five subscales showed ordered category thresholds. Despite removal of two misfitting items the person separation reliability was high and the QOL-VFQ could distinguish among three strata of patient ability. However, there was suboptimal targeting of patient ability to item difficulty as most of the patients had higher levels of visual functioning. None of the subscales demonstrated acceptable psychometric properties.

Conclusions: These results support the good overall functioning of the QOL-VFQ in patients with cataract. However, adding more items, that suit the more able patients including those who are awaiting cataract surgery in the fellow eye, will help improve the targeting.

Key words: Quality of life and Vision Function questionnaire, cataract, Rasch analysis.

Optom Vis Sci 2009;86:E836–E844.
Accepted for publication January 22, 2009.

Vijaya K. Gothwal PhD, Thomas A. Wright BPsyc(Hons), Ecosse L. Lamoureux PhD, and Konrad Pesudovs PhD, FAAO
Department of Ophthalmology, NH&MRC Centre for Clinical Eye Research, Flinders Medical Centre and Flinders University of South Australia, Bedford Park, South Australia, Australia (VKG, TW, KP),
Meera and L. B. Deshpande Centre for Sight Enhancement, L. V. Prasad Eye Institute, Hyderabad, India (VKG), Department of Ophthalmology, Centre for Eye Research Australia, The University of Melbourne, Melbourne, Victoria, Australia (ELL),
Vision CRC, Sydney, New South Wales, Australia (ELL), and
Singapore Eye Research Institute, Singapore National Eye Centre, Singapore (ELL).


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