The Contact Lens Impact on Quality of Life (CLIQ) Questionnaire:
Development and Validation


Purpose. To develop and validate a questionnaire for the measurement of the impact of contact lenses on quality of life (QoL): The Contact Lens Impact on Quality of Life (CLIQ) Questionnaire.

Methods. The questionnaire was developed and validated using conventional methods and Rasch analysis to assure content validity, repeatability, construct validity, and low respondent burden. Item identification and selection (647 items) were performed with an extensive literature review, professional advice, and lay focus groups. Item reduction used focus groups and data obtained from 161 subjects completing a 90-item pilot questionnaire. Validity and reliability, from data of 128 additional subjects, were assessed using Rasch analysis, intraclass correlation coefficient, and Bland-Altman limits of agreement.

Results. A 28-item CLIQ Questionnaire was developed and shown to have good validity and reliability by Rasch analysis statistics: real person separation, 2.02; model person separation, 2.17; reliability, 0.80; root mean square measurement error, 2.73; mean square ± SD infit, 1.01 ± 0.18; outfit, 1.01 ± 0.19. The items (mean score, 49.8 ± 4.9) were well targeted to the subjects (mean score, 51.2 ± 6.2) with a mean difference of 1.35 (scale range, 0-100) units. Test-retest intraclass correlation coefficient (0.86) and coefficient of repeatability (±8.00 units) demonstrated good repeatability.

fig 4

Figure 4. Scatterplot of the person measure estimated from Rasch analysis versus the average rating for each person across items.
These data can be fit with a double-asymptotic nonlinear equation:
CLIQperson measure =34.41_log(CLIQraw score/5–- CLIQraw score) + 26.69.

Conclusions. Rasch analysis and standard psychometric analyses demonstrated that the 28-item CLIQ Questionnaire is a valid and reliable measure of QoL in contact lens wearers. A scoring algorithm is provided for CLIQ Questionnaire users to convert raw scores into the Rasch analysis- derived linear person measures. (Invest Ophthalmol Vis Sci. 2006;47:2789-2796)

Key words: quality of life, questionnaire, Rasch analysis, reliability and validity

Investigative Ophthalmology & Visual Science, July 2006, Vol. 47, No. 7; 2789-2796. Submitted for publication July 19, 2005; accepted May 5, 2006.

Konrad Pesudovs,1 Estibaliz Garamendi,2 and David B. Elliott2
1 National Health and Medical Research Council (NH&MRC) Centre for Clinical Eye Research, Department of Ophthalmology, Flinders Medical Centre and Flinders University, Bedford Park, Australia;
2 Department of Optometry, University of Bradford, Bradford, United Kingdom.

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