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      Predicting changes in cataract surgery health outcomes using a cataract surgery appropriateness and prioritization instrument

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          Abstract

          Objective

          Determine whether items in a cataract surgery appropriateness and prioritization questionnaire can predict change in best corrected visual acuity (BCVA) and health related quality of life (HRQOL) following cataract surgery.

          Methods

          313 patients with a cataract in Ontario, Canada were recruited to participate. BCVA was measured using the Snellen chart. HRQOL was measured using a generic instrument (EQ5D), a visual functioning instrument (Catquest-9SF), and an appropriateness and prioritization instrument (17 items). Outcomes were measured preoperatively and 3–6 months postoperatively. Descriptive statistics were used to describe demographics and outcomes. For each appropriateness and prioritization questionnaire item, a one-way ANOVA was used to compare group means of the change in BCVA, EQ5D, and Catquest-9SF.

          Results

          Participants had a mean age of 69 years and were 56% female. BCVA improved in 81%, EQ5D in 49.6%, and Catquest-9SF score in 84% of patients. Improvement in both BCVA and Catquest-9SF scores were found in 68.5% of patients. The ANOVA showed a statistically significant association between a change in BCVA and the ability to participate in social life, and a statistically significant association between a change in Catquest-9SF and glare, extent of impairment in visual function, safety and injury concerns, ability to work and care for dependents, ability to take care of local errands, ability to assist others and ability to participate in social life.

          Conclusions

          Almost all patients had improved BCVA and/or visual functioning after surgery. Seven variables from the cataract appropriateness and prioritization instrument were found to be predictors of improvement in Catquest-9SF measuring visual functioning.

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          Most cited references28

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          EuroQol - a new facility for the measurement of health-related quality of life

          (1990)
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            Health Measurement Scales : A Practical Guide to Their Development and Use

            Clinicians and those in health sciences are frequently called upon to measure subjective states such as attitudes, feelings, quality of life, educational achievement and aptitude, and learning style in their patients. This fifth edition of Health Measurement Scales enables these groups to both develop scales to measure non-tangible health outcomes, and better evaluate and differentiate between existing tools.<br> <br> Health Measurement Scales is the ultimate guide to developing and validating measurement scales that are to be used in the health sciences. The book covers how the individual items are developed; various biases that can affect responses (e.g. social desirability, yea-saying, framing); various response options; how to select the best items in the set; how to combine them into a scale; and finally how to determine the reliability and validity of the scale. It concludes with a discussion of ethical issues that may be encountered, and guidelines for reporting the results of the scale development process. Appendices include a comprehensive guide to finding existing scales, and a brief introduction to exploratory and confirmatory factor analysis, making this book a must-read for any practitioner dealing with this kind of data.<br>
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              Validation of a short Orientation-Memory-Concentration Test of cognitive impairment.

              A 6-item Orientation-Memory-Concentration Test has been validated as a measure of cognitive impairment. This test predicted the scores on a validated 26-item mental status questionnaire of two patient groups in a skilled nursing home, patients in a health-related facility, and in a senior citizens' center. There was a positive correlation between scores on the 6-item test and plaque counts obtained from the cerebral cortex of 38 subjects at autopsy. This test, which is easily administered by a nonphysician, has been shown to discriminate among mild, moderate, and severe cognitive deficits.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SoftwareRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: MethodologyRole: Writing – original draftRole: Writing – review & editing
                Role: Data curationRole: InvestigationRole: MethodologyRole: Project administrationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: MethodologyRole: Writing – review & editing
                Role: Formal analysisRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                28 January 2021
                2021
                : 16
                : 1
                : e0246104
                Affiliations
                [1 ] Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada
                [2 ] Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
                [3 ] Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milano, Italy
                [4 ] Department of Surgery, Trillium Health Partners, Mississauga, Ontario, Canada
                [5 ] Prism Eye Institute, Oakville, Ontario, Canada
                University of Warmia, POLAND
                Author notes

                Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: Iqbal Ahmed: Consultant/Consulting Fees: Arucela, Aerie Pharmaceuticals, Alcon, Allergan, ArcScan, Bausch and Lomb, Beaver Visitec, Camras Vision, Carl Zeiss Meditec, Centervue, Ellex, ElutiMed, Equinox, Foresight Labs, Genentech, Glaukos, Gore, Iantech, InjectSense, Iridex, iStar, Ivantis, Johnson and Johnson Vision, KeLoTec, LayerBio, Leica Microsystems, MicroOptx, New World Medical, Omega Ophthalmics, PolyActiva, Sanoculis, Santen, Science Based Health, Sight Sciences, Stroma, True Vision, Vizzario. Speakers Honoraria: Alcon, Allergan, Carl Zeiss Meditec, Johnson and Johnson Vision. Research Grant/Support: Aerie Pharmaceuticals, Alcon, Allergan, Camras Vision, Glaukos, Ivantis, Johnson and Johnson Vision, New World Medical, Santen. Matthew B. Schlenker: Consulting: Alcon, Allergan, Light Matter Interaction, Santen. Honorarium: Alcon, Allergan, Aequus, J&J, Thea-Labtician. All other authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

                Author information
                https://orcid.org/0000-0002-8381-4960
                Article
                PONE-D-20-15026
                10.1371/journal.pone.0246104
                7842922
                33507910
                1047fccd-061d-4416-ac6f-7738a08d20cd
                © 2021 Lim et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 19 May 2020
                : 13 January 2021
                Page count
                Figures: 4, Tables: 5, Pages: 14
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/100007816, Alcon;
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/100011284, Valeant Pharmaceuticals International;
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/100011953, Abbott Medical Optics;
                Award Recipient :
                IA and ML received funding from Alcon, Valeant Pharmaceuticals and Abbot Medical Optics. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Medicine and Health Sciences
                Surgical and Invasive Medical Procedures
                Ophthalmic Procedures
                Cataract Surgery
                Medicine and Health Sciences
                Ophthalmology
                Visual Impairments
                Medicine and Health Sciences
                Surgical and Invasive Medical Procedures
                Biology and Life Sciences
                Anatomy
                Head
                Eyes
                Medicine and Health Sciences
                Anatomy
                Head
                Eyes
                Biology and Life Sciences
                Anatomy
                Ocular System
                Eyes
                Medicine and Health Sciences
                Anatomy
                Ocular System
                Eyes
                Research and Analysis Methods
                Research Design
                Survey Research
                Questionnaires
                Medicine and Health Sciences
                Surgical and Invasive Medical Procedures
                Ophthalmic Procedures
                Biology and Life Sciences
                Neuroscience
                Cognitive Science
                Cognitive Psychology
                Perception
                Sensory Perception
                Vision
                Visual Acuity
                Biology and Life Sciences
                Psychology
                Cognitive Psychology
                Perception
                Sensory Perception
                Vision
                Visual Acuity
                Social Sciences
                Psychology
                Cognitive Psychology
                Perception
                Sensory Perception
                Vision
                Visual Acuity
                Biology and Life Sciences
                Neuroscience
                Sensory Perception
                Vision
                Visual Acuity
                Biology and Life Sciences
                Neuroscience
                Cognitive Science
                Cognitive Psychology
                Perception
                Sensory Perception
                Vision
                Biology and Life Sciences
                Psychology
                Cognitive Psychology
                Perception
                Sensory Perception
                Vision
                Social Sciences
                Psychology
                Cognitive Psychology
                Perception
                Sensory Perception
                Vision
                Biology and Life Sciences
                Neuroscience
                Sensory Perception
                Vision
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                All relevant data are within the paper and its Supporting information files.

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