Catquest-9SF questionnaire: validation of Malay and Chinese-language versions using Rasch analysis

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Abstract

Background

Catquest questionnaire was originally developed in Swedish to measure patients’ self-assessed visual function to evaluate the benefit of cataract surgery. The result of the Rasch analysis leading to the creation of the nine-item short form of Catquest, (Catquest-9SF), and it had been translated and validated in English. The aim is therefore to evaluate the translated Catquest-9SF questionnaire in Malay and Chinese (Mandarin) language version for measuring patient-reported visual function among cataract population in Malaysia.

Methods

The English version of Catquest-9SF questionnaire was translated and back translated into Malay and Chinese languages. The Malay and Chinese translated versions were self-administered by 236 and 202 pre-operative patients drawn from a cataract surgery waiting list, respectively. The translated Catquest-9SF data and its four response options were assessed for fit to the Rasch model.

Results

The Catquest-9SF performed well in the Malay and Chinese translated versions fulfilling all criteria for valid measurement, as demonstrated by Rasch analysis. Both versions of questionnaire had ordered response thresholds, with a good person separation (Malay 2.84; and Chinese 2.59) and patient separation reliability (Malay 0.89; Chinese 0.87). Targeting was 0.30 and −0.11 logits in Malay and Chinese versions respectively, indicating that the item difficulty was well suited to the visual abilities of the patients. All items fit a single overall construct (Malay infit range 0.85–1.26, outfit range 0.73–1.13; Chinese infit range 0.80–1.51, outfit range 0.71–1.36), unidimensional by principal components analysis, and was free of Differential Item Functioning (DIF).

Conclusions

These results support the good overall functioning of the Catquest-9SF in patients with cataract. The translated questionnaire to Malay and Chinese-language versions are reliable and valid in measuring visual disability outcomes in the Malaysian cataract population.

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Most cited references 18

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Catquest-9SF patient outcomes questionnaire: nine-item short-form Rasch-scaled revision of the Catquest questionnaire.

Mats Lundström, Konrad Pesudovs (2009)

To assess and optimize the Catquest questionnaire for measuring patient-reported outcomes of cataract surgery using Rasch analysis. Fifty-eight ophthalmic surgical units in Sweden. Catquest questionnaires (n = 21364) from the Swedish National Cataract Register were selected and randomized to 2 groups. Data from 10486 questionnaires were comprehensively Rasch analyzed using a 4-Andrich rating scale model in Winsteps software. A revised version of Catquest was developed (Catquest-9SF) and tested in 10886 patients for validity and responsiveness to cataract surgery. Only the visual disability subscale formed a valid measurement scale. This could be enhanced through the addition of the 2 global assessment items; however, the symptoms and frequency of performing the activities items did not contribute to the measurement. The 9-item short-form version (Catquest-9SF) had ordered response thresholds and good person separation (2.65) and was largely free from differential item functioning. All items fit a single overall construct (infit range, 0.75 to 1.29; outfit range, 0.70 to 1.39) and unidimensional by principal components analysis. The items were well targeted to the preoperative participants (0.34 logit difference in means). The score correlated with visual acuity (r = 0.43 preoperatively; r = 0.48 postoperatively) and was highly responsive to cataract surgery (preoperatively -0.32 +/- 2.15 logits; postoperatively -3.21 +/- 2.50 logits (P<.0001). The 9-item Rasch-scaled Catquest-9SF was highly valid in measuring visual disability outcomes of cataract surgery. Its brevity makes it suited to routine clinical use, and a raw-data to Rasch-measure conversion simplifies application.

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The determinants of participation in activities of daily living in people with impaired vision.

Jill Keeffe, Ecosse L. Lamoureux, J Hassell (2004)

To investigate the determinants of participation in daily activities in people with impaired vision using the Impact of Vision Impairment (IVI) instrument. Cross-sectional study. We recruited 319 participants with no vision rehabilitation history, distance visual acuity (VA) <6/12 (better eye), the ability to converse in English, and 18 years or older. Participants completed the 32-item IVI questionnaire and provided demographic, personal, cultural, and environmental details on vision-related functioning. Visual acuity data were either abstracted from the participants' files or assessed by qualified personnel. Participants also completed the SF-12 to evaluate physical (PCS-12) and mental health (MCS-12). The areas of greatest restriction of participation were associated with reading, outdoor mobility, participation in leisure activities, and shopping. In stepwise linear regression presenting VA, the PCS-12 and MCS-12 explained the variance in leisure and work (60 participants or 19%), consumer and social interaction (92 participants or 30%), household and personal care (76 participants or 24%), mobility (92 participants or 30%), emotional reaction to visual loss and (106 participants or 33%), and total IVI score (114 participants or 36%). Having age-related macular degeneration contributed marginally to the IVI domains and total score (P <.05-.01), except for the emotional domain. Belonging to a social group explained 3% and 2% of the variance in the consumer and social interaction and emotional domains, respectively (P <.05). Distance VA and physical and mental health explained more than a third of the variance of the total score, suggesting that an intervention aimed at improving quality of life may include strategies to improve not only vision-related rehabilitation but also mental and physical health.

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The measurement of vision disability.

Robert Massof (2002)

The American Medical Association's (AMA) visual efficiency scale, a vision disability metric based on visual impairment measurements, was adopted in 1925. That scale was based on a 30-year history of theoretical models in vision economics, a misinterpretation of Snellen notation for visual acuity, and an erroneous application of Weber's psychophysical law. The AMA visual efficiency scale survived uncontested for 75 years. In 2001, the AMA adopted a new vision disability scale based on logarithmic transformations of visual acuity and visual field diameter. Like the earlier visual efficiency scale, the new scale is theoretical-it is not supported by any data that speak to the relationship between vision disability and visual impairments. Attempts to measure vision disability date to the early 1980s with the development of self-assessment visual function rating scale questionnaires. Nearly all of the questionnaires developed over the last 20 years use Likert scales, but use them incorrectly. The development of a vision disability metric based on Likert scaling parallels the historical development of other forms of measurement. A tutorial review of psychometrics-classical test theory, item response theory, and Rasch analysis-shows how vision disability measurement scales can be estimated from Likert-type visual function rating scales. We conclude that preliminary data relating measures of vision disability to measures of visual acuity and visual fields support the new AMA vision disability scale.

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Author and article information

Contributors

Tassha Hilda Adnan: +603-40443060 , tassha@crc.gov.my

Mokhlisoh Mohamed Apandi: mokhlisoh@yahoo.com

Haireen Kamaruddin: haireenk@gmail.com

Mohamad Aziz Salowi: mohamadazizsalowi@gmail.com

Kian Boon Law: kblaw@crc.gov.my

Jamaiyah Haniff: jamaiyah@crc.gov.my

Pik Pin Goh: gohpp@crc.gov.my

Journal

Journal ID (nlm-ta): Health Qual Life Outcomes

Journal ID (iso-abbrev): Health Qual Life Outcomes

Title: Health and Quality of Life Outcomes

Publisher: BioMed Central (London )

ISSN (Electronic): 1477-7525

Publication date (Electronic): 5 January 2018

Publication date PMC-release: 5 January 2018

Publication date Collection: 2018

Volume: 16

Electronic Location Identifier: 5

Affiliations

[1 ]ISNI 0000 0004 0621 7139, GRID grid.412516.5, National Clinical Research Centre, , Kuala Lumpur Hospital, ; Kuala Lumpur, Malaysia

[2 ]ISNI 0000 0004 1802 4561, GRID grid.413442.4, Ophthalmology Department, , Selayang Hospital, ; Batu Caves, Selangor Malaysia

[3 ]Clinical Research Centre, Ampang Hospital, Ampang, Selangor Malaysia

[4 ]Ophthalmology Department, Faculty of Medicine, Sultan Zainal Abidin University, Kuala Terengganu, Terengganu Malaysia

Article

Publisher ID: 833

DOI: 10.1186/s12955-017-0833-3

PMC ID: 5755437

PubMed ID: 29304817

SO-VID: 3f2eb319-ba64-4329-94d6-45e844fe3fca

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 7 June 2016

Date accepted : 26 December 2017

Funding

Funded by: Ministry of Health, Malaysia

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ScienceOpen disciplines: Health & Social care

Keywords: validation,catquest-9sf questionnaire,rasch analysis

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ScienceOpen disciplines: Health & Social care

Keywords: validation, catquest-9sf questionnaire, rasch analysis

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Catquest-9SF questionnaire: validation of Malay and Chinese-language versions using Rasch analysis

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Most cited references 18

Catquest-9SF patient outcomes questionnaire: nine-item short-form Rasch-scaled revision of the Catquest questionnaire.

The determinants of participation in activities of daily living in people with impaired vision.

The measurement of vision disability.

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Cited by 13

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