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      Improvement in Patient-Reported Quality of Life Outcomes in Severely Visually Impaired Individuals Using the Aira Assistive Technology System

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          Abstract

          Purpose

          We evaluate patient-reported quality of life outcomes in severely visually impaired (SVI) individuals using the Aira system, an on demand assistive wearable technology.

          Methods

          Aira is an on-demand assistive wearable technology designed for the severely visually impaired (visual acuity of better eye <20/200). The user wears glasses with a video camera mounted that, when activated, livestreams to a human agent who assists the user in the specified task. Aira subscribers were recruited consecutively and administered the 28-item Impact of Vision Impairment-Very Low Vision (IVI-VLV) Questionnaire, a previously validated survey for vision-related quality of life specifically for low vision individuals. The questionnaire was administered by phone before starting Aira and at 3-month follow-up. Total score as well as validated subset scores of activities of daily living, mobility and safety (ADLMS) and emotional wellbeing (EWB) were assessed.

          Results

          A total of 69 participants (mean age, 52.1; 35 female, 34 male) were recruited with a mean of 108 (SD = 19.7) days to follow-up. Mean total minutes used over the interval were 334.1 (SD = 318.5). Initial total score (mean 51.7 ± 18.6) significantly improved at follow-up (mean 62.2 ± 15.0; P < 0.0001) with mean change +10.4 ± 12.5. ADLMS subset score (mean 30.4 ± 10.8) significantly improved at follow-up (mean 36.6 ± 8.8; P < 0.0001) with mean change +6.5 ± 8.7. EWB subset score (mean 21.6 ± 8.8) significantly improved at follow-up (mean 25.6 ± 7.9 respectively; P < 0.0001) with mean change +4.0 ± 5.2. There was no correlation between minutes used and improvement in total ( r = −0.205, P = 0.098), ADLMS ( r = −0.237, P = 0.055), and EWB ( r = −0.242, P = 0.051) scores.

          Conclusions

          In this exploratory study, regardless of minutes used, the use of Aira significantly improves IVI-VLV total score and ADLMS and EWB subscores for SVI individuals. This improvement is not correlated with total minutes used.

          Translational Relevance

          The Aira assistive technology system may provide improvement in quality of life for low vision patients and is worthy of further study to assess the use of this technology to assist SVI patients.

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          Most cited references27

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          The economic burden of major adult visual disorders in the United States.

          To estimate the societal economic burden and the governmental budgetary impact of the following visual disorders among US adults aged 40 years and older: visual impairment, blindness, refractive error, age-related macular degeneration, cataracts, diabetic retinopathy, and primary open-angle glaucoma. We estimated 3 components of economic burden: direct medical costs, other direct costs, and productivity losses. We used private insurance and Medicare claims data to estimate direct medical costs; epidemiologic evidence from multiple published sources to estimate other direct costs, such as nursing home costs; and data from the Survey of Income and Program Participation to estimate productivity losses. We used budgetary documents and our direct medical and other direct cost estimates to approximate the governmental budgetary impact. We estimated that the annual total financial burden of major adult visual disorders is $35.4 billion ($16.2 billion in direct medical costs, $11.1 billion in other direct costs, and $8 billion in productivity losses) and that the annual governmental budgetary impact is $13.7 billion. Major visual disorders among Americans older than 40 years result in substantial economic costs for the US economy. Well-designed public health programs may have the ability to reduce this burden in the future.
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            How accurate are self-reports? Analysis of self-reported health care utilization and absence when compared with administrative data.

            To determine the accuracy of self-reported health care utilization and absence reported on health risk assessments against administrative claims and human resource records. Self-reported values of health care utilization and absenteeism were analyzed for concordance to administrative claims values. Percent agreement, Pearson's correlations, and multivariate logistic regression models examined the level of agreement and characteristics of participants with concordance. Self-report and administrative data showed greater concordance for monthly compared with yearly health care utilization metrics. Percent agreement ranged from 30% to 99% with annual doctor visits having the lowest percent agreement. Younger people, males, those with higher education, and healthier individuals more accurately reported their health care utilization and absenteeism. Self-reported health care utilization and absenteeism may be used as a proxy when medical claims and administrative data are unavailable, particularly for shorter recall periods.
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              Visual Impairment and Blindness in Adults in the United States: Demographic and Geographic Variations From 2015 to 2050.

              The number of individuals with visual impairment (VI) and blindness is increasing in the United States and around the globe as a result of shifting demographics and aging populations. Tracking the number and characteristics of individuals with VI and blindness is especially important given the negative effect of these conditions on physical and mental health.
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                Author and article information

                Journal
                Transl Vis Sci Technol
                Transl Vis Sci Technol
                tvst
                Transl Vis Sci Technol
                TVST
                Translational Vision Science & Technology
                The Association for Research in Vision and Ophthalmology
                2164-2591
                September 2018
                29 October 2018
                : 7
                : 5
                : 30
                Affiliations
                [1 ]Shiley Eye Institute, Department of Ophthalmology, University of California, San Diego, La Jolla, CA, USA
                Author notes
                Correspondence: Daniel L. Chao, Shiley Eye Institute, Department of Ophthalmology, University of California, San Diego, 9415 Campus Point Dr, La Jolla, CA 92093, USA. email: d6chao@ 123456ucsd.edu
                Article
                tvst-07-05-24 TVST-18-0865
                10.1167/tvst.7.5.30
                6205681
                9d937b1c-2fbd-4609-92e3-13e06fcda3fb
                Copyright 2018 The Authors

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 7 May 2018
                : 18 July 2018
                Categories
                Articles

                wearable technology,severe vision impairment,adaptive technology

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