Cat-PROM5: a brief psychometrically robust self-report questionnaire instrument for cataract surgery

Abstract

PurposeTo develop a short, psychometrically robust and responsive cataract patient reported outcome measure suitable for use in high-volume surgical environments.MethodsA prospective study in which participants completed development versions of questionnaires exploring the quality of their eyesight using items harvested from two existing United Kingdom developed parent questionnaires. Participants were 822 patients awaiting cataract surgery recruited from 4 cataract surgical centres based in the UK. Exclusion criteria were other visually significant comorbidities and age <50 years. An iterative multi-stage process of evaluation using Rasch and factor analyses with sequential item reduction was undertaken.ResultsA definitive item set of just five items delivered performance in accordance with the requirements of the Rasch model: no threshold disordering, no misfitting items, Rasch-based reliability 0.90, person separation 2.98, Cronbach’s α 0.89, good targeting of questions to patients with cataract with pre-operative item mean −0.41 logits and absence of significant floor or ceiling effects, minor deviations of item invariance, and confirmed unidimensionality. The test–re-test repeatability intra-class correlation coefficient was 0.89 with excellent responsiveness to surgery, Cohen’s d −1.45 SD. Rasch calibration values are provided for Cat-PROM5 users.ConclusionsA psychometrically robust and highly responsive five-item cataract surgery patient reported outcome measure has been developed, which is suitable for use in high-volume cataract surgical services.

A randomized controlled trial comparing femtosecond laser–assisted cataract surgery versus conventional phacoemulsification surgery

“…Participants' refractive errors were collected using an RK-501A Autorefractor (Nidek Co. Ltd, Aichi, Japan). a Rasch calibrated psychometrically robust measure which is highly responsive to cataract surgery, in which a higher score indicates greater visual disability 17,18 .…”

“…Our aim was to complete the largest RCT published to date comparing FLACS with CPS with the intention to inform clinical practice and health policy worldwide. As there have been a lack of patient reported outcome measures (PROMs) in previous RCTs, this study aimed to correct this by measuring quality of life with EuroQOL's EQ-5D and patient reported quality of vision with Cat-PROM5 17,18 .…”

Assessing the construct validity and responsiveness of Preference-Based Measures (PBMs) in cataract surgery patients

“…All participants completed the Cat-PROM5 and ICECAP-O. The Cat-PROM5 is a fiveitem questionnaire designed to measure the HRQL impact of cataract surgery [22]. The Cat-PROM5 is responsive to changes in vision following cataract surgery (Cohen's d = -1.45) [22], although is not preference based and thus cannot be used in CUA.…”

“…The Cat-PROM5 is a fiveitem questionnaire designed to measure the HRQL impact of cataract surgery [22]. The Cat-PROM5 is responsive to changes in vision following cataract surgery (Cohen's d = -1.45) [22], although is not preference based and thus cannot be used in CUA. It is currently being piloted in the National Ophthalmology Database Cataract Surgery Audit [23], its use having been encouraged by NICE [24].…”

A randomised, prospective study of ‘off-the-shelf’ use of toric intraocular lenses for cataract patients with pre-existing corneal astigmatism in the NHS

“…Secondary outcome measures were TIOL rotational stability data and safety data for both groups. Following an amendment to the protocol during the study, patient-reported outcome measures (PROMs) were studied using Cat-PROM5 [ 7 , 8 ] questionnaire as well as EuroQOL EQ-5D quality of life questionnaire with visual analogue score (VAS) ( https://euroqol.org ).…”