A Systematic Review of Patient-Reported Outcomes for Surgically Amenable Epiphora

Schulz, C.; Kennedy, Alasdair; Rogers, Simon

doi:10.1097/iop.0000000000000977

Cited by 14 publications

(30 citation statements)

References 38 publications

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“…[ 8 ] GBI is not procedure-specific and therefore also permits comparison across different in terventions, and can differentiate between successful and unsuccessful procedures. [ 9 ] Other methods of measuring QOL are Single-item symptom scores, single-item reports of improvement, Lacrimal Symptom Questionnaire (0.5%), Nasolacrimal Duct Obstruction Symptom Score, Ocular Surface Disease Index, Visual Function Questionnaire, the Short Form-36 Health Survey[ 10 ] and Lac-Q questionnaire[ 11 ]…”

Section: Discussionmentioning

confidence: 99%

Subjective outcome and quality of life following external dacryocystorhinostomy

Dani

Yadalla

Joy

et al. 2021

Indian Journal of Ophthalmology

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Purpose: To assess the patient reported outcome and quality of life in post external dacryocystorhinostomy operated patients. Methods: A prospective questionnaire based study was carried out on 112 patients diagnosed with chronic dacryocystitis who underwent external dacryocystorhinostomy in the department of Orbit and Oculoplasty at a tertiary eye hospital in South India. Results: We included 112 cases in our study. Mean (SD) of the age of patients was 48.03 (12.79) years and ranged from 7 to 72 years of age. 44 (39.3%) patients were males and 68 (60.7%) were females. All cases had subjective symptoms of tearing, pain and swelling at baseline which were relieved by post-operative 3 in all cases. The mean (SD) best corrected visual acuity was 0.28 (0.39) at baseline and 0.25 (0.37) at postoperative 3 (p < 0.001). All four parameters studied in the GBI questionnaire - total mean GBI (32.22 vs 48.86, P < 0.001), general subscale (31.21 vs 44.08, P < 0.001), social health (46.28 vs 61.01, P < 0.001), physical outcome (22.17 vs 55.80, P = 0.0001) scores showed significant improvement from 1 vs 3 months post DCR. Conclusion: The GBI questionnaire is an effective tool for assessing patients’ quality of life following DCR. External DCR can not only produce a successful anatomical outcome but also bring about a measurable improvement in subjective symptoms and quality of life among patients with symptomatic NLDO.

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Section: Discussionmentioning

confidence: 99%

Subjective outcome and quality of life following external dacryocystorhinostomy

Dani

Yadalla

Joy

et al. 2021

Indian Journal of Ophthalmology

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“…A systematic review of PROMs for surgically amenable epiphora identified that 69% of 227 studies included a PROM as the primary outcome measure, although in 48% the PROM was a single-item symptom score 80. The authors critically appraised each PROM and concluded that they lacked adequate content validity.…”

Section: Impact Of Proms By Ophthalmic Subspecialtymentioning

confidence: 99%

<p>The use of patient-reported outcome research in modern ophthalmology: impact on clinical trials and routine clinical practice</p>

Braithwaite¹,

Calvert²,

Gray³

et al. 2019

PROM

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This review article considers the rising demand for patient-reported outcome measures (PROMs) in modern ophthalmic research and clinical practice. We review what PROMs are, how they are developed and chosen for use, and how their quality can be critically appraised. We outline the progress made to develop PROMs in each clinical subspecialty. We highlight recent examples of the use of PROMs as secondary outcome measures in randomized controlled clinical trials and consider the impact they have had. With increasing interest in using PROMs as primary outcome measures, particularly where interventions have been found to be of equivalent efficacy by traditional outcome metrics, we highlight the importance of instrument precision in permitting smaller sample sizes to be recruited. Our review finds that while there has been considerable progress in PROM development, particularly in cataract, glaucoma, medical retina, and low vision, there is a paucity of useful tools for less common ophthalmic conditions. Development and validation of item banks, administered using computer adaptive testing, has been proposed as a solution to overcome many of the traditional limitations of PROMs, but further work will be needed to examine their acceptability to patients, clinicians, and investigators.

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“…While in some, the epiphora represents no more than a tolerable nuisance, in others it significantly affects their quality of life. 4 At the more severe end of the spectrum, some cases necessitate repeated medical or surgical intervention for recurrent infection.…”

Section: Introductionmentioning

confidence: 99%

The ‘tears’ score: A tool for grading and monitoring epiphora

Schulz

Malhotra

2022

European Journal of Ophthalmology

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Purpose To test the reliability, validity and utility of the TEARS score, a scale of clinical and patient-reported severity in patients with epiphora, comprising 4 subscales: Times wiping (T), clinical Effects (E), Activity limitation (A), and symptoms of Reflex epiphora (R). Methods The TEARS score was completed by 136 patients with epiphora (78 treated surgically, and 51 non-surgically). Inter-rater reliability was evaluated using Cohen's Kappa and Bland-Altman analysis. 129 (95%) participants were followed up 2–6 months after baseline (non-surgical patients) or 3–6 months post-operatively (surgical patients). For each TEARS subscale, differences in scores were compared. Convergent validity was evaluated by testing correlation between TEARS and both The Lacrimal Symptom Questionnaire (Lac-Q) and The Watery Eye Quality of Life Score (WEQOL). Results Inter-rater reliability (Cohen's K) ranged from 0.5 for ‘A’ and ‘R’ to 0.8 for ‘T’ and ‘E’ subscales. Scores were lower post-operatively in surgical patients (p < 0.001). ‘R’ scores (reflex tearing) were higher in non-surgical cases compared with surgical (p = 0.02) but no difference was observed in other subscales at baseline. TEARS subscale scores were positively correlated with both WEQOL (r = 0.51 to 0.73) and Lac-Q score (r = 0.55 to 0.63). Conclusion The TEARS score is quickly and easily implemented in a busy clinical setting. It provides an overview of both subjective and objective clinical severity in patients with epiphora, with appropriate reliability, post-operative responsiveness and convergent validity for this purpose and in this setting. It is a valuable template to be used alongside individualised symptomology.

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A Systematic Review of Patient-Reported Outcomes for Surgically Amenable Epiphora

Cited by 14 publications

References 38 publications

Subjective outcome and quality of life following external dacryocystorhinostomy

Subjective outcome and quality of life following external dacryocystorhinostomy

<p>The use of patient-reported outcome research in modern ophthalmology: impact on clinical trials and routine clinical practice</p>

The ‘tears’ score: A tool for grading and monitoring epiphora

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