The Houston Vision Assessment Test (HVAT): an assessment of validity

Prager, Thomas C.; Chuang, Alice Z.; Slater, Carl H.; Glasser, Jay H.; Ruiz, Richard

doi:10.1076/0928-6586(200006)7:2;1-z;ft087

Cited by 6 publications

(8 citation statements)

References 18 publications

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“…Table outlines the 22 items that this study identified from existing vision‐specific quality of life research and questionnaires . Evaluation of the vision and driving research also helped to derive an additional three items that were considered relevant but had not been used in existing questionnaires.…”

Section: Methodsmentioning

confidence: 99%

Development and validation of a vision and night driving questionnaire

Kimlin

Black

Djaja

et al. 2016

Ophthalmic Physiologic Optic

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Section: Methodsmentioning

confidence: 99%

Development and validation of a vision and night driving questionnaire

Kimlin

Black

Djaja

et al. 2016

Ophthalmic Physiologic Optic

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“…The Houston Vision Assessment Test (HVAT) published in 2000 has been proposed as an instrument to guide the decision‐making process between the patient and the ophthalmologist when considering cataract surgery 13 . The HVAT uses a two‐part rating scale with the hypothesis that performing an activity requires a non‐visual (for example, physical or cognitive) and a visual component, so both non‐visual and visual impairments can be estimated and together these form the total impairment.…”

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confidence: 99%

“…Values for total, visual and non‐visual impairments can be averaged across all answered questions to give an overall score, which is expressed as a percentage. Using rudimentary psychometric analysis, the HVAT has high internally consistent reliability (Cronbach's alpha = 0.96 preoperatively) and validity 13 . The scoring approach attempts to use Classical Test Theory (CTT) to provide the measurement.…”

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confidence: 99%

“…This assumption is commonly invalid because numbers or scores only indicate an ordering relationship and do not represent counts of equal units of measurement, due to which the scores do not share the interval properties of measures. Consequently, raw scores cannot be considered as measures 13,17,19 . The issue becomes further complicated with the use of a two‐part multiplicative rating scale and specifically the philosophy that underpins the development of the HVAT (that is, to disentangle visual from non‐visual impairment).…”

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confidence: 99%

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Multiplicative rating scales do not enable measurement of vision‐related quality of life

Gothwal

Wright

Lamoureux

et al. 2011

Clinical and Experimental Optometry

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Purpose: Many questionnaires for the measurement of visual impairment exist. One, the Houston Vision Assessment Test (HVAT), takes a different approach: the patient is asked to rate overall impairment and the proportion attributed to vision, then through multiplication the visual and non-visual (physical) impairments are calculated. The purpose of this study was to determine whether the scores derived from this approach can be considered to be measures. Methods: The participants were 193 cataract patients awaiting surgery (mean age 74.1 Ϯ 9.8 years, 54 per cent female and 53.6 per cent were awaiting first eye surgery), who self-administered the HVAT, which consists of 10 questions, whereby impairment on each activity and the proportion attributable to vision is rated. Therefore, total, visual and physical impairments are calculated. For each question, multiplying the impairment (five response categories) by the proportion due to eyesight (five categories) gives 10 possible levels of visual impairment. Assessment of the multiplicative rating scales included frequency of category use and hierarchical ordering of response categories using category thresholds. Summary statistics of Rasch analysis were generated for the rating scale and overall questionnaire performance. Results: In the multiplicative scale, higher response categories were under-utilised and thresholds were disordered, indicating that the categories did not function as intended. Some of the dysfunction arose from disordered thresholds in the 'proportion due to eyesight scale', but repairing this gave little improvement to the multiplicative scale. The ill-defined nature of the disordered categories precluded further repair by combining categories. Measurement precision, as indicated by person separation reliability, was poor (0.70). Conclusion: Rasch analysis demonstrated that the categories of the multiplied rating scale of the HVAT were not ordered, as the user would expect; this precludes measurement. This provides evidence against the use of multiplicative rating scales in quality-oflife questionnaires. It would be better to use a single rating scale for each construct of interest.

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“…In general terms, the tests can be divided into the following headings with examples of each given below: Visual functionThe Cataract Symptom Scale (CSS) (Crabtree et al 1999)Visual Function-14 (VF-14) (Steinberg et al 1994)Daily Tasks Dependent on Vision Questionnaire (Hart et al 2005)National Eye Institute Visual Function Questionnaire (NEI VFQ) (Mangione et al 1998)Vision Core Module 1 (VCM1) (Frost et al 1998)Visual Disability Assessment (Pesudovs and Coster 1998)Visual Symptoms and Quality of Life Questionnaire (VSQ) (Donovan et al 2003)Houston Vision Assessment Test (HVAT) (Prager et al 2000)Cataract TyPE specification (Javitt et al 2003)Quality of Vision Questionnaire (Aslam et al 2004)General functionNottingham Extended Activities of Daily Living (NEADL) scale (Nouri and Lincoln 1987)Activities of daily living scale (Mangione et al 1992)General physical healthGeneral Health Questionnaire (GHQ) (Goldberg and Hillier 1979)Sickness Impact Profile (Desai et al 1996)Medical Outcomes Study Short Form Health Survey (SF-36) (Ware and Gandek 1998)CognitionMini Mental State Examination (MMSE) (Folstein et al 1975)MoodHospital Anxiety and Depression (HAD) scale (Zigmond and Snaith 1983)…”

Section: How Is Visual Function Assessed?mentioning

confidence: 99%

Cataract surgery and quality of life implications

Morris¹,

Fraser²,

Gray³

2007

Clinical Interventions in Aging

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Cataract surgery in the developed world has undergone a revolution over the last 20 years. An operation which used to require a stay in hospital and long visual rehabilitation is now a quick day-case procedure with immediate benefits. As with any surgery there is an associated morbidity, but there is now the potential to provide cataract surgery at an earlier stage of cataract maturation and save patients from a period of severe visual impairment. This article reviews the new techniques available to measure the impact that cataracts have not only on a patient’s visual acuity but also their general physical health, function, cognition, and emotional well-being. New research is described that takes into account these more holistic tests and how they can be used to judge the best time to refer and operate on a patient with cataracts.

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The Houston Vision Assessment Test (HVAT): an assessment of validity

Cited by 6 publications

References 18 publications

Development and validation of a vision and night driving questionnaire

Development and validation of a vision and night driving questionnaire

Multiplicative rating scales do not enable measurement of vision‐related quality of life

Cataract surgery and quality of life implications

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