VA LOVIT II: a protocol to compare low vision rehabilitation and basic low vision

Stelmack, Joan A.; Tang, Xiaoyin; Reda, Domenic J.; Stroupe, Kevin T.; Rinne, Stephen; Massof, Robert W.

doi:10.1111/j.1475-1313.2012.00933.x

Cited by 15 publications

(27 citation statements)

References 37 publications

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“…24 LOVIT II complemented LOVIT by comparing the outcomes of 2 types of outpatient LV programs for veterans who had less severe visual impairment from macular diseases (BCDVA better-eye, 20/50-20/200). 9,20 The mean (SD) direct health care costs were similar for basic LV services and LV rehabilitation: $1662 ($671) per patient for basic LV services compared with $1788 ($864) per patient for multidisciplinary LV rehabilitation. Moreover, LV rehabilitation was associated with improvement in several dimensions of functional visual ability, particularly for patients with greater impairment (ie, BCDVA better-eye worse than 20/63-20/200).…”

Section: Discussionmentioning

confidence: 99%

Economic Evaluation of Low-Vision Rehabilitation for Veterans With Macular Diseases in the US Department of Veterans Affairs

et al. 2018

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; for the LOVIT II Study Group IMPORTANCE Examining costs and consequences of different low-vision (LV) programs provides important information about resources needed to expand treatment options efficiently. OBJECTIVE To examine the costs and consequences of LV rehabilitation or basic LV services. DESIGN, SETTING, AND PARTICIPANTS The US Department of Veterans Affairs (VA) Low Vision Intervention Trial (LOVIT) II was conducted from September 27, 2010, to July 31, 2014, at 9 VA facilities and included 323 veterans with macular diseases and a best-corrected distance visual acuity of 20/50 to 20/200. Veterans were randomized to receive basic LV services that provided LV devices without therapy, or LV rehabilitation that added a therapist to LV services who provided instruction and homework on using LV devices, eccentric viewing, and environmental modification. We compared costs and consequences between these groups. INTERVENTIONS Low-vision devices without therapy and LV devices with therapy. MAIN OUTCOMES AND MEASURES Costs of providing basic LV services or LV rehabilitation were assessed. We measured consequences as changes in functional visual ability from baseline to follow-up 4 months after randomization using the VA Low Vision Visual Functioning Questionnaire. Visual ability was measured in dimensionless log odds units (logits). RESULTS Of 323 randomized patients, the mean (SD) age was 80 (10.5) years, 314 (97.2%) were men, and 292 (90.4%) were white. One hundred sixty (49.5%) received basic LV services and 163 (50.1%) received LV rehabilitation. The mean (SD) total direct health care costs per patient were similar between patients who were randomized to receive basic LV services

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Section: Discussionmentioning

confidence: 99%

Economic Evaluation of Low-Vision Rehabilitation for Veterans With Macular Diseases in the US Department of Veterans Affairs

et al. 2018

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“…Previous research has shown that vision impairment in Portugal is a common condition that leads to significant costs at personal and societal levels . The general lack of cost‐effectiveness analysis (CEA) may delay decisions to implement more and better basic‐VRS and creates barriers to the development of vision rehabilitation . But, why do we need to perform a CEA now if magnifiers have been dispensed in many hospitals regularly since, at least, 1970? Recent systematic reviews showed that better evidence on the cost‐effectiveness of using magnifiers is necessary .…”

Section: Discussionmentioning

confidence: 99%

Cost‐effectiveness of basic vision rehabilitation (The basic VRS‐effect study): study protocol for a randomised controlled trial

Hernández-Moreno

Senra

Lewis

et al. 2020

Ophthalmic Physiologic Optic

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Purpose: To investigate the cost-effectiveness of a basic vision rehabilitation service (basic-VRS) in Portugal. We designed a parallel group, randomised controlled trial whose aim is to compare the effects and costs of 'usual low vision care' with a 'basic-VRS intervention' on self-reported visual ability and other psychosocial and health-related quality-of-life outcomes. Methods: The trial will recruit participants that meet the following inclusion criteria: (1) visual acuity between 0.4-1.0 logMAR in the better-seeing eye, (2) cause of vision loss is diabetic retinopathy or age-related macular degeneration, (3) 18 years or older and iv) live in the community (not in nursing homes or other type of institution). Participants will be randomised to one of the study arms consisting of immediate intervention and delayed intervention. The delayed intervention group will receive 'usual care' or no intervention in the first 12 weeks. Visual acuity, contrast sensitivity and retinal structure will be assessed during the study. Results: The primary outcome measure is visual ability, which will be evaluated with the Massof Activity Inventory, we expect that the intervention will raise the overall person measure or visual ability. Reading, health-related quality-of-life, anxiety and depression and social support will be also assessed. The analysis will be undertaken on an intention-to-treat basis. A cost-effectiveness analysis will be performed to provide information about the cost per unit of utility. To evaluate the cost-effectiveness of the intervention we will adopt the perspective of the healthcare system. Conclusion: This study will provide additional evidence about the effects of basic-VRS on self-reported visual ability. Findings from this study should also contribute to better planning of low vision provision and, consequently, may contribute to reduce barriers to basic-VRS.

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“…8 Compared to modern devices, these older forms of HMD were relatively bulky and employed large cameras that connected to the display and limited their portability. Currently, several ongoing RCTs are focused on rehabilitation of CVL and seek to demonstrate the effectiveness of competing LVR strategies 15 and of newer forms of HMD 16 for patients with CVL.…”

Section: Current Low Vision Aidsmentioning

confidence: 99%

Head-Mounted Display Technology for Low-Vision Rehabilitation and Vision Enhancement

Ehrlich

Ojeda

Wicker

et al. 2017

American Journal of Ophthalmology

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Purpose To describe the various types of head-mounted display technology, their optical and human factors considerations, and their potential for use in low vision rehabilitation and vision enhancement. Design Expert perspective. Methods An overview of head-mounted display technology by an interdisciplinary team of experts drawing on key literature in the field. Results Head-mounted display technologies can be classified based on their display type and optical design. See-through displays such as retinal projection devices have the greatest potential for use as low vision aids. Devices vary by their relationship to the user’s eyes, field of view, illumination, resolution, color, stereopsis, effect on head motion and user interface. These optical and human factors considerations are important when selecting head-mounted displays for specific applications and patient groups. Conclusions Head-mounted display technologies may offer advantages over conventional low vision aids. Future research should compare head-mounted displays to commonly prescribed low vision aids in order to compare their effectiveness in addressing the impairments and rehabilitation goals of diverse patient populations.

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VA LOVIT II: a protocol to compare low vision rehabilitation and basic low vision

Abstract: LOVIT II is the first multicentre RCT comparing the effectiveness and cost-effectiveness of LVR and basic LV for patients with macular diseases and near normal or moderate levels of visual impairment.

Cited by 15 publications

References 37 publications

Economic Evaluation of Low-Vision Rehabilitation for Veterans With Macular Diseases in the US Department of Veterans Affairs

Economic Evaluation of Low-Vision Rehabilitation for Veterans With Macular Diseases in the US Department of Veterans Affairs

Cost‐effectiveness of basic vision rehabilitation (The basic VRS‐effect study): study protocol for a randomised controlled trial

Head-Mounted Display Technology for Low-Vision Rehabilitation and Vision Enhancement

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