Addressing Low Vision due to Severe Peripheral Field Loss: Development and Validation of a Patient-Centered Outcome Measure

解决因严重周边视野丧失导致的低视力问题：以患者为中心的结果测量的开发和验证

• 批准号: 9294683
• 负责人: Joshua Robert Ehrlich
• 金额: $ 22.45万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-01 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9294683
• 关键词: Activities of Daily Living; Address; Affect; Area; Attenuated; Awareness; Behavior; Blindness; Caregivers; Caring; Chronic; Clinical; Clinical Research; Clinical Trials; Cognitive; Consensus; Data; Development; Dorsal; Effectiveness; Ensure; Evaluation; Focus Groups; Future; Glaucoma; Goals; Hispanics; Impairment; Individual; Institutes; Intervention; Interview; Journals; Knowledge; Life; Measurement; Measures; Mentors; Mentorship; Methodology; Methods; Michigan; Mission; Modeling; Motion Perception; Motor; National Eye Institute; Ophthalmologist; Ophthalmology; Outcome; Outcome Measure; Outcomes Research; Pathway interactions; Patient Outcomes Assessments; Patient-Focused Outcomes; Patients; Peripheral; Population; Population Intervention; Prevalence; Principal Component Analysis; Provider; Psychometrics; Public Health; Quality of life; Randomized Controlled Trials; Rehabilitation therapy; Research; Research Design; Research Personnel; Research Priority; Retinal Degeneration; Review Literature; Self-Direction; Self-Help Devices; Stream; Surveys; Testing; Training; United States; University resources; Validation; Validity and Reliability; Vision; Vision Disorders; Vision Tests; Visual Acuity; Visual Fields; Visual impairment; Work; blind; career; career development; compare effectiveness; design; functional disability; improved; improved functioning; information processing; insight; instrument; patient oriented; programs; rehabilitation strategy; response; skills; spatial vision; systematic review; theories; vision rehabilitation; visual processing

Abstract The burden of blindness and visual impairment in the United States is expected to double between 2015 and 2050 to 8.96 million people. Blacks, Hispanics and older individuals will be disproportionally affected, further accentuating the disparate impact of vision disorders. Although low vision rehabilitation (LVR) has been shown to improve the functioning of patients, considerable opportunities remain to better understand and overcome functional limitations due to low vision. Specifically, the effectiveness of LVR for patients with peripheral field loss (PFL) has not been well-studied, though 15-20% of patients presenting for LVR have glaucoma or a retinal degeneration, two important causes of PFL. In order to evaluate and compare interventions for this population, a highly relevant measure of functioning is needed. The proposed project will address this through the development and validation of a patient-reported outcome measure, the Low Vision Severely Constricted Peripheral Eyesight (LV-SCOPE) Assessment. In Aim 1 of this proposal, focus groups with patients, caretakers and vision providers will identify the impairments and LVR goals associated with severe PFL. Since PFL often exists in combination with visual acuity loss, patients with PFL and a range of visual acuities will be included. We anticipate that PFL will preferentially impact known functions of the dorsal visual processing stream, as this pathway depends on peripheral vision for spatial awareness and motor behavior. In Aim 2, focus group data will guide the selection of survey items for the outcome measure. In Aim 3, psychometric evaluations will test the validity, reliability and precision of the LV-SCOPE. Once validated, the LV-SCOPE may be an optimal outcome measure to evaluate and identify targeted LVR strategies for patients with PFL, a sizable understudied population. This project directly addresses the National Eye Institute's low vision priority research area “to create and validate vision tests relevant for the tasks of daily living.” Dr. Ehrlich's long-term career goal is to improve the vision-dependent functioning of patients with low vision. He will achieve this through coursework, mentorship and research to improve the measurement of functional impairment and facilitate the evaluation of targeted LVR strategies. The applicant's training plan is a natural progression from his background in ophthalmology, clinical research and public health. He will acquire knowledge and expertise in outcome measure development and psychometrics, low vision and rehabilitation, mixed-methods analyses and clinical trials. Dr. Ehrlich has devised a plan of pertinent coursework, individualized mentorship, and directed self-study to achieve his training and research goals. Dr. Ehrlich's career development will benefit from the vast resources of the University of Michigan and the support of his mentors, including Drs. Noelle Carlozzi, Paul Lee, Robert Massof and Joan Stelmack. This proposal demonstrates Dr. Ehrlich's commitment to gaining the necessary skills to become an independent investigator and to addressing a pressing public health need.

抽象的 预计在2015年至 2050年至896万人。黑人，西班牙裔和年龄较大的人将受到不成比例的影响，进一步 强调视力障碍的不同影响。尽管显示了低视力康复（LVR） 为了改善患者的功能，仍然有很多机会可以更好地理解和克服 由于低视力而引起的功能局限性。具体而言，LVR对外周场患者的有效性 损失（PFL）尚未得到充分研究，尽管有15-20％的LVR患者患有青光眼或视网膜 变性，PFL的两个重要原因。为了评估和比较该人群的干预措施， 需要一个高度相关的功能衡量标准。拟议的项目将通过 对患者报告的结局指标的开发和验证，低视力严重受限 外围视力（LV-SCOPE）评估。在该提案的目标1中，与患者，看护人的焦点小组 视力提供者将确定与严重PFL相关的障碍和LVR目标。由于PFL经常 与视力丧失相结合，将包括PFL和一系列视觉患者。 我们预计PFL最好影响背面视觉处理流的已知功能，因为 途径取决于空间意识和运动行为的外围视力。在AIM 2中，焦点小组数据 将指导选择结果措施的调查项目。在AIM 3中，心理测量评估将测试 LV-SCOPE的有效性，可靠性和精度。一旦验证，LV-SCOPE可能是最佳的 评估和识别PFL患者的目标LVR策略的结果度量，这是相当大的 研究的人口。该项目直接解决国家眼科研究所的低视力优先研究 区域“创建和验证与日常生活任务相关的视力测试。” Ehrlich博士的长期职业目标 是为了改善低视力患者的视力依赖性功能。他将通过 课程，指导和研究以改善功能障碍的测量并促进 评估目标LVR策略。申请人的培训计划是自然而然的 眼科，临床研究和公共卫生的背景。他将获得知识和专业知识 结果衡量发展和心理计量学，低视力和康复，混合方法分析以及 临床试验。埃里希（Ehrlich）博士已经制定了一个相关课程的计划，个性化的指导和指导 实现自己的培训和研究目标的自学。 Ehrlich博士的职业发展将受益于新的 密歇根大学的资源及其导师的支持，包括博士。诺埃尔·卡洛兹（Noelle Carlozzi），保罗 Lee，Robert Massof和Joan Stelmack。该建议表明，埃里希博士致力于获得 成为独立调查员并满足紧迫的公共卫生需求的必要技能。