Comparative studies of low vision rehabilitation outcome measures

描述（由申请人提供）：我们提议对常规低视力康复（LVR）服务的结果进行一项多治疗师、前瞻性、观察性研究。本项目旨在研究三种不同类型LVR结果测量（患者报告、治疗师报告和功能表现）的一致性，研究治疗师偏差对估计结果测量的影响，研究合并症和其他患者状态对LVR结果的影响，研究LVR的有效性与疗效的关系。我们的目标是招募10名LVR治疗师作为临床合作者。每位治疗师将在4年或更短的时间内招募45名患者。治疗师将在基线和随访结果测量之间提供他们通常的低视力康复服务。研究助理将通过电话采访患者，并管理自适应活动量表（AI），该量表要求患者在LVR之前和之后对活动目标的重要性和难度进行评分，并对每个重要和困难目标下的附属任务的难度进行评分。治疗师将生成目标实现量表（GAS）对患者的活动目标进行评分，并在此之前进行一系列功能表现测试

DESCRIPTION (provided by applicant): We propose to conduct a multi-therapist, prospective, observational study of the outcomes of usual low vision rehabilitation (LVR) services. The purpose of this project is to study the concordance of three different types of LVR outcome measures (patient-reported, therapist-reported, and functional performance), study the influence of therapists' biases on estimated outcome measures, study the effects of co-morbidities and other patient states on LVR outcomes, and study the relationship of the effectiveness of LVR to its efficacy. We aim to recruit 10 LVR therapists as clinical collaborators. Each therapist will be expected to recruit 45 patients over a period of 4 years or less. The therapists will provide their usual low vision rehabilitation services between baseline and follow-up outcome measures. Research assistants will interview patients by telephone and administer the adaptive Activity Inventory (AI), which requires patients to rate the importance and difficulty of activity goals and rate the difficulty of subsidiary tasks under each important ad difficult goal, before and after LVR. The therapists will generate Goal Attainment Scale (GAS) ratings of patients' activity goals and administer a battery of functional performance tests before and after LVR. We have developed a measurement model that will be used to estimate interval-scaled measures of patients' functional abilities in different functional domains from patients' difficulty ratings, therapists' GAS ratings, and functional performance measures. Changes after LVR in patient-reported functional ability measures estimated from patients' difficulty ratings of AI goals will be compared to changes after LVR in functional ability measures estimated from therapists' ratings of the same AI goals using the GAS method. We also will compare changes after LVR in patient-reported measures of functional ability (estimated from patients' difficulty ratings of the appropriate subset of AI tasks) to changes after LVR in corresponding performance measure estimates of functional ability (reading speed versus print size measures for reading function, walking speed measures for mobility function, measures of maze tracing errors for visual motor function, and measures of facial expression recognition probability correct for visual information processing function). The objective of the proposed research is to understand sources of bias in, and effects of confounding variables on, the three different types of LVR outcome measures that can be used in clinical research on LVR.