Comparative studies of low vision rehabilitation outcome measures

描述(由申请人提供)：我们建议对通常的低视力康复(LVR)服务的结果进行一项多治疗师、前瞻性、观察性研究。本项目的目的是研究三种不同类型的LVR结果测量(患者报告、治疗师报告和功能表现)的一致性，研究治疗师的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，并研究LVR有效性与其疗效的关系。我们的目标是招募10名LVR治疗师作为临床协作者。预计每个治疗师将在4年或更短的时间内招募45名患者。治疗师将在基线和后续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实施适应性活动问卷(AI)，该量表要求患者在LVR前后对活动目标的重要性和难度进行评级，并对每个重要和困难目标下的辅助任务的难度进行评级。治疗师将生成患者活动目标的目标实现量表(GAS)评级，并在此之前进行一系列功能表现测试 在LVR之后。我们已经开发了一个测量模型，该模型将用于从患者的难度等级、治疗师的气体等级和功能表现测量来估计患者在不同功能领域的功能能力的间隔尺度测量。根据患者对AI目标的难度评级估计的患者报告的功能能力测量在LVR后的变化将与根据使用GAS方法的治疗师对相同AI目标的评分估计的LVR后功能能力测量的变化进行比较。我们还将比较LVR后患者报告的功能能力测量(从患者对适当AI任务子集的难度评级估计)的变化与LVR后相应功能能力性能测量估计(阅读功能的阅读速度与打印大小的测量、移动功能的行走速度测量、视觉运动功能的迷宫跟踪错误测量以及视觉信息处理功能的面部表情识别正确概率测量)的变化。这项研究的目的是了解三种不同类型的LVR结果指标的偏差来源以及混杂变量对其的影响，这三种指标可用于临床研究。

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.