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An Index of Functional Impairment in Patients With Cataract

Earl P. Steinberg, MD, MPP; James M. Tielsch, PhD; Oliver D. Schein, MD, MPH; Jonathan C. Javitt, MD, MPH; Phoebe Sharkey, PhD; Sandra D. Cassard, ScD; Marcia W. Legro, PhD; Marie Diener-West, PhD; Eric B. Bass, MD, MPH; Anne M. Damiano, ScD; Donald M. Steinwachs, PhD; Alfred Sommer, MD, MHS

Arch Ophthalmol. 1994;112(5):630-638.

Abstract
Objective
To describe the development and the performance of a brief questionnaire designed to measure functional impairment caused by cataract (the VF-14).

Design
Observational cross-sectional study. Patients were recruited between July 15 and December 15, 1991.

Setting
Patients were recruited from the practices of 70 ophthalmologists, located in Columbus, Ohio (N=21), St Louis, Mo (N=26), and Houston, Tex (N=23).

Patients
Seven hundred sixty-six patients undergoing cataract surgery for the first time.

Main Outcome Measures
Preoperative best corrected visual acuity in each eye; scores on the VF-14, a new index of functional impairment in patients with cataract; patient reports of overall trouble and satisfaction with their vision; and scores on the Sickness Impact Profile, a measure of general health status.

Results
The VF-14 has high internal consistency (Cronbach's =.85) and correlates more strongly with the overall self-rating of the amount of trouble and satisfaction patients have with their vision than do several measures of visual acuity or the Sickness Impact Profile score. The VF-14 score is moderately correlated with visual acuity in the better eye.

Conclusions
The VF-14 is a reliable and valid measure of functional impairment caused by cataract and provides information not conveyed by visual acuity or a general measure of health status.

Author Affiliations
From the Departments of Medicine (Drs Steinberg and Bass) and Ophthalmology (Drs Tielsch, Schein, Diener-West, and Sommer), The Johns Hopkins University School of Medicine; the Departments of Health Policy and Management (Drs Steinberg, Cassard, Legro, Bass, Damiano, and Steinwachs) and Biostatistics (Dr Diener-West) and the Dean's Office (Dr Sommer), The Johns Hopkins University School of Hygiene and Public Health; the Department of Information Systems and Decision Sciences, Sellinger School of Business, Loyola College (Dr Sharkey), Baltimore, Md; and The Worthen Center for Eye Care Research, Georgetown University School of Medicine, Washington, DC (Dr Javitt).

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