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Psychometric performance of the National Eye Institute visual function questionnaire in Latinos and non-Latinos.

Richard S Baker1, Mohsen Bazargan, José L Calderón

  • 1Department of Ophthalmology, Research Centers in Minority Institutions, Charles R. Drew University of Medicine and Science, Los Angeles, California 90059, USA. rbaker2@ucla.edu

Ophthalmology
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Summary

The Spanish National Eye Institute Visual Function Questionnaire (NEI VFQ-25) showed lower reliability in some scales compared to English versions. While generally adequate for Latino populations, caution is advised for cross-group comparisons.

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Area of Science:

  • Ophthalmology and Vision Science
  • Psychometrics and Health Outcomes Research

Background:

  • The National Eye Institute Visual Function Questionnaire (NEI VFQ) is a critical tool for assessing patient-reported visual function.
  • Evaluating the psychometric performance of translated versions, such as the Spanish NEI VFQ, is essential for equitable clinical application in diverse populations.
  • Understanding potential performance differences between Spanish and English versions in Latino and non-Latino patients is crucial for accurate interpretation.

Purpose of the Study:

  • To compare the psychometric performance of Spanish and English versions of the NEI VFQ-25 and NEI VFQ-39.
  • To assess the reliability and validity of these questionnaires when administered to Latino and non-Latino patients, respectively.
  • To identify any significant differences in performance between ethnic groups and questionnaire versions.

Main Methods:

  • A clinic-based cross-sectional survey was conducted with 403 patients (160 Latinos, 243 non-Latinos) from urban public hospital ophthalmology clinics.
  • Data were collected via structured face-to-face interviews using Spanish and English versions of the NEI VFQ-25 and NEI VFQ-39.
  • Psychometric properties, including internal consistency reliability (Cronbach alpha, average inter-item correlation) and construct validity, were analyzed.

Main Results:

  • The Spanish NEI VFQ-25 demonstrated significantly lower internal consistency reliability in three scales compared to the English version, with three scales showing inadequate reliability (alpha ≤ 0.70).
  • The Spanish NEI VFQ-39 scales generally met minimum reliability standards.
  • Statistically significant differences in reliability were found for four scales (Ocular Pain, Mental Health, Role Difficulties, Dependency) between Latino and non-Latino subgroups, with Latinos exhibiting lower reliability, particularly for Ocular Pain.

Conclusions:

  • The NEI VFQ demonstrates adequate overall performance in Latino populations.
  • Specific subscales in the Spanish version of the NEI VFQ-25 require modification to improve reliability.
  • Comparisons between Latino and non-Latino subgroups using the NEI VFQ should be interpreted with caution due to observed performance differences.