Developing the draft descriptive system for the child amblyopia treatment questionnaire (CAT-Qol): a mixed methods...

Area of Science:

• Ophthalmology
• Pediatric Vision
• Health Outcomes Research

Background:

• Amblyopia, a common childhood visual condition, necessitates effective screening and treatment programs.
• Existing patient-reported outcome (PRO) measures for amblyopia lack adherence to current development and administration guidelines.
• There is a need for a child-friendly PRO instrument for amblyopia tailored to young children.

Purpose of the Study:

• To develop a self-complete PRO instrument for amblyopia in children aged 4-7 years.
• To incorporate children's direct responses into the development and refinement of the instrument.
• To refine the descriptive system of the draft Child Amblyopia Treatment Questionnaire (CAT-QoL) using qualitative and quantitative methods.

Main Methods:

• Children aged 4-7 years independently completed a draft CAT-QoL questionnaire.
• Cognitive debriefing interviews were conducted to assess children's understanding and identify reading difficulties.
• A ranking exercise was employed with some children to determine the order of response levels, with mid-rank scoring and agreement calculated.

Main Results:

• Thirty-two children completed the draft questionnaire and debriefing; 22 participated in the ranking exercise.
• Qualitative feedback informed modifications to item wording and instrument layout.
• Ranking results guided the sequencing of response levels, though 10 children struggled with the ranking concept.

Conclusions:

• Young children's input is valuable for developing PRO instruments, ensuring content and face validity.
• The CAT-QoL instrument was further refined based on children's responses.
• Further research is necessary to evaluate the psychometric properties of the refined CAT-QoL.