For future clinical trials and epidemiological studies in pediatric eye disease there is a critical need for comprehensive patient-reported outcome measures (PROMs) that include both child and parent perspectives. PROMs provide a very important means of assessing treatment benefit in clinical trials and observational studies. PROMs also provide a means to assess quality outcomes and effectiveness of health care from the patient's perspective. One component of PROMs is assessment of health-related quality of life (HRQOL). Existing HRQOL instruments for pediatric eye disease are either: not patient derived, or are single-condition specific, or specific to visual impairment, or do not apply item response theory (such as Rasch analysis). In this proposal we plan to: 1) develop an HRQOL item bank for children and their parents covering the spectrum of pediatric eye disease, by conducting individual interviews with children and parents and collating items from existing instruments 2) calibrate the items using Rasch analysis 3) evaluate validity of the new Rasch-based domain short forms including comparison to the existing generic PedsQL and assessment of construct validity, test-retest reliability and responsiveness. We envision that the new Rasch-based short forms created for each domain (for child, proxy and parent) will be implemented across clinical research in pediatric eye disease, and the Rasch calibrated items will be used in future computerized adaptive testing.
Future studies comparing treatments for childhood eye disease need better methods of assessing outcomes. One important way to assess effectiveness of treatment, and quality of care, is asking the child and parents about their condition and their treatment. Existing questionnaires have significant weaknesses; they have often not been developed with input from children, are not applicable to the spectrum of childhood eye conditions and have not been scored using the most current methods of analysis. This study will develop new questionnaires to assess a child's perspective and their parent's perspective. The new questionnaires will then be used in future clinical studies of childhood eye diseases and for assessing quality of care.
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