Reliability and validity of refractive error-specific quality-of-life instruments

Academic Article


  • Objective: To evaluate the reliability and validity of the National Eye Institute Refractive Error Quality of Life Instrument (NEI-RQL-42) and the Refractive Status and Vision Profile survey (RSVP). Methods: Eighty-one participants with good visual acuity (better than 20/30 best-corrected acuity in each eye) completed the NEI-RQL-42 and RSVP on 2 occasions. Noncycloplegic, subjective refractions and high-contrast visual acuity assessments were also performed. Statistical analyses addressed internal consistency, test-retest reliability, and validity (ie, concurrent and construct validity) of the 2 instruments. Outcome Measures: The NEI-RQL-42, RSVP survey, subjective refraction, and visual acuity. Results: The internal consistency for the overall NEI-RQL-42 was excellent (Cronbach α=0.91); and for the overall RSVP, good (Cronbach α=0.81). Likewise, the test-retest reliability for the overall NEI-RQL-42 was excellent (intraclass correlation coefficient [ICC], 0.91; 95% limits of agreement, -9.1 to 10.1); and for the RSVP, fair (ICC, 0. 76; 95% limits of agreement, -12.1 to 12.5). The NEI-RQL-42 overall score showed good concurrent validity as it correlated significantly with subjective refraction, whereas the RSVP overall score did not. The NEI-RQL-42 and RSVP showed similar construct validity in terms of refractive error discrimination, but the NEI-RQL-42 showed better construct validity when discriminating by the type of refractive correction used by patients. Between-instrument convergent and divergent validity was good. Conclusions: The NEI-RQL-42 and RSVP generally have good reliability and validity in this sample of patients with refractive error. However, other factors such as content should be considered in choosing 1 of these instruments for studies of refractive error correction.
  • Authors

    Published In

  • JAMA Ophthalmology  Journal
  • Digital Object Identifier (doi)

    Author List

  • Nichols JJ; Mitchell GL; Saracino M; Zadnik K
  • Start Page

  • 1289
  • End Page

  • 1296
  • Volume

  • 121
  • Issue

  • 9