An update of the Eye-tem Bank project: a novel system to measure ophthalmic patient-reported outcomes

Purpose: The Eye-tem Bank project aims to develop comprehensive quality of life (QOL) patient-reported outcomes measures in the form of item banks implemented via computer adaptive testing (CAT) system for all eye diseases across all populations. Here we present an update of the project. Methods: The first wave of the Eye-tem Bank project focuses on 13 eye diseases: age-related macular degeneration (AMD), glaucoma, diabetic retinopathy (DR), cataract, cornea, retinal detachment, other vitreo-retinal, refractive error, amblyopia & strabismus, lacrimal & ocular surface, uveitis, ocular inflammation other than uveitis, and neuro-ophthalmic. Each disease-specific module undergoes four phases of development: Phase I: Content identification (items from existing instruments and disease-specific patient focus groups); Phase II: Pilot testing the initial item sets for item calibration using Rasch analysis; Phase III: Validation of the Eye-tem Bank implemented via a CAT system; and Phase IV: Evaluating ophthalmic QOL using the Eye-tem Bank. Results: The pilot instruments (Phase I) for Glaucoma, DR and AMD have sets of 349, 314 and 397 unique items respectively across 10 QOL domains. Almost two thirds of the items were common across these three disease modules. The DR and Glaucoma pilot instruments (Phase II) have demonstrated promising psychometric properties when analysed with Rasch analysis. Phase II of the AMD module is ongoing. Phase I of the RD (2 focus groups, 20 interviews), cornea (7 focus groups, 13 interviews), Amblyopia and strabismus (3 focus groups, 7 interviews), and inflammation (4 focus groups, 20 interviews) modules have been completed. Items for these four modules are being extracted and refined using a systematic qualitative method to develop disease-specific pilot item banks. Phase I patient recruitment for other modules is ongoing. The CAT system has been developed. Conclusions: The majority of the items were common among the AMD, DR and glaucoma modules, a pattern likely to continue across the remaining disease groups. The pilot items of the Glaucoma and DR modules are being calibrated using Rasch analysis to setup computer algorithms for the CAT system. These disease-specific CAT-based modules will undergo a series of validity and reliability tests. All the other modules of the Eye-tem Bank project will follow the same development steps.