Psychometric properties of visual functioning index using Rasch analysis

Vijaya Gothwal, Thomas Wright, Ecosse Lamoureux, Konrad Pesudovs

    Research output: Contribution to journalArticlepeer-review

    16 Citations (Scopus)


    Purpose:- The visual functioning index (VFI) was one of the first questionnaires developed using classical test theory to assess outcomes of cataract surgery. However, it was not Rasch-validated. The objective of this study was to examine the psychometric properties of the VFI using Rasch analysis in patients with cataract. Methods:- The 11-item VFI was self-administered to 243 patients (mean age 73.9years) drawn from a cataract surgery waiting list. We examined the response category thresholds, item fit statistics, differential item functioning and unidimensionality for the VFI and its three subscales. Results:- Category thresholds were ordered. The person separation and reliability were low, indicating the poor discriminatory ability of the VFI. No items misfit but there was suboptimal targeting of item difficulty to patient ability. On the whole the items in the VFI were too easy for the sample. Only one item showed moderate differential item functioning. Conclusion:- The VFI does not meet the stringent requirements of the Rasch model. However adding more items to suit the more able patients with cataract as well as those awaiting second-eye cataract surgery could optimize the VFI.

    Original languageEnglish
    Pages (from-to)797-803
    Number of pages7
    JournalActa Ophthalmologica Scandinavica
    Issue number7
    Publication statusPublished - Nov 2010


    • cataract
    • cataract surgery
    • classical test theory
    • Rasch analysis
    • visual functioning index


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