Biomedical subjects

Denise R Globe

Publications and source records attributed to Denise R Globe.

7 recordsLinked to original sources

PubMed2006

Validation and test characteristics of a 10-item neuro-ophthalmic supplement to the NEI-VFQ-25.

PURPOSE: To determine whether a 10-Item Neuro-Ophthalmic Supplement increases the capacity of the 25-Item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) to capture self-reported visual dysfunction in patients with neuro-ophthalmologic disorders. DESIGN: A cross-sectional survey to examine the characteristics of a 10-Item Neuro-Ophthalmic Supplement to the 25-Item NEI-VFQ-25 in a cohort of patients with neuro-ophthalmologic disorders. METHODS: The 10-Item Neuro-Ophthalmic Supplement was designed previously by our research group by survey and focus-group methods. In the present study, the NEI-VFQ-25 and 10-Item Supplement were administered concurrently to patients and disease-free control subjects. High-contrast visual acuities with patient usual distance correction were measured with the use of Early Treatment Diabetic Retinopathy Study (ETDRS) charts. RESULTS: Diagnoses for patients (n = 215) included optic neuritis, multiple sclerosis, idiopathic intracranial hypertension, ischemic optic neuropathy, stroke, ocular myasthenia gravis, ocular motor palsies, and thyroid eye disease. Scores for the 10-Item Supplement had a significant capacity to distinguish patients vs disease-free control subjects that was independent of the NEI-VFQ-25 composite score (odds ratio in favor of patient vs control status for 10-point worsening in Supplement scores: 2.7 [95% confidence interval [CI], 1.6, 4.6]; P < .001, logistic regression models that account for NEI-VFQ-25 composite score, age, and gender). Patients with visual dysfunction (binocular Snellen equivalents worse than 20/20) had significantly lower mean scores (9-21 points lower); these differences remained significant after accounting for age and gender (P >or= .001, linear regression). Supplement items and composite scores demonstrated appropriate degrees of internal consistency reliability. CONCLUSION: The 10-Item Neuro-Ophthalmic Supplement demonstrates a capacity to capture self-reported visual dysfunction beyond that of the NEI-VFQ-25 alone, which supports validity for this new scale. The use of the 10-Item Supplement in clinical trials and epidemiologic studies will examine its capacity to demonstrate treatment effects in longitudinal cohorts.

Adult↗

PubMed2005

Prevalence and correlates of fatigue in long-term survivors of childhood leukemia.

PURPOSE: To estimate the prevalence of fatigue, identify the factors associated with fatigue, and to explore the relationship between fatigue and quality of life (QOL) in long-term survivors of childhood acute lymphoblastic leukemia (ALL). METHODS: One hundred sixty-one ALL survivors diagnosed at Childrens Hospital Los Angeles (Los Angeles, CA) before age 18 years and between January 1, 1975 and December 31, 1995, participated in a structured telephone interview. Participants were aged 18 to 41 years and off treatment for an average of 14 years. Four measures of fatigue, including the Revised-Piper Fatigue Scale, were used to assess fatigue; depression was assessed using the Center for Epidemiological Studies Depression Scale. Multivariate logistic regression models were developed to identify factors associated with fatigue and depression. RESULTS: Prevalence of fatigue (30%) fell within the general population normal limits. Fatigue and depression were highly correlated (Pearson r = 0.75). Fatigue was associated with marriage (OR = 0.11; 95% CI, 0.02 to 0.50), having children (OR = 5.80; 95% CI, 1.30 to 25.82), sleep disturbances (OR = 6.15; 95% CI, 2.33 to 16.22), pain (OR = 5.56; 95% CI, 2.13 to 14.48), obesity (OR = 3.80; 95% CI, 1.41 to 10.26), cognitive impairment (OR = 2.56; 95% CI, 1.02 to 6.38), and exercise-induced symptoms (OR = 2.98; 95% CI, 1.11 to 8.02). Four factors associated with fatigue were also associated with depression: sleep disturbances, pain, obesity, and cognitive impairment. Fatigue was inversely related to QOL. CONCLUSION: Some survivors of childhood ALL experience fatigue many years after treatment. Fatigued survivors represent a high-risk subgroup as they report more depression and poorer QOL than non-fatigued survivors and their peers.

Adolescent↗

PubMed2005

Self-reported comorbidities and visual function in a population-based study: the Los Angeles Latino Eye Study.

OBJECTIVE: To assess the association of self-reported systemic and ocular comorbid disease and visual function in Latino subjects. METHODS: National Eye Institute 25-item Visual Function Questionnaire (NEI-VFQ-25) and eye examination data were obtained from 5380 participants in the Los Angeles Latino Eye Study, a population-based prevalence study of eye disease in Latino subjects 40 years and older. We developed and contrasted 5 comorbidity measures. One-way analysis of variance was used to assess the association between comorbidity and visual impairment and self-reported visual function. Regression analyses determined the association of sociodemographic variables, clinical variables, and the best measure of comorbidity with the NEI-VFQ-25 composite score. The main outcome measure was self-reported visual function as assessed by the NEI-VFQ-25 composite score. RESULTS: On average, visual function subscale scores were lowest for those participants with the most systemic comorbid conditions (P<.05). This was more evident in participants with moderate or severe visual impairment compared with those with mild or no visual impairment (P<.05). CONCLUSIONS: Self-reported systemic comorbidities were associated with self-reported visual function. This association was greater at more severe levels of visual impairment. Of the 5 comorbidity measures assessed, the measure that summed the number of self-reported systemic comorbidities correlated most with self-reported visual function.

Adult↗

PubMed2004

The impact of visual impairment on self-reported visual functioning in Latinos: The Los Angeles Latino Eye Study.

OBJECTIVE: To assess the association between presenting binocular visual acuity (VA) and self-reported visual function as measured by the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). DESIGN: A population-based, prevalence study of eye disease in Latinos 40 years and older residing in La Puente, California (Los Angeles Latino Eye Study [LALES]). PARTICIPANTS: Six thousand three hundred fifty-seven Latinos 40 years and older from 6 census tracts in La Puente. METHODS: All participants completed a standardized interview, including the NEI-VFQ-25 to measure visual functioning, and a detailed eye examination. Two definitions of visual impairment were used: (1) presenting binocular distance VA of 20/40 or worse and (2) presenting binocular distance VA worse than 20/40. Analysis of variance was used to determine any systematic differences in mean NEI-VFQ-25 scores by visual impairment. Regression analyses were completed (1) to determine the association of age, gender, number of systemic comorbidities, depression, and VA with self-reported visual function and (2) to estimate a visual impairment-related difference for each subscale based on differences in VA. MAIN OUTCOME MEASURES: The NEI-VFQ-25 scores in persons with visual impairment. RESULTS: Of the 5287 LALES participants with complete NEI-VFQ-25 data, 6.3% (including 20/40) and 4.2% (excluding 20/40) were visually impaired. In the visually impaired participants, the NEI-VFQ-25 subscale scores ranged from 46.2 (General Health) to 93.8 (Color Vision). In the regression model, only VA, depression, and number of comorbidities were significantly associated with all subscale scores (R(2) ranged from 0.09 for Ocular Pain to 0.33 for the composite score). For 9 of 11 subscales, a 5-point change was equivalent to a 1- or 2-line difference in VA. Relationships were similar regardless of the definition of visual impairment. CONCLUSION: In this population-based study of Latinos, the NEI-VFQ-25 was sensitive to differences in VA. A 5-point difference on the NEI-VFQ-25 seems to be a minimal criterion for a visual impairment-related difference. Self-reported visual function is essentially unchanged if the definition of visual impairment includes or excludes a VA of 20/40.

Adult↗

PubMed2003

Relationship between self-reported depression and self-reported visual function in Latinos.

OBJECTIVE: To validate and assess the relationship between self-reported depression as measured by a single item on the Medical Outcomes Study Short-Form 12 (SF-12) and self-reported visual function. METHODS: The Los Angeles Latino Eye Study is population-based and designed to assess the prevalence of visual impairment, ocular disease, and visual functioning in Latinos. Both the 25-item National Eye Institute-Visual Function Questionnaire (NEI VFQ-25) (self-reported visual function) and the SF-12 (health-related quality of life) were administered. A single item from the SF-12 was used to measure self-reported depression and validated against the Center for Epidemiologic Studies-Depression measure of depression. Covariate-adjusted NEI VFQ-25 subscale scores were contrasted across the 6 response choices of the SF-12, as well as across 3 combined response categories of the SF-12 using analysis of covariance. Covariate-adjusted regression analyses assessed the contribution of self-reported depression in explaining self-reported visual function. RESULTS: The sensitivity and specificity of the SF-12 single item with the Center for Epidemiologic Studies-Depression measure was 0.96 and 0.50, respectively. Using the 3 combined response categories of the SF-12 single item, it was found that (1) all covariate-adjusted subscales of the NEI VFQ-25 were statistically significantly different across the self-reported depression categories (P<.001) and (2) covariate-adjusted self-reported depression was a significant predictor of self-reported visual function (P<.001). CONCLUSIONS: A single SF-12 item may be used as a measure of self-reported depression. In addition, self-reported depression is an important covariate to consider when assessing self-reported visual function in Latinos.

Adult↗

PubMed2002

Validity of the SF-12 quality of life instrument in patients with retinal diseases.

OBJECTIVE: To investigate the construct validity and reliability of the SF-12 with the SF-36 composite scores in patients with retinal diseases. DESIGN: Cross-sectional study. PARTICIPANTS: One thousand eighty-one patients with retinal disease presenting for care at a tertiary referral university-based retina practice. METHODS: Each patient completed the SF-36 before his or her initial ocular examination. The SF-12 is based on a subset of 12 items from the SF-36. MAIN OUTCOME MEASURES: Physical Composite Score (PCS) and Mental Composite Score (MCS) as determined by the SF-36 and SF-12. RESULTS: Eight hundred thirty-nine (78%) of the participants had scorable PCS and MCS scores on the SF-12. No significant differences were found between the SF-36 and SF-12 for the PCS and MCS overall and stratified by the four most frequently occurring disease categories (all P > 0.20). There were statistically significant differences across the disease categories in the mean PCS scores (P < 0.001) on the SF-36 and SF-12 and the MCS score on the SF-36 (P = 0.04). The SF-12 PCS and MCS scores were highly correlated with similar indicators (composite scores and subscales) on the SF-36. CONCLUSIONS: The SF-12 is a valid measure of general health status for ophthalmic research, as long as differences in mental composite scores do not need to be demonstrated between different ocular disease groups. The benefit of reduced administration time makes the SF-12 a recommended general quality-of-life outcomes tool.

Adult↗

PubMed2002

Using focus groups to develop a culturally sensitive methodology for epidemiological surveys in a Latino population: findings from the Los Angeles Latino Eye Study (LALES).

BACKGROUND: Many standardized survey instruments are initially developed in English-speaking populations. These instruments may not be culturally appropriate for other ethnic groups, such as Latinos. METHODS: The Los Angeles Latino Eye Study (LALES) was designed to determine the prevalence of blindness, visual impairment, and ocular diseases; risk factors for these diseases; and general and ocular healthcare use among non-institutionalized adult Latinos in suburban Los Angeles County, California. The LALES investigators used focus groups to develop questionnaires and to devise culturally sensitive methods for implementing this epidemiologic study in a Latino population. Eighty-four respondents were administered the in-home questionnaire and then scheduled into one of 6 in-home focus groups, allowing participants to reflect in groups about the study, their participation, and the state of the instruments and the translations. FINDINGS: Overall, respondents reported that the questionnaire was well written, easy to understand, and very clear. Recommendations from participants included: 1) keep questions brief; 2) minimize the number of response choices; 3) keep phrasing clear; 4) simplify technical terms; 5) provide test results immediately after the clinical examination; and 6) hire Spanish-speaking staff to increase participants' trust and confidence. CONCLUSION: Focus groups assisted in yielding a culturally appropriate survey research tool and methodology for this population-based study in a Latino community.

Adult↗