title: The outcome of cataract surgery measured with the Catquest-9SF.
abstract: OBJECTIVE
  The purpose of this study was to use the Catquest-9SF to measure cataract surgery outcomes, and to use Rasch analysis to test the psychometric properties of this questionnaire, including its validity and responsiveness.
  
  
  METHODS
  Patients were recruited as consecutive cataract surgery patients during 1 month at six surgical units in Sweden (via the National Cataract Register). The patients completed the questionnaire before surgery and 3 months after. The Catquest-9SF data were assessed for fit to the Rasch model using version 3.63.2 of the WINSTEPS software (Winsteps.com, Beaverton, OR, USA). Both preoperative and postoperative questionnaires were included in the analysis. The responsiveness to cataract surgery was calculated as the effect size.
  
  
  RESULTS
  Completed questionnaires before and after surgery were received from 846 patients. The Rasch analysis showed that the category thresholds were ordered. All items fit a single overall construct (infit range 0.79-1.40; outfit range 0.74-1.40). The ability to discriminate different strata of person ability was good, with a real patient separation of 2.58 and patient separation reliability of 0.87. The questionnaire showed unidimensionality and was largely free from differential item functioning. The item difficulty was reasonably well targeted to both preoperative and postoperative patient ability. The Catquest-9SF Rasch score correlated significantly with visual acuity, and cataract surgery resulted in a significant improvement with an effect size of 1.8.
  
  
  CONCLUSIONS
  The Catquest-9SF shows excellent psychometric properties, as demonstrated by Rasch analysis. It is highly responsive to cataract surgery, and its brevity (nine items) makes it well suited for use in daily clinical practice.
authors.affiliation: EyeNet Sweden, Blekinge Hospital, Karlskrona, Sweden. mats.lundstrom@ltblekinge.se
authors.forename: Mats
authors.initials: M
authors.lastname: Lundstrom
authors.forename: Anders
authors.initials: A
authors.lastname: Behndig
authors.forename: Maria
authors.initials: M
authors.lastname: Kugelberg
authors.forename: Per
authors.initials: P
authors.lastname: Montan
authors.forename: Ulf
authors.initials: U
authors.lastname: Stenevi
authors.forename: Konrad
authors.initials: K
authors.lastname: Pesudovs
mesh_terms: D000368:Aged; D002386:Cataract / Q000503:physiopathology*; D002387:Cataract Extraction; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D019591:Pseudophakia / Q000503:physiopathology; D011594:Psychometrics; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014786:Vision Disorders / Q000503:physiopathology*; D014792:Visual Acuity / Q000502:physiology*