title: Identifying content for the glaucoma-specific item bank to measure quality-of-life parameters.
abstract: OBJECTIVE
  Patient-reported outcomes (PROs) have become essential clinical trial end points. However, a comprehensive, multidimensional, patient-relevant, and precise glaucoma-specific PRO instrument is not available. Therefore, the purpose of this study was to identify content for a new, glaucoma-specific, quality-of-life (QOL) item bank.
  
  
  METHODS
  Content identification was undertaken in 5 phases: (1) identification of extant items in glaucoma-specific instruments and the qualitative literature; (2) focus groups and interviews with glaucoma patients; (3) item classification and selection; (4) expert review and revision of items; and (5) cognitive interviews with patients.
  
  
  RESULTS
  A total of 737 unique items (extant items from PRO instruments, 247; qualitative articles, 14 items; focus groups and semistructured interviews, 476 items) were identified. These items were classified into 10 QOL domains. Four criteria (item redundancy, item inconsistent with domain definition, item content too narrow to have wider applicability, and item clarity) were used to remove and refine the items. After the cognitive interviews, the final minimally representative item set had a total of 342 unique items belonging to 10 domains: activity limitation (88), mobility (20), visual symptoms (19), ocular surface symptoms (22), general symptoms (15), convenience (39), health concerns (45), emotional well-being (49), social issues (23), and economic issues (22).
  
  
  CONCLUSIONS
  The systematic content identification process identified 10 QOL domains, which were important to patients with glaucoma. The majority of the items were identified from the patient-specific focus groups and semistructured interviews suggesting that the existing PRO instruments do not adequately address QOL issues relevant to individuals with glaucoma.
authors.affiliation: *NH&MRC Centre for Clinical Eye Research, Discipline of Optometry and Vision Science, Flinders University, Adelaide †Department of Ophthalmology, Flinders Medical Centre, Flinders University of South Australia, SA ‡Department of Ophthalmology, Centre for Eye Research Australia, University of Melbourne, Vic., Australia §Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
authors.forename: Jyoti
authors.initials: J
authors.lastname: Khadka
authors.forename: Colm
authors.initials: C
authors.lastname: McAlinden
authors.forename: Jamie E
authors.initials: JE
authors.lastname: Craig
authors.forename: Eva K
authors.initials: EK
authors.lastname: Fenwick
authors.forename: Ecosse L
authors.initials: EL
authors.lastname: Lamoureux
authors.forename: Konrad
authors.initials: K
authors.lastname: Pesudovs
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D017144:Focus Groups; D005901:Glaucoma / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires