COVD-QOL questionnaire: An adaptation for school vision screening using Rasch analysis

Abstract

Purpose: To adapt the College of Optometrist in Vision Development (COVD-QOL) questionnaire as a vision screening tool for primary school children. Methods: An interview session was conducted with children, teachers or guardians regarding visual symptoms of 88 children (45 from special education classes and 43 from mainstream classes) in government primary schools. Data was assessed for response categories, fit items (infit/outfit: 0.6–1.4) and separation reliability (item/person: 0.80). The COVD-QOL questionnaire results were compared with vision assessment in identifying three categories of vision disorders: reduce visual acuity, accommodative response anomaly and convergence insufficiency. Analysis on the screening performance using the simplified version of the questionnaire was evaluated based on receiver-operating characteristic analysis for detection of any type of target conditions for both types of classes. Predictive validity analysis was used a Spearman rank correlation (>0.3). Results: Two of the response categories were underutilized and therefore collapsed to the adjacent category and items were reduced to 14. Item separation reliability for the simplified version of the questionnaire was acceptable (0.86) but the person separation reliability was inadequate for special education classes (0.79) similar to mainstream classes (0.78). The discriminant cut-off score of 9 (mainstream classes) and 3 (special education classes) from the 14 items provided sensitivity and specificity of (65% and 54%) and (78% and 80%) with Spearman rank correlation of 0.16 and 0.40 respectively. Conclusion: The simplified version of COVD-QOL questionnaire (14-items) performs adequately among children in special education classes suggesting its suitability as a vision screening tool.

Keywords

• Vision screening
• Learning disabilities
• School children
• Questionnaire