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Table 2 Summary of changes made to version one to create version two of the new instrument

From: Development of a patient reported outcome measures for measuring the impact of visual impairment following stroke

Version one Changes Made Reason Version two
Section heading No of items Section heading No of Items
General vision 10 • ‘Blurred vision’ and ‘distortion’ merged • High correlation 0.801 General vision 9
Distance vision 4 • All items replaced by general distance vision items ‘difficulty seeing far side of a room’ and ‘difficulty seeing far away’ • 4 items in version 1 refer to specific tasks. ‘Bus numbers’ high N/A response Distance vision 2
Near vision 7 • Wording change in ‘recognising faces and seeing facial expressions’ to ‘seeing faces and facial expressions’ • Original wording related to prosopagnosia Near vision 5
• ‘Doing work or hobbies’, ‘identifying coins and bank notes’, ‘telling time on a watch’ and ‘using a telephone’ replaced by new item ‘difficulty with close up vision’. • 4 items in version 1 refer to specific tasks
• Addition of ‘difficulty using a computer’ item from television section • Item relates to near vision
Reading 4 • ‘ordinary print’ ‘small print’ and ‘large print’ items replaced by ‘reading same size print as before’ • New item isolates impact of new stroke related visual impairment Reading 2
Television 4 • ‘Watching television’ and ‘reading text on television’ removed used as example for ‘difficulty seeing far side of a room’ item in distance vision section • Items related to distance vision activities Section removed
• ‘Watching a film at the cinema’ removed • High N/A response 26.9%
• ‘Difficulty using a computer’ item reworded and moved to near vision section • Item relates to near vision
Peripheral vision 3 No changes made Peripheral vision 3
Lighting 5 • ‘Adjusting to brightness from dim light’ and ‘adjusting to darkness from bright light’ combined to create ‘adjusting to differing lighting’ • High correlation 0.810 Light 4
• ‘Haloes’ item removed • Floor effect 44.2% reporting no issue and 11.5% N/A response
• Addition of ‘change in colour’ from colour section
Colour 3 • All items replaced by ‘change in colour’ item • All items floor effects (‘recognising colour’ 70.2%, ‘picking out clothes’ 75.6%, ‘colours appear dull’ 62.1%) Section removed
• ‘Change in colour’ item moved to light section • New item isolates impact of new stroke related visual impairment
Discomfort 5 • ‘Pain and discomfort’, ‘headaches’ and ‘eyes feeling strained’ items removed • Difficult to attribute cause and therefore to answer accurately Discomfort 2
Walking 9 • ‘Steps, curbs and stairs’ item combined with ‘uneven ground’ item • Similar situations Moving around 9
• ‘Tripping and falling’ and ‘bumping into’ items reworded • Context added
• Walking replaced by moving around in all items • Reworded to include mobilisation by other methods e.g. wheelchair
• Addition of ‘travelling as a passenger’ item from travelling section • Now section not specific to walking
Driving 7 • All items removed • Floor and ceiling effects all participants had either never driven or given up driving Section removed
Travelling 3 • ‘Travelling alone’ and ‘traveling on public transport’ items removed • High correlations 0.786 and 0.761 with ‘travelling in a car as a passenger’ Section removed
• ‘Travelling in a car as a passenger’ reworded to incorporate ‘travelling on public transport’ and moved to moving around section
Socialising 7 • ‘Visiting family and friends’, ‘entertaining in your home’ and ‘making new friends’ items removed • High correlations 0.773 and 0.776 identified duplication with ‘social activities’ Socialising 4
• Wording of the ‘social activities’ and the ‘outdoor activities’ items combined to create two items, ‘indoor social activities’ and ‘outdoor social activities’. • Differentiation between indoor and outdoor activities
Role limitations 6 • ‘Performing usual activities’ and ‘people limiting your opportunities’ items removed • High correlation 0.816 with ‘doing usual work to usual standard’ and N/A response 11.5% Role limitations 4
• ‘Doing usual work to usual standard’ and ‘limit of how long you can work’ reworded
• N/A response of not working/retired 11.5%
Self-care 10 No changes made Independent living 10
Well-being 13 • ‘Feeling sad and low’, ‘frustrated’, ‘anxious’, ‘worry’, ‘feeling isolated’, ‘feeling less control’ and ‘stressed’ combined into one item ‘negative emotions’ • High correlations 0.810 to 0.929 Well-being 6
• High correlation 0.810
• ‘Feeling a burden’ and ‘needing help from others’ combined into one item, ‘feeling a burden’