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National Eye Institute 25 Item Visual Functioning Questionnaire (NEI-VFQ-25)
Availability
Publically available. Can be obtained from the NEI Website: National Eye Institute 25 Item Visual Functioning Questionnaire
Users should also cite the following article:
Development of the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25) — 2001 Mangione, C. M., Lee, P. P., Gutierrez, P. R., Spritzer, K., Berry, S.,& Hays, R. D. Archives of Ophthalmology, 119, 1050-1058.
Classification
Supplemental for MS
Short Description of Instrument
Construct measured: Dimensions of self-reported vision-targeted health status.
Generic vs. disease specific: Generic.
Means of administration: Interview or Self-Assessment.
Intended respondent: Patient.
# of items: 28.
# of subscales and names of sub-scales: 10 – General health, general vision, expectations, well-being/distress, ocular pain, near vision, distance vision, peripheral vision, social fx, color vision.
# of items per sub-scale: General health (2 items), General vision (2 items), Expectations (4 items), Well-being/distress (4 items), Ocular pain (2 items), Near vision (7 items), Distance vision (4 items), Peripheral vision (1 item), Social function (1 item), Color vision (1 item).
Comments/Special Instructions
Background: The National Eye Institute (NEI) sponsored the development of the VFQ-25 with the goal of creating a survey that would measure the dimensions of self-reported vision-targeted health status that are most important for persons who have chronic eye diseases. Because of this goal, the survey measures the influence of visual disability and visual symptoms on generic health domains such as emotional well-being and social functioning, in addition to task-oriented domains related to daily visual functioning. Questions included in the VFQ-25 represent the content identified during a series of condition- specific focus groups with patients who had age-related cataracts, glaucoma, age-related macular degeneration, diabetic retinopathy, or CMV retinitis.
Scoring
First, original numeric values from the survey are re-coded following the scoring rules outlined in the manual. All items are scored so that a high score  represents better functioning. Each item is then converted to a 0 to 100 scale so that the lowest and highest possible scores are set at 0 and 100 points, respectively. In this format scores represent the achieved percentage of the total possible score, e.g. a score of 50 represents 50% of the highest possible score. In step 2, items within each sub-scale are averaged together to create  the 12 sub-scale scores. Items that are left blank (missing data) are not taken into account when calculating the scale scores. Sub-scales with at least one  item answered can be used to generate a sub-scale score. Hence, scores represent the average for all items in the subscale that the respondent answered.
 
To calculate an overall composite score for the VFQ-25, simply average the vision-targeted subscale scores, excluding the general health rating question. By averaging the sub-scale scores rather than the individual items we have given equal weight to each sub-scale, whereas averaging the items would give more weight to scales with more items.
References
Mangione CM, et al. Development of the 25-item National Eye Institute visual Function Questionnaire. Arch Ophthalmol. 2001 Jul;119(7): 1050-1058.
Rationale/Justification
Strengths/Weaknesses: The questionaire has never been validated in multiple sclerosis patients.
Psychometric Properties: Estimates of internal consistency indicate that the subscales of the NEI VFQ-25 are reliable. The validity of the NEI VFQ-25 is supported by high correlations between the short- and long-form versions of the measure, observed between-group differences in scores for persons with different eye diseases of varying severity, and the moderate-to-high correlations between the NEI VFQ-25 subscales that have the most to do with central vision and measured visual acuity.
 
Administration: The VFQ-25 takes approximately 10 minutes on average to administer in the interviewer format. There is also a self-administered version of the survey, however, psychometric testing of the self-administered version has not been done. Self-administered in the majority of patients. May require assistance from trained interviewers in patients with cognitive deficits and patients with severe visual impairment.