A weighted version of the Melbourne low-vision ADL index : a measure of disability impact

Haymes, Sharon A., Johnston, Alan W. and Heyes, Anthony D. 2001, A weighted version of the Melbourne low-vision ADL index : a measure of disability impact, Optometry and vision science, vol. 78, no. 8, pp. 565-579.

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Title A weighted version of the Melbourne low-vision ADL index : a measure of disability impact
Author(s) Haymes, Sharon A.
Johnston, Alan W.
Heyes, Anthony D.
Journal name Optometry and vision science
Volume number 78
Issue number 8
Start page 565
End page 579
Total pages 15
Publisher Lippincott Williams & Wilkins
Place of publication Philadelphia, Pa.
Publication date 2001
ISSN 1040-5488
Keyword(s) low vision
disability impact,
functional assessment
activities of daily living
Summary Objective. To develop a version of the Melbourne Low-Vision ADL Index that measures the personal impact of disability in activities of daily living (ADL's). Also, to determine the relationship between clinical measures of vision impairment and disability impact.

Methods. The Melbourne Low-Vision ADL Index (MLVAI) is a desk-based clinical assessment of disability in ADL's. Ability to perform each item is rated on a five-level descriptive scale from zero to four. In this study, the original version of the MLVAI was modified to measure disability impact. The simple modification involved weighting each item by the importance of that item to the person being tested. Importance was also rated on a five-level scale from zero to four. The validity and reliability of the Weighted Melbourne Low-Vision ADL Index (MLVAIW) was determined for 97 vision-impaired subjects in a cross-sectional study.

Results. Cronbach's alpha coefficient indicated an internal reliability of 0.94, and an intraclass correlation coefficient indicated an overall reliability of 0.88. The standard error of measurement was 24.7 points (out of a possible score of 400). There was a statistically significant difference in test scores between normal subjects and vision-impaired subjects. All vision measures had a high, statistically significant correlation with MLVAIW score. Near-word acuity had the strongest correlation (rs = 0.78, p < 0.001), followed by Melbourne Edge Test contrast sensitivity (rs = -0.72, p < 0.001). Visual field had the weakest correlation (rs = -0.52, p < 0.001). The best predictive model of MLVAIW score incorporated the variables age, near-word acuity, and visual field. Together, these variables accounted for 65.1% of the variance in MLVAIW score.

Conclusions. The MLVAI is highly valid and reliable when weighted by a scale that reflects the personal importance of ADL's. The MLVAIW can provide information over and above that obtained with the usual clinical vision measures and may be used to assess low-vision patients and to measure low-vision rehabilitation outcomes. It is suggested that the assessment of disability using the original MLVAI and the assessment of the impact of disability using the MLVAIW should be kept separate to facilitate the clear interpretation of the outcomes of low-vision rehabilitation.
Language eng
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2001, American Academy of Optometry
Persistent URL http://hdl.handle.net/10536/DRO/DU:30047585

Document type: Journal Article
Collections: Faculty of Health
School of Medicine
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