Objectives: Reporting of research for stroke-related visual impairment is inconsistent. The aim of this study was to define three core outcome sets (COS) and related core outcome measurements (COM) for central visual impairment, visual field loss and ocular motility disorders in stroke research.
Design: The consensus process consisted of an online three-round Delphi survey followed by a consensus meeting of key stakeholders.
Setting: UK-wide survey.
Participants: Stakeholders included orthoptists, occupational therapists, ophthalmologists, stroke survivors and COS users such as researchers, journal editors and guideline developers.
Outcome measures: For COS development, a list of potentially relevant visual outcomes was created after review of the literature and further grouped into outcome domains. For COM development, a list of potential instruments was created after review of the literature and quality appraised for reliability and validity.
Results: COS-119 potential outcomes extracted from published literature. Similar assessment outcomes were grouped into 24 outcome domains. Delphi process included 123 participants in round 1, 65 round 2, 51 round 3. Twelve participants attended the consensus meeting with recommended outcome domains for central visual impairment (visual acuity, functional vision, quality of life), visual field loss (visual fields, functional vision, quality of life) and ocular motility disorders (eye alignment, eye movements, functional vision, quality of life). COM-52 test options extracted from the COS outcomes and grouped into 16 domains. Thirteen participants attended the COM consensus meeting. Recommended instruments for measurement of these outcomes include; Logarithm of the Minimal Angle of Resolution visual acuity, cover test, cardinal position eye movement assessments, peripheral visual field perimetry, Visual Function Questionnaire-25.
Conclusions: COS and COM are defined for vision research for stroke survivors. Their use has potential to reduce heterogeneity in routine clinical practice and improve standardisation and accuracy of vision assessment. Future research is required to evaluate the use of these COS and COM.
The aim of this study was to define three core outcome sets (COS) and related core outcome measurements (COM) for central visual impairment, visual field loss and ocular motility disorders in stroke research.
ContributorsF. J. Rowe, L. R. Hepworth and J. J. Kirkham
Disease Category: Eyes & vision
Disease Name: Ocular motility disorders, central visual impairment, visual field loss
Age Range: 18
Sex: Either
Nature of Intervention: Other, Screening
- Clinical experts
- Consumers (caregivers)
- Consumers (patients)
- Guideline developers
- Journal editors
- Researchers
- COS for clinical trials or clinical research
- Consensus meeting
- Delphi process
- Interview
- Systematic review
An initial list of outcomes was based on an overview of seven systematic reviews of studies/trials reporting vision screening, assessment and treatment of
poststroke visual impairment. A panel of 10 patients/carers were asked to consider whether any further outcomes should be added. This list of outcomes was put foward to a 3-round delphi survey. Fianlly, a consensus meeting took place to discuss the survey results and reach consensus on a final COS.