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  1. Article ; Online: Development of core outcome sets and core outcome measures for central visual impairment, visual field loss and ocular motility disorders due to stroke

    Jamie J Kirkham / Fiona J Rowe / Lauren R Hepworth

    BMJ Open, Vol 12, Iss

    a Delphi and consensus study

    2022  Volume 3

    Keywords Medicine ; R
    Language English
    Publishing date 2022-03-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Development of a patient reported outcome measures for measuring the impact of visual impairment following stroke

    Lauren R. Hepworth / Fiona J. Rowe / Girvan Burnside

    BMC Health Services Research, Vol 19, Iss 1, Pp 1-

    2019  Volume 17

    Abstract: Abstract Background Among the available patient-reported outcome measures (PROMs) there is an absence of a PROM with a specific focus on the impact of the wide variety of visual impairments following stroke. Our aim was to develop a patient reported ... ...

    Abstract Abstract Background Among the available patient-reported outcome measures (PROMs) there is an absence of a PROM with a specific focus on the impact of the wide variety of visual impairments following stroke. Our aim was to develop a patient reported quality of life outcome measure for stroke survivors with visual impairment. Methods Potential items were sourced from a combination of existing PROMs from a systematic review and qualitative in-depth interviews, duplicates were removed and items shortlisted. The initial pilot instrument was created following a ranking exercise of these potential items and consultation with stroke survivors. Version 1 was piloted with 37 stroke survivors at acute and chronic stages. Version 2 was piloted with 243 stroke survivors with visual impairment at acute and chronic stages. This data was analysed using the Rasch measurement model. Simultaneously, items from Version 2 underwent a Delphi process with stroke survivors and stroke clinicians, to assess the importance of each item. Final consensus decisions on item removal were made using the combined analysis from the Rasch measurement model and Delphi process in a nominal group meeting. Results Due to the wide range of rank given to the majority of categories/items, only two items were discarded. Version 1 comprised of 102 items with 5 response categories relating to amount of difficulty. The pilot of Version 1 allowed item reduction based on analysis of floor/ceiling effects and not applicable responses. Version 2 comprised of 62 items. Within the nominal group meeting, the expert panel created a set of rules which aided them with decision making in addition to the Rasch and Delphi analysis data. This resulted in the removal of 43 items and the combination of seven items to create three new items. The expert panel also recommended the rewording of three items. Conclusion The Brain Injury associated Visual Impairment Impact Questionnaire (BIVI-IQ-15), a 15-item instrument with 4 response categories has been developed for capturing ...
    Keywords Stroke ; Brain injury ; Visual impairment ; Patient reported outcome measure ; Development ; Rasch analysis ; Public aspects of medicine ; RA1-1270
    Subject code 150
    Language English
    Publishing date 2019-05-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Biomechanical adaptation to post-stroke visual field loss

    Adel Elfeky / Kristiaan D’Août / Rebecca Lawson / Lauren R. Hepworth / Nicholas D. A. Thomas / Abigail Clynch / Fiona J. Rowe

    Systematic Reviews, Vol 10, Iss 1, Pp 1-

    a systematic review

    2021  Volume 41

    Abstract: Abstract Background Homonymous visual field defects represent the most frequent type of visual field loss after stroke, affecting nearly 30% of individuals with unilateral post-chiasmal brain damage. This review aimed to gather the available evidence on ... ...

    Abstract Abstract Background Homonymous visual field defects represent the most frequent type of visual field loss after stroke, affecting nearly 30% of individuals with unilateral post-chiasmal brain damage. This review aimed to gather the available evidence on the biomechanical changes to visual field loss following stroke. Methods A systematic review was conducted inclusive of randomised controlled trials, cohort studies, before-after studies and case-controlled studies. Studies including adult and paediatric participants that investigated eye, head, or body movements in post-stroke visual field loss during visual exploration tasks were included. Search terms included a range of MESH terms as well as alternative terms relating to stroke, visual field loss, hemianopia, visual functions and scanning behaviour. Articles were selected by two authors independently. Data were extracted by one author and verified by a second. All included articles were assessed for risk of bias using checklists appropriate to the study design. Results Thirty-six articles (1123 participants) were included in the overall review (Kappa 0.863) and categorised into simulated or true visual field loss (typically hemianopia). Seven studies identified the biomechanical alterations to simulated hemianopia compared to normal performance. Twenty-nine studies detailed eye, head and body movement parameters in true hemianopia. Hemianopic participants and healthy adults with simulated hemianopia differed significantly from controls in various fixation and saccade parameters as indicated by increased number and duration of fixations, number and duration of saccades and scan path length with shorter mean saccadic amplitude. Under simulated hemianopia, participants were consistently biased towards the sighted visual field while gaze behaviour in true hemianopia was biased in the direction of the blind hemifield. Conclusions There is considerable evidence on the altered eye movements that occur in true hemianopia and in healthy adults with simulated ...
    Keywords Biomechanical ; Movement ; Hemianopia ; Stroke ; Visual field ; Medicine ; R
    Subject code 150
    Language English
    Publishing date 2021-03-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: High incidence and prevalence of visual problems after acute stroke

    Fiona J Rowe / Lauren R Hepworth / Claire Howard / Kerry L Hanna / Christopher P Cheyne / Jim Currie

    PLoS ONE, Vol 14, Iss 3, p e

    An epidemiology study with implications for service delivery.

    2019  Volume 0213035

    Abstract: Background Visual problems are an under-reported sequela following stroke. The aim of this study is to report annual incidence and point prevalence of visual problems in an acute adult stroke population and to explore feasibility of early timing of ... ...

    Abstract Background Visual problems are an under-reported sequela following stroke. The aim of this study is to report annual incidence and point prevalence of visual problems in an acute adult stroke population and to explore feasibility of early timing of visual assessment. Methods and findings Multi-centre acute stroke unit, prospective, epidemiology study (1st July 2014 to 30th June 2015). Orthoptists reviewed all patients with assessment of visual acuity, visual fields, ocular alignment, ocular motility, visual inattention and visual perception. 1033 patients underwent visual screening at a median of 3 days (IQR 2) and full visual assessment at a median of 4 days (IQR 7) after the incident stroke: 52% men, 48% women, mean age 73 years and 87% ischaemic strokes. Excluding pre-existent eye problems, the incidence of new onset visual sequelae was 48% for all stroke admissions and 60% in stroke survivors. Three quarters 752/1033 (73%) had visual problems (point prevalence): 56% with impaired central vision, 40% eye movement abnormalities, 28% visual field loss, 27% visual inattention, 5% visual perceptual disorders. 281/1033 (27%) had normal eye exams. Conclusions Incidence and point prevalence of visual problems in acute stroke is alarmingly high, affecting over half the survivors. For most, visual screening and full visual assessment was achieved within about 5 days of stroke onset. Crucial information can thus be provided on visual status and its functional significance to the stroke team, patients and carers, enabling early intervention.
    Keywords Medicine ; R ; Science ; Q
    Subject code 700 ; 150
    Language English
    Publishing date 2019-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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    Inter-library loan at ZB MED

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