ArticleQuality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation2026
Responsiveness and minimal important change of the Dutch Adult Strabismus-20 Questionnaire (Dutch-AS-20).
Article in Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThe Dutch Adult Strabismus-20 questionnaire (Dutch-AS-20) is a patient-reported outcome measure (PROM) developed to assess the strabismus-specific quality of life (QoL) in adult patients with strabismus in the Netherlands. This 18-item questionnaire comprises a psychosocial and visual function subscale. The aim of this prospective, multicenter, longitudinal study was to evaluate the responsiveness and determine the minimal important change (MIC) of the Dutch-AS-20 in patients undergoing strabismus surgery.
methodsAdult patients scheduled for strabismus surgery were enrolled. The Dutch-AS-20, EQ-5D-5L, Amblyopia and Strabismus Questionnaire (A&SQ), Diplopia Questionnaire (DQ) and two global rating of change (GRC) questions were administered pre- and/or postoperatively. We used a construct approach to assess the responsiveness, testing eight pre-specified hypotheses. We determined the MIC using adjusted anchor-based predictive modelling.
resultsA total of 136 patients completed the questionnaires at baseline. All pre-specified hypotheses were met, indicating sufficient responsiveness of both subscales of the Dutch-AS-20. We estimated a MIC of 3.1 T-score points for the psychosocial subscale. We could not estimate the MIC for the visual function subscale due to a low correlation with the GRC question.
conclusionBoth subscales of the Dutch-AS-20 are sufficiently responsive to change in strabismus-specific QoL following strabismus surgery. These findings are an important step towards the use of the Dutch AS-20 in both research and clinical practice. Future research is needed to determine a more precise MIC and individual-level statistics for both subscales, in order to improve the interpretability of change scores for both clinical and research purposes.
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