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   <dc:title>Development and Initial Validation of the MCL-PRO-CAT: A computerized adaptive test designed to measure multifocal contact lens performance from the patient's perspective</dc:title>
   <dc:creator>Albero-Ros, Elsa</dc:creator>
   <dc:creator>Lorente Velázquez, Amalia</dc:creator>
   <dc:creator>Madrid Costa, David</dc:creator>
   <dc:creator>González Pérez, Mariano</dc:creator>
   <dcterms:abstract>Purpose: To create a valid and reliable computer-adaptive testing (CAT) tool for assessing Multifocal Contact Lens (MCL) performance in presbyopic individuals, ensuring high precision. The self-administered tool will initially be accessible online in Spanish.

Methods: Five steps were followed for the correct development of the instruments: item bank development, item refinement phase, item response theory calibration of the refined item bank, CAT simulations and design, and an initial validation study. A total of 1163 presbyopic patients were involved in the over-all study. Convergent validity was assessed by comparing results to the CLDQ-8 questionnaire, and repeatability assessment was performed two weeks after the initial completion.

Results: The final item bank consisted of 108 items assessing various relevant domains for MCL performance evaluation. The calibration study showed a person separation index of 4.69 and a reliability of 0.96 along with a measurement precision of 0.27. The final CAT distinguished between 16 levels of MCL performance by presenting an average of 10.61 ± 1.00 items per patient, with an average completion time of 3:04 ± 1:24 min. Signs of convergent validity showed a correlation of 0.73 and repeatability was assessed showing an intraclass Correlation Coefficient of 0.881 with a 95% Confidence Interval 0,815-0,924, and Limits of Agreement of ± 1.07.

Conclusion: The MCL-PRO-CAT is a groundbreaking tool for evaluating MCL performance in presbyopic individuals. With automated scoring and fewer items, it was feasible, valid, and precise, enhancing clinical practicality.</dcterms:abstract>
   <dcterms:dateAccepted>2025-02-13T13:42:59Z</dcterms:dateAccepted>
   <dcterms:available>2025-02-13T13:42:59Z</dcterms:available>
   <dcterms:created>2025-02-13T13:42:59Z</dcterms:created>
   <dcterms:issued>2025-01</dcterms:issued>
   <dc:type>journal article</dc:type>
   <dc:identifier>https://hdl.handle.net/20.500.14352/118055</dc:identifier>
   <dc:identifier>XXXX-XXXX</dc:identifier>
   <dc:identifier>10.1016/j.clae.2025.102378</dc:identifier>
   <dc:language>eng</dc:language>
   <dc:relation>Albero-Ros E, Lorente-Velázquez A, Madrid-Costa D, González-Pérez M. Development and Initial Validation of the MCL-PRO-CAT: A computerized adaptive test designed to measure multifocal contact lens performance from the patient's perspective. Cont Lens Anterior Eye. 2025 Jan 31:102378. doi: 10.1016/j.clae.2025.102378. Epub ahead of print. PMID: 39893061.</dc:relation>
   <dc:rights>restricted access</dc:rights>
   <dc:publisher>PubMed</dc:publisher>
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