Health-related quality of life of cataract cross-cultural comparisons of utility and psychometric measures

BACKGROUND This study was conducted to assess the presence and/or absence of cross-cultural differences or similarities between Korean and United States cataract patients. A systematic assessment was performed using utility and psychometric measures in the study population. RESEARCH DESIGN A cross-sectional study design was used to examine the comparison of preoperative outcomes measures in cataract patients in Korea and the United States. Study subjects were selected using non-probabilistic methods and included 132 patients scheduled for cataract surgery in one eye. PARTICIPANTS Subjects were adult cataract patients at Samsung and Kunyang General Hospital in Seoul, Korea, and Tulane University Hospital and Clinics in New Orleans, Louisiana. MEASUREMENTS Preoperative utility was assessed using the verbal rating scale and standard reference gamble techniques. Current preoperative health status was assessed using the SF-36 and VF-14 surveys.Current preoperative Snellen visual acuity was used as a clinical measure of vision status. RESULTS Korean patients were more likely to be younger (p = 0.001), less educated (p = 0.001), and to have worse Snellen visual acuity (p = 0.002) than United States patients. Multivariate analysis of variance (MANOVA) revealed that in contrast to Korean patients, United States patients were assessed to have higher scoring in general health, vitality, VF-14, and verbal rating for visual health. This higher scoring trend persisted after controlling for age, gender, education and Snellen visual acuity. The difference in health-related quality of life (HRQOL) between the two countries was quite clear, especially in the older age and highly educated group. CONCLUSIONS Subjects in Korea and the United States were significantly different in quality of life, functional status and clinical outcomes. Subjects in the United States had more favorable health outcomes than those in Korea. These differences may be caused by multiple factors, including country-specific differences in economic status, health care system, cultural value system, and health policy. Cross-cultural differences should be considered when making international comparisons of quality of life.