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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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adult patients scheduled for strabismus surgery were enrolled. The Dutch-AS-20, EQ-5D-5L, Amblyopia and Strabismus Questionnaire (A&amp;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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A 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\u00a0T-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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Both 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11136-026-04348-z","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T15:22:16Z","timestamp":1788362536000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Responsiveness and minimal important change of the Dutch Adult Strabismus-20 Questionnaire (Dutch-AS-20)"],"prefix":"10.1007","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5697-8433","authenticated-orcid":false,"given":"Fenna","family":"Burggraaf","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0435-096X","authenticated-orcid":false,"given":"Hinke Marijke","family":"Jellema","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7439-9315","authenticated-orcid":false,"given":"Martha J.","family":"Tjon-Fo-Sang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1227-1177","authenticated-orcid":false,"given":"Ruth M. 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