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PubMed2003

The internal and external validity of the Major Depression Inventory in measuring severity of depressive states.

BACKGROUND: We have developed the Major Depression Inventory (MDI), consisting of 10 items, covering the DSM-IV as well as the ICD-10 symptoms of depressive illness. We aimed to evaluate this as a scale measuring severity of depressive states with reference to both internal and external validity. METHOD: Patients representing the score range from no depression to marked depression on the Hamilton Depression Scale (HAM-D) completed the MDI. Both classical and modern psychometric methods were applied for the evaluation of validity, including the Rasch analysis. RESULTS: In total, 91 patients were included. The results showed that the MDI had an adequate internal validity in being a unidimensional scale (the total score an appropriate or sufficient statistic). The external validity of the MDI was also confirmed as the total score of the MDI correlated significantly with the HAM-D (Pearson's coefficient 0.86, P < or = 0.01, Spearman 0.80, P < or = 0.01). CONCLUSION: When used in a sample of patients with different states of depression the MDI has an adequate internal and external validity.

Adult↗

PubMed2006

Development and validation of a nomogram for predicting outcome of patients with vulvar cancer.

OBJECTIVE: To construct and validate a nomogram to predict relapse-free survival of patients treated for vulvar cancer. METHODS: Data from 244 patients treated for vulvar cancer at a single institution (Creteil, France) were used as a training set to develop and calibrate a nomogram for predicting relapse-free survival and local relapse-free survival. We used bootstrap resampling for the internal validation and we tested the nomogram on an independent validation set of patients (Torino, Italy) for the external validation. RESULTS: The nomograms were based on a Cox proportional hazards regression model. Covariates for the relapse-free survival model included age, T stage, number of metastatic nodes, bilateral lymph node involvement, omission of the lymphadenectomy, margin status, lymphovascular space invasion, and depth of invasion. The concordance indices were 0.85 and 0.83 in the training set before and after bootstrapping, respectively, and 0.83 in the validation set. The predictions of our nomogram discriminated better than did the International Federation of Gynecology and Obstetrics stage (0.83 compared with 0.78, P = .01). The calibration of our nomogram was good. In the validation set, 2-year and 5-year relapse-free survival were well predicted with less than 5% difference between the predicted and observed survivals for each quartile. A nomogram for predicting local relapse was also developed. CONCLUSION: We have developed nomograms for predicting distant and local relapse of vulvar cancer at 2 and 5 years and validated them both internally and externally. These nomograms will be freely available on the International Society for the Study of Vulvovaginal Disease Web site. LEVEL OF EVIDENCE: III.

Adult↗

PubMed1999

EDITS: development of questionnaires for evaluating satisfaction with treatments for erectile dysfunction.

OBJECTIVES: To develop Patient and Partner versions of a psychometrically sound questionnaire, the EDITS (Erectile Dysfunction Inventory of Treatment Satisfaction), to assess satisfaction with medical treatments for erectile dysfunction. METHODS: Treatment satisfaction differs from treatment efficacy as it focuses on a person's subjective evaluation of treatment received. Twenty-nine items representing the domain of treatment satisfaction for men and 20 representing partner satisfaction were generated. Two independent samples of 28 and 29 couples completed all items at two points in time. Spearman rank-order correlations were derived to assess test-retest reliability and couple coefficients of validity. Internal consistency coefficients were calculated for both Patient and Partner versions and a content validity panel was used to analyze content validity. RESULTS: Only items that met all the following criteria were selected to comprise the final questionnaires: (a) range of response four or more out of five; (b) test-retest reliability greater than 0.70; (c) ratings by at least 70% of the content validity panel as belonging in and being important for the domain; and (d) significant correlation between the subjects' and partners' responses. Eleven patient items met criteria and formed the Patient EDITS; five partner items met criteria and formed the Partner EDITS. Scores on the two inventories were normally distributed with internal consistencies of 0.90 and 0.76, respectively. Test-retest reliability for the Patient EDITS was 0.98; for the Partner EDITS, it was 0.83. CONCLUSIONS: Reliability and validity were well established, enabling the EDITSs to be used to assess satisfaction with treatment modalities for erectile dysfunction and to explore the impact of patient and partner satisfaction on treatment continuation.

Erectile Dysfunction↗

PubMed2003

Validation of the TONOPORT V ambulatory blood pressure monitor according to the European Society of Hypertension International Protocol for Validation of Blood Pressure Measuring Devices in Adults.

BACKGROUND: It is now accepted that blood pressure measuring devices should be subjected to an independent evaluation of their accuracy before they are marketed for clinical use. The results of validation of the TONOPORT V blood pressure monitor for the measurement of ambulatory blood pressure according to the European Society of Hypertension International Protocol for Validation of Blood Pressure Measuring Devices in Adults are presented in this paper. POPULATION: Thirty-three subjects were recruited from among staff and patients at Beaumont Hospital, Dublin, Ireland. METHODS: The TONOPORT V monitor was connected to the Sphygmocorder, an audiovisual system for validation, which records blood pressure on tape and video for later analysis. Nine sequential same-arm measurements between the device and a standard mercury sphygmomanometer were recorded using the Sphygmocorder. RESULTS: In phase 1, the TONOPORT V monitor produced 28 measurements within 5 mmHg, 37 within 10 mmHg and 40 within 15 mmHg for systolic blood pressure (SBP), and 26 within 5 mmHg, 38 within 10 mmHg and 44 within 15 mmHg for diastolic blood pressure (DBP). The mean differences were -2.2 (8.6) [mean (SD)] mmHg for SBP and +0.5 (7.2) mmHg for DBP. The TONOPORT V monitor passed all the criteria for both SBP and DBP. In phase 2.1, the TONOPORT V monitor had 56 measurements within 5 mmHg, 78 within 10 mmHg and 88 within 15 mmHg for SBP, and 60 measurements within 5 mmHg, 83 within 10 mmHg and 97 within 15 mmHg for DBP. The mean differences were -1.4 (8.7) mmHg for SBP and -0.2 (6.8) mmHg for DBP. The TONOPORT V monitor passed the criteria for DBP but failed to meet any of the criteria for SBP. In phase 2.2, 19 subjects had at least two of the differences within 5 mmHg and six subjects had no differences within 5 mmHg for SBP, and 22 subjects had at least two of the differences within 5 mmHg and six subjects no differences within 5 mmHg for DBP. The TONOPORT V monitor failed to meet the criteria for SBP and for DBP. CONCLUSIONS: The TONOPORT V monitor cannot be recommended for clinical use in an adult population because it records SBP inaccurately and because it records DBP inaccurately in an unacceptably high proportion of people.

Adult↗

PubMed2006

Validity of a food-frequency questionnaire for elderly men in southeast China.

OBJECTIVE: To investigate the internal validity of a food-frequency questionnaire (FFQ) developed for a case-control study of prostate cancer in southeast China. DESIGN: A comprehensive questionnaire comprising a quantitative FFQ and a short food habit questionnaire (SFHQ) was developed and modified from previous cancer and nutritional studies. The Goldberg formula (ratio of energy intake (EI) to basal metabolic rate (BMR), EI/BMR) was used to assess the validity of the FFQ by making comparisons with physical activity levels. Physical activity levels were measured by the estimated total metabolic equivalents (MET) and the ratio of energy expenditure (EE) to BMR (EE/BMR). Correlation analyses were undertaken to compare the SFHQ variables with those of the quantitative FFQ. SETTING: Hangzhou, Zhejiang Province, China. SUBJECTS: A total of 404 men over 45 years old with or without prostate cancer were recruited from eight hospitals. RESULTS: The partial correlation coefficients, controlling for age and family history of prostate cancer, were moderate to high (P<0.05) for preserved foods intake, fat consumption and tea drinking variables between the SFHQ and the quantitative FFQ. The average EI/BMR was 1.72, with 76% of subjects exceeding the Goldberg cut-off value of 1.35. Apart from weight, BMI, EE/BMR and MET, there were no significant differences in characteristics between low (<1.35) and normal EI/BMR groups. CONCLUSIONS: The FFQ is demonstrated to be a valid instrument to measure energy and food intake for elderly men in southeast China.

Basal Metabolism↗

PubMed2004

[Cardiovascular risk assessment for informed decision making. Validity of prediction tools].

BACKGROUND AND PURPOSE: Patient involvement in health care decisions is increasingly requested. The authors investigated whether currently available assessment tools for prediction of cardiovascular risk can be used for individual risk prediction as a basis of informed decision making. METHODS: The authors searched for risk assessment tools and respective validation studies in Medline (until August 16, 2004) and the Cochrane Library (issue 2/2004). The following criteria were used for evaluation of prognostic studies: (1) discrimination between risk groups; (2) predictive values; (3) prognostic agreement; (4) transferability across populations. RESULTS: A total of twelve assessment tools were identified. The Framingham function, Sheffield Tables, Canadian Tables, Framingham Categorial, New Zealand, Joint British, and European Charts (1994 and 1998) are based on the Framingham Study; PROCAM Risk Score, UKPDS Risk Engine, and SCORE Risk Charts use different source data. Framingham-based instruments overestimate cardiovascular risk of Central-European populations by at least 30%, with substantial regional variation even within a country (between 30% and 100%, British Regional Heart Study). Therefore, prior to application the assessment tools would need recalibration using regional data of cardiovascular mortality and adjustment for social class differences. Published sensitivity, specificity, and C-statistics for external validation (area under the curve [AUC] approximately 0.6) are clearly inferior to internal validation (AUC approximately 0.8). Agreement between instruments beyond chance is moderate (kappa approximately 0.5). No studies on external validation could be identified for the new European SCORE Risk Charts and UKPDS Risk Engine. CONCLUSION: Validation of currently available assessment tools for cardiovascular risk prediction is inadequate. Uncritical use may lead to substantial under- or overestimation of individual cardiovascular risk and inappropriate treatment decisions.

Adult↗

PubMed2006

Novel semi-automated methodology for developing highly predictive QSAR models: application for development of QSAR models for insect repellent amides.

Conventional 3D-QSAR models are built using global minimum conformations or quantum-mechanics based geometry-optimized conformations as bioactive conformers. QSAR models developed using the global minima as bioactive conformers, employing the GFA, PLS and G/PLS methodologies, gave good non-validated r(2) (0.898, 0.868 and 0.922) and performed well on an internal validation test with leave-one-out correlation q(2) (LOO) (0.902, 0.726 and 0.924), leave-10%-out correlation q(2) (L10O) (0.874, 0.728 and 0.883) and leave-20%-out q(2) (L20O) (0.811, 0.716 and 0.907). However, they showed poor predictive ability on an external data set with best predictive r(2) (Pred-r(2)) of 0.349, 0.139 and 0.204 respectively. A novel methodology to mine bioactive conformers, from clusters of conformations with good 3D-spatial representation around pharmacophoric moiety, furnishes highly predictive 3D-QSAR models. The best QSAR model (model A) showed r(2) of 0.989, q(2) (LOO) of 0.989, q(2) (L10O) of 0.980, q(2) (L20O) of 0.963 and Pred-r(2) on eight test compounds of 0.845. The methodology is based on mimicking the multi-way Partial Least Squares (PLS) technique by performing several automated sequential PLS analyses. The poses/shapes of the mined bioactive conformers provide valuable insight into the mechanism of action of the insect repellents. All of the repetitive tasks were automated using Tcl-based Cerius2 scripts.

Algorithms↗

PubMed2005

Predictive Bayesian neural network models of MHC class II peptide binding.

We used Bayesian regularized neural networks to model data on the MHC class II-binding affinity of peptides. Training data consisted of sequences and binding data for nonamer (nine amino acid) peptides. Independent test data consisted of sequences and binding data for peptides of length </=25. We assumed that MHC class II-binding activity of peptides depends only on the highest ranked embedded nonamer and that reverse sequences of active nonamers are inactive. We also internally validated the models by using 30% of the training data in an internal test set. We obtained robust models, with near identical statistics for multiple training runs. We determined how predictive our models were using statistical tests and area under the Receiver Operating Characteristic (ROC) graphs (A(ROC)). Most models gave training A(ROC) values close to 1.0 and test set A(ROC) values >0.8. We also used both amino acid indicator variables (bin20) and property-based descriptors to generate models for MHC class II-binding of peptides. The property-based descriptors were more parsimonious than the indicator variable descriptors, making them applicable to larger peptides, and their design makes them able to generalize to unknown peptides outside of the training space. None of the external test data sets contained any of the nonamer sequences in the training sets. Consequently, the models attempted to predict the activity of truly unknown peptides not encountered in the training sets. Our models were well able to tackle the difficult problem of correctly predicting the MHC class II-binding activities of a majority of the test set peptides. Exceptions to the assumption that nonamer motif activities were invariant to the peptide in which they were embedded, together with the limited coverage of the test data, and the fuzziness of the classification procedure, are likely explanations for some misclassifications.

Amino Acid Sequence↗

PubMed2000

Sensitivity to change of the functional index for hand osteoarthritis.

BACKGROUND: The functional index for hand osteoarthritis (FIHOA), a 10-item investigator-administered questionnaire, was validated in 1995. It is relevant, reliable and has good external and internal validities. OBJECTIVE: To assess the sensitivity to change over time of the FIHOA. PATIENTS/METHODS PATIENTS: symptomatic [visual analog scale (VAS) > or = 30 mm, FIHOA > or = 5] hand OA patients [American College of Rheumatology (ACR) criteria, > or = 2 radiologically affected joints] were included in a 6-month randomized, double-blind, placebo-controlled trial. Recorded parameters: Pain on VAS, FIHOA score, morning stiffness duration, grip strength. STATISTICAL ANALYSIS: mean standardized response (MSR = delta DO-M6/S.D. of delta) was calculated for each parameter in an intention-to-treat (ITT) population before breaking the randomization code. RESULTS: 239 women, 22 men, mean age 61 +/- 7.5 years were recruited. Characteristics of HOA: 88% of patients were right-handed, 48% had a family history of hand OA. The location of OA was the first trapezo-metacarpal (TMC) joint (62%), proximal interphalangeal (PIP) joint (47.5%), distal interphalangeal (DIP) joint (67.6%). The mean number of painful flares (previous 12 months) was 4.4, that of painful joints was 3.7, that of nodal joints in the right hand 3.1, and that of radiologically affected joints was 4.4. Baseline symptomatic severity assessment gave pain on VAS=54.4 +/- 14 mm, FIHOA score=10.4 +/- 3.7, morning stiffness duration=20 +/- 27.6 min and grip strength=59.3 +/- 21.2 mm Hg. The MSR value was 0.58 for the FIHOA and 0.87 for pain on VAS. CONCLUSION: The sensitivity to change of the FIHOA over 6 months is high, but inferior to that of pain on VAS in this trial.

Activities of Daily Living↗

PubMed2002

The Gotland Male Depression Scale: a validity study in patients with alcohol use disorder.

The Gotland Male Depression Scale has been developed to improve the recognition of major depression in males. The Gotland Male Depression Scale was compared to the Major Depression Inventory in a population of male patients treated for alcohol dependency at the Alcohol Outpatients Clinic of Copenhagen University Hospital. The prevalence of depression as well as the prescription of antidepressants were used as indices of validation. The Gotland Male Depression Scale was shown to have an adequate internal validity. The prevalence of depression according to the Major Depression Inventory was 17% and according to the Gotland Male Depression Scale 39% of the patients had a probable or definite depression and should be considered for treatment with antidepressants. The Gotland Depression Subscale was found to be better than the Gotland Distress Subscale at discriminating between patients treated and not treated with antidepressants.

Adult↗

PubMed1986

The assessment of health policy changes using the time-reversed crossover design.

The time-reversed crossover design is a quasi-experimental design which can be applied to evaluate the impact of a change in health policy on a large population. This design makes use of separate sampling and analysis strategies to improve the validity of conclusions drawn from such an evaluation. The properties of the time-reversed crossover design are presented including the use of stratification on outcome in the sampling stage, which is intended to improve external validity. It is demonstrated that, although this feature of the design introduces internal validity threats due to regression toward the mean in extreme-outcome strata, these effects can be measured and eliminated from the test of significance of treatment effects. Methods for within- and across-stratum estimation and hypothesis-testing are presented which are similar to those which have been developed for the traditional two-period crossover design widely used in clinical trials. The procedures are illustrated using data derived from a study conducted by the United Mine Workers of America Health and Retirement Funds to measure the impact of cost-sharing on health care utilization among members of its health plan.

Costs and Cost Analysis↗

PubMed2002

Development and validation of a questionnaire for the assessment of bowel and lower urinary tract symptoms in women.

OBJECTIVE: To develop a simple but sensitive instrument to evaluate and document symptoms of both bowel and urinary dysfunction in women. DESIGN: A 22-item questionnaire covering a range of bowel and urinary symptoms was developed and underwent rigorous psychometric testing. SETTING: The gynaecology departments of three hospitals, a urogynaecology clinic, a functional bowel clinic and a general practice. POPULATION: Six hundred and thirty women, comprising four groups: 1. women awaiting hysterectomy (n = 379), 2. women following hysterectomy (n = 45), 3. women referred with functional bowel and/or urinary symptoms (n = 65), 4. asymptomatic controls (n = 141). MAIN OUTCOME MEASURES: The content, construct and criterion validity, internal consistency, reliability and responsiveness of the questionnaire were measured. RESULTS Peer and patient reports and missing data patterns supported face and content validity. Factor analysis showed a clinically relevant four-factor structure with low content replication able to distinguish between patient groups, indicating good internal structure. Comparison with clinical, anorectal physiological, videoproctographic, transit time and urodynamic test results provide provisional indication of criterion validity. Key domain question analysis and Cronbach's alphas showed internal consistency. Kappa values demonstrated good test-retest reliability and key question correlation over time proved responsiveness. CONCLUSIONS: Our findings support the suitability, clinical validity, reliability and responsiveness of a simple questionnaire, which is sensitive to the constraints of clinical practice. The authors recommend its use in health care evaluation research assessing the effects of pelvic surgery and as a useful tool in comparing treatment efficacy.

Adult↗

PubMed1999

Criterion validity of a new measure of self-actualization.

Many authors have questioned the validity of the major existing measures of self-actualization (the Personal Orientation Inventory, the Personal Orientation Dimensions, and the Short Index of Self-actualization), given their serious theoretical and methodological limitations. A new inventory was developed, the Measure of Actualization of Potential, and various studies were conducted to assess its theoretical and empirical content as well as its construct validity, internal consistency, and temporal reliability. The present aim was to estimate the criterion validity of the new measure using humanistic clinical psychologists' assessments as the criterion. The results show that eight clinical psychologists' rankings of 73 individuals are positively and highly correlated with the scores obtained by the same individuals on the Measure of Actualization of Potential.

Adolescent↗

PubMed1995

Is it clinically possible to distinguish nonhemorrhagic infarct from hemorrhagic stroke?

BACKGROUND AND PURPOSE: Diagnosis of the nonhemorrhagic ischemic type of stroke by analysis of patients' clinical features is considered unreliable because no clinical feature is specific. The diagnosis is so difficult to establish that we cannot hope to use the same method to make a reliable diagnosis in all stroke cases. In this study, we propose a simple scoring system with a positive predictive value of close to 100% to distinguish nonhemorrhagic infarct from hemorrhagic stroke. This scoring is available for all physicians in bedside diagnosis even if this score can be applied to a subgroup of patients. METHODS: Twenty-six clinical variables that might potentially distinguish cerebral hemorrhage from infarction were recorded in patients consecutively admitted to our stroke unit for stroke lasting more than 24 hours with at least unilateral motor weakness affecting face and/or arm and/or leg (internal validity study). Patients previously receiving anticoagulant therapy were excluded. We used CT scan as the gold standard. We used multivariate logistic regression to establish a clinical score from which we derived the classification rule. This rule was validated with data from the next 200 consecutive patients hospitalized in the stroke unit (external validity study). RESULTS: Three hundred sixty-eight patients were enrolled in the internal study. The obtained score was (2 x alcohol consumption) + (1.5 x plantar response) + (3 x headache) + (3 x history of hypertension)--(5 x history of transient neurological deficit)--(2 x peripheral arterial disease)--(1.5 x history of hyperlipidemia)--(2.5 x atrial fibrillation on admission). All patients with a score less than 1 (n = 123) had a nonhemorrhagic infarct (ie, 40% of the 305 patients with a nonhemorrhagic infarct). No threshold was found to diagnose cerebral hemorrhage with a sufficiently high positive predictive value. Among the 200 patients enrolled in the external validity study, 72 patients with a score below 1 had a nonhemorrhagic infarct (ie, 43% of patients with a nonhemorrhagic infarct). CONCLUSIONS: Diagnosis of nonhemorrhagic infarct can be made in 36% (95% confidence interval [CI], 29 to 43) of patients with a high level of accuracy (100% in the external validity study, which gives a 95% CI of 93 to 100). Thus, 43% (95% CI, 36 to 50) of patients with a nonhemorrhagic infarct could receive a bedside diagnosis. The score is simple and can be calculated from information available to all physicians.

Adult↗

PubMedDate not supplied

The Hamilton Anxiety Scale: reliability, validity and sensitivity to change in anxiety and depressive disorders.

The Hamilton Anxiety Scale (HAM-A) was tested for reliability and validity in two different samples, one sample (n = 97) defined by anxiety disorders, the other sample (n = 101) defined by depressive disorders. The reliability and the concurrent validity of the HAM-A and its subscales proved to be sufficient. Internal validity tested by latent structure analysis was insufficient. The major problems with the HAM-A are that (1) anxiolytic and antidepressant effects cannot be clearly distinguished; (2) the subscale of somatic anxiety is strongly related to somatic side effects. The applicability of the HAM-A in anxiolytic treatment studies is therefore limited. More specific anxiety scales are needed.

Agoraphobia↗

PubMed2006

A comparison of socio-demographic and psychological factors between patients consenting to randomisation and those selecting treatment (the ProtecT study).

BACKGROUND: Patient preferences for treatment can pose problems for the conduct of randomised controlled trials: patients with a preference may refuse participation and thereby potentially compromise external validity. Moreover, randomising patients with a preference may affect treatment efficacy and threaten internal validity. AIMS: This study compared baseline characteristics and short-term psychological outcomes of patients who selected their treatment and those who agreed to random allocation. METHODS: Men participating in the prostate testing for cancer and treatment (ProtecT) study and who were randomised to active monitoring (n=138) were compared with those who had refused randomisation and selected this management (n=180). Socio-demographic data were collected at baseline, and anxiety and depression data were collected at baseline and six month follow-up. Socio-demographic characteristics were compared across these two groups in univariable analyses, and then linear regression was used to compare levels of anxiety and depression at follow-up with adjustments for confounders. RESULTS: Participants who selected active monitoring were more affluent (based on occupation details) and had less anxiety at baseline than those who were randomised. There were no differences with respect to age and marital status. Levels of anxiety and depression at six months follow-up were similar across the two groups of men. CONCLUSIONS: This study found some differences at baseline between the socio-demographic and psychological status of those randomised and self-selecting treatment, but no psychological differences at short-term follow-up. Further empirical evidence is required to assess whether preferences impact upon the process and outcome of randomised controlled trials.

Aged↗

PubMed2002

Identifying patients for blood conservation strategies.

BACKGROUND: Generally, only the type of operation is used to estimate the need for perioperative homologous blood transfusion. This study quantified the extent to which the estimation could be improved if, in addition, simple patient characteristics were taken into account. METHODS: Retrospective data on 24 509 consecutive adult surgical patients were used to derive and validate three models to predict perioperative homologous transfusion. The first model was a univariable model with type of operation as the only predictor. The second and third models were a full and a simplified multivariable logistic regression model. The performance of the multivariable models was tested in two validation sets: in similar patients who had operations in the same general hospital (internal validation) and in patients who had operations in a university hospital (external validation). The areas under the receiver-operator characteristic (ROC) curve were compared with that found in the derivation set. RESULTS: There were no important differences in characteristics between the derivation and validation sets. The ROC area of the model including surgery only was 0.92 (99 per cent confidence interval (c.i.) 0.91 to 0.94) and that of the full and simplified multivariable models 0.95 (99 per cent c.i. 0.94 to 0.96) and 0.94 (99 per cent c.i. 0.93 to 0.95) respectively. The latter two were significantly different from the first one. In the external validation set the ROC area of the simplified model was 0.84 (95 per cent c.i. 0.83 to 0.86). Patients who had a preoperative haemoglobin level lower than 13 g/dl and underwent major invasive surgery had the highest risk (43 per cent) of transfusion. CONCLUSION: A simple algorithm using type of operation and haemoglobin concentration was effective in identifying patients likely to need perioperative homologous blood transfusion.

Adult↗

PubMed2001

Reliability and validity of the Danish version of the Calgary Depression Scale for Schizophrenia.

Depressive symptoms within the range of schizophrenic syndromes constitute a major diagnostic and therapeutic problem. Earlier research has indicated that available depression scales are not adequate when examining mood disturbances in patients with schizophrenia. We have made an attempt to estimate the reliability and validity of the Danish version of the Calgary Depression Scale for Schizophrenia. The external validity has been analysed in relation to the Major Depression Inventory (MDI). The internal validity has been analysed by using Loevinger's coefficient of homogeneity as the primary statistic. For the inter-observer reliability the intra-class coefficients have been calculated. It was shown that a subscale of the Calgary scale has sufficient reliability and validity.

Adult↗