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PubMed2000

Development and validation of a patient based measure of outcome in ocular melanoma.

BACKGROUND: Patients with uveal melanoma can be treated by a number of modalities. As none of the different treatments offer a survival advantage, a key factor in choosing among treatments is their differential impact on patients' quality of life. A short, patient based questionnaire was developed and validated for evaluating outcomes following treatment for uveal melanoma. METHODS: The 21 item measure of outcome in ocular disease (MOOD) assesses the patient's view of outcome in terms of visual function and the impact of treatment. The reliability and validity of the three MOOD scores (total, vision, impact) were evaluated in 176 patients who had been treated for uveal melanoma (75 brachytherapy, 78 proton beam radiotherapy, 23 enucleation). Of these, 165 patients also completed the SF-36. RESULTS: All three MOOD scales met standard criteria for acceptability, reliability, and validity. The proportion of missing data was low, and responses to all items were well distributed across response categories. Internal consistency, assessed by Cronbach's alpha coefficients, exceeded the standard criterion of 0. 70 for all three summary scores. Item total correlations ranged from 0.22 to 0.77 (mean item total correlation 0.58), indicating good homogeneity. Test-retest correlations for all three summary scores exceeded 0.85. Scaling assumptions, assessed by item convergent and discriminant validity correlations, were met for the vision and impact scores. The MOOD showed good content validity, as assessed by review by ophthalmologists and patients. Construct validity was demonstrated by high intercorrelations between the vision and impact scores and the total scale; higher scores for patients who reported being very satisfied compared with those who were not very satisfied and for those who reported persistent red eye compared with those who did not have this complication (known group differences/hypothesis testing); moderate correlations between the MOOD and the SF-36 and visual acuity (convergent validity); and low correlations between the MOOD and age and sex (discriminant validity). CONCLUSIONS: The MOOD is a practical and scientifically sound patient based measure which can be used in research and audit to evaluate outcomes following treatment for uveal melanoma. It takes 5 minutes to complete and meets standard psychometric criteria for reliability and validity.

Activities of Daily Living↗

PubMed1981

Dietetic performance evaluation: establishment of validity and reliability.

Performance evaluation as conducted among a number of raters using several evaluation tools requires the qualities of content validity and interrater reliability to be fair and effective. A procedural model was tested and implemented by faculty and students in the Coordinated Undergraduate Program (CUP) at the University of Tennessee, Knoxville. A checklist for evaluation of employee counseling techniques achieved an intraclass correlation of 0.72 when used by clinical instructors in a series of workshops. The procedure included development of a form, its use in a standardized situation, discussion, calculation of intraclass correlation, and review. The model is suggested for implementation in any program from which established validity and reliability in evaluation are desired.

Clinical Competence↗

PubMedDate not supplied

Postpartum Depression Screening Scale: development and psychometric testing.

BACKGROUND: Approximately 400,000 mothers in the United States experience postpartum depression each year. However, only a small proportion of these women are identified as depressed by health care professionals. OBJECTIVES: To improve detection of this postpartum mood disorder, the purpose of this study was to assess the psychometric properties of a newly devised instrument, the Postpartum Depression Screening Scale (PDSS), a 35-item Likert-type self-report instrument. METHODS: Content validity was supported through the literature and the judgments rendered by a panel of five content experts and a focus group. The PDSS was administered to 525 new mothers. RESULTS: Confirmatory factor analysis provided empirical support for the existence of the hypothesized seven dimensions. A Tucker-Lewis goodness-of-fit index of 0.87 and a root mean square residual of 0.05 were judged supportive of model fit. Item response theory techniques provided further construct validity support for finer interpretations of the respective seven dimensions. Analysis of the Likert 5-point response categories further supported meaningful score interpretations. Alpha internal consistency reliabilities ranged from 0.83 (sleeping/eating disturbances) to 0.94 (loss of self). CONCLUSIONS: Empirically, all of the reliability and validity analyses supported the score interpretations posited for the PDSS. Currently, the sensitivity, specificity, and positive predictive value of the PDSS are being determined.

Adult↗

PubMed2000

Developing and testing an instrument to measure the effectiveness of clinical teaching in an academic medical center.

PURPOSE: Instruments that rate teaching effectiveness provide both positive and negative feedback to clinician-educators, helping them improve their teaching. The authors developed the Clinical Teaching Effectiveness Instrument, which was theory-based and generic across their entire academic medical center, The Cleveland Clinic Foundation. They tested it for reliability, validity, and usability. METHOD: In 1997, using an iterative qualitative development process involving key stakeholders, the authors developed an institution-wide instrument to routinely evaluate clinical faculty. The resulting instrument has 15 questions that use a five-point evaluation scale. The instrument, which was administered to medical students, residents, and fellows over a 20-month period, produced data that were rigorously tested for instrument characteristics, reliability, criterion-related and content validity, and usability. RESULTS: This instrument, implemented in all departments across the institution, produced data on a total of 711 clinician-educators. Correlation coefficients among the items were high (.57 to .77). The scores were reliable (g coefficient of 0.935), and the instrument had both content and criterion-related validity. CONCLUSIONS: The Cleveland Clinic's Clinical Teaching Effectiveness Instrument is reliable and valid, as well as usable. It can be used as an evaluation tool for a wide variety of clinical teaching settings.

Academic Medical Centers↗

PubMed2006

Pain assessment tools: is the content appropriate for use in palliative care?

Inadequate pain assessment prevents optimal treatment in palliative care. The content of pain assessment tools might limit their usefulness for proper pain assessment, but data on the content validity of the tools are scarce. The objective of this study was to examine the content of the existing pain assessment tools, and to evaluate the appropriateness of different dimensions and items for pain assessment in palliative care. A systematic search was performed to find pain assessment tools for patients with advanced cancer who were receiving palliative care. An ad hoc search with broader search criteria supplemented the systematic search. The items of the identified tools were allocated to appropriate dimensions. This was reviewed by an international panel of experts, who also evaluated the relevance of the different dimensions for pain assessment in palliative care. The systematic literature search generated 16 assessment tools while the ad hoc search generated 64. Ten pain dimensions containing 1,011 pain items were identified by the experts. The experts ranked intensity, temporal pattern, treatment and exacerbating/relieving factors, location, and interference with health-related quality of life as the most important dimensions. None of the assessment tools covered these dimensions satisfactorily. Most items were related to interference (231) and intensity (138). Temporal pattern (which includes breakthrough pain), ranked as the second most important dimension, was covered by 29 items only. Many tools include dimensions and items of limited relevance for patients with advanced cancer. This might reduce compliance and threaten the validity of the assessment. New tools should reflect the clinical relevance of different dimensions and be user-friendly.

Humans↗

PubMed1978

Quality considerations in medical records abstracting systems.

Health Information Systems utilizing computerized medical records abstracting services are widely applied to clinical research, utilization review, health statistics, and similar programs. The utility of such systems is determined primarily by the accuracy of stored abstracts. Even very low per-character error rates can result in a relatively high proportion of abstracts in error. Application of quality control procedures and purposeful design of error identification systems is essential for establishing face validity. Acceptance sampling with comparison of abstracts to medical records can be employed to assure content validity.

Abstracting and Indexing↗

PubMed1983

Assessing the outcomes of nursing-home patients.

This paper describes the development of multidimensional measures of nursing-home patients' functioning. The technique was designed to gather information directly from the patients, using demonstrated ability in place of self-report wherever possible. Six domains are tapped: physiologic, activities of daily living, affective, cognitive, social, and satisfaction. Test-retest reliability ranges from .59 for social interaction to .85 for affect. Validity was tested by replication on successive waves of data as well as discriminant and content validity.

Activities of Daily Living↗

PubMed1990

Measurement of stress in clinical nursing.

The Nurse Stress Checklist was developed to measure stress in clinical nursing as a multidimensional construct. The instrument was formulated within a transactional model of stress. The items were derived from five domains thought to contribute to nurse stress in clinical settings and were organized into a questionnaire. Holmes Schedule of Recent Events was included as a validity measure. The instrument was tested on 104 staff nurses working in three institutions in an urban community. Exploratory factor analysis was applied to the 74 items presented to subjects in Likert-type format. Five factors were derived and subjected to psychometric evaluation. Internal consistency reliability for the five factors was good, ranging from 0.80 to 0.91. Means and measures of dispersion supported the potential of the five subscales to discriminate among respondents on the attributes being measured. Intercorrelations of the factors provided evidence of the distinctiveness of the five components of stress, although factor loadings showed some overlap between Personal Reactions and Work Concerns and Work Concerns and Work Completion Concerns. Validity of the factors also was supported by correlations with Holmes' Schedule of Recent Events. Content validity was supported by comparison of these results with findings of other investigators. Limitations of the results are discussed, and recommendations for future work on the instrument are offered.

Adult↗

PubMedDate not supplied

The hearing handicap inventory for the elderly: a new tool.

This report describes the development and standardization of the Hearing Handicap Inventory for the Elderly (HHIE). This self-assessment tool is designed to assess the effects of hearing impairment on the emotional and social adjustment of elderly people. The inventory is comprised of two subscales: a 13-item subscale explores the emotional consequences of hearing impairment; a 12-item subscale explores both social and situational effects. The inventory was administered to 100 elderly subjects (mean age = 75 years) with hearing threshold levels in the better ear ranging from normal to severe. The reliability of the HHIE was evaluated by assessing its internal consistency through the computation of Chronbach's alpha. Alpha values ranged from 0.88 (social/situational subscale) to 0.95 for the entire inventory. Split-half reliabilities were equally high. The validity of the HHIE was not directly evaluated. Certain aspects of the data, however, support the construct validity of the instrument, while analysis of the questions themselves appears to attest to its content validity. Possible uses of the inventory were described and suggestions were made regarding future research on the instrument. The reliability and validity of the HHIE as well as its brevity, simplicity, and ease of administration and interpretation all recommend its use in assessing hearing handicap in the elderly.

Aged↗

PubMed2005

Preliminary validation of the Chinese version of the Pediatric Quality of Life Inventory.

The Pediatric Quality of Life Inventory (PedsQL) is a scale for assessing health-related quality of life of children and adolescents aged 2--18 years. Three reports of PedsQL for the age ranges 2--4 years and 5--7 years were translated into Chinese and their validities were examined. A total of 186 children and parents were involved in the study. Content validity, test-retest reliability, internal consistency reliability and construct validity were assessed. The correlation of parents' and children's reports was also examined. The results showed that the internal consistency is generally good, test-retest reliability ranged from moderate to good, differences between disabled and non-disabled individuals are significant in total scores and in all subscales except for the physical functioning subscale for the children's self-report for the age ranges of 2-4 years and 5-7 years and the correlation between the reports of the parents and children for the age range of 5-7 years is moderate to high. This suggests that the newly translated Chinese PedsQL for children aged 2-4 years and 5-7 years seems to be reliable and valid to be used as a measure of health-related quality of life in Chinese pediatric research and clinical applications.

Asian People↗

PubMed1997

Comparison of the Musculoskeletal Function Assessment questionnaire with the Short Form-36, the Western Ontario and McMaster Universities Osteoarthritis Index, and the Sickness Impact Profile health-status measures.

We compared the reliability, validity, and responsiveness of the Musculoskeletal Function Assessment (MFA) questionnaire with those of three commonly used health-status measures: the Short Form-36 (SF-36), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Sickness Impact Profile (SIP). The MFA, like the other health-status measures, demonstrated good reliability (intraclass correlation coefficients of more than 0.70), good sensitivity and specificity (more than 70 per cent), good criterion validity that correlated with physicians' ratings (p < 0.01), and good construct validity that correlated with the characteristics of the patients (p < 0.01). It also demonstrated better content validity than the other questionnaires, with no ceiling or floor effects for the total score. In addition, it was more responsive than the SF-36; for eight of the eleven comparisons, it was more efficient (relative efficiency of more than 2.00) in measuring changes in function between the baseline values and the values determined at the latest follow-up evaluation. These findings suggest that the MFA can be used to assess the health status of patients who have a musculoskeletal disorder.

Activities of Daily Living↗

PubMed2006

Reliability and validity of a Thai version of the General Practice Assessment Questionnaire (GPAQ).

BACKGROUND: The Assessment Questionnaire (GPAQ) is a questionnaire for patients to evaluate primary care in a number of key areas ranging from the access to care, the helpfulness of receptionists, the continuity of care, the doctors'communication skills, the patient's knowledge of self the General Practice care plans after consultation, and overall satisfaction. All questions can be calculated as a GPAQ score allowing services to be analysed, developed, and improved. OBJECTIVE: The General Practice Assessment Questionnaire (GPAQ) was developed in the United Kingdom to evaluate the quality of general practice (i.e. primary care or family medicine). The aim of the present study was to translate and validate a Thai language version of GPAQ. MATERIAL AND METHOD: Cross-sectional study: the content validity was examined by three experts in the Family Medicine field, and then the original GPAQ was translated into Thai with permission from the National Primary Care Research and Development Centre, University of Manchester and Safran. The translation process followed the guidelines for cross-cultural adaptation of self-report measures, including forward translation, synthesis of the translation, back translation, cross-cultural adaptation and pre-testing. The pilot study was done by distributing the questionnaire to a sample of 30 people before revision of the questionnaire. The reliability and validity of the translated version was then examined by distributing the questionnaire to 2,600 people visiting the out-patient clinic at the Department of Family Medicine, Ramathibodi Hospital in October, 2005. RESULTS: The response rate is about 70 percent. The results of the present study showed that the Thai version of GPAQ achieved good levels of reliability and validity, with the range of Cronbach's alpha coefficients being 0.7293-0.8324 in each aspect of GPAQ, namely access, doctor's communication skills, and patient enablement (understanding of self care after the consultation). However, a question about telephone consultations had to be excluded from the questionnaire to reach Cronbach's alpha coefficient of 0.8221. CONCLUSION: After translation and cross-cultural adaptation the Thai version of GPAQ can be used as a patient-administered instrument to evaluate the quality of primary care in Thailand.

Adolescent↗

PubMed1981

Construct validity of an empathy instrument.

The purpose of the study was to determine the construct validity of the Empathy Construct Rating Scale (ECRS), developed as part of a larger investigation. Two procedures were used: (a) Campbell and Fiske's (1959) multitrait- multimethod approach and (b) factor analysis. The results suggest that the ECRS is a valid and a reliable instrument for measuring empathy. It was shown to have high internal consistency, content validity, and discriminant validity. Results of the factor analysis placed the rating scale in the primary factor, sharing that factor with no other measured trait. The results further suggest that empathy cannot be divided meaningfully into subscales; empathy exists as a whole and all elements must be present in the relationship for it to exist.

Adult↗

PubMed2003

Simulators, first experiences.

It is increasingly being recognized that laparoscopic surgery poses specific strains on the surgical novice. Specific psychomotor skills are required, which cannot easily be acquired by extrapolation from open surgery. Also, limited teaching time in the strict surgical training curricula makes it difficult to acquire such skills. Two surgical simulation platforms, the Advanced Dundee Psychomotor Tester (ADEPT(R)), and the Xitact LS500(R), are objects of study in our hospital for the training and objective assessment of laparoscopic task performance. Multiple validation studies, both at our center and at other institutions, are ongoing. Face-construct and content validity of the two systems under investigation have been established at our skills laboratory. This article highlights the most important findings of our studies using simulative surgical lapraoscopic technologies.

Journal Article↗

PubMed1999

The psychometric properties of clinical rating scales used in multiple sclerosis.

OullII;l y Many clinical rating scales have been proposed to assess the impact of multiple sclerosis on patients, but only few have been evaluated formally for reliability, validity and responsiveness. We assessed the psychometric properties of five commonly used scales in multiple sclerosis, the Expanded Disability Status Scale (EDSS), the Scripps Neurological Rating Scale (SNRS), the Functional Independence Measure (FIM), the Ambulation Index (AI) and the Cambridge Multiple Sclerosis Basic Score (CAMBS). The score frequency distributions of all five scales were either bimodal (EDSS and AI) or severely skewed (SNRS, FIM and CAMBS). The reliability of each scale depended on the definition of 'agreement'. Inter-and intra-rater reliabilities were high when 'agreement' was considered to exist despite a difference of up to 1.0 EDSS point (two 0.5 steps), 13 SNRS points, 9 FIM points, 1 AI point and 1 point on the various CAMBS domains. The FIM, AI, and the relapse and progression domains of the CAMBS were sensitive to clinical change, but the EDSS and the SNRS were unresponsive. The validity of these scales as impairment (SNRS and EDSS) and disability (EDSS, FIM, AI and the disability domain of the CAMBS) measures was established. All scales correlated closely with other measures of handicap and quality of life. None of these scales satisfied the psychometric requirements of outcome measures completely, but each had some desirable properties. The SNRS and the EDSS were reliable and valid measures of impairment and disability, but they were unresponsive. The FIM was a reliable, valid and responsive measure of disability, but it is cumbersome to administer and has a limited content validity. The AI was a reliable and valid ambulation-related disability scale, but it was weakly responsive. The CAMBS was a reliable (all four domains) and responsive (relapse and progression domains) outcome measure, but had a limited validity (handicap domain). These psychometric properties should be considered when designing further clinical trials in multiple sclerosis.

Activities of Daily Living↗

PubMed2004

Constructing and validating a consumer health portal rating index.

Web-based consumer health information portals are on the increase. With such a large number of health related sites available, design and information quality are key concerns. This article provides an evaluation framework based on the work of Slack (2001) and the HONcode guidelines. Research shows that greater transparency is needed with regard to how rating instruments are constructed and validated. The consumer health portal index developed in this research has been tested for face and content validity through a series of focus groups following Sullivan's 5 step process.

Evaluation Studies as Topic↗

PubMed1993

Measuring managerial motivation: the Power Management Inventory.

Psychometric properties for Part I of the Power Management Inventory (Hawker & Hall, 1981) are presented following validation of the instrument with samples of nurse managers (N = 54) and executives (N = 92). The content validity indices were .85 for management issues (item stems), .65 for Personalized Power (PP), .75 for Socialized Power (SP), and .70 for Affiliative Motive (AM) scales. Internal consistency reliabilities were acceptable (.63 to .87). Test-Retest correlations (n = 19 managers) ranged from .74 to .85. Correlation of nurse manager (n = 50) scores with subordinate scores of managers were significant (p < .05) for PP (r = .32) and AM (r = .29). Correlation of nurse executive (n = 59) scores with chief executive officer scores of executives were significant for PP (r = .32, p < .01) and AM (r = .25, p < .05). Mean scores of PP, SP and AM failed to profile the motive pattern for "successful" managers. About 29% of the managers and 39% of the executives were categorized as having no power motive preference. Use of the PMI for career counseling/decisions in nursing is not recommended, however, its use as an organizational development tool is endorsed.

Humans↗

PubMed1994

Evaluation of a German version of the physical dimensions of the Health Assessment Questionnaire in patients with rheumatoid arthritis.

OBJECTIVE: Our objective was to translate and adapt the disability section of the health assessment questionnaire (HAQ) into German (HAQ-G) to suit Swiss-German conditions and to test its metric properties, reliability, and validity. METHODS: We tested 62 consecutive patients with rheumatoid arthritis (RA) attending the outpatient Clinic of the Department of Rheumatology, University Hospital Zurich. All patients fulfilled the American Rheumatism Association 1987 revised criteria for RA. The translation was done by 2 translators aware of the objective of the questionnaire and some questionable items were discussed and resolved in a panel by 4 rheumatologists including one bilingual clinical researcher. Test-retest reliability was assessed with Pearson's correlation coefficient on the scores of 2 questionnaire mailed in a 10-day interval. The internal consistency was assessed with Cronbach's coefficient alpha. To assess the construct validity, we compared the HAQ scores to clinical, laboratory, and radiological variables of disease activity and outcome. To assess criterion validity, we compared physicians' assessment of functional class (observed disability) to the HAQ (referred disability). The content validity was assessed in a multivariate model explaining HAQ scores with a variety of other measurements of disease activity and outcome. RESULTS: The test-retest reliability was 0.94; the internal consistency was 0.92; the criterion validity was 0.76; and correlations with other disease variables ranged from 0.39 (Larsen radiological score) to 0.66 (grip strength). CONCLUSION: The HAQ-G is a reliable and valid instrument for measuring functional disability in a German speaking population with RA.

Aged↗