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PubMed2005

Recognition of delirium in ICU patients: a diagnostic study of the NEECHAM confusion scale in ICU patients.

BACKGROUND: A delirium, is a serious, high-frequency complication in intensive care unit (ICU) patients. The consequences of this complication range from high morbidity and mortality to greater need for nursing care. Despite these, delirium is often not recognized and there for not treated. In this study a nursing screening instrument, the NEECHAM confusion scale, was studied for early recognition of delirium ICU patients. This scale proved valid and reliable in several studies in the general hospital population. METHODS: In this study validity and reliability were tested in a prospective cohort of 105 patients. Gold standard for delirium was an independent DSM-IV diagnosis. User friendliness was tested by structured evaluation of nurses' experiences working with the scale. RESULTS: The NEECHAM confusion scale showed high internal consistency (Cronbach's alpha 0.88) and an interrater reliability of Cohen's Kappa 0.60. The concurrent validity with the DSM-IVcriteria showed a strong link (chi-square 67.52, p [less than or equal to] 0.001). Sensitivity was high, 97% and specificity was good 83%. ICU nurses completed the NEECHAM confusion rating in 3.69, +/- 1.21 minutes average. In general the nurses were positive about the NEECHAM confusion scale. They were able to collect data during regular care, but experienced problems in rating the scale in intubated patients. The items in themselves were clear, the content validity, measured by the language used was rated good. CONCLUSION: The psychometric characteristics of the NEECHAM confusion scale of this ICU study are generally consistent with validity research previously reported for the general hospital population. The psychometric characteristics and the ease of use of the NEECHAM confusion scale enables ICU nurses to early recognize delirium. Further study, especially in intubed patients is recommended.

Journal Article↗

PubMed2003

Patient centered assessment of ankylosing spondylitis-specific health related quality of life: evaluation of the Patient Generated Index.

OBJECTIVE: To evaluate the Patient Generated Index (PGI) for the measurement of individualized health related quality of life in ankylosing spondylitis (AS). METHODS: The PGI asks patients to nominate areas of their lives affected by their disease that they consider the most important. Semistructured interviews with AS patients produced a trigger list of areas of life affected by AS. The PGI was self-completed by UK patients taking part in a multicenter postal survey. The instrument was assessed for data quality, reliability, validity, and responsiveness. RESULTS: The PGI had acceptable completion rates. Scores covered the available range and approximated normality. Test-retest reliability estimates support the use of the PGI in group evaluation (intraclass correlation coefficient > 0.80). Comparisons with scores for other health status instruments provided evidence for the validity of the PGI. The largest levels of correlation were found for the AS Quality of Life Questionnaire (ASQoL) and the EuroQol. The informed and open format of the PGI had the strongest linear relationship with responses to both specific and general health transition questions (p < 0.01), and was the most responsive format of the PGI. CONCLUSION: The PGI is the first AS-specific individualized measure of health related quality of life. There is good support for the content validity of the instrument and patient acceptability is high. Adequate levels of data quality and reliability support the use of the PGI in group evaluation. Moderate levels of responsiveness to changes in health were produced by the informed and open format of the PGI.

Adult↗

PubMedDate not supplied

Validating the Interpersonal Communication Assessment Scale.

Despite the centrality of interpersonal communication in nursing, there are few psychometrically sound instruments to measure the communication competencies of undergraduate and graduate nursing students. This article reports on the development and testing of the Interpersonal Communication Assessment Scale (ICAS), which was designed to assess the communication competencies of students in undergraduate and graduate nursing programs. Retroductive triangulation, using both deductive and inductive methods, and the Model of Relational Competence guided the measure's conceptualization and development. We used responses from 531 (24%) undergraduate and graduate clinical faculty from 246 American Association of Colleges of Nursing member schools for the psychometric testing of the 54-item content-validated and pilot-tested ICAS. Exploratory-factor analysis resulted in a three-factor solution labeled as advocacy, therapeutic use of self, and validation. These factors accounted for 60% of the variance. Items that loaded .60 or higher were retained, resulting in a 23-item scale with a Cronbach's alpha of .96. The ICAS significantly differentiated the communication competencies of beginning and graduating students in both undergraduate and graduate programs. The ICAS was found to have construct validity and internal consistency, underscoring its potential as a formative and summative tool to assess the interpersonal communication competencies of nursing students.

Analysis of Variance↗

PubMed2000

Reliability and validity studies of the Facial Discrimination Task for emotion research.

The Facial Discrimination Task (FDT) (Erwin, R.J., Gur, R.C., Gur, R. E., Skolnick, B., Mawhinney-Hee, M., Smailis, J., 1992. Facial emotion discrimination: I. Task construction and behavioural findings in normal participants. Psychiatry Research 42, 231-240.) consists of standardized black-and-white photographs of Caucasian actors exhibiting happy, sad, and neutral faces. Originally designed for brain-imaging research in emotion recognition in schizophrenia and major depression, it has since been successfully employed in emotion recognition studies on mental retardation and psychosomatic disorders. This article presents new basic psychometric data from three studies with a total of 401 college undergraduates. Content validity, item reliability (test-retest, item-total correlation, item difficulty) and test reliability (internal consistency) were established. Happy and sad items were easier to agree upon than neutral ones. In general, happy items had the highest validity, highest test-retest reliability, and highest item-total correlations. Recognition errors of neutral items were biased toward negative affect. Advantages and limitations of the FDT for clinical research applications are discussed.

Adult↗

PubMed1996

Developing and evaluating the student assessment system in the preclinical problem-based curriculum at Sherbrooke.

BACKGROUND: Students' learning was used as an outcome measure in the first phases of the major curriculum reform started in 1987 by the Université de Sherbrooke Faculty of Medicine, which shifted from a traditional to a student-centered, problem-based learning (PBL) and community-oriented program. The system for evaluating preclinical students' learning is intended to reinforce the integration of basic and clinical sciences. METHOD: To discover whether the evaluation system was fulfilling its intended goals, the authors used data from the classes of 1991-1993 to assess the reliability and validity of three evaluation instruments. The three instruments were (1) written examinations composed of multiple-choice questions (MCQs), short-answer questions (SAQs), and problem-analysis questions (PAQs); (2) PBL tutor rating forms that evaluate students' reasoning skills, communication and group-interaction skills, and autonomy and humanism; and (3) clinical skills evaluations, including objective structured clinical examinations (OSCEs). The weights allocated to the instruments reflected how the faculty valued each evaluation dimension in each of the three phases of the preclinical curriculum. RESULTS: Reliability indexes improved throughout the system implementation. The written examinations proved to have content validity according to the PBL learning objectives. As evaluated by students, the PAQs were found to be at a taxonomic level that assessed ability to analyze information a third of the time in the first year of implementation of the PBL curriculum and 17% in the second year. Variations and correlations of students' mean performances across instructional units and between the evaluation instruments led to the development of a student longitudinal performance profile to be used before yearly promotion decisions are proposed. The profile was introduced in the fifth year of PBL implementation. CONCLUSION: The system allows students to learn higher-taxonomic-level content and fulfills the institution's social responsibility of judging program outcomes and promoting qualified students, although evaluation by PBL tutors is still psychometrically questionable and the measurement of students' reasoning and ability to analyze problems is still an unfinished evaluation task.

Clinical Competence↗

PubMed1991

Coronary heart disease knowledge test: developing a valid and reliable tool.

This study tested the validity and reliability of a written test designed to assess knowledge of coronary heart disease (CHD) and its risk factors. The subjects were 93 males diagnosed with CHD. Subjects were classified into a treatment group (n = 48) or a control group (n = 45) based on whether or not they participated in a cardiac rehabilitation program (CRP). An additional 38 subjects were used to pilot test the original form of the knowledge test, which consisted of 80 multiple-choice questions. Content validity was established by a five-member jury of cardiac rehabilitation experts. Each question was rated using a Likert-type scale. Questions that did not receive an average rating of at least four were eliminated. The revised form was pilot tested for validity and internal consistency with the discrimination index (point biserial correlation coefficient) and the Kuder-Richardson formula 20 (KR-20). Questions with a discrimination index of less than 0.14 were eliminated; thus, the final form of the test consisted of 40 questions. Validation of this test yielded difficulty ratings (DRs) between 0 percent and 98 percent, with an average DR of 63 percent. Construct validation indicated that the average test score of subjects participating in a CRP was significantly higher than that of non-participants (t = 3.51, df = 91, p less than or equal to 0.01). The internal-consistency reliability of the test was 0.84. The results indicate that this test is a valid and reliable tool for assessing patients' knowledge of CHD and its risk factors.

Adult↗

PubMed2002

The food amount rating scale: development, reliability, and validity.

OBJECTIVE: Implied in measures of binge eating is the assumption that individuals agree on what comprises a large amount of food. However, whether individuals estimate food amounts similarly or whether estimation of food amounts varies as a function of personal characteristics is unknown. The Food Amount Rating Scale (FARS) is a standardized set of stimuli for assessing individuals' judgment of food amounts. RESEARCH METHODS AND PROCEDURES: Two versions of the FARS were developed, and their psychometric properties were assessed. These versions are the same in all respects except that the rater is instructed to rate various food amounts for the average woman on Form W and for the average man on Form M. RESULTS: Content validity was confirmed by 14 researchers and research assistants in the field of eating disorders. The FARS is a 24-item inventory with adequate test-retest reliability (Form W = 0.85; Form M = 0.87) and split-half reliability (Form W = 0.90; Form M = 0.89). Convergent validity is suggested by the finding that ratings for the average woman (Form W) were significantly higher than ratings for the average man (Form M). DISCUSSION: The FARS is a psychometrically sound tool for use in basic research focused on identifying whether the subjective judgment of food amounts varies as a function of personal characteristics and in clinical research where it may be important to know how individuals judge food amounts.

Adolescent↗

PubMed2005

Developing a self-report outcome measure for complementary and alternative medicine.

OBJECTIVE: Our objective was to develop a pilot measure of subjective outcomes of complementary and alternative medicine (CAM). Current options for assessing subjective outcomes in CAM are either too burdensome or fail to represent diverse outcomes. A single measure specifying common, patient-reported outcomes of CAM would be of value. DESIGN: We conducted a three-phase instrument development study. In phase I, 30 CAM-receiving patients and 12 CAM practitioners completed a battery of standardized measures. Participants identified those standardized items relevant to CAM outcome and suggested additional outcome issues. In phase II, 20 CAM-receiving patients completed a Q-sort to determine which items from phase I were most relevant to CAM outcome. In phase III, five experts reviewed the items from phase II for content validity. SETTING: An integrative medicine clinic at a private, Midwest US hospital. PARTICIPANTS: CAM patients, practitioners, and researchers and an outcomes measurement specialist. RESULTS: In phase I, 30 standardized items were judged relevant to CAM outcome, and 8 additional items were suggested. In phase II, 29 of the 38 phase I items were deemed at least "moderately relevant" to CAM outcome. In phase III, experts added 15 items, dropped 9 items, and altered 3 items. The 35 resulting items were classified into content domains, forming a testable, pilot version of the instrument.

Adult↗

PubMed2000

Validity and reliability of a practice-based infant pain assessment instrument.

The purpose of this study was to determine the validity and reliability of an infantpain assessment instrument. This instrument is an algorithm derived from a model of infant pain assessment that emerged from interviews with pediatric nurses and includes methods for evaluating clinical data that suggest the Iikelihood of pain. Unlike other instruments, this instrument is not restricted to use in clinical situations where the likelihood of pain is evident. This instrument determines the three levels of pain that guide subsequent nursing interventions: no pain, mild pain (discomfort), and severe pain. Content validity was determined by obtaining and incorporating feedback from a focus group of practicing pediatric nurses on various developmental stages of the instrument. Criterion-like validity was excellent: Mean Pearson correlations between the pain ratings of 18 videotaped infants by 24 nursing students using the instrument with ratings performed by a panel of 5 expert nurses not using any instrument was 0.96. Test-retest reliability, as measured by Pearson correlations between pain ratings 3 months apart, was also excellent (r = 0.91).

Humans↗

PubMed2005

Design of a questionnaire to measure trust in an emergency department.

OBJECTIVE: To develop a valid and reliable questionnaire for measuring patient trust in an emergency department (ED) that can be administered by phone, direct interview, or mail. METHODS: This was a survey conducted at a Level 1 urban trauma center with an annual census of 52,000 visits. Literature review, focus group discussions, and direct patient interviews identified potential items for pilot surveys. Fifteen ED nurses, residents, and faculty scored the items on a 1-10 scale, rephrasing or removing ambiguous items to ensure face and content validity. A telephone survey with responses recorded on a five-point Likert scale was conducted. Reliability and internal consistency of items were tested using SPSS software. Factor analyses were performed using principal components analysis and Varimax rotation with Eigen values set at 1.0. RESULTS: A total of 383 patients seen in the ED were surveyed. Using two pilot surveys, 18 of 42 potential items were extracted among five factors identified as important to the development of trust. Internal consistency for the final 18 items was calculated, and a Cronbach's alpha of 0.88 was obtained for all items. Test-retest reliability was calculated by telephoning 38 patients twice, two weeks apart, and correlation coefficients of >0.748 were obtained for all items. CONCLUSIONS: This questionnaire can be used for telephone or direct interview to survey patients' trust in EDs.

Factor Analysis, Statistical↗

PubMed2002

A self-assessment instrument designed for measuring independent mobility in RP patients: generalizability to glaucoma patients.

PURPOSE: To determine whether the patient-based assessment of difficulty in mobility, developed and validated in a group of patients with retinitis pigmentosa (RP), is valid for measuring perceived visual ability for independent mobility in patients with glaucoma. METHODS: A mobility questionnaire that had previously been developed was administered to 83 patient-volunteers who had various amounts of visual impairment caused by glaucoma. Each volunteer rated the perceived difficulty of walking independently in each of 35 mobility situations. A Rasch analysis of the ordinal difficulty ratings was used to estimate interval measures of perceived visual ability for independent mobility. RESULTS: The instrument showed good construct and content validity and high reliability scores. Criterion validity of the instrument was demonstrated by its ability to discriminate mobility-related behaviors such as fear of falling, asking for accompaniment, and believing their ability to travel independently is less than that of persons with normal vision. To make the perceived mobility scale comparable for the two diagnostic groups the questionnaire was restricted to those items whose difference in item-logit distributions was within +/-3 (18 items). Using the same instrument calibration, we compared the person measures between the patients with glaucoma and those with RP. Patients with glaucoma had, on average, higher perceived visual ability for independent mobility than those with RP. CONCLUSIONS: The instrument developed for patients with RP, to determine difficulty across a range of mobility situations, is a valid measure of perceived ability for independent mobility in patients with glaucoma.

Activities of Daily Living↗

PubMedDate not supplied

[Diagnostic usefulness of the Carlsson-Dent questionnaire in gastroesophageal reflux disease (GERD)].

BACKGROUND: Diagnosis of GERD is based on presence of symptoms (heartburn) associated to abnormal esophageal acid exposure or esophageal erosions determined by 24-hr pH monitoring and/or endoscopy, respectively. Different instruments have been evaluated in order to diagnose GERD without invasive studies. Carlsson-Dent questionnaire (CDQ), validated among European patients, have shown good sensitivity and positive predictive values for detection of GERD. Diagnostic usefulness of the CDQ in Mexican patients is unknown. OBJECTIVE: To evaluate usefulness of CDQ among patients with erosive GERD (EG) and non-erosive GERD (NERD). PATIENTS AND METHODS: Consecutive patients with heartburn at least twice per week during the last three months and previous endoscopy were included. All patients answered a self-administered Spanish version of the CDQ, previously evaluated for its content validity and easy application. A score of > or = 4 was considered as positive for GERD. All patients underwent 24-hr pH esophageal monitoring to determine the presence of pathologic reflux (% time pH < 4, > 4.2), as well as the symptom index (SI). Questionnaire's sensitivity (S), specificity (E), positive and negative predictive values (PPV, NPV) were calculated using 24-hr pH monitoring and endoscopic oesophagitis as gold-standard tests. RESULTS: A total of 125 patients were evaluated, 81 women (65%) and 44 men (35%) with an age of 47.9 (21-83). Eighty-six patients (69%) had NERD and 39 (31%) EG. Among patients with NERD, 28 (32%) had abnormal pH study, 10 (12%) had normal pH study with positive SI (> 50%), and 48 (65%) had normal pH study with negative SI. Most common symptom was a burning feeling rising from the stomach or lower chest up towards the neck (classic definition of heartburn) in 53%, noncardiac chest pain in 14%, and nausea in 5%. In 44 patients (35%) the main discomfort occurred within 2 hours of taking food, and in 77% it worsed with larger meals and food rich in fat, as well as in 77% after taking spicy food. One hundred and seven patients (86%) scored > or = 4 on CDQ and there was no significantly difference between CDQ score among groups. CDQ's sensitivity compared to pH monitoring was 89%, and PPV 55%. When compared to endoscopic findings, sensitivity was 94% and PPV 90. There was strong and significative correlation between esophageal acid exposure and higher CDQ's scores. CONCLUSIONS: CDQ in Spanish is an useful instrument for detection of GERD, and its score correlates with the degree of esophageal acid exposure.

Adult↗

PubMed2004

Assessing undergraduate palliative care education: validity and reliability of two scales examining perceived efficacy and outcome expectancies in palliative care.

BACKGROUND: Medical students have traditionally received little education in palliative care. However, in 1999, as part of a revised medical curriculum, Year 4 undergraduates at Liverpool University participated in a 2-week programme of education in palliative care. To assess the effect of the education programme, 2 assessment scales were identified: the Self-efficacy in Palliative Care Scale (SEPC) (assessing efficacy in communication, patient management and multiprofessional teamworking) and the Thanatophobia Scale (assessing attitudes towards palliative care). The aim of this study was to examine the psychometric properties of these scales. METHODS: The scales were examined by 5 palliative care doctors for content validity and appropriate wording. Following this, the SEPC and Thanatophobia Scales were completed by the undergraduates (n = 139) prior to and after completion of the education programme. RESULTS: Both scales were analysed independently on pre- and post-test scores. Cronbach's alphas of 0.84-0.85 and 0.92-0.95 were recorded, respectively, indicating high reliability. Varimax rotated principal components analysis of the SEPC Scale suggested 3 distinct factors, as theoretically expected, with high factor loadings of 0.45-0.89 at pre- and post-test. Principal components analysis of the Thanatophobia Scale suggested only 1 factor underlies the scale, as theoretically expected. All 7 items had high factor loadings of 0.60-0.81 at pre- and post-test. CONCLUSIONS: The results suggest that the SEPC and Thanatophobia Scales are valid and reliable assessment scales that may be of use when evaluating the impact of an education programme.

Curriculum↗

PubMed2003

The development of the LV Prasad-Functional Vision Questionnaire: a measure of functional vision performance of visually impaired children.

PURPOSE: To develop a reliable and valid questionnaire (the LV Prasad-Functional Vision Questionnaire, LVP-FVQ) to assess self-reported functional vision problems of visually impaired school children. METHODS: The LVP-FVQ consisting of 19 items was administered verbally to 78 visually impaired Indian school children aged 8 to 18 years. Responses for each item were rated on a 5-point scale. A Rasch analysis of the ordinal difficulty ratings was used to estimate interval measures of perceived visual ability for functional vision performance. RESULTS: Content validity of the LVP-FVQ was shown by the good separation index (3.75) and high reliability scores (0.93) for the item parameters. Construct validity was shown with good model fit statistics. Criterion validity of the LVP-FVQ was shown by good discrimination among subjects who answered "seeing much worse" versus "as well as"; "seeing much worse" versus "as well as/a little worse" and "seeing much worse" versus "a little worse," compared with their normal-sighted friends. The task that required the least visual ability was "walking alone in the corridor at school"; the task that required the most was "reading a textbook at arm's length." The estimated person measures of visual ability were linear with logarithm of the minimum angle of resolution (logMAR) acuity and the binocular high contrast distance visual acuity accounted for 32.6% of the variability in the person measure. CONCLUSIONS: The LVP-FVQ is a reliable, valid, and simple questionnaire that can be used to measure functional vision in visually impaired children in developing countries such as India.

Adolescent↗

PubMed1998

Comparison of professional judgment versus an algorithm for nutrition status classification.

OBJECTIVES: The classification of a patient's nutrition status is important for identifying patients who require nutrition care, for designing effective nutrition interventions, and for measuring severity of illness. The objective of this study was to evaluate the reliability and validity of two variants of the Department of Veterans Affairs' nutrition status classification: professional judgment versus an algorithm. METHODS: The study consisted of two phases, both of which included providing a sample of approximately 60 registered dietitians and 60 clinical dietetic technicians with data on 16 (phase I) and 20 (phase II) patients, to which they assigned nutrition statuses using both professional judgment and the algorithm. Improvements in instructions and training were implemented between the two phases. Interrater reliability of the responses was calculated, and content validity was measured by comparing the staff's responses with those of an expert panel. RESULTS: Reliability improved significantly between phases for both professional judgment and the algorithm. Greater reliability and validity were observed with use of the algorithm, by both dietitians and technicians, during both phases. CONCLUSION: Classification of a patient's nutrition status is important in the delivery of cost-effective health care. The Department of Veterans Affairs' nutrition status classification is a good one for assessing nutrition status quickly and reliably, especially when an algorithm is used. The results underscore the advantages of a classification system based on an algorithm when the system is designed to be used by many different staff across multiple facilities.

Adult↗

PubMed2001

The psychometric properties of patient preferences in osteoporosis.

OBJECTIVE: Osteoporosis is a chronic disease manifested by wrist, vertebral, and hip fractures that results in significant morbidity and burden to society. About 30% of postmenopausal women have osteoporosis according to the WHO criteria. Women with one vertebral fracture have a 4-fold increased risk of a subsequent fracture. The goal of treatment is to prevent fractures and improve quality of life. Preferences or utilities are now recommended for incorporating quality of life into evaluations of the cost effectiveness of new therapeutic interventions. We evaluated the psychometric properties of preference based measures in osteoporosis. METHODS: Preference scenarios were constructed with a health state classification system. The reliability and validity of the feeling thermometer and the standard gamble was assessed by interviewing 42 women from 4 different patient groups. The sensitivity to change of the feeling thermometer and standard gamble was compared with the Health Utilities Index Mark 2 (HUI2) and SF-36. All subgroups were reassessed about 2 months after their first interview. RESULTS: Preference measurement was feasible in women of different age groups. The reliability coefficients for health states ranged from 0.65 to 0.87. The preference scores for the marker states demonstrated content validity. Convergent validity of the feeling thermometer was supported by a significant correlation with the HUI2 (r = 0.38, p < 0.05) and the physical health summary of the SF-36 (r = 0.56, p < 0.005). The standard gamble did not correlate with the HUI2 (r = 0.15) or the feeling thermometer (r = 0.09), but correlated with 2 domains of the SF-36. The preference measures were sensitive to change, with the efficiency scores ranging from 0.78 to 1.0. CONCLUSION: Preference measurements in the evaluation of osteoporosis are feasible. The feeling thermometer and standard gamble appear to be related to different aspects of health related quality of life. Both instruments were sensitive to change over a 2 month period.

Aged↗

PubMed2006

The validity and reliability of the WHO Schedules for Clinical Assessment in Neuropsychiatry (SCAN Thai Version): Mood Disorders Section.

BACKGROUND: Mood disorders are one of the most prevalent psychiatric disorders that have early onset, are chronic and can cause functional impairment. It is therefore crucial to establish an accurate diagnosis for treatment and research purposes. OBJECTIVES: The authors aimed to test the validity and reliability of the WHO Schedules for Clinical Assessment in Neuropsychiatry (SCAN Thai Version): Mood Disorders Section. MATERIAL AND METHOD: First, psychiatrists competent in the use of the schedules and their underlying objectives tests the linguistic clarity of the Thai psychiatric schedules in four regions of the country. Then between October 2003 and August 2004, Reliability of SCAN: mood disorder section was tested among 30 participants, including mood disordered patients and normal volunteers. RESULTS: Based on reactions from Thais and consultations from competent psychiatrists, content validity was established. The duration of interviews for the mood disorder sections averaged 63.6 min (SD = 17.1). The inter- and intra-rater reliability kappa were 0.80 (0.77-0.83) and 0.86 (0.84-0.88), respectively. The reliability of the majority of items reached substantial to almost perfect agreement; however, 1 item (1%) had only slight agreement and 15 items (12%) had moderate agreement, and needed clarification of the scoring method CONCLUSION: The Mood Disorders Sections of the WHO Neuropsychiatry Schedules for Clinical Assessment (SCAN Thai Version) were effective tools for diagnosing mood disorders among Thais.

Female↗

PubMed1988

[Clinical trial of BOBCAT: 1st report on the reliability and validity of computerized pure-tone audiometry].

Computerized diagnostic audiometry is quickly emerging as a viable productivity tool in the audiology clinic. To date, there has been little reported on its reliability and validity with the hearing-impaired. The 'Battery of Basic Computerized Audiometric Tests' (BOBCAT) is a computer program which puts a wide variety of clinical hearing tests under computer control. The purpose of the present study was to ascertain the reliability and validity of BOBCAT in the measurement of hearing sensitivity. A field study was conducted in a group of 92 workers exposed to noise to measure air- and bone-conduction thresholds. Coefficients of reliability of 0.85 and higher were obtained between air and bone thresholds for both methods of testing; that is, manual and computer-controlled audiometry. The same measurement between manual and computerized air-conduction pure-tone thresholds gave values ranging from 0.93 to 0.98. A principal-components analysis documented content validity of computerized audiometry. These results are interpreted as clear evidence of both reliability and validity of the BOBCAT procedure, with one exception: 6.7% of all observations are showing air-conduction computerized thresholds of -10 dB at one or more frequencies, with no confirmation by manual audiometry. This is attributed to insufficient randomization of intervals between stimuli, a problem which should be taken care of by new versions of the software.

Adult↗