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Reproducibility and validity of a simple checklist-type questionnaire for food intake and dietary behavior.

BACKGROUND: A simple, reliable, and valid food questionnaire is needed in clinical dietary assessments, community health education, and multi-purpose epidemiologic studies to obtain a crude measure of dietary intake. METHODS: To assess the validity and reproducibility of a simple 4-point scale food intake and behavior checklist, it was compared to two 3-day weighed dietary records. The FBC was administered to 47 students of a dietician course and their parents (n = 94) over a 9-month interval to assess the reproducibility. The mean intakes of selected food groups assessed by the two dietary records completed between food intake and behavior checklists were compared to the responses to the food intake and behavior checklist to assess its validity. RESULTS: The kappa statistics for reproducibility ranged from 0.25 for confectionaries to 0.63 for a preference for fatty foods (median, 0.39). There was a reasonable level of correlation between the dietary record and the food intake and behavior checklist in the intake of eggs, milk, and fruits (r = 0.53, 0.56, and 0.50, respectively). There was a weaker but still significant correlation in the intake of vegetables, and alcohol (r = 0.31 and 0.45, respectively). No significant correlation was observed in the intake of meat, fish, confectionaries, and soft drinks. However, those who reported consuming mainly fish rather than meat were found to eat significantly less meat and animal fat. Similarly, those who did not prefer fatty foods consumed significantly less meat, animal fat, and polyunsaturated fatty acids. CONCLUSIONS: This simple food checklist was useful in collecting data on egg, milk, and fruit consumption. Assessing intake frequency of vegetables, meat or fish with the FBC may be useful in screening high- or low-intake individuals.

Adult↗

Validity of the Amsterdam Child Behavior Checklist: a short rating scale for children.

The Amsterdam Child Behavior Checklist is a short behavior checklist meant to distinguish between attention problems and several other common behavioral and emotional problems of children in primary education. The list has four scales, Attention Behavior, Restlessness, Aggressive Behavior, and Fear/Uncertainty. We examined the relationships among the scores on the scales and similar scales of the Teacher Report Form, the teachers' version of the Child Behavior Checklist. Teachers from 94 schools rated 454 children on both lists. Analysis showed that the associations between the scores of the scales of the Amsterdam Child Behavior Checklist and of similar scales of the Teacher Report Form ranged from moderate to strong. These data support the validity of the scales of the Amsterdam Child Behavior Checklist.

Attention Deficit Disorder with Hyperactivity↗

Improving the quality of randomized controlled trials in Chinese herbal medicine, part IV: applying a revised CONSORT checklist to measure reporting quality.

OBJECTIVE: To discuss the quality of reporting in randomized controlled trials (RCTs) of Chinese herbal medicine (CHM), and to provide suggestions for improving the reporting of future clinical studies in this therapeutic area. METHODS: A search of the Cochrane Library was conducted to identify RCTs of CHM. A revised CONSORT checklist designed for CHM clinical studies was implemented. The revised CONSORT checklist contained 63 items, including the following new items added specifically for CHM: (1) "syndrome of disease" based on Chinese medicine theories; (2) rationale of CHM formula; (3) formula composition; (4) preparation form of CHM; (5) quality control of CHM. RESULTS: The overall reporting quality of the RCTs as assessed with the revised CONSORT checklist varied between 19% and 44%, with a median score of 32% (standard deviation 8%). CONCLUSION: The overall quality of reporting of RCTs of CHM evaluated with a revised CONSORT checklist was poor, reflecting the need for improvements in reporting future clinical trials in this area. RECOMMENDATIONS: To improve the quality of reporting of RCTs of CHM, we recommend adopting a revised CONSORT checklist that includes items specific to CHM. We also recommend that editors of CHM journals require authors to use a structured approach to presenting their trials as a condition of publication.

Drugs, Chinese Herbal↗

Use of a standardised checklist to assess peripheral sputum smear microscopy laboratories for tuberculosis diagnosis in Uganda.

SETTING: TB diagnostic units in Uganda. OBJECTIVES: To assess and improve the supervision and performance of sputum smear microscopy in the peripheral diagnostic units in Uganda using a standardised laboratory checklist. DESIGN: A standardised checklist was developed and used during the quarterly supervisory visits of the District TB and Leprosy Supervisors for five quarters from the fourth quarter of 1997 until the last quarter of 1998. Individual peripheral laboratory performance was monitored during the study period. RESULTS: Forty-eight of 304 TB diagnostic units in six of the 45 Ugandan Districts were supervised using the checklist. A total of 208 checklists were analysed. The situational analysis of the peripheral diagnostic units at the beginning and at the end of the study showed a marked improvement in laboratory performance in all aspects related to sputum smear microscopy. Individual laboratory performance was monitored over five quarters, and timely response to shortcomings was provided. CONCLUSION: The systematic use of a standardised laboratory checklist can be considered an important step forward in improving the performance of the peripheral laboratories in Uganda through on-the-spot correction of any identified shortcomings.

Bacteriological Techniques↗

Checklist of perceptual-motor and language skills for developmentally handicapped preschoolers.

This report describes the development of a checklist of perceptual-motor and language skills which has been designed to identify specific skills and to estimate acquisition of skill in 21 developmentally delayed preschoolers. The preschoolers were administered the checklist at the beginning and end of the school year. Significant mean differences between early and late total checklist scores were obtained. The correlation between early and late total checklist scores was .97. The chief advantages of this checklist are the specificity of assessment and the ease with which it may be used by professionals and paraprofessionals.

Art↗

Epiluminescence microscopy for the diagnosis of doubtful melanocytic skin lesions. Comparison of the ABCD rule of dermatoscopy and a new 7-point checklist based on pattern analysis.

OBJECTIVE: To compare the reliability of a new 7-point checklist based on simplified epiluminescence microscopy (ELM) pattern analysis with the ABCD rule of dermatoscopy and standard pattern analysis for the diagnosis of clinically doubtful melanocytic skin lesions. DESIGN: In a blind study, ELM images of 342 histologically proven melanocytic skin lesions were evaluated for the presence of 7 standard criteria that we called the "ELM 7-point checklist." For each lesion, "overall" and "ABCD scored" diagnoses were recorded. From a training set of 57 melanomas and 139 atypical nonmelanomas, odds ratios were calculated to create a simple diagnostic model based on identification of major and minor criteria for the "7-point scored" diagnosis. A test set of 60 melanomas and 86 atypical nonmelanomas was used for model validation and was then presented to 2 less experienced ELM observers, who recorded the ABCD and 7-point scored diagnoses. SETTINGS: University medical centers. PATIENTS: A sample of patients with excised melanocytic lesions. MAIN OUTCOME MEASURES: Sensitivity, specificity, and accuracy of the models for diagnosing melanoma. RESULTS: From the total combined sets, the 7-point checklist gave a sensitivity of 95% and a sepcificity of 75% compared with 85% sensitivity and 66% specificity using the ABCD rule and 91% sensitivity and 90% specificity using standard pattern analysis (overall ELM diagnosis). Compared with the ABCD rule, the 7-point method allowed less experienced observers to obtain higher diagnostic accuracy values. CONCLUSIONS: The ELM 7-point checklist provides a simplification of standard pattern analysis because of the low number of features to identify and the scoring diagnostic system. As with the ABCD rule, it can be easily learned and easily applied and has proven to be reliable in diagnosing melanoma.

Humans↗

Adequacy of interviews vs checklists for classifying childhood psychiatric disorder based on parent reports.

BACKGROUND: The advantages and disadvantages of lay-administered structured interviews and self-administered problem checklists for estimating prevalence and associated features of childhood psychiatric disorder have attracted little comment. This article compares the scientific adequacy of these 2 instruments for classifying DSM-III-R categories of childhood psychiatric disorder in general population samples. METHODS: Study data are from parental assessments of 251 children aged 6 to 16 years participating in a 2-stage measurement evaluation study. Reliability and validity were compared between the Diagnostic Interview for Children and Adolescents (the structured interview in the study) and the revised Ontario Child Health Study scales (the self-administered problem checklist used in the study). RESULTS: Reliability estimates based on the kappa statistic were comparable for the 2 instruments and ranged from 0.21 (conduct disorder) to 0.70 (depression) on the lay interview and from 0.17 (depression) to 0.61 (oppositional defiant disorder) on the self-administered checklist. Validity coefficients tended to favor the checklist categories, but only marginally. CONCLUSIONS: On balance, differences in reliability and validity were small between the 2 instruments. These differences would appear to have no discernible impact on the knowledge about prevalence and associated features of disorder generated by use of such instruments in general population surveys.

Adolescent↗

Normative and validity data for the Missouri Children's Behavior Checklist.

Presented normative data, collected on an unselected sample of 302 7- and 9-year-old children, for the Missouri Children's Behavior Checklist. Boys were found to be rated as more deviant than girls, while age, occupation of head of household, and estimated IQ were found to be unrelated to checklist ratings of deviant behavior. The use of a cutting point on the Total Pathology Scale of the checklist derived from the normative data identified a group of clinic children, 89% of whom were found to be in need of professional attention. The potential usefulness of the checklist as an aid in making important clinical decisions is discussed, as is the need for more extensive normative data.

Adolescent↗

Cognitive impairment in depressed outpatients as measured with the Dementia Checklist: a simple method for primary care and in field research.

The Dementia Checklist is a 12-item dementia rating scale for physicians who, for whatever reason, cannot be specifically trained. It addresses symptoms of cognitive decline that can easily be identified, and that are typical for different stages of cognitive impairment. This allows an easy classification of the severity of dementia. In a first study, the dementia checklist was used in 937 geriatric outpatients who were treated by neuropsychiatrists for depression. All items contribute to the accuracy of measurement (Cronbach's alpha = 0.84). Differences in cognitive impairment depending on age (chi 2 = 51.7; p < or = 0.001) and depression (chi 2 = 47.6; p < or = 0.001) indicate external validity of the dementia checklist and 5.7% of the outpatients were rated as demented. The Dementia Checklist provides a very economical and easy-to-use assessment of cognitive decline.

Age Factors↗

Screening for autism in young children: The Modified Checklist for Autism in Toddlers (M-CHAT) and other measures.

The literature on the importance of early identification and early intervention for children with developmental disabilities such as autism continues to grow. The increased prevalence of autistic spectrum disorders has fostered research efforts on the development and validation of autism-specific screening instruments for use with young children. There are currently several such autism-specific screening tools meant to be used with young children in various stages of development. Data from a few of these screening instruments have been published, and they include the Checklist for Autism in Toddlers (CHAT), Pervasive Developmental Disorders Screening Test (PDDST), Screening Tool for Autism in Two year olds (STAT), Checklist for Autism in Toddlers-23 (CHAT-23), and the Modified Checklist for Autism in Toddlers (M-CHAT). In this review, these five tools designed for use with children under three years old will be highlighted. In particular, the Modified Checklist for Autism in Toddlers (M-CHAT) will be discussed.

Age Factors↗

Convergence of clinically derived diagnoses and parent checklists among inpatient children.

The extent to which parent rating scales differentiated children according to DSM III diagnoses was examined. A total of 113 psychiatric inpatient boys (ages 6-11) were rated by their mothers or maternal figures on the Child Behavior Checklist (CBCL) and the Behavior Problem Checklist (BPC). Children with DSM III diagnoses of conduct disorder or depression were compared to children without these diagnoses. Externalizing and internalizing scales of the parent checklists and additional measures of child aggression and depression differentiated children according to major diagnoses. The use of parent checklists to classify children indicated a high level of sensitivity for CBCL and BPC scales for diagnosing conduct disorder and depression. However, specificity of the subscales, particularly for the CBCL, was relatively low, indicating a high rate of false positives. The need for further work that extends the range of diagnosis, that examines subtypes of disorders, and that increases the specificity of the measures for diagnostic purposes is discussed.

Aggression↗

Methodological considerations in the evaluation of the convergence of psychiatric diagnoses and parent-informant checklists.

Psychiatric diagnoses and objective parent checklists are alternative ways to describe child adjustment problems. There has recently been interest in evaluating the degree of agreement or convergence between these sources of information. This paper addresses three issues neglected by researchers in this area. The appropriateness of the use of indices of sensitivity and specificity to describe the correspondence of diagnoses and checklist scores is questioned. Implications of failure to consider the reliability of diagnoses in interpreting diagnosis-checklist agreement are discussed. Also, possible parameters of diagnosis-checklist agreement that should be identified by researchers are reviewed. Suggestions for improving research in this area are offered.

Child↗

The relationship between checklist scores on a communication OSCE and analogue patients' perceptions of communication.

Many efforts to teach and evaluate physician-patient communication are based on two assumptions: first, that communication can be conceptualized as consisting of specific observable behaviors, and second, that physicians who exhibit certain behaviors are more effective in communicating with patients. These assumptions are usually implicit, and are seldom tested. The purpose of this study was to investigate whether specific communication behaviors are positively related to patients' perceptions of effective communication. Trained raters used a checklist to record the presence or absence of specific communication behaviors in 100 encounters in a communication Objective Structured Clinical Examination (OSCE). Lay volunteers served as analogue patients and rated communication during each encounter. Correlations between checklist scores and analogue patients' ratings were not significantly different from zero for four of five OSCE cases studied. Within each case, certain communication behaviors did appear to be related to patients' ratings, but the critical behaviors were not consistent across cases. We conclude that scores from OSCE communication checklists may not predict patients' perceptions of communication. Determinants of patient perceptions of physician communication may be more subtle, more complex, and more case-specific than we were able to capture with the current checklist.

Aged↗

A checklist to evaluate a report of a nonpharmacological trial (CLEAR NPT) was developed using consensus.

BACKGROUND AND OBJECTIVE: To develop a checklist of items measuring the quality of reports of randomized clinical trials (RCTs) assessing nonpharmacological treatments (NPTs). STUDY DESIGN AND SETTING: The Delphi consensus method was used to select and reduce the number of items in the checklist. A total of 154 individuals were invited to participate: epidemiologists and statisticians involved in the field of methodology of RCTs (n = 55), members of the Cochrane Collaboration (n = 41), and clinicians involved in planning NPT clinical trials (n = 58). Participants ranked on a 10-point Likert scale whether an item should be included in the checklist. RESULTS: Fifty-five experts (36%) participated in the survey. They were experienced in systematic reviews (68% were involved in the Cochrane Collaboration) and in planning RCTs (76%). Three rounds of the Delphi method were conducted to achieve consensus. The final checklist contains 10 items and 5 subitems, with items related to the standardization of the intervention, care provider influence, and additional measures to minimize the potential bias from lack of blinding of participants, care providers, and outcome assessors. CONCLUSIONS: This tool can be used to critically appraise the medical literature, design NPT studies, and assess the quality of trial reports included in systematic reviews.

Consensus↗

Long-term efficacy of a checklist to improve patient education in cardiology.

In a randomised controlled trial a Frequently Asked Questions (FAQ) checklist intended to prepare coronary artery disease (CAD) outpatients for a medical check-up visit at the cardiologist was evaluated. The checklist was mailed to patients in preparation to their visits after 1, 4 and 10 months following patients' discharge from hospitalisation for CAD. It was hypothesised that the intervention would result in lower state anxiety, better patient-doctor communication, more knowledge of CAD and greater patient satisfaction, while it would not result in longer visits. Repeated measurements analyses of covariance showed that experimental patients (N = 46) were less anxious before the first visit. This visit was shorter than in the controls, though the third visit was longer. Control patients (N = 59) showed more CAD knowledge than experimental patients at the first and third visit. Experimental patients found the checklist useful, though its value diminished at subsequent visits. Using the checklist thus decreased anxiety prior to the first visit and the duration of that visit, while negatively affecting knowledge. No conclusions about long-term effects could be drawn, due to the likelihood of type II and type III errors. Process evaluation indicated that the approach used is not sufficiently stimulating for patients to use as a preparation to every visit.

Aftercare↗

Signalising psychosocial problems in cancer care :the structural use of a short psychosocial checklist during medical or nursing visits.

OBJECTIVE: In this summary of literature, we evaluated 16 studies with respect to recognition and screening for psychosocial problems of cancer patients during nursing or medical visits, and with respect to the effects of providing quality of life information during these visits. METHODS: A review of the literature was conducted. To obtain the relevant literature, a search was made of two databases: Medline and Nursing and Allied Health Literature. The literature from the last 12 years - from 1993 till 2004 - was selected. RESULTS: The results show that in a number of studies a gap is demonstrated between the presence of cancer patients' psychosocial problems and health care providers' ability to signalise these problems adequately. The outcomes of these studies further show that the use of a psychosocial checklist is helpful in screening and communicating psychosocial problems, and that supplying information about quality of life facilitates provider-patient communication about these issues. CONCLUSION: None of the studies, however, provides extensive insight into the feasibility of a psychosocial checklist in daily oncology practice. Implementation projects have to be conducted focussing on conditions that block or facilitate the use of a psychosocial checklist in daily practice. PRACTICE IMPLICATIONS: By monitoring blocking and facilitating conditions strictly and, if necessary, by adjusting them, we can create guidelines to make the use of a psychosocial checklist feasible.

Communication↗

Development and preliminary validation of the pain assessment checklist for seniors with limited ability to communicate (PACSLAC).

The purpose of this study, conducted in three phases, was to develop a clinically useful observational tool (i.e., the Pain Assessment Checklist for Seniors With Limited Ability to Communicate [PACSLAC]) to assess pain in seniors with severe dementia. In Phase 1, professional caregivers of seniors with severe dementia were interviewed in order to generate a list of pain-related behaviors that are characteristic of care recipients living in long-term-care facilities. Based on a systematic examination of interview transcripts by experienced researchers and an independent coder, a behavioral checklist (i.e., the initial version of the PACSLAC) was developed. The checklist items were organized into conceptually based subscales (e.g., facial expressions, activity/body movement). Phase 2 focused on an assessment of the internal consistency of the checklist (alpha =.92). Following an item analysis, the subscales of the PACSLAC (Social/Personality/Mood Indicators, Facial Expressions, Activity/Body Movement, and Physiological Indicators/Eating/Sleeping Changes/Vocal Behaviors) were found to be internally consistent. Phase 3 focused on a preliminary validation of the PACSLAC. Analyses suggest that the PACSLAC discriminated among pain events (during which there was a clear and recognizable cause for the patients' pain), events during which patients were experiencing nonpainful distress, and situations during which patients were calm.

Adult↗

Nutrition Screening Initiative Checklist may be a better awareness/educational tool than a screening one.

OBJECTIVE: To evaluate the Nutrition Screening Initiative (NSI) checklist as a screening and an awareness/educational tool in an elderly population. DESIGN: Epidemiologic follow-up study. Information similar to the questions of the NSI checklist was collected by the Nutrition Status Survey of Boston elders between 1981 and 1984. Vital status of volunteers was obtained during 8 to 12 years of follow-up. SUBJECTS/SETTING: Community-dwelling men (n = 200) and women (n = 381) aged 60 years and older who participated in the survey. STATISTICAL ANALYSES PERFORMED: Multivariate analysis was used to assess the association between mortality and each of the NSI-similar questions and the cumulative score, which is the sum of the values assigned to each question. Attributable risk percent, a measure of association, was calculated to measure the percentage of deaths that could potentially be prevented if the risk factors or their consequences were eliminated. RESULTS: Eating meals alone, problems biting or chewing, difficulties with shopping or cooking, and taking more than three medications per day were positively associated with mortality (P < .05). The cumulative score, although significant, was a weaker predictor of mortality. Attributable risk percent of mortality was 19.9% and 51.2% for men and women, respectively. APPLICATIONS/CONCLUSIONS: Some but not all of the individual questions of the NSI checklist equivalent were significantly associated with mortality and identify specific problems that may have a long-term negative effect yet may be missed if the cumulative score were the sole criterion for screening people. The attributable risk percent suggests that the checklist may be best used as an awareness/educational tool as intended originally and could have an important public health effect on early death of community-dwelling elderly people.

Aged↗