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Results for “Validation study”

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PubMed2026

Artificial intelligence-assisted histopathological diagnosis of endocervical gastric-type adenocarcinoma: a multicenter model development and validation study.

Endocervical gastric-type adenocarcinoma (GAS) is one of the most aggressive subtypes of cervical cancer and is frequently underdiagnosed due to morphological ambiguity, leading to delayed diagnosis. Despite the availability of molecular and genomic assays, their high cost, complexity, and limited reproducibility restrict clinical use. This study therefore proposes a highly sensitive artificial intelligence (AI)-assisted diagnostic system for GAS based exclusively on H&E-stained histopathological images. We included 309 slides from 96 GAS cases collected at Peking University Third Hospital from January 2018 to January 2025, representing the largest GAS cohort reported to date for AI research. In addition, we incorporated other morphologically analogous diseases, encompassing a total of 1,320 slides sourced from four categories: normal cervical mucosa (NORM), benign endocervical lesion entities (BELE), HPV-associated adenocarcinoma (HPVA), and endometrioid carcinoma with mucinous differentiation (ECMD). We developed GASPath, based on a novel multiple instance learning framework that efficiently captures fine-grained morphological variations from H&E-stained images. Beyond internal validation, GASPath was evaluated across 12 independent retrospective cohorts and further subjected to large-scale real-world validation on more than 7,000 samples from March 2024 to April 2025. Across three stages, GASPath demonstrated high performance. In internal validation (Stage I), it achieved an accuracy of 0.980 (95% CI 0.977-0.983) and an ROC-AUC of 0.995 (95% CI 0.994-0.997). In external validation (Stage II), the sensitivity reached 0.902 and improved to 0.968 with proposed strategies. For biopsy samples, GASPath achieved an ROC-AUC of 0.990 (95% CI 0.984-0.997). In large-scale real-world deployment (Stage III, n = 7,056), GASPath achieved a balanced accuracy of 0.953, with 100% sensitivity for GAS (45/45 cases correctly identified). The heatmaps highlight morphological features of GAS that are easily underestimated, such as irregular, angulated glands, subtle loss of nuclear polarity, and mild cytologic atypia, which show substantial morphological overlap with other diagnostic categories. GASPath enables high-sensitivity detection of GAS in routine H&E-stained slides, obviating the need for extensive auxiliary testing while preventing underdiagnosis and misdiagnosis. This advancement addresses a critical gap by streamlining diagnostic workflows without compromising accuracy. Its implementation could enable cost-effective, scalable AI-assisted diagnostics, potentially transforming the early detection and management of this aggressive cancer subtype.

Female↗

PubMed1975

Attachment behavior: a validation study in two age groups.

To assess the validity of attachment scores derived from the Ainsworth "strange situation," 56 1-year-olds and 79 2-year-olds accompanied by either the mother, the father, or a brief acquaintance were studied. Proximity to the adult, duration of play, crying, activity, and the incidence of looks and distance bids were measured. 1-year-olds were more secure with their parents: they were more active, played more, cried less, and stood closer to their parents than to an acquaintance. 2-year-olds accompanied by their parents were less settled in the presence of a stranger than children accompanied by the acquaintance. The adequacy of current conceptions and measures of attachment was discussed in light of these results.

Adult↗

PubMed1976

Cross-validation study of the personality aspects of involvement in pilot-error accidents.

Pilot-error accidents have dominated accident statistics consistently from the 1940s to the present. Sanders and Hofmann (3) found that three factors from Cattell's Sixteen Personality Factor Questionnaire (16 PF) significant differences (p less than 0.05) between pilot-error accident groups and were used to correctly classify 86% of the aviators tested as to their previous pilot-error accident involvement. There were 66 aviators given the 16 PF in the present study in an attempt to cross-validate the findings reported in the original study. The results indicate that the personality factors did not significantly discriminate between the pilot-error accident groups. The primary personality differences between the present sample and the original sample were due to variations in the pilot-error accident-free groups. The findings indicate that individual differences in personality characterstics of the aviators prevent consistent identification of traits associated with pilot-error groups.

Accidents, Aviation↗

PubMedDate not supplied

Validation study on medical recording practices in primary care clinics.

The validity of records of visits to physicians was studied in three primary care clinics in Beersheba, Israel. A wide variation was found between clinics in the completeness of recording and in the proportion of records that could not be found. The results suggest that data on clinic utilization obtained by an analysis of records may be an underestimate. They should be used only if completeness of recording has been tested and found satisfactory.

Ambulatory Care Facilities↗

PubMed1992

A validity study of the posture and fine motor assessment of infants.

This study investigated the concurrent and construct validity of the Posture and Fine Motor Assessment of Infants (PFMAI) (Case-Smith, 1991). The subjects were 90 infants, 65 of whom were healthy and full-term and 25 of whom were premature and had medical risk factors. Concurrent validity was investigated through administration of the Peabody Developmental Motor Scales (Folio & Fewell, 1983) and the PFMAI (n = 25). Strong positive correlations resulted between the Peabody Gross Motor scale and PFMAI Posture scale and between the Peabody Fine Motor scale and PFMAI Fine Motor scale. Concurrent validity was also measured through correlation scores on the Bayley Scales of Infant Development (Bayley, 1969) with scores on the PFMAI. The correlations between the Bayley Motor scale and the PFMAI Posture scale and between the Bayley Mental scale and the PFMAI Fine Motor scale were high. Construct validity was estimated through an evaluation of how accurately the PFMAI discriminated between the premature subjects and the full-term subjects. A discriminant analysis indicated that the PFMAI accurately classified 78% of the subjects as being either premature or full-term (i.e., 80% of the full-term subjects and 72% of the premature subjects). When the premature subjects were categorized as low-risk or high-risk according to their medical histories, the PFMAI accurately classified 66.7% of the total subject population as full-term, low-risk premature, or high-risk premature. These results indicate that the PFMAI has the adequate reliability and validity necessary for use as a clinical and a research instrument.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain Damage, Chronic↗

PubMed1991

Siriraj stroke score and validation study to distinguish supratentorial intracerebral haemorrhage from infarction.

OBJECTIVES: To develop a simple, reliable, and safe diagnostic tool for acute stroke syndromes in a setting where computerised brain scanning was not readily available and to validate its accuracy with regard to pathological types of stroke. DESIGN: 13 clinical variables that potentially might differentiate supratentorial cerebral haemorrhage from infarction were recorded and tested by multivariate analysis in a prospective study of 174 patients with acute stroke. In developing the Siriraj stroke score stepwise discriminant analysis of the variables was followed by a linear discriminant equation to differentiate between supratentorial haemorrhage and infarction. The score obtained was validated against scores in 206 other patients with stroke, computerised brain scans being used for definitive diagnosis. SETTING: Siriraj Hospital Medical School, Mahidol University, Bangkok. SUBJECTS: Prospective study: 174 consecutive patients with acute supratentorial stroke syndrome (not subarachnoid haemorrhage) admitted to Siriraj Hospital during 1984-5; validation study: 206 patients admitted to Siriraj Hospital or another hospital for supratentorial intracerebral haemorrhage or infarction. RESULTS: The Siriraj stroke score was developed and calculated as (2.5 x level of consciousness) + (2 x vomiting) + (2 x headache) + (0.1 x diastolic blood pressure) - (3 x atheroma markers) - 12. A score above 1 indicates supratentorial intracerebral haemorrhage, while a score below -1 indicates infarction. The score between 1 and -1 represents an equivocal result needing a computerised brain scan or probability curve to verify the diagnosis. In the validation study of the Siriraj stroke score the diagnostic sensitivities of the score for cerebral haemorrhage and cerebral infarction were 89.3% and 93.2% respectively, with an overall predictive accuracy of 90.3%. CONCLUSION: The Siriraj stroke score is widely accepted and applied in hospitals throughout Thailand as a simple and reliable bedside method for diagnosing acute stroke.

Acute Disease↗

PubMed1990

Validation studies from the Western Australian Congenital Malformations Registry.

A series of studies was undertaken in 1989 to validate the data held by the Western Australian Congenital Malformations Registry. Comparison with hospital discharge data identified 1585 children six years of age or younger with malformations discharged from hospitals in Western Australia in 1986, 226 of whom were not already recorded on the Congenital Malformations Register. When the records of a special register for cleft lip and palate were examined, all cases of facial cleft known to the special register were also recorded on the Malformations Register. Comparison of the Western Australian data for major groups of malformations with data from the South Australian Birth Defects Register raised the possibility of under ascertainment in Western Australia of cases of congenital heart disease. Multiple sources of ascertainment and evaluation of the ways in which such sources are tapped are important factors in striving for complete and accurate information on congenital malformations for research and public health purposes.

Child, Preschool↗

PubMed1987

A validation study of three anxiety and depression self-assessment scales.

All measuring instruments require further validation both in the setting for which they were designed and in other fields. The Hospital Anxiety and Depression Scale was designed for detection and assessment of those mood disorders in the setting of hospital medical and surgical clinics. Reasons are given for supposing it has advantages over other similar scales. The present study undertakes a further validation of the scale in a general hospital setting. The opportunity is taken to assess the usefulness, in this setting of the Irritability Depression and Anxiety Scale and also of two subscales of the General Health Questionnaire, the one relating to the concept of depression and the other to the concept of anxiety. Score ranges of the latter two subscales are suggested and will require replication for confirmation of their usefulness.

Ambulatory Care Facilities↗

PubMed1983

The RCRAS and legal insanity: a cross-validation study.

Examined the RCRAS as an empirically based approach to insanity evaluations. Previous research has been encouraging with regard to the RCRAS' interrater reliability and construct validity. The present study, with a larger data base (N = 111), sought to cross-validate these findings. Results from five forensic centers established satisfactory reliability for the RCRAS (mean kappa r = .80 for decision variables for criminal responsibility) and differentiating patterns for four of the five scales between sane and insane patient-defendants. Results further suggested that the RCRAS was generalizable across age, sex, criminal behavior, and location of the forensic evaluation. These findings were discussed with respect to the potential clinical utility of the RCRAS.

Commitment of Persons with Psychiatric Disorders↗

PubMed1986

A validity study of a new rating scale for psychiatric patients.

A criterion validation of a new scale, REHAB (Rehabilitation Evaluation Hall And Baker) (1) is described. Forty-three long-stay psychiatric patients from two wards were observed by a psychologist over a 2-week period using a time sampling procedure. The observed behaviour was coded into predetermined categories based on Blunden & Kushlick's (2) concept of engagement. Also during this period the ward nurses rated the 43 patients using the REHAB assessment. The time sampled observations were correlated with REHAB factors and items. Five hypotheses about the relationship between the two measures were tested. Four of the five hypotheses were supported by the data. Overall, despite certain limitations of the study, it is concluded that evidence is provided for the criterion validity of REHAB.

Activities of Daily Living↗

PubMed1992

Bioelectrical impedance estimation of fat-free body mass in children and youth: a cross-validation study.

The purposes of this study were to develop and cross-validate the "best" prediction equations for estimating fat-free body mass (FFB) from bioelectrical impedance in children and youth. Predictor variables included height2/resistance (RI) and RI with anthropometric data. FFB was determined from body density (underwater weighing) and body water (deuterium dilution) (FFB-DW) and from age-corrected density equations, which account for variations in FFB water and bone content. Prediction equations were developed using multiple regression analyses in the validation sample (n = 94) and cross-validated in three other samples (n = 131). R2 and standard error of the estimate (SEE) values ranged from 0.80 to 0.95 and 1.3 to 3.7 kg, respectively. The four samples were then combined to develop a recommended equation for estimating FFB from three regression models. R2 and SEE values and coefficients of variation from these regression equations ranged from 0.91 to 0.95, 2.1 to 2.9 kg, and 5.1 to 7.0%, respectively. As a result of all cross-validation analyses, we recommend the equation FFB-DW = 0.61 RI + 0.25 body weight + 1.31, with a SEE of 2.1 kg and adjusted R2 of 0.95. This study demonstrated that RI with body weight can predict FFB with good accuracy in Whites 10-19 yr old.

Adipose Tissue↗

PubMedDate not supplied

Altered family processes related to an ill family member: a validation study.

The purpose of this retrospective descriptive survey was to validate the defining characteristics for altered family processes related to an ill family nursing diagnosis. Using Ferhing's (1987) Diagnostic Cantent Validation Model, data were collected from 58 registered nurses. Clinical nurses submitted 14 defining characteristics not identified by NANDA nor found in the literature. Many of these characteristics expressed the same concepts in different terms from those used by NANDA. The results of this study give credibility to NANDA's conceptually stated defining characteristics and suggest further clinical research.

Adaptation, Psychological↗

PubMed1995

The Rehabilitation Activities Profile: a validation study of its use as a disability index with stroke patients.

OBJECTIVE: This study evaluates the criterion, content, and construct validity of the Rehabilitation Activities Profile (RAP) in patients with stroke. This instrument is constructed for screening, monitoring, and prognosis purposes to assist clinical rehabilitation. It consists of 21 activities, covering the domains communication, mobility, personal care, occupation, and relationships. Disabilities and perceived problems are assessed in parallel on two four-point severity scales. The disability sum scores of the first four RAP domains were used in the analyses presented in this article. DESIGN: An inception cohort of stroke patients was studied during 26 weeks. Patients that were still hospitalized on the 14th day after stroke were included. The functional assessments took place 2, 3, 4, 8, 12, and 26 weeks after stroke. SETTING: The patients were visited at the hospital, at home, nursing home, or rehabilitation center. PATIENTS: 125 patients were included in the study. After 26 weeks, 105 patients were still alive; 18 patients had died, and 2 patients were lost to follow-up. MAIN OUTCOME MEASURES: The RAP, Barthel Index (BI) and Frenchay Activities Index (FAI). RESULTS: The domain "mobility+personal care" correlated highly with the BI score (r: 0.87 to 0.90). The domain "occupation" correlated with the FAI score before the stroke and 26 weeks after stroke (r: 0.72, 0.73, respectively). The disability sum score of the domain "mobility+personal care" allowed a prediction of the living arrangement 26 weeks after stroke (receiver operator characteristic area surface: 0.90). The same domain showed significant differences (p < 0.05) in the 8-week disability sum score for most living arrangements. Exceptions were rehabilitation center versus intermediate care in a nursing home (p = 0.23) and acute care hospital versus chronic care in a nursing home (p = 0.45). Hypotheses on subgroup differences in mean scores in the domains "communication" and "mobility+personal care" could be confirmed (the discerned subgroups were: gender, having a partner, motor deficit of upper or lower extremity, urinary incontinence, higher cortical deficits, conjugate deviation of the eye, coma, hemianopsia). CONCLUSION: The disability sum scores of the RAP can be used as discriminative, evaluative, and predictive indexes.

Aged↗

PubMedDate not supplied

Meconium analysis for cocaine: a validation study and comparison with paired urine analysis.

We established the validity of a drug-screening method to detect the presence of cocaine or benzoylecgonine or both in meconium and then undertook an analysis of results from urine and meconium specimens obtained concurrently from neonates within 3 days of birth. Meconium specimens from 82 consecutive newborns were analyzed using fluorescence polarization immunoassay (FPIA), Kinetic Interaction of Microparticles in Solution (KIMS), and gas chromatography-mass spectrometry (GC-MS). Each meconium specimen was analyzed by all three methods. Fifty-four paired urine and meconium specimens were obtained over a 13-month period from a neonatal intensive care unit. Urine drug testing was performed by immunoassay (enzyme multiplied immunoassay [EMIT] technique), whereas meconium specimens utilized FPIA with GC-MS confirmation on all but one specimen (due to insufficient quantity). Ten true positives were found by GC-MS, 10 positives were found by FPIA, and 70 positives were found by KIMS. Of the 54 paired samples, 39 samples tested negative for cocaine in both urine and meconium; four specimens were positive by both routes; 10 specimens were negative in urine but positive in the meconium; and one specimen tested positive in urine but negative in the meconium. Thus, 9.3% of the urine specimens tested positive, and 25.9% of meconium samples tested positive (p = .011; McNemar's Test). We conclude that screening meconium specimens by FPIA followed by GC-MS confirmation of screened positives yields highly accurate determinations of the presence of cocaine or benzoylecgonine or both in meconium and that testing of meconium for cocaine and its metabolites is more sensitive than testing of urine.

Cocaine↗

PubMed1989

Emotional indicators in the human figure drawings of hearing-impaired children: a small sample validation study.

The use of human figure drawings as projective personality assessment techniques is a well-established practice among psychological service providers to hearing-impaired children yet few studies have shown these techniques to be valid indicators of emotional functioning in any population. The purpose of the present work is to establish concurrent validity for the Koppitz scoring technique in a sample of 7- to 12-year old hearing-impaired students. Results indicate that the Koppitz technique shows a positive correlation with emotional status as measured on the Stress Response Scale. The Koppitz technique is especially sensitive to impulsive and passive-aggressive types of response modes.

Child↗

PubMed1994

Construct validation study of the Fear of Powerlessness Scale.

To establish construct validity with 129 subjects for the Fear of Powerlessness Scale parallels were drawn among Levenson's Locus of Control Scales, the Fear of Powerlessness, and the Desire for Control Scale. Analysis yielded significant correlations between scores on the Fear of Powerlessness Scale, the Desire for Control Scale (negative), and 2 of Levenson's Locus of Control Scales, the Chance Scale and the Powerful Others Scale (positive).

Adolescent↗

PubMed2026

Predicting 5-Year Mortality in Non-Small-Cell Lung Cancer Using the Korean Central Cancer Registry: Model Development and Validation Study.

BACKGROUND: Non-small-cell lung cancer (NSCLC) is one of the most common cancers and a leading cause of cancer-related mortality, making prognostic prediction clinically essential. Machine learning models are increasingly used to assess prognosis; however, developing systems that combine high discrimination with clear, clinically interpretable reasoning remains challenging. OBJECTIVE: This study aimed to develop deep learning models that predict 5-year mortality in NSCLC using data from the Korea Central Cancer Registry and quantify feature importance through permutation testing. METHODS: We identified 3144 patients diagnosed between 2014 and 2017 who had complete clinical data, pulmonary function test results, histological information, genomic data, and staging details. After preprocessing, the cohort was divided into stratified training, validation, and test sets in a 70%-15%-15% ratio. Five models were tuned using Hyperband across 10 predefined feature groups. The primary evaluation metric was the area under the receiver operating characteristic curve (AUC); additional metrics included accuracy, F1-score, precision, and recall. Groupwise permutation importance was calculated for each model, and the concordance of importance rankings was assessed using the Friedman test. RESULTS: All 5 models yielded comparable discrimination values on the test set (AUC=0.875-0.879). Model A was selected as the primary model and achieved an AUC of 0.879, an accuracy of 0.806, an F1-score of 0.824, and a Brier score of 0.142. Permuting the stage resulted in the largest decrease in AUC (0.217), followed by the pulmonary function test (0.016). Gene mutation had a modest overall impact but became more influential within the adenocarcinoma subset. The Friedman test showed no statistically significant differences in importance rankings across the models (P=.93). CONCLUSIONS: A grouped-input deep learning framework achieved discrimination comparable to a conventional Cox proportional hazards model using the same routine clinical variables for 5-year mortality prediction in NSCLC. Group-level permutation importance provided stable and reproducible insights into the clinical factors influencing risk, which may guide future model refinement and clinical decision-making.

Humans↗

PubMed1990

Psychosocial vulnerability, life stress, and suicide ideation in a jail population: a cross-validation study.

The purpose of this present investigation was to cross-validate a stress-psychosocial vulnerability model of suicidal ideation and behavior in a jail population. Measures of social alienation, cognitive distortions, adaptive resources, situational (jail environment) stress, depression, hopelessness, and suicide ideation were administered to 146 male inmates at a county jail facility. It was predicted that each of the vulnerability factors, in addition to jail stress, would be significantly related to suicide ideation among inmates. Furthermore, it was hypothesized that psychosocial vulnerability among inmates would interact with jail stress to best explain suicide intent. The result of a multiple-regression analysis, stepwise forward-inclusion algorithm, indicated that 51% of the variation in suicide ideation could be accounted for by the linear combination of low reasons for living, irrational beliefs, jail stress, and loneliness. In addition, when the variables were entered into a hierarchical multiple-regression model, interactions between select psychosocial vulnerability factors and jail stress were found to best explain suicide intent. Results of the study are discussed in terms of the proposed model, and implications for future research and prevention efforts in jail suicide are noted.

Adaptation, Psychological↗