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Construction and validation of a specific quality of life instrument for adolescents with spine deformities.

STUDY DESIGN: The development and construction of a specific instrument for measuring quality of life in adolescents with spine deformities was investigated. OBJECTIVES: To assess the validity and reliability of the Quality of Life Profile for Spine Deformities. SUMMARY OF BACKGROUND DATA: An 88-item questionnaire was self-administered to 174 patients ranging in age from 10 to 20 years with spine deformities. Items were rated on a five-point Likert scale. Higher scores means high level of impairment in quality of life. Age, gender, menarche or voice change, salient symptoms in the medical record, ordinary parameters on physical examination, and measurements on standard anteroposterior and lateral radiographs were recorded. The retest was done 10 days after the initial administration in a subsample of 35 patients. METHODS: The test-retest reliability was analyzed calculating the intraclass correlation coefficient. Internal consistency was measured with the Cronbach's alpha method. Factor analysis was used to obtain a reduced number of variables. Construct validity was assessed using the principal components model of factor analysis based on the correlation matrix and using the varimax computer algorithm for orthogonal rotation. Discriminant validity was assessed using the Kruskal-Wallis test. RESULTS: The Quality of Life Profile for Spine Deformities contained 21 items and five factors in conceptual terms labeled psychosocial functioning, sleep disturbances, back pain, body image, and back flexibility. The overall questionnaire score showed an internal consistency of 0.88 and a test-retest correlation of 0.91. Patients with structural curves showed significantly higher scores in all dimensions of the Quality of Life Profile for Spine Deformities except for the subscale of body image than patients with postural curves. When patients were grouped according to the symptom of back pain, those with backache had a significantly higher quality of life overalls score and scores in the dimensions of sleep disturbances and pain. Brace-treated patients showed statistically significant differences in the quality of life overall score and scores in the dimensions of psychosocial functioning and back flexibility. CONCLUSIONS: The instrument developed for measuring quality of life in patients with spine deformities during the period of bone growth has validity, internal consistency, and high test-retest reliability. The conceptualization of quality of life of the Quality of Life Profile for Spine Deformity includes psychosocial dimensions and pain and function.

Adolescent↗

Reliability and validity of the National Institutes of Health: Chronic Prostatitis Symptom Index in a Malaysian population.

The objective of the study is to determine the short- and long-term utility of the Chinese, Malay and English versions of the National Institutes of Health--Chronic Prostatitis Symptom Index (NIH-CPSI) in our ethnically diverse population. The NIH-CPSI was translated into Chinese and Malay, and then verified by back translation into English. Subjects included 100 new chronic prostatitis/chronic pelvic pain (CP/CPPS) patients, 71 new benign prostatic hyperplasia patients and 97 healthy individuals. Reliability was evaluated with test-retest reproducibility (TR) by calculating intraclass correlation coefficients (ICC). Internal consistency was evaluated by calculating Cronbach's alpha (alpha). Validity assessments included discriminant and construct validity. (Presented in the order of Chinese, Malay then English). ICC values for short-term (1 week) TR were 0.90, 0.80 and 0.89, while ICC values for long-term (14 weeks) TR were 0.54, 0.61 and 0.61. Cronbach's alpha values were 0.63, 0.62 and 0.57. The NIH-CPSI total score discriminated CP/CPPS patients (P<0.001) from the control groups with receiver operating curve values of 0.95, 0.98 and 0.94, respectively. Construct validity, reflected by the correlation coefficient values between the International Prostate Symptom Score and the NIH-CPSI of CP/CPPS patients were 0.72, 0.49 and 0.63 (all P<0.05). The Chinese, Malay and English versions of the NIH-CPSI each proved effective in our population. Short-term TR and discriminant validity were excellent for all three versions. However, long-term TR was only moderate, which might reflect variation in patients' perceptions of symptoms over time.

Adult↗

Construction and validation of a practical prognostic index for patients with metastatic breast cancer.

PURPOSE: To identify the readily available prognostic factors most helpful in predicting survival and to construct and validate a prognostic index for metastatic breast cancer (MBC) patients. PATIENTS AND METHODS: Data from 233 MBC patients, accrued on a multiinstitutional randomized phase III trial (Japan Clinical Oncology Group [JCOG] study 8808), were analyzed to identify significant prognostic factors and a prognostic index was constructed by incorporating these prognostic factors. For validation of the prognostic index, another data set from 315 consecutive MBC patients, who had been treated with standard anthracycline-containing regimens, was analyzed. RESULTS: In multivariate regression analyses, history of adjuvant chemotherapy (ADJCT) (P = .0005), presence of distant lymph nodes (DLNs) (P = .0117) and liver (HEP) (P = .0099) metastases, elevation of serum lactate dehydrogenase (LDH) (P < .0001), and shorter disease-free interval (DFI) (P < .0001) significantly contributed to poorer survival. The prognostic index was constructed as follows: Prognostic Index = ADJCT (not received = 0, received = 1) + DLNs (absent = 0, present = 1) + HEP (absent = 0, present = 1) + LDH (< or = one times normal = 0, > one times normal = 1) + DFI (> or = 24 months = 0, < 24 months = 2). With this prognostic index, patients could be stratified into three risk groups. The median survival times (MSTs) of low-, intermediate- and high-risk groups were 45.5, 24.6, and 10.6 months, respectively (P < .0001). This prognostic index was applied to the validation patients. The respective MSTs for each risk group were 49.6,22.8, and 10.0 months (P < .0001). CONCLUSION: ADJCT, DLNs, HEP, LDH, and DFI were important prognostic factors for MBC patients. The prognostic index readily enables MBC patients to be stratified into three risk groups and is worth considering for future clinical trials.

Analysis of Variance↗

Testing Antonovsky's sense of coherence (SOC) scale among Swedish physically active older people.

In Antonovsky's salutogenic theory, the major concept sense of coherence (SOC) is constituted of three core components called comprehensibility, manageability, and meaningfulness. Several scales that are intended to measure SOC are available and used by researchers in health and caring sciences all over the world. When using a scale, evidence of its quality in different study groups is needed in order to get reliable and valid data. The aim of this study was to test reliability and construct validity of the Swedish version of Antonovsky's original 29-item sense of coherence (SOC) scale in a group of physically active older people. The scale was tested with a convenience sample of 140 physically active older individuals, who took part in different fitness-training groups in eastern Sweden. Reliability was assessed as item to total correlations and with the Cronbach's alpha coefficient. Construct validity was assessed with the known groups technique, confirmatory factor analysis, and with logistic regression analysis. The results showed that in the studied group of older individuals, the instrument was a very reliable tool with a Cronbach's alpha coefficient of 0.92. Construct validity of the scale was supported by the fact that the global concept sense of coherence was found to be hierarchically organized in a model that consisted of the three core components of comprehensibility, manageability, and meaningfulness. Furthermore, perceived health could be explained to some degree by sense of coherence, but even more by comprehensibility, in both cases independently of chronological age. The results clearly corroborated Antonovsky's theory.

Aged↗

Screening for depression in a hepatitis C population: the reliability and validity of the Center for Epidemiologic Studies Depression Scale (CES-D).

RATIONALE: Depression is reported as a serious adverse event of antiviral therapy used to treat patients with hepatitis C (HCV); therefore, there is a need to identify a reliable and valid measure of depressive symptoms for this population. AIMS: To determine reliability, construct validity and predictive validity of the Center for Epidemiological Studies Depression Scale (CES-D) in a hepatitis C (HCV) population. ETHICAL ISSUES: Study reviewed/approved by the University Institutional Review Board and informed consent obtained. METHODS: Longitudinal design testing psychometric properties of the CES-D prior to treatment and 4 and 24 weeks postinitiation of treatment. Reliability was tested using Cronbach's coefficient alpha. Construct validity was tested, prior to therapy, using principal components factoring with varimax rotation. Predictive validity was tested using repeated measures analysis of variance (anova) of CES-D scores at 4 and 24 weeks postinitiation of treatment. RESULTS: Non-probability sample, 116 adult HCV patients [62 (53%) males and 54 (47%) females]. Reliability (Cronbach's alpha) = 0.88 pretreatment, 0.89 week 4 and 0.90 week 24. Construct validity testing revealed four factors: negative affect; positive affect; somatic; and depressed affect/somatic. Exception for two items, 'felt sad' and 'couldn't get going', all items loaded distinctly with correlation coefficients in the range of 0.51-0.84. Predictive validity testing revealed a statistically significant effect over time (P < 0.001) in the direction predicted (pretreatment x = 13.97; post 4 weeks x = 19.54 and 24 weeks x = 19.97). CONCLUSIONS: The CES-D is a reliable and valid instrument to screen for depressive symptoms in HCV patients. The instrument detected the predicted increase in depression associated with HCV. Examination of the sensitivity and specificity is needed to determine the most accurate cut-off score.

Adult↗

The Depressive Cognition Scale: further psychometric evaluation.

Depressive cognitions often precede the development of affective and behavioral symptoms of depression. Cognitive factors have been shown to influence the development of depression in older adults and thus identification of depressive cognitions is important for prevention of clinical depression and early intervention. The Depressive Cognition Scale (DCS) assesses cognitions that may precipitate clinical depression, and it has been found to be internally consistent and to demonstrate construct validity with measures of psychosocial development. This psychometric investigation was designed to further examine the construct validity of the DCS through comparison with measures of hypothetically related constructs. An alpha of .78 indicated acceptable internal consistency. Construct validity was demonstrated by significant correlations with measures of depression, resourcefulness, adaptive functioning, and life satisfaction. The study, conducted with 160 healthy elders, provides additional support for the reliability and validity of the DCS and yields promising evidence of its usefulness with elderly persons.

Aged↗

Validity of health status measures in patients with ulnar wrist disorders.

PURPOSE: To assess measurement properties and construct validity of health status measures. METHOD: Forty-three patients with surgically managed ulnocarpal impingement completed a self-report mail survey, including regional (Disabilities of the Arm, Shoulder and Hand [DASH] questionnaire), disease-specific (Brigham Functional Scale), and generic (Short Form 36 [SF-36] Acute Health Survey) health status measures and questions on condition severity and work status. STATISTICAL ANALYSIS: Scores were transformed and frequency distributions constructed to compare the distribution of responses to the measures. Correlation analysis and analysis of variance were applied to assess construct validity. RESULTS: The DASH and Brigham questionnaires had similar distributions of scores, with a slightly greater spread of responses and no ceiling effect on the DASH. Patients appeared slightly less healthy on the basis of the SF-36 scores, which reflected in part the effect of comorbidities. Both the DASH and the Brigham discriminated across levels of severity and work status; the DASH also discriminated on the basis of type of surgery. The SF-36 was able to discriminate some constructs but not as well as the regional and disease-specific measures. CONCLUSION: This study provides evidence of construct validity for the DASH and Brigham questionnaires in patients with ulnar wrist problems in the late post-operative period.

Adult↗

Validity and sensitivity to change of spondylitis-specific measures of functional disability.

OBJECTIVE: To compare the construct validity and sensitivity to change of 2 spondylitis-specific measures of functional disability, the Health Assessment Questionnaire Disability Index modified for the spondyloarthropathies (HAQ-S) and the Dougados Functional Index, with 2 more generic instruments, the Health Assessment Questionnaire (HAQ) and the Arthritis Impact Measurement Scales-2 (AIMS2), in patients with ankylosing spondylitis (AS). METHODS: Construct validity was assessed in 2 ways: (1) by comparisons of the cross sectional correlations between each functional disability instrument and 6 measures of physical impairment in 216 patients, and (2) by relating changes over time in the HAQ-S and the Functional Index with changes in patient reported pain and stiffness in 153 patients followed for at least 2 years. Sensitivity to change was measured from the responses of 155 patients who reported a qualitative change in the activity of their AS during followup. RESULTS: Most patients had mild functional disability, with median scores of 0.5 on the HAQ-S (possible range 0-3), 0.375 on the HAQ (possible range 0-3), 11 on the Functional Index (possible range 0-40), and 5 on the AIMS2 (possible range 0-60). Scores on the HAQ-S (R2 = 0.24) and the unmodified HAQ (R2 = 0.18) were more highly correlated with measures of physical impairment than were scores on the AIMS2 (R2 = 0.10) or the Functional Index (R2 = 0.09). Changes over time in the HAQ-S and HAQ were more closely related to changes in pain and stiffness than were changes in the Functional Index. The HAQ-S and HAQ were also more sensitive to change than the Functional Index. CONCLUSION: The HAQ-S showed greater construct validity and sensitivity to change than the Functional Index, but performed similarly to the unmodified HAQ.

Adult↗

Behavioral models of binge-type eating.

PURPOSE: To describe and evaluate behavioral models of binge-type eating. DATA IDENTIFICATION: Studies were identified using Medline and hand searches of bibliographies of identified articles. STUDY SELECTION: Isomorphic studies were selected that were judged to have some measure of construct validity. DATA EXTRACTION: Face and construct validity were assessed, as well as simplicity and cost of use. RESULTS OF DATA SYNTHESIS: Several different models of binge-type eating exist, each with different strengths of validity and use. These include models using sham feeding, restriction/refeeding cycles and/or stress, limited access (LA) to optional foods, and eating induced by operant schedules of behavior. CONCLUSIONS: We concur with Harry Harlow, who was quoted by Gerry Smith as saying: "You'd be crazy to use animal models, but you'd also be crazy not to use them."

Animals↗

Psychometric properties of the 15-item geriatric depression scale in functionally impaired, cognitively intact, community-dwelling elderly primary care patients.

OBJECTIVES: To examine the psychometric properties of the 15-item Geriatric Depression Scale (GDS-15), a brief depression screening measure. DESIGN: Cross-sectional. SETTING: Nineteen counties in western New York, West Virginia, and Ohio. PARTICIPANTS: Nine hundred sixty functionally impaired, cognitively intact, community-dwelling primary care patients aged 65 and older. MEASUREMENTS: The GDS-15, major depression as measured using the Mini-International Neuropsychiatric Interview, depressed mood, life satisfaction, suicidal ideation, and reported suicide attempts. RESULTS: Exploratory factor analyses suggested a two-factor structure for the GDS-15 in this category of patients, with component subscales assessing depression and positive affect. Cronbach alpha coefficients provide evidence for moderate, although acceptable, internal consistency reliability. Significant associations between the GDS-15 and measures of depressed mood, life satisfaction, and suicidal ideation demonstrated construct validity, whereas acceptable sensitivity and specificity to discriminate between depressed and nondepressed patients demonstrated criterion validity. Internal consistency reliability and construct validity did not differ significantly between patients with low and high functional impairment. A significant weakness of the scale is its low correlation with suicide attempt status. CONCLUSION: In general, this study provides evidence of impressive psychometric properties of the GDS-15 when administered to a sample of functionally impaired, cognitively intact, community-dwelling primary care patients.

Aged↗

Calculating the direct costs of urinary incontinence: a new test instrument.

OBJECTIVES: To develop a universally applicable test instrument to measure the total direct costs of urinary incontinence, including personal costs and treatment costs, i.e. the Dowell-Bryant Incontinence Cost Index (DBICI), and to study the construct validity and test-retest reliability of the instrument. PATIENTS AND METHODS: In a prospective observational study, 100 consecutive community-dwelling ambulatory women who presented with stress, urge or mixed incontinence were asked to complete the DBICI questionnaire on two occasions, 7 days apart, before any treatment. The construct validity of the DBICI was ascertained by correlation with other standard measures of urinary incontinence severity; (i) a visual analogue scale (VAS) to assess the impact of leakage upon lifestyle; (ii) frequency-volume charts (voids/24 h, leaks/week); (iii) urine loss during a standard 1 h pad test; and (iv) two disease-specific quality of life questionnaires. The test-retest reliability was measured by comparing the two test results and the construct validity of the individual subsets (personal and treatment) of the DBICI similarly assessed. RESULTS: Ninety-seven women completed the baseline assessment and 84 completed the re-test. The median (interquartile range) total direct incontinence cost (in Au$) was 12. 89 (5.26-22.67) per week, which comprised the median personal costs of 5.61 (1.68-10.36) and the median treatment costs of 4.96 (1.22-13. 37). The total direct incontinence cost was significantly correlated with the severity of urinary leakage on a 1 h pad test (Kendall's rank correlation, P=0.01), with the VAS impact score (P<0.001) and with the number of leaks/week (P=0.005). The correlation between the personal cost subset and other quantitative measures was also highly significant. Test-retest analysis of the personal costs subset revealed that this subset was robust and satisfied the statistical criteria of repeatability. CONCLUSIONS: The DBICI gives a detailed measure of the direct economic costs of urinary incontinence in ambulatory home-dwelling women, with the construct validity confirmed by the significant correlation with other quantitative measures of incontinence. By substituting local prices into the test format, the index should be useful in other countries. In the current climate of economic rationalization, such an index should be a part of future urinary incontinence research.

Adult↗

A valid and reliable tool to quantify stool output in tube-fed patients.

A major problem in determining whether diarrhea exists in tube-fed patients is the quantification of stool output. On the basis of this need a stool output assessment tool was developed and tested for validity and reliability. Interrater reliability and construct validity were determined by using staff nurses' and principal investigators' observations. Observers blindly rated the bowel movement (BM) on size and consistency and on whether the BM was thought to represent "diarrhea." Interrater reliability was found to be significant. Stool output scores were determined by using a 24-hour output form that assessed stool size, consistency, and frequency. Content validity was established as well as concurrent and construct validity.

Anti-Bacterial Agents↗

Construction and validation of a short-form benign prostatic hypertrophy health-related quality-of-life questionnaire. BPH Group in General Practice.

OBJECTIVE: To construct and validate a short-form benign prostatic hypertrophy (BPH) health-related quality-of-life (HRQL) questionnaire which is more practical in use and as informative as the 20-item visual analogue scale questionnaire (QOL20) previously validated in French. PATIENTS AND METHODS: From the factorial structure of the QOL20, a nine-item questionnaire (QOL9) was constructed using stepwise linear regression and factorial analysis. The feasibility and reliability of the QOL9 were analysed in a cross-sectional case-control study and a longitudinal cohort study, including symptomatic patients with BPH treated for 6 months with an alpha 1-blocker (alfuzosin). RESULTS: The reduction of the QOL20 to QOL9 showed a minimal loss of information (90-95% of the variance of QOL20 was explained by QOL9) and lead to a three-dimensional structure: well being, patients' perceived sexual-life status, and BPH interference with activities. The QOL9 was practical in use (completion rate 87-100%; duration of completion at inclusion 11.6, SD 2.0 min), consistent (Cronbach's alpha > 0.7), reliable (intraclass correlation coefficient > 0.80) and responsive (effect-size index 0.9, SD 0.01 in the longitudinal study). CONCLUSIONS: The QOL9 is a good BPH HRQL questionnaire, including an assessment of patients' perceived sexual-life status; it easy to administer, accurate, reproducible and responsive to change with treatment. We suggest that the QOL9 be substituted for the QOL20 and administered in addition to the International Prostate Symptom Score to obtain a better assessment of the patients' perception of their disease.

Adrenergic alpha-Antagonists↗

Measuring disability and function in older women: psychometric properties of the late-life function and disability instrument.

BACKGROUND: The recent development of the Late-Life Function and Disability Instrument (LL-FDI) was an important contribution to the measurement of function and disability in older adults. The present study examined the psychometric properties and construct validity of the LL-FDI measure in a sample of older women. METHODS: Older black (n = 81) and white (n = 168) women completed the LL-FDI, several measures of physical function, and physical activity measures, and had their body mass index assessed at baseline of an ongoing prospective study. Confirmatory factor analyses (CFA) and correlational analyses were used to examine factorial and construct validity of the measure. RESULTS: The CFA, using an iterative model modification technique, resulted in an acceptable 15-item solution for the function component and an 8-item solution for the disability component. This abbreviated instrument demonstrated high correlations with the original scales. Construct validity for the LL-FDI was supported. Participants who demonstrated better physical function, reported being more active, and had lower body mass index reported less disability and less difficulty with function on the LL-FDI. CONCLUSIONS: The LL-FDI appears to be an effective instrument for assessing function and disability in older women, and the abbreviated version reported here may prove useful in certain circumstances due to its brevity. However, continued determination of the construct validity of the complete and abbreviated scales is recommended.

Aged↗

Construction and validation of a measure of authoritarian personality.

This paper reports the results of a series of studies in which the construction and validation of a behavioral measure of authoritarianism is reported. Factor analysis of already established behavioral scales (e,g., Ray's (1976) Directiveness scale; the Buss-Durkee (1957) Hostility inventory, etc.) and items especially written for the study resulted in a Revised F scale with a reliability (Cronbach's alpha) of .79 and a rpN of -.45. The items loaded significantly on four factors, namely, Dominance/Leadership, Achievement motivation. Interpersonal conflict and Verbal hostility. Furthermore, validity studies revealed the scale to possess satisfactory validity. It is suggested that this measure be seriously considered as an alternative indicator of levels of authoritarianism.

Journal Article↗

Stability of clinical reasoning assessment results with the Script Concordance test across two different linguistic, cultural and learning environments.

The Script Concordance (SC) test is designed to measure the organization of knowledge that allows interpretation of data in clinical reasoning. An originality of the test is that answer keys use an aggregate scoring method based on answers given by a panel of experts. Previous studies have shown that the SC test has good construct validity. This study, done in urology, explores (1) the stability of the construct validity of the test across two different linguistic and learning environments and (2) the effect of the use of experts who belong to different environments. An 80-item SC test was administered to participants from a French and a Canadian university. Two levels of experience were tested: 25 residents in urology (11 from the French university and 14 from the Canadian university) and 23 students (15 from the French faculty, eight from the Canadian faculty). Reliability analysis was studied with Cronbach's alpha coefficient. Scores between groups were compared by analysis of variance. Reliability coefficient of the 80 items test was 0.794 for the French participants and 0.795 for the Canadian participants. Scores increased with clinical experience in urology in the two sites. Candidates obtained higher scores when correction was done using the answer key provided by the experts from the same country. These data support the stability of the construct validity of the tool across different learning environments.

Adult↗

Preliminary study to evaluate the validity of the mini-mental state examination in a normal population in Turkey.

Although the Mini-Mental State Examination (MMSE) is widely used in clinical practice, normative scores for a healthy population have not been documented in Turkey. The aim in this study was to validate the MMSE in a healthy population and to provide normal scores. Internal construct validity of the Turkish version of MMSE among a preliminary sample of 406 normal people was assessed by Rasch unidimensional measurement model. Scores of the normal sample varied according to age and education but not according to sex. The data derived from this sample showed poor fit to the Rasch model (mean item fit, -2.082, SD 3.022). Only four of 11 items met model expectations. There was also differential item functioning by education and age for most items. Thus the internal construct validity of the Turkish MMSE in a normative sample could not be demonstrated by Rasch analysis. The scale failed modern psychometric criteria for scalability. We would therefore suggest other large normative MMSE data sets to be tested in terms of internal construct validity. If these findings are replicated, the validity of MMSE norms and their consequent use in clinical practice should be reconsidered.

Adolescent↗

Preliminary validation of clinical remission criteria using the OMERACT filter for select categories of juvenile idiopathic arthritis.

OBJECTIVE: To begin the validation process of the preliminary criteria for inactive disease (ID), clinical remission on medication (CRM), and clinical remission off medication (CR) in children with select forms of juvenile idiopathic arthritis (JIA). METHODS: We used the OMERACT filter paradigm to estimate the validity of the criteria within each of the filter's 3 components: truth, discrimination, and feasibility, in 5 categories of JIA: systemic arthritis, persistent and extended oligoarthritis, and rheumatoid factor-positive and negative polyarthritis. Data sources for determining validity estimates included a Delphi questionnaire survey sent to 246 pediatric rheumatologists in 34 countries, a consensus conference attended by 20 senior pediatric rheumatologists representing 9 countries, a retrospective chart review of 437 patients with JIA from 3 tertiary care clinics who had been followed between 4 and 22 years, and the literature. RESULTS: Truth component: face and content validity. These aspects of validity were largely established via the Delphi questionnaire exercise and the consensus conference. Using an 80% consensus level, participants felt that a set of non-redundant variables could effectively differentiate the clinical states of ID, CRM, and CR. Criterion validity could not be irrefutably established because no gold standard for inactive disease exists for JIA. As an alternative, published investigations of remission in JIA were used to estimate concurrent and convergent validity, as surrogates for criterion validity and as indicators of overall construct validity. Correlational analyses revealed the new criteria to have good construct validity. Discrimination component: the criteria demonstrated moderate to high levels of classification, prognosis, and responsiveness (sensitivity to change) using data from the chart review. Patients who were able to attain CR remained disease-free for substantially longer periods than did those who attained only ID or CRM. Responsiveness was evidenced by the ability of the criteria to allow movement of most patients between the disease states, consistent with what is known of the course of the disease. Feasibility component: Results of the Delphi and consensus conference produced a set of criteria that are easily, quickly, and inexpensively completed in the physician's office, and present minimal or no risk to the patient. CONCLUSION: The preliminary criteria demonstrated moderate to excellent validity characteristics in some, but not all components of the OMERACT filter. Prospective validation studies are under way.

Arthritis, Juvenile↗