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Results for “construct validity”

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At least 1,153 records · Page 64Linked to original sources

PubMed2001

Measuring knee extensor muscle strength.

OBJECTIVE: To compare manual muscle test with hand-held dynamometer measurements of knee extension strength. A secondary analysis of measurements (n = 256 knees) from 128 acute rehabilitation patients was performed. DESIGN: Knee extensor muscle testing was conducted according to the technique of Hislop and Montgomery; 0 to 5 grades were converted to an expanded 0 to 12 scale. Dynamometry was used to measure the isometric knee extension force with 'gravity eliminated.' RESULTS: Manual muscle test and dynamometer measures were highly correlated (r = 0.768; P < 0.001); the correlation was higher when the quadratic nature of the relationship was taken into account (R = 0.887; P < 0.001). Although the dynamometer forces that were associated with different manual muscle test grades differed overall (F = 67.736; P < 0.001), the forces associated with some of the higher grades did not differ statistically. CONCLUSIONS: These findings reinforce the convergent construct validity of the manual muscle test and dynamometry measurements but challenge the discriminant construct validity of manual muscle testing. An alternative manual muscle testing grading scheme is suggested that provides for discriminant validity and retains convergent validity.

Adult↗

PubMed1988

An interactive patient simulation for the study of medical decision-making.

An interactive patient simulation for the study of medical decision-making was developed which is basically a flexible question and answer simulation between a doctor and a simulator conducting the simulation. To insure a thorough insight into the management of cases over time, provisions were made for doctors to interact with the simulated patients as many as five times. The simulation was tested on 16 family doctors and 16 specialist physicians to evaluate its realism and construct validity. The realism scores were highly favourable for both groups. With regard to construct validity, the hypothesis that the two specialty groups would manifest themselves in decision-making as distinct and homogeneous groups was tested. This hypothesis was confirmed in the case of specialist physicians, but not in the case of family doctors.

Decision Making↗

PubMed1990

Developing a test of knowledge of surgical options for breast cancer.

Because many women now have a choice regarding the type of surgery they prefer for early stage breast cancer, it is important for clinicians to provide comprehensive information about these options and to determine whether patients have understood this information. The purpose of this study was to develop a short, easily administered, valid and reliable test of women's knowledge of surgical treatment options for early stage breast cancer. Instrument development was carried out in two phases: (a) content domains were established and items were generated and examined for content validity and clarity; and (b) the known-groups technique was used to determine construct validity and to generate data for reliability testing. The test was administered to 44 student nurses, 21 women with breast cancer, and 24 practicing nurses. An 18-item test--the BCIT-R (Breast Cancer Information Test-Revised)--with modest internal consistency and very good construct validity resulted from these steps. Nurses scored significantly better than either students or patients. The instrument is discussed in terms of psychometric issues and clinical use.

Adult↗

PubMed2003

A valid method of laparoscopic simulation training and competence assessment.

BACKGROUND: The purpose of our study was to evaluate the construct validity of laparoscopic technical performance measures and the face validity of three laparoscopic simulations. MATERIALS AND METHODS: Subjects (N = 27) of varying levels of surgical experience performed three laparoscopic simulations, representing appendectomy (LA), cholecystectomy (LC), and inguinal hemiorrhaphy (LH). Five laparoscopic surgeons, blinded to the identity of the subjects, rated the subjects on procedural competence on a binary scale and in four skills categories on a 5-point scale: clinical judgment, dexterity, serial/simultaneous complexity, and spatial orientation. Using a task-specific checklist, non-clinical staff assessed the technical errors. The level of surgical experience was correlated with the ratings, the technical errors, and the time for each procedure. Subject responses to a survey regarding the utility of the inanimate models were evaluated. RESULTS: Years of experience directly correlated with the skills ratings (all P < 0.001) and with the competence ratings across the three procedures (P < 0.01). Experience inversely correlated with the time for each procedure (P < 0.01) and the technical error total across the three models (P < 0.05). Nearly all subjects agreed that the corresponding procedures were well represented by the simulations (LA 96%, LC 96%, LH 100%). CONCLUSION: The laparoscopic simulations demonstrated both face and construct validity. Regardless of the level of surgical experience, the subjects found the models to be suitable representations of actual laparoscopic procedures. Task speed improved with surgical experience. More importantly, the quality of performance increased with experience, as shown by the improvement in the skills assessments by expert laparoscopic surgeons.

Appendectomy↗

PubMed2006

A comparison of postoperative pain scales in neonates.

BACKGROUND: Practical, valid and reliable pain measuring tools in neonates are required in clinical practice for effective pain management and prevention of the evaluator bias. METHODS: This prospective study was designed to cross-validate three pain scales: CRIES (cry, requires O(2), increased vital signs, expression, sleeplessness), CHIPPS (children's and infants' postoperative pain scale) and NIPS (neonatal infant pain scale) in terms of validity, reliability and practicality. The pain scales were translated. Concurrent validity, predictive validity and interrater reliability in postoperative pain were studied in 22 neonates after major surgery. Construct validity and concurrent validity in procedural pain were determined in 24 neonates before and during frenulectomy under topical anaesthesia. RESULTS: All scales had excellent interrater reliability (intraclass correlation >0.9). Construct validity was determined for all pain scales by the ability to differentiate the group with low pain scores before surgery and high scores during surgery (P<0.001). The positive correlations among all scales, ranging between r=0.30 and r=0.91, supported concurrent validity. CRIES showed the lowest correlation with other scales with correlation coefficients of r=0.30 and r=0.35. All scales yielded very good agreement (K>0.9) with routine decisions to treat postoperative pain. High sensitivity and specificity (>90%) for postoperative pain from all scales were achieved with the same cut-off point of 4. In terms of practicality, NIPS was the most acceptable (65%). CONCLUSIONS: Based on our findings, we recommended NIPS as a valid, reliable and practical tool.

Critical Care↗

PubMed2005

Validation of the EQ-5D in patients with a history of acute coronary syndrome.

OBJECTIVE: To analyze the construct validity of the EQ-5D in patients with acute coronary syndromes (ACS). METHODS: All ACS-diagnosed patients discharged from a university-affiliated hospital during a 3-year period were mailed a questionnaire that included the EQ-5D and the SF-8. The EQ-5D includes a visual analogue scale (EQ VAS) to measure self-reported current health-status (0-100) and a five-item descriptive system measuring mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Also included were disease severity measures [Duke Activity Status Index (DASI), cardiac symptom count (SC), patient-perceived cardiac disease severity], comorbidity measures (Charlson comorbidity index, total medication count), and other demographic and disease-related items. RESULTS: Of 1217 patients, 490 (40.3%) responded. Patients averaged 65.2 (SD 11.3) years of age; 71.0% male; 91.9% Caucasian; 64.3% history of MI. Only 0.2%-0.4% of EQ-5D items and 8% of the EQ VAS were left unanswered by respondents. The nine most common health states were identified based on the five EQ-5D item scores. Levels of responses to EQ-5D items and the EQ VAS score were significantly better for patients with very mild/mild perceived disease severity compared to severe/very severe, for patients with lower comorbidity, for patients with lower symptom responses, and for patients with a higher cardiac-related functioning. EQ VAS score and SF-8 subscale score correlation coefficients ranged from 0.527 to 0.798 (all p < 0.0001). Significant differences were observed between the response level of individual EQ-5D items and scores of comparable SF-8 subscales. CONCLUSIONS: This study demonstrated the construct validity of the EQ-5D in a population-based sample of patients with a history of ACS.

Acute Disease↗

PubMed2006

Construction and validation of tissue microarrays of ductal carcinoma in situ and terminal duct lobular units associated with invasive breast carcinoma.

Construction of tissue microarrays (TMAs) to efficiently characterize large sets of noninvasive epithelial lesions in the breast by immunohistochemistry is an appealing investigative approach, but presents technical challenges. We report methodologic studies performed to optimize methods for building TMAs from noninvasive breast tissues collected in a large case-control study of breast cancer. Using a manual arraying technique with 2.0-mm diameter needles, we constructed TMAs from specimens obtained from 32 women with breast cancer containing the following targets: (1) 28 terminal duct lobular units (TDLUs); (2) 28 ductal carcinomas in situ, and (3) 23 invasive carcinomas. Using careful target selection, we achieved representation of approximately 80% of noninvasive targets with sustained preservation through section 30 of the TMAs. Immunohistochemical staining of TDLU targets demonstrated positive staining for estrogen receptor (ER) in 30.8% of tubules and for progesterone receptor (PR) in 50.0%. To establish an efficient method to evaluate staining results in TDLUs, we created a categorical scoring system to approximate the percentage of tubules containing positive stained cells (<10%, 10% to 50%, >or=50%), and compared the results with those obtained by tubule counting. Comparison between the two methods demonstrated exact agreement for 70.8% of ER and 79.2% of PR stains without two-category discrepancies. ER/PR expression levels in multiple (up to 4) noninvasive targets of the same tissue type (TDLU or DCIS) from a single block showed good correlation. These data suggest that it is feasible to produce TMAs of noninvasive breast structures, albeit with careful selection of targets, and that immunostains of such cores may permit efficient immunohistochemical characterization of peritumoral tissues. Additional exploration of this approach is needed.

Breast Neoplasms↗

PubMed1992

Validation of a patient satisfaction system in the United Kingdom.

This paper describes the results from a study to assess the validity of a patient satisfaction system used extensively in the United Kingdom. The study involved over 700 interviews with patients. The face, content, discriminant and construct validity have been tested. The discriminant and construct validity were judged to be satisfactory and there was some evidence of face validity. The results suggest that this system has the ability to reveal differences in satisfaction between hospitals. The findings from the study are being used to modify the questionnaire design in order to improve the system's ability to indicate which aspects of the service require improvement.

Adolescent↗

PubMed2005

Development of the US PSORIQoL: a psoriasis-specific measure of quality of life.

BACKGROUND: Several instruments are available for assessing impairment and disability associated with psoriasis. The first true psoriasis-specific quality of life (QoL) questionnaire suitable for use in clinical trials, the Psoriasis Index of Quality of Life (PSORIQoL), has recently been developed in the UK. The aim of the current study was to produce and validate a conceptually equivalent US version of the PSORIQoL with equally good psychometric properties. METHODS: A lay translation panel was employed to ensure that the wording of the questionnaire was appropriate for a US population. Semi-structured interviews conducted with 37 patients tested the instrument's ease of completion, relevance and comprehensiveness. Finally, a test-retest validation mail survey was conducted with 72 patients to determine reliability, internal consistency and construct validity. RESULTS: Few changes were necessary to the wording of the questionnaire. Interviewees found the questionnaire easy to complete (requiring an average of 4 min) and the content relevant and comprehensive. The adapted measure had comparable psychometric properties to the original, with a test-retest reliability coefficient of 0.90, indicating excellent reproducibility. Internal consistency and initial indications of construct validity were also good, with scores on the measure related as expected to perceived general health and severity of psoriasis and the presence of visible lesions. CONCLUSIONS: The US PSORIQoL is a practical, reliable and valid instrument for measuring the impact of psoriasis and its treatment on QoL in clinical trials and in routine practice. It remains necessary to establish the instrument's responsiveness to changes in QoL associated with effective interventions.

Adult↗

PubMed1997

The Edmans ADL index: validity and reliability.

The Edmans ADL index was developed to assess functional abilities in stroke patients, including the activities necessary to enable a person to live independently at home, and graded to enable staff to monitor patient's progress over time. Content validity was established by comparing the Edmans ADL index with other published ADL assessments. Construct validity was established by comparing the Edmans and Barthel ADL indices, for 60 patients admitted consecutively to the Nottingham stroke unit. This showed a strong association between assessments. Inter-rater reliability was assessed by two occupational therapists, who independently and simultaneously assessed 20 patients individually on the stroke unit. This showed 96% excellent/good agreement between observers. Test-retest reliability was established by assessing 20 patients, 1 year post-stroke, on two separate occasions, 1 month apart. Results showed 85% excellent/good agreement over time. We conclude that the Edmans ADL index has content and construct validity, is sensitive to change over time, and has inter-rater and test-retest reliability.

Activities of Daily Living↗

PubMed1995

Unified Neurological Stroke Scale is valid in ischemic and hemorrhagic stroke.

BACKGROUND AND PURPOSE: The growing interest in testing new therapeutic agents for acute brain injury has lead to increased use of stroke scales. The reliability and validity of these measures need to be examined more completely. We used structural equation modeling, a technique that merges the analytic procedures of factor analysis and multiple regression, to examine the reliability and construct validity of the Middle Cerebral Artery Neurological Scale and the Scandinavian Neurological Stroke Scale used together as the Unified Neurological Stroke Scale. We also analyzed the predictive validity, sensitivity, and specificity of the scales in predicting mortality and functional outcome. METHODS: We prospectively studied 84 consecutive patients admitted to a neurology/neurosurgery intensive care unit with intracerebral hemorrhage (n = 30), subarachnoid hemorrhage (n = 15), ischemic stroke (n = 15), and traumatic brain injury (n = 24). Patients were evaluated within 24 hours of admission and at 48-hour intervals until intensive care unit discharge. A total of 386 assessments were obtained. The Functional Independence Measure was administered by telephone 3 months after hospital discharge. RESULTS: High levels of reliability and construct validity were observed for the majority of the Unified Stroke Scale items. Facial palsy and eye movement items had the lowest reliability and validity. Both the Middle Cerebral Artery and Scandinavian Scales were significant predictors of outcome. Sensitivity and specificity varied by diagnosis. Predictive validity of functional outcome was best in groups with ischemic and hemorrhagic stroke rather than traumatic brain injury and subarachnoid hemorrhage. CONCLUSIONS: The Unified Stroke Scale demonstrates reliability and construct and predictive validity, and its use is supported in ischemic and hemorrhagic stroke. Structural equation modeling is an appropriate technique for use with scales of this type.

Activities of Daily Living↗

PubMed1999

The Spanish Version of the Quality-of-Life in Epilepsy Inventory (QOLIE-31): translation, validity, and reliability.

PURPOSE: Spanish adaptation of the Quality of Life in Epilepsy Inventory (QOLIE-31). METHODS: Internal consistency and construct validity of the Spanish translation of the QOLIE-31 were tested in 252 patients with epilepsy. Patients also were administered the General Health Questionnaire (GHQ-28), and the Nottingham Health Profile (NHP). Two weeks after the first test, a subgroup of randomly selected patients were readministered the QOLIE-31 along with a new five-option question about change in health status. Patients reporting no change in health status were included in the study of temporal stability. Sensitivity to clinical change was assessed in 31 additional patients who had successfully undergone epilepsy surgery. RESULTS: The QOLIE-31 was highly correlated with the GHQ-28 (r = -0.63) and the NHP (r = -0.69), demonstrating construct validity. Cronbach's alpha coefficient was 0.92, showing the items of the QOLIE-31 to be interdependent and homogeneous. For a 2-week test retest, both Pearson product-moment correlation and intraclass correlation coefficients were 0.90, indicating temporal stability. Sensitivity to clinical change was suggested by a significant mean difference between the global scores both before and after epilepsy surgery (-21.87, p<0.0001; 95% CI, -28.08 to -15.66). The standardized response mean of the global score was 1.67, and the effect size was 1.35, both indicating large clinical change as a result of seizure relief. CONCLUSIONS: The similarity of psychometric properties between the English and the Spanish versions of the QOLIE-31 supports their conceptual equivalence. The questionnaire's responsiveness to clinical change suggests its utility in outcome assessment of drug trials and epilepsy surgery.

Adult↗

PubMed1985

"Negative symptoms": conceptual and methodological problems.

Research into the so-called negative symptoms of schizophrenia is plagued by often ignored problems in item identification, scale selection, quantification, clinical assessment process, and symptom (and, probably, causal) nonspecificity. Neither a negative symptom syndrome per se nor the recent rating scales designed to measure it have been validated, although some data useful in this regard have been presented for the scales. Since no criterion against which to validate these scales exists, construct validation is needed. The construct of negative symptoms, as defined by its hypothesized empirical relationships with other variables, and the procedures used to measure it must be validated simultaneously and gradually through a programmatic series of studies. In the meantime, research results pertaining to negative symptoms should be interpreted with considerable caution.

Arousal↗

PubMed2005

Validation of a short questionnaire in English and French for use in patients with persistent upper gastrointestinal symptoms despite proton pump inhibitor therapy: the PASS (Proton pump inhibitor Acid Suppression Symptom) test.

BACKGROUND: The management of persistent symptoms during acid suppression therapy in patients with gastroesophageal reflux disease or dyspepsia might be improved if patient-physician communication regarding the presence and character of these persistent symptoms were facilitated. AIM: To validate a short, simple questionnaire (the Proton pump inhibitor [PPI] Acid Suppression Symptom [PASS] test), in English and French, to identify patients with persistent acid-related symptoms during PPI therapy and document their response to a change in therapy. METHODS: Patients with persistent acid-related symptoms on PPI therapy were interviewed to produce a draft, five-item questionnaire; content validity was evaluated by focus groups comprising English- and French-speaking patients. Psychometric validity was subsequently evaluated in a multicentre, family practice-based study of English- and French-speaking patients with persistent acid-related upper gastrointestinal symptoms despite PPI therapy. The PASS test, Global Overall Symptom scale, Gastrointestinal Symptom Rating Scale (GSRS), Quality of Life in Reflux and Dyspepsia questionnaire and Reflux Disease Questionnaire were completed at baseline and repeated after one week while patients continued their original PPI therapy. All patients then received esomeprazole 40 mg once daily for four weeks, after which all questionnaires and an evaluation of overall treatment effect were completed. RESULTS: Content validity was established in 20 English- and 16 French-speaking patients. Psychometric validation in 158 English- and 113 French-speaking patients revealed good-to-excellent test-retest reliability coefficients: 0.76 for English; 0.68 for French. For construct validity, the PASS test showed moderate-to-high correlation with the GSRS scale (0.51 for English; 0.43 for French). After four weeks of therapy, the PASS test score fell to zero in 30% of English- and 33% of French-speaking patients, while the Global Overall Symptom score fell to one (no symptoms) in 32% of patients (English- and French-speaking); the PASS test demonstrated good responsiveness in comparison with the GSRS, Reflux Disease Questionnaire and Quality of Life in Reflux and Dyspepsia questionnaire. CONCLUSION: The five-item PASS test is a valid tool for the evaluation of persistent acid-related symptoms in patients receiving PPI therapy. It demonstrates good content validity, test-retest reliability, responsiveness and construct validity in both English and French forms. The PASS test is a simple, clinically applicable tool for the identification of patients with persistent acid-related symptoms during therapy and the assessment of their responses to a change in therapy.

Dyspepsia↗

PubMed2005

[The Oswestry index for low back pain translated into Arabic and validated in a Arab population].

OBJECTIVE: To translate into Arabic and validate the Oswestry index for low back pain in an Arab population. BACKGROUND: No functional disability index to assess low back pain written in the Arabic language and validated in an Arab population is available. DESIGN: Arabic translation of the Oswestry index was obtained by the "forward translation/backward translation" method. Adaptations were made after a pilot study involving ten patients aged 18 to 65 years old. Impairment outcome measures (pain as measured on a visual analog scale [VAS], Schober-McRae, index, duration of morning stiffness and number of night awakenings), disability (Quebec index, Waddell index), handicap (as measured on a VAS) and Beck depression scale scores were recorded. Inter-rater reliability was assessed by use of the intra-class correlation coefficient (ICC) and the Bland and Altman method. Construct validity was investigated with use of the Spearman rank correlation coefficient (convergent and divergent validity), and factor analysis was performed. Internal consistency was assessed by use of the Cronbach alpha coefficient. RESULTS: Eighty Tunisian patients with low back pain were included in the validation study. Two items were excluded. Inter-rater reliability was excellent (ICC = 0.98). Expected divergent and convergent validity results suggested good construct validity. Two main factors were extracted by factor analysis and explained 58.19% of the cumulative variance: the first factor represented discomfort in dynamic activities, the second discomfort in static activities. The Cronbach alpha coefficient was 0.76 for factor 1 and 0.70 for factor 2. CONCLUSION: We translated into and adapted the Oswestry index for the Arabic language in a population of Tunisian women? with low back pain. The 8-item version is reliable and valid. Although the scale was validated in a Tunisian population, we expect that it is suitable for other Arab populations, especially North Africans. Further study is needed to confirm such a hypothesis.

Adolescent↗

PubMed1998

[Validity and reliability of a new questionnaire on patient satisfaction in rehabilitative therapy].

BACKGROUND: The aim of this study was to examine some psychometric properties of a new questionnaire measuring patients' satisfaction with respect to the quality of care during stay in a rehabilitation unit. The instrument (called SAT-16) is composed of 16 four-level items and 2 open-ended questions. The construct validity of the 16-item section was already demonstrated in a previous study based on factorial analysis. In this study the concurrent validity, further aspects of the construct validity and test-retest reliability were analyzed. METHODS: The SAT-16 was administered to 339 inpatients, admitted consecutively to a Rehabilitation Center. RESULTS: 262 questionnaires (77%) were returned, of which 221 with all items filled in. The SAT-16 correlated well with two other measures of satisfaction (CSQ-8 and global satisfaction regarding the hospital stay). The answers to two open-ended questions came out to be consistent with those to the 16 closed-ended questions. The high values for the indices of test-retest reliability (ICC and kappa) are evidence of the stability of the scores in two repeated administrations. CONCLUSIONS: The SAT-16 was found to be provided with good psychometric characteristics. It can be proposed as a valid instrument for use in clinical practice for the continuous quality improvement of inpatient medical rehabilitation programmes.

Adult↗

PubMed1986

Testing a classification instrument for the ambulatory care setting.

The purpose of this study was to evaluate the construct validity, generalizability, and interrater reliability of an instrument designed to measure the complexity of nursing care in the ambulatory care setting. The conceptual framework for the development of the classification instrument was adapted from a theory of organizations and is based upon knowledge technology. Previous research using the Delphi methodology delineated 44 activity categories for the classification instrument. These categories were organized under six literature-based responsibility areas. The instrument was tested in seven areas of one hospital-based ambulatory care setting. A total of 641 valid patient ratings were used for the analysis. Results indicate the instrument has beginning construct validity and high interrater reliability with training. It is not generalizable across services unless the effect of clinic type on nursing care complexity is considered.

Ambulatory Care↗

PubMed2006

Toward a model of drug relapse: an assessment of the validity of the reinstatement procedure.

BACKGROUND AND RATIONALE: The reinstatement model is widely used to study relapse to drug addiction. However, the model's validity is open to question. OBJECTIVE: We assess the reinstatement model in terms of criterion and construct validity. RESEARCH HIGHLIGHTS AND CONCLUSIONS: We find that the reinstatement model has adequate criterion validity in the broad sense of the term, as evidenced by the fact that reinstatement in laboratory animals is induced by conditions reported to provoke relapse in humans. The model's criterion validity in the narrower sense, as a medication screen, seems promising for relapse to heroin, nicotine, and alcohol. For relapse to cocaine, criterion validity has not yet been established primarily because clinical studies have examined medication's effects on reductions in cocaine intake rather than relapse during abstinence. The model's construct validity faces more substantial challenges and is yet to be established, but we argue that some of the criticisms of the model in this regard may have been overstated.

Alcoholism↗