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Using Monte Carlo techniques to judge model prediction accuracy: validation of the pesticide root zone model 3.12.

Individuals from the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) Environmental Model Validation Task Force (FEMVTF) Statistics Committee periodically met to discuss the mechanism for conducting an uncertainty analysis of Version 3.12 of the pesticide root zone model (PRZM 3.12) and to identify those model input parameters that most contribute to model prediction error. This activity was part of a larger project evaluating PRZM 3.12. The goal of the uncertainty analysis was to compare site-specific model predictions and field measurements using the variability in each as a basis of comparison. Monte Carlo analysis was used as an integral tool for judging the model's ability to predict accurately. The model was judged on how well it predicts measured values, taking into account the uncertainty in the model predictions. Monte Carlo analysis provides the tool for inferring model prediction uncertainty. We argue that this is a fairer test of the model than a simple one-to-one comparison between predictions and measurements. Because models are known to be imperfect predictors prior to running the model, the inaccuracy in model predictions should be considered when models are judged for their predictive ability. Otherwise, complex models can easily fail a validation test. Few complex models, such as PRZM 3.12, would pass a typical model validation exercise. This paper describes the approaches to the validation of PRZM 3.12 used by the committee and discusses issues in sampling distribution selection and appropriate statistics for interpreting the model validation results.

Forecasting↗

Interexaminer reliability and clinical validity of the temporomandibular index: a new outcome measure for temporomandibular disorders.

AIMS: The operational definitions for the Craniomandibular Index (CMI) were redesigned to conform precisely to those of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), resulting in a single examination protocol, the Temporomandibular Index (TMI). The objectives were to evaluate interexaminer reliability of the TMI as well as its criteria and construct validity for measurement of TMD severity. METHODS: Interexaminer reliability of the TMI was assessed on 12 subjects. Criterion validity of the TMI was evaluated relative to the CMI, the latter having established validity. Construct validity of the TMI was evaluated for its capacity to differentiate TMD patients (n = 79) from normal subjects (n = 20) and to detect changes in severity over time. RESULTS: The examiner's average TMI scores were 0.27 +/- 0.19 (SD) and 0.26 +/- 0.20. Agreement was excellent, with an intraclass correlation coefficient (ICC) of 0.93. The scores for the TMI and the CMI correlated highly, with an ICC of 0.97. Statistical contrasts between the symptomatic groups and the normal subjects were highly significant (P < .001). In 20 TMD patients who underwent treatment for their disorder, their mean change of 0.12 from their pretreatment TMI scores was highly significant (P < .001). CONCLUSION: This study has provided statistical evidence for the clinical reliability and validity of the TMI, which indicates that the RDC examination protocol is appropriate for determining TMD severity by the TMI algorithm, and diagnosis of TMD subtypes by the RDC algorithm.

Adolescent↗

Diagnostic validity statistics and the MCMI-III.

This article (a) describes and illustrates the nonredundant and clinically important information that may be obtained from 5 diagnostic validity statistics (DVSs): incremental validities of positive and negative test diagnoses, Cohen's kappas, Cohen's effect sizes, and areas under receiver operating characteristic (ROC) curves and (b) determines values of these DVSs for 24 Million Multiaxial Clinical Inventory III scales from results reported in 1994 and 1997 validity studies. The DVSs for the 1997 study (T. Millon, R. Davis, & C. Millon, 1997) were often more than 3 times larger than corresponding DVSs for the 1994 study (T. Millon, 1994). The author suggests these large differences could reflect not only effects of factors that caused underestimation of validities by DVSs of the 1994 study, but also effects of factors that may have caused overestimation of validities by DVSs of the 1997 study.

Diagnosis, Differential↗

Adaptation and validation of a gastroesophageal reflux questionnaire for use on a Spanish population.

OBJECTIVE: To produce and validate for telephone use in Spain a cross-cultural adaptation of the gastroesophageal reflux questionnaire (GERQ) developed by Locke et al. MATERIAL AND METHOD: The Spanish version of the questionnaire was developed through translation, assessment of comprehensibility, back translation, and appraisal of applicability. Subsequently, reproducibility was measured by a test-retest procedure in 125 patients, and concurrent validity was evaluated by comparing self-reported questionnaire data against a gastroenterologist's findings from clinical interviews with 50 patients. RESULTS: The Spanish version showed itself to be easily understandable and widely applicable. Reproducibility for the two cardinal symptoms of gastroesophageal reflux disease (heartburn and acid regurgitation) as measured by the kappa index (95% confidence interval), was 0.85 (0.73-0.97) and 0.81 (0.70-0.92), respectively. With respect to the process of concurrent validation, kappa values (95% confidence interval) for heartburn and acid regurgitation were 0.85 (0.68-1) and 0.91 (0.79-1), respectively. Median kappa for all questions on the questionnaire was 0.75 (range: 0.42 a 1) in the reproducibility analysis and 0.83 (range: 0.44 a 1) in the concurrent validity analysis. CONCLUSIONS: The reproducibility and concurrent validity of the Spanish version of the GERQ is excellent and comparable to that of the original English version.

Cross-Cultural Comparison↗

Cross cultural adaptation and validation of the Arabic version of the Childhood Health Assessment Questionnaire for measuring functional status in children with juvenile idiopathic arthritis.

OBJECTIVE: To cross culturally adapt the American-English version of the Childhood Health Assessment Questionnaire (CHAQ) and to evaluate the validity and reliability of the modified translated version on children with juvenile idiopathic arthritis (JIA). METHODS: A cohort of 62 children suffering from JIA (32 Egyptian, 30 Saudi Arabian) were recruited and asked to participate in the study. Two questions had been changed to suit the Arabic culture and to tackle some aspects that are more typical of the Arabic culture. After modification, translation and back translation of the questionnaire, it was administered to the selected patients as well as their parents and tested for internal consistency, reliability and construct validity by correlating the yield of the questionnaire with other disease activity parameters. The questionnaire was administered again after a one-week interval for evaluation of the reliability of this test. The modified questions were tested for their loyalty to the principal component and their correlation with that of the other unchanged items was compared. RESULTS: CHAQ proved to be valid in clinically discriminating between healthy subjects and patients with different patterns of JIA. Test-retest showed strong reliability with a high percentage of agreement and high kappa values. Internal consistency showed a high value for the standardized Cronbach's alpha (0.951), and this value did not show any significant change when any one of the items was eliminated. The modified questionnaire showed a strong and significant validity when its results were correlated with disease activity parameters. CONCLUSION: The Arabic CHAQ is a reliable and valid instrument that can be administered to Arabic children suffering from JIA and to their parents, to evaluate the patients' functional disability. Its measurement properties were comparable to versions in other languages.

Activities of Daily Living↗

[Evaluation of Post-traumatic Stress Disorder: validation of a measure, the PCLS].

Post-Traumatic Stress Disorder (PTSD) is a psychiatric disorder frequently found in psychiatric clinic and in the population of victims of traumatic events. PTSD, characterized by an intense fear, helplessness or horror, resulting from exposure to a traumatic event, is clinically manifested with three main syndromes: reexperiencing, avoidance behavior and numbing of emotion, and physiological hyperarousal. The Post-Traumatic Checklist Scale (PCLS) is a brief and self-report questionnaire for evaluating the severity of three main syndromes of PTSD. The scale can be divided into three sub-scores corresponding to the three main syndromes of the disorder: reexperiencing (items 1-5), avoidance (items 6-12) and hyperarousal (items 13-17). The validation studies in English version (Weathers et al., 1993, Blanchard et al., 1996) and French version (Ventureyra et al., 2001) showed that the PCLS possesses good psychometric properties. But the discriminating validation with another pathological group and the sensitivity of the scale to change of treatment have not yet been studied up to now. The aim of this study is the validation of the French version of the PCLS in Post-Traumatic Stress Disorder (PTSD) subjects compared with subjects suffering from other anxiety disorders and non-clinical subjects. The sensitivity of the PCLS after a cognitive behavioral therapy (CBT) for PTSD was studied for the first time. Fifty-seven outpatients suffering from PTSD according to DSM IV criteria, 23 patients suffering from other anxiety disorders and 28 non-clinical subjects were included in this study. All subjects were assessed with the PCLS. The Beck Depression Inventory--13 items (BDI-13) and the Fear Questionnaire (FQ) were used for the two groups of patients. Fifty-five PTSD patients were administered the PCLS twice over an interval of one to two weeks without any intervention in order to determine the test-retest reliability of the PCLS. And 24 PTSD patients were reassessed with the PCLS after 16 sessions of cognitive behavioral therapy (CBT) in order to study the sensitivity to treatment of the PCLS. The CBT technique for PTSD consisted of relaxation, exposition, recital, cognitive restructuration and stress management. The total score and the subscores on the PCLS were found to be significantly higher in PTSD patients than in two control groups: suffering from other anxiety disorders subjects (61.2/41.4, p<0.0001) and non-clinical subjects (61.2/28.8, p<0.0001). The correlation between the PCLS total score and the others measures showed that the PCLS correlated significantly with the depression measure, the BDI-13 (p<0.001), and the sub-scores of Fear Questionnaire (agoraphobia: p<0.001; anxiety-depression: p<0.001; distress: p<0.001), but not with the social phobia sub-score of the FQ. The PCLS showed a satisfactory test-retest reliability in 55 patients (the total score: r=0.75, p<0.0001; the sub-score of reexperiencing: r=0.844, p<0.0001; the sub-score of avoidance: r=0.702, p<0.0001; the sub-score of hyperarousal: r=0.712, p<0.0001). The t-test showed that the total score of the PCLS was significantly reduced in 24 patients after 16 sessions of CBT (the mean gain=13.1, t=5.63, p<0.0001). The results of our study confirm that the PCLS possesses good empirical and discriminating validity and a good sensitivity. The fact that the PTSD patients reported significantly higher total scores on the PCLS and its three subscores than other anxiety disorder subjects and non-clinical subjects indicates that the PCLS differentiates well the patients presenting PTSD from other anxiety disorder subjects and non-clinical subjects. The PCLS total score also correlates significantly with the other measures of psychopathology used in the study, such as measures of phobia (the Fear Questionnaire agoraphobia subscale), depression (the Beck Depression Inventory -13) and distress (the Fear Questionnaire distress subscale). This may be explained by the fact that some PTSD symptoms overlap with those of depression and of anxiety or phobia. The PCLS showed anxiety or phobia. The PCLS showed a satisfactory test-retest reliability. The PCLS is therefore a valid and effective measurement of PTSD. It may be a useful tool for screening and assessing PTSD in clinical practice and research in psychiatry.

Adult↗

Translation, cross-cultural adaptation, and validation of the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Dougados Functional Index (DFI) in a Spanish speaking population with spondyloarthropathies.

OBJECTIVES: The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI) and the Dougados Functional Index (DFI) are the most commonly used instruments to measure disease activity and functioning in ankylosing spondylitis (AS). The aim of this study was to translate, adapt and validate these instruments into the Spanish language. METHODS: The BASDAI, BASFI, and DFI questionnaires were translated into Spanish by three independent bilingual physicians who were familiar with the medical aspects of AS and by one professional translator. Two rheumatologists familiar with instrument validation, and who were aware of the purpose of the study, examined semantic, idiomatic and conceptual issues and produced by consensus unified versions of each instrument. English back-translations from the Spanish were done by a professional translator unaware of the original version. Both English versions were compared, and where needed, modifications to the Spanish versions were made. The Spanish versions were administered to 61 ambulatory patients with AS and to 80 patients with undifferentiated spondyloarthropathy for validation purposes. Reliability and responsiveness were measured in 28 patients participating in a physiotherapy program. RESULTS: Reliability showed an acceptable 24-hour test-retest intraclass correlation coefficient (ICC)--BASFI ICC: 0.68, 95% CI: 0.29-0.85; BASDAI ICC: 0.74, 95% CI: 0.52-0.88 and DFI ICC: 0.87, 95% CI: 0.73-0.94. The construct validity of the instruments was evaluated, and BASDAI was correlated with disease activity measured by the total enthesis count (rs: 0.34); general well being in the last week (rs: 0.7); spinal pain (rs: 0.53) and duration of morning stiffness (rs: 0.64). BASFI correlated with Schöber's test (rs: -0.4); occipital-wall distance (rs: 0.38) and thoracic expansion (rs: -0.3). DFI correlated with Schöber's test (rs: -0.36); occipital-wall distance (rs: 0.29) and chest expansion (rs: -0.3). The correlation among DFI and BASFI was rs: 0.83. All instruments showed clinical responsiveness in the physiotherapy program (baseline and end of program; mean +/- SD): BASDAI: 6.25 +/- 1.97 and 3.07 +/- 2.04 (p = 0.0001); BASFI: 5.68 +/- 2.29 and 2.88 +/- 1.77 (p = 0.0001); DFI: 16 +/- 7.6 and 8.0 +/- 5.5 (p = 0.001) with effect sizes and standardized effect sizes > 1. CONCLUSIONS: The Mexican Spanish versions of the BASDAI, BASFI, and DFI showed adequate reliability, validity and responsiveness to clinical change. These instruments can be used in the clinical evaluation of Spanish-speaking patients with AS.

Activities of Daily Living↗

[Development and initial validation of an instrument to measure the lifestyles of type 2 diabetes mellitus patients 2].

OBJECTIVE: To develop and validate a specific instrument to measure lifestyle of type 2 diabetes mellitus (DM2) patients. MATERIAL AND METHODS: A longitudinal, observational, prospective study was conducted between March 2001 and April 2002 at family medicine healthcare units of the Instituto Mexicano del Seguro Social (Mexican Institute of Social Security (MISS)) in Mexico State's East District. A self-administered instrument (instrument to measure diabetic lifestyles, IMEVID) was designed to measure the lifestyles of diabetic patients. It was submitted for review by a multidisciplinary group of experts who assessed its logical and content validity to measure the lifestyle in DM2 patients. The instrument was administered on two different days to 412 adult subjects with DM2. Some items were excluded on the basis of the frequency with which their answer choices were selected, as well as the item-total correlation, and the item's significant loads in several domains in factorial analysis. RESULTS: The sample population consisted of 389 (94.7% response) subjects who completed the study. Intraclass correlation coefficients for logical and content validity were 0.91 and 0.95 respectively. After depuration of items, the instrument had 25 closed items grouped in 7 domains: nutrition, physical activity, tobacco consumption, alcohol consumption, information on diabetes, emotions, and therapeutic adherence. The global rating of the questionnaire had a Cronbach's alpha of 0.81 and a test-retest correlation coefficient of 0.84. CONCLUSIONS: The specific questionnaire IMEVID is the first to measure the lifestyle in subjects with DM2. It has logical validity, content validity, and a good level of consistency.

Adult↗

[Reliability and validity of a 7-day physical activity questionnaire for elementary students].

OBJECTIVE: To evaluate the use of a 7-day physical activity questionnaire in epidemiologic studies on 4-6th grades children. METHODS: Focus group discussion, observation and expert consultation were used to develop 7-day physical activity questionnaire. The reliability and validity of questionnaire were determined in a sample of 92 children in 4-6th grades who were randomly selected from four schools in urban Beijing. A two-week test-retest reliability was determined. The questionnaire was validated against experts' evaluation and Caltrac motion sensor. RESULTS: For different measures of activity, the agreement was good between the test and retest. Kappa values ranged from 0.46 to 0.79, and the Spearman correlations ranged from 0.66 to 0.87 in boys and 0.57 to 0.82 in girls, with significant difference (P < 0.01). The face validity and content validity were good by experts' evaluation. There was no significant difference between questionnaire results and Caltrac motion sensor for both boys and girls, and the questionnaire correlated significantly (r = 0.46, 0.38 for different measures of activity) with Caltrac motion sensor for boys. CONCLUSION: These data provided evidence that the 7-day physical activity questionnaire yield a reliable estimate of past week physical activity for 4 - 6-grade children and provided valid estimation of past week physical activity for boys.

Child↗

[Validation study of the Depressive Experience Questionnaire].

Sidney Blatt, considering as being insufficient the categorical-symptomatic approach of depression, has worked out a theory of depression and psychopathology that integrates the contributions of psychoanalysis as well as cognitive and developmental psychology. Within a broad psychoanalytic framework, Blatt's formulation focus on the quality of interpersonal relationship, the nature of object representation and early life experiences. Personality development is viewed as the consequence of the interaction of 2 basic developmental tasks: the establishment of the capacity to form stable, enduring, mutually satisfying interpersonal relationships and the achievement of a differentiated, realistic, essentially positive identity. The relationship between these 2 developmental lines involves a complex dialectical process during which progress in each line is essential for progress in the other and which contributes to the development of both a sense of identity and the capacity for interpersonal relatedness. These developmental lines permit not only to define an during individual's primary personality configuration but also enable to identify cognitive structures that are inherent in various forms of psychopathology, including depression. Disruptions at different developmental stages create vulnerability to different subsequent psychological disturbances. Blatt characterised as anaclitic or dependent the axis concerned with interpersonal relationship and as introjective or self-critical the axis concerned with development of the sense of self and identity. Depressive Experience Questionnaire was developed by Blatt et al. to determine the validity of this model of psychopathology which emphazises continuities between normal and pathological forms of depression. The instrument was developed by Blatt et al. by assembling a pool of items describing experiences frequently reported by depressed individual. Sixty-six items were selected and administered to a large nonclinical sample (500 female and 160 male undergraduates). Principal component analysis within sex performed on the answers to DEQ confirmed his assumption in identifying two principal depressive dimensions. The first factor involved items that are primarily externally directed and refer to a disturbance of interpersonal relationships (anaclitism); the second factor consists of items that are more internally directed and reflect concerns about self-identity (self-criticism). A third factor emerged, assessing the good functioning of subject and confidence in his resources and capacities (efficacy). Scales derived from these factors have high internal consistency and substantial test-retest reliability. The solutions for men and women were highly congruent. Factor structure has been replicated in several nonclinical and clinical samples, supporting considerable evidence to the construct validity of the DEQ Dependency and Self-criticism scales. An adolescent form of DEQ (DEQ-A) has successively been developed. Factor analysis revealed three factors that were highly congruent in female and male students and with the three factors of the original DEQ. The reliability, internal consistency and validity of DEQ-A indicate that the DEQ-A closely parallels the DEQ, especially in the articulation of Dependency and Self-criticism as two factors in depression. These formulations and clinical observations about the importance of differentiating a depression focused on issues of self-criticism from issues of dependency are consistent with the formulations of others theorists which, from very different theoretical perspectives, posit 2 types of depression, one in which either perceived loss or rejection in social relationships is central and the other in which perceived failure in achievement, guilt or lack of control serves as the precipitant of depression. These 2 types of experiences have been characterized as dominant other and dominant goal , as anxiously attached and compulsively self-reliant and as sociotropic and autonomous . Our work presents the results of a validation study of both forms of Blatt's questionnaire (for adults--DEQ--and for adolescents--DEQA) translated in French in a large population of normal subjects, aged 15 to 45 years. DEQ and DEQ-A were compared by inspection of items loading strongly on each factor and by correlation of the three factors of adults and adolescents. The exploratory factor analysis of DEQ and DEQA revealed three orthogonal factors, corresponding with Blatt's original dimensions. Consistency and external validity were adequate for all 3 factors of DEQ and DEQ-A. Anaclitism and self-criticism dimensions of DEQ and DEQ-A correlate positively with measures of depression (DSM-IV, Beck Depression Inventory), consistently with the results obtained by Blatt. Differently from this author, anaclitism appears to be less differentiated in males than in females, suggesting that the concept of dependence could assume different relevance for men and women.

Adult↗

Reliability and validity of opiate use self-report in a population at high risk for esophageal cancer in Golestan, Iran.

OBJECTIVE: To assess the reliability and validity of self-reported opium use in a rural Iranian population at high risk for esophageal cancer in preparation for a large cohort study. METHOD: 1,057 subjects ages 33 to 84 years were recruited from Gonbad city and three surrounding villages in Golestan province of Iran and completed a questionnaire and provided biological samples. The history and duration of using opium, smoking tobacco, chewing nass, and drinking alcohol were measured by questionnaire in the entire cohort. A subgroup of 130 people was reinterviewed after 2 months to assess reliability. Validity of the opium question was assessed by comparing the questionnaire responses with the presence of codeine and morphine in the urine of 150 selected subjects. RESULTS: Self-reported opiate use is reliable and valid in this population. The reliability of ever opium use and duration of opium use had kappa's of 0.96 and 0.74, respectively. The validity of self-reported opium use was also high. Using urine codeine or morphine as the gold standard for use of opium, self-report had a sensitivity of 0.93 and a specificity of 0.89. CONCLUSIONS: The self-reported use of opium can provide a reliable and valid measurement in this population and will be useful for studying associations between opium use and occurrence of esophageal cancer and other diseases.

Adult↗

[Reliability and validity of Turkish form of Endicott Work Productivity Scale].

OBJECTIVE: The Endicott Work Productivity Scale (EWPS) is a brief self-report questionnaire designed to enable investigators to obtain a sensitive measure of work productivity. The purpose of the study was to investigate reliability and validity of the Turkish form of EWPS. METHOD: The study was performed with two separate groups; a patient group (n=74) and a community sample (n=107). Through the adaptation process the original form was translated into Turkish, and translated back into English. Statistical tests about construct validity, the concurrent validity, the test re-test reliability and internal consistency were performed. RESULTS: The internal consistency coefficient (Cronbach's alpha) was >.90 for both groups. The correlations of the individual items with the EWPS total scores ranged between.32 and.75. EWPS and HAM-D scores of the patient group was positively correlated (r =.52 and r =.62). The CGI scores correlation was.64 and SF-36 social functioning subscale was correlated negatively (r= -.43). The correlations of the test-retest scores of EWPS were.76. There was a significant mean difference between the total scores of patient and the community groups. CONCLUSION: The Turkish form of EWPS was found to be valid and reliable. The findings concerning the reliability and the validity of the EWPS indicate that this instrument can be used in the studies that will be conducted in Turkey.

Depressive Disorder↗

Reliability and validity of the Pressure Management Inventory in a Malaysian population.

There is a general lack of valid tools to measure work stress of Malaysian. This study examines the validity and reliability of the Pressure Management Inventory (PMI). Reliability was evaluated using test retest method, and its correlation coefficient was calculated using Pearson's r. Internal consistencies were examined using Cronbach's Alpha. For precision, the Intraclass coefficients (ICC) were calculated for all the scales. Face Validity and Content Validity were assessed using an open-ended questionnaire on 6 content experts (psychiatrists in HKL). The results show good internal consistencies (alpha < or = 0.7) for most subscales, with the best results in the 'Pressure Scale'. The weak scales are 'Individual-Differences' scale and 'Social Support' scale. The test-retest correlation coefficients were significant at the level of p<0.001 for all, except one scale. The ICC coefficients were high (>0.7) for most scales, particularly for Pressure, Health and Coping Scales. The PMI is a suitable, reliable and valid tool to measure stress of Malaysians. More in-depth study with a wider sampling needs to be carried out to add confidence of its usage on Malaysians.

Adolescent↗

Validation of the HITS domestic violence screening tool with males.

BACKGROUND AND OBJECTIVES: To date, screening tools for domestic violence have been validated only for use with female patients. A four-item HITS (Hurt-Insult-Threaten-Scream) screening tool is one of those instruments. The purpose of the current research was to validate the HITS screening tool in a population of male patients. METHODS: In Phase I of the study, 78 non-victim male subjects from an ambulatory clinic, a Human Immunodeficiency Virus (HIV) clinic, or emergency room completed the HITS and the Conflict Tactics Scale to establish the concurrent validity of the HITS. In Phase II, Optimal Data Analysis (ODA) was used to establish the construct validity of the HITS by identifying the score that reliably differentiated Phase I non-victims from 17 self-identified male victims of domestic violence. RESULTS: Concurrent validity of the HITS was good. ODA found that the score of 11 on the HITS differentiated between non-victims and victims. Sensitivity and specificity were 88% and 97%, respectively. Predictive values were 97% for non-victims and 88% for victims. The positive and negative likelihood ratios were 34.41 and 0.12, respectively. CONCLUSIONS: HITS differentiated between male victimized respondents from non-victims in clinical settings.

Adolescent↗

The validity and reliability of the Knowledge of Women's Issues and Epilepsy (KOWIE) Questionnaires I and II.

The Knowledge of Women's Issues in Epilepsy (KOWIE) Questionnaires I and II were developed to assess what women with epilepsy (WWE) and practitioners know about relevant topics and concerns. Prior to disseminating any tool, an instrument should be both valid and reliable. The purpose of this study was to report the validity and reliability of the KOWIE Questionnaires I and II. To establish validity, the original KOWIE was sent to five experts who critiqued the relevance of each item. A content validity inventory (CVI) was developed later and sent to 20 additional epilepsy experts across the country. Tool stability was evaluated by test-retest procedures. Patients and practitioners completed corresponding tools on day one, and 24 hours later, on day two. Participants were asked to not review information on the topic of interest until after study procedures were completed. Sixteen of 20 expert responses were included in data analysis; 4 were excluded due to incomplete data. The CVI correlation coefficient was 0.92. Test-retest results from all 9 patients and 18 of 20 healthcare professionals were included in data analysis. Correlation coefficients were 0.88 and 0.83 for the KOWIE I and II, respectively, confirming these questionnaires are valid and reliable. While future knowledge may require altering both tools, the current instrument may be used as an assessment tool and guide intervention as it pertains to outcomes in WWE.

Anticonvulsants↗

Psychometric validation of the French version of the side-effects and life satisfaction inventory (SEALS) in epileptic patients: comparison with the QOLIE-31 inventory and a generic quality of life questionnaire.

A psychometric evaluation of a French version of the side-effects and life satisfaction inventory (SEALS) was carried out. SEALS was compared to the quality of life in epilepsy-31 questionnaire (QOLIE-31) and a generic, health-related quality-of-life questionnaire, the Nottingham health profile (NHP). The psychometric properties of SEALS, assessed in 190 adult subjects with epilepsy, included: acceptability, test-retest reliability and validity, multitrait analysis including internal consistency and item-to-scale correlations, construct validity using factor analysis and discriminative validity using associations with disease characteristics and treatment effects, and, correlations with NHP and QOLIE-31 scores for convergent and divergent validity. Both acceptability and reproducibility were good and internal consistency was high (Cronbach's alpha coefficient = 0.92). Factor analysis with varimax rotation identified five factors: the first, related to cognitive function accounted for 26.0% of the variance. Discriminative validity was good for most treatment characteristics (tolerability, seizure control, compliance) and clinical features (epilepsy type, seizure frequency and severity, depressive symptoms). Correlations with the NHP and QOLIE-31 scores were consistently strong. It was concluded that the psychometric properties of the French translation of SEALS were similar to the original English version. In addition, SEALS provides information on quality of life that is complementary to that obtained with QOLIE-31. In particular, with respect to the QOLIE-31, the SEALS provides information on cognitive and neuropsychological aspects of impairment of quality of life, whereas the QOLIE-31 has a broader scope, taking into account multiple aspects of quality of life in epilepsy.

Adolescent↗

Cross-validation of a self-report scale for postoperative pain in school-aged children.

The present study cross-validated self-report pain scales: Verbal Rating Scale (VRS), Facial Expression Scale (FACES), Color Analogue Scale (CAS) and Poker Chip Tool (PCT) in Thai children aged 5-12 years. The concordance with observational measure, Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) was also tested. Among 100 students, test-retest reliability of all self-report measures was moderate to good (K = 0.501-0.712) and only FACES yielded acceptable face validity(IC > 0.5). Validation in 87 patients, all scales showed construct and concurrent validity. FACES was the most preferred scale. Agreement of self-report measures and CHEOPS was better in the age group 5-8 years (K = 0.417-0.826) than 9-12 years (K = 0.231-0.529). In conclusion, FACES is a valid, reliable and practical tool. Self-report measures are more in concordance with CHEOPS in the younger age group.

Child↗

Validation of the asthma quality of life questionnaire (AQLQ-UK English version) in Indian asthmatic subjects.

BACKGROUND: The Asthma Quality of Life Questionnaire (AQLQ) has been shown to have strong measurement properties. Quality of life instruments need to be validated under local conditions before these can be accepted for application in that community. The AQLQ has not been formally validated in India. OBJECTIVES: To measure the evaluative and discriminative properties of the AQLQ (UK English version) in Indian asthmatics. METHODOLOGY: Thirty-eight adult patients with asthma underwent spirometry and completed the AQLQ and the Asthma Control Questionnaire (ACQ), administered by an interviewer. Standard treatment was given for four weeks during which daytime and nocturnal symptoms of asthma, and use of rescue medication were recorded in diaries. The questionnaires were administered again at the end of four weeks and spirometry was repeated. RESULTS: The total and domain-wise scores of AQLQ improved in patients whose control of asthma improved during treatment. It had good reproducibility with no changes in scores in patients whose condition remained stable, and also high intraclass correlation coefficients for the total and domain-wise scores in these patients. Significant correlations were found between the changes in AQLQ scores and in ACQ scores confirming the longitudinal construct validity. The symptoms domain score of the AQLQ was related significantly to the patient diary-recorded scores of cough, sputum and nocturnal asthma. Cross-sectional construct validity of AQLQ was established by demonstrating significant correlation of total, and symptoms and emotions domain scores with the ACQ scores. CONCLUSIONS: It was concluded that the AQLQ (UK English version) has sufficiently acceptable evaluative and discriminatory properties in Indian subjects and is therefore a valid instrument for quality of life measurements in clinical and research studies in asthmatics in Indian patients.

Adult↗