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Validation of a Dutch translation of the fibromyalgia impact questionnaire.

OBJECTIVES: To validate a Dutch translation of the fibromyalgia impact questionnaire (FIQ). MATERIALS AND METHODS: Data were taken from two randomized clinical trials on Spa treatment and venlafaxine in fibromyalgia (FM). Participants completed the Dutch FIQ and a set of validated questionnaires for general health (RAND-36), depression (Beck depression inventory, BDI), pain (McGill pain questionnaire, MPQ) and fatigue (checklist individual strength, CIS). Internal consistency within the FIQ item 'physical functioning' was studied using Cronbach's alpha. Test-retest reliability was studied with intra-class-correlation (ICC) in a subsample of 76 control subjects over a 3 month period without specific intervention. Construct validity was evaluated by correlating the FIQ to other questionnaires. Sensitivity to change was studied using standardized response means (SRM). RESULTS: The study sample consisted of 213 women and 11 men (mean age 47 yrs, mean disease duration 11 yrs). Cronbach's alpha for the item 'physical functioning' was 0.91, indicating high internal consistency. Test-retest reliability was acceptable, with ICC ranging from 0.45 for 'morning tiredness' to 0.71 for 'physical function'. FIQ correlated significantly with the RAND-36, with Spearman's rho ranging from -0.60 to -0.70 for items measuring the same concept. Similar patterns of correlation were seen with MPQ, BDI and CIS. Sensitivity to change was sufficient, with SRM after Spa treatment ranging from 0.3 for 'work days missed' to 0.9 for 'days felt good'. Similar SRM were found in the venlafaxine trial for patients reporting general improvement. CONCLUSION: The Dutch FIQ is a valid instrument for measuring health status in FM, showing sufficient reliability, construct validity and responsiveness.

Activities of Daily Living↗

Development of the Childhood Atopic Dermatitis Impact Scale: initial validation of a quality-of-life measure for young children with atopic dermatitis and their families.

To measure the effects of atopic dermatitis (AD) on the quality of life of affected young children and their families, we developed a prototype 62-item instrument, the Childhood Atopic Dermatitis Impact Scale (CADIS). The prototype CADIS was developed from a comprehensive conceptual framework based on data from parents and clinicians. The instrument had eight subscales (four each for child and parent): physical health, emotional health, physical functioning, and social functioning. The goal of this work was to test the validity of and to refine the prototype of CADIS. Two hundred seventy parents of children under the age of 6 y with AD responded to the instrument. Content validity was demonstrated by expert and parent reviews of the drafted and refined instrument, and by analyzing parents' responses to open-ended questions about their children's skin disease. Construct validity was assessed in exploratory factor analyses which supported a refinement in the conceptual framework to consist of two dimensions with five domains: child dimensions (symptoms and activity limitation/behavior), and parent dimensions (family/social function, sleep, and emotions). Seventeen items were eliminated, yielding a 45-item refined version of CADIS (score 0-180) with evidence of content and construct validity and suggested use in clinical research.

Adolescent↗

Balance in personal care home residents: a comparison of the Berg Balance Scale, the Multi-Directional Reach Test, and the Activities-Specific Balance Confidence Scale.

PURPOSE: This study used the Berg Balance Scale (BBS), the Multi-Directional Reach Test (MDRT), and the Activitiesspecific Balance Confidence Scale (ABC) to quantify balance of elderly residents of a personal care home. The reliability and construct validity of these measures were also examined. METHODS: Twenty one females and 5 males, 74 to 92 years old, participated. Participants completed each balance test once, during 2 testing sessions. Reliability was quantified using intraclass correlation coefficients (ICCs). Construct validity was quantified using Pearson's correlation coefficients (r) and Cronbach's alpha. RESULTS: The mean (+/-sd) scores were: BBS=41.3+/-9.0, MDRT (forward=5.6+/-3.0 in, backward=2.9+/-2.2 in, right=3.3+/-2.5 in, left=3.7+/-3.1 in), and ABC=54.0+/-24.9%. Inter-rater reliability was good for the BBS and MDRT (ICC=0.88-0.98). Test-retest reliability was moderate to good for all 3 balance tests (ICC=0.66-0.83). Pearson's correlations between the BBS and MDRT were moderate to good (r=0.53-0.78), and correlations involving the ABC were fair to moderate (r=0.41-0.59). Cronbach's alpha was strong (0.80) when only the MDRT and BBS were included. CONCLUSIONS: Results indicate residents of personal care homes are at high fall risk. The balance tests showed moderate to good reliability for this population. The BBS and MDRT appear to be valid measures of motor ability to maintain balance, while the self report ABC appears to measure a different component of the balance construct in this population.

Aged↗

Validation of the Dutch version of the CDC core healthy days measures in a community sample.

An important disadvantage of most indicators of health related quality of life used in public health surveillance is their length. In this study the authors investigated the reliability and validity of a short indicator of health related quality of life, the Dutch version of the four item 'CDC Core Healthy Days Measures' (CDC HRQOL-4). The reliability was evaluated by calculating Cronbach's alpha of the CDC HRQOL-4. The concurrent validity was tested by comparing the CDC HRQOL-4 with three other indicators of health related quality of life, the SF-36, the WHOQoL-BREF and the GHQ-12. The construct validity was evaluated by assessing the ability of the CDC HRQOL-4 to discriminate between respondents with and without a (non-mental) chronic condition, depression, a visit to the general practitioner and use of prescription drugs. Randomly sampled respondents from the city of Utrecht were asked to fill in a questionnaire. 659 respondents (response rate 45%) completed the questionnaire. Participants represented the adult, non-institutionalised population of the city of Utrecht, the Netherlands: 58% women; mean age 41 years; 15% of non-Dutch origin. The reliability of the CDC HRQOL-4 was good. Cronbach's alpha of three of the four CDC HRQOL-4-items was 0.77 which is good for internal consistent scales. The concurrent validity was good. The four items of the CDC HRQOL-4 showed higher correlations with their corresponding domains of the other instrument than the other domains. Comparison of respondents with or without a chronic condition, depression, visit to the GP and use of prescription drugs produced evidence for an excellent construct validity of the CDC HRQOL-4.

Adolescent↗

Reliability and validity of the digestive health status instrument in samples of community, primary care, and gastroenterology patients.

AIM: We evaluated a previously reported digestive health status instrument in community, primary care, and gastroenterology practice populations. Multiple types of reliability, validity and responsiveness were assessed to determine the performance of the questionnaire. METHODS: Study populations included community, primary care and gastroenterology subjects. Psychometric analyses included internal consistency and test-retest reliability, criterion and construct validity, and responsiveness. RESULTS: Acceptable internal consistency was seen on all scales in all three populations. Test-retest reliability was excellent in a speciality population with reflux disease. Criterion validity was demonstrated by strong correlation of reflux scale scores and results on 24-h pH monitoring. Scale scores varied predictably in those receiving gastrointestinal tract imaging and according to diagnosis, indicating construct validity. The reflux scale and pain index were sensitive to change with treatment for reflux disease. Multi-trait scaling analyses from the community sample revealed a structure equivalent to that reported from a primary care sample. CONCLUSIONS: The reliability and validity of the digestive health status instrument on multiple measures in multiple settings have been demonstrated. The instrument was responsive to change with treatment for reflux disease. The demonstrated robustness attests to the suitability for future studies and clinical application.

Adult↗

Identifying patients who require a change in their current acute migraine treatment: the Migraine Assessment of Current Therapy (Migraine-ACT) questionnaire.

The aim of the study was to design and test a new, easy to use, assessment tool, the Migraine Assessment of Current Therapy (Migraine-ACT), for identifying patients who require a change in their acute treatment. A 27-item questionnaire was developed by an international advisory board including questions formulated in four domains: headache impact, global assessment of relief, consistency of response and emotional response. Migraine patients entered a multinational, prospective study to investigate the test-retest reliability and construct validity of the tool, which was completed by the patients on two occasions. Test-retest reliability was assessed by Pearson's and by Spearman correlation coefficients. Construct validity was assessed by correlating patients' answers to the 27-item questionnaire with those of well-reported measures: SF-36, MIDAS and Migraine Therapy Assessment Questionnaire (MTAQ). The test-retest reliability of the 27 initial questions ranged from good to excellent. Correlations of all items with SF-36, MIDAS and MTAQ scores--assessed by discriminatory t-tests--indicated that the following 4 were the most discriminating items: Does your migraine medication work consistently, in the majority of your attacks? Does the headache pain disappear within 2 hours? Are you able to function normally within 2 hours? Are you comfortable enough with your medication to be able to plan your daily activities? The 4-item Migraine-ACT is a brief, simple, and reliable assessment tool to identify patients who require a change in their acute migraine treatment, and can be recommended for primary care physicians, neurologists and headache clinicians.

Acute Disease↗

A newly constructed and validated isoflavone database for the assessment of total genistein and daidzein intake.

The principal phyto-oestrogens (PO) in food are isoflavones, lignans, coumestans and prenylated flavonoids, with isoflavones and lignans being the most commonly found in UK diets. Until recently obtaining accurate data on the PO content of foods was hampered by lack of suitable analytical methods and validation techniques. Furthermore, although PO data exist for some foods, these foods may not be available in the UK. The aim of the present study was to construct a new, comprehensive isoflavone (total genistein + daidzein) database. Using data, mainly from recent GC-MS analysis, for approximately 300 foods available in the UK, and extensive recipe calculations, a new database was constructed containing approximately 6000 foods allocated an isoflavone value. By analysing 7 d weighed food diaries, the database was subsequently used to estimate isoflavone intake in two groups of healthy volunteers, omnivores (n 9) and vegetarians (n 10). Mean isoflavone intake in the vegetarian and omnivorous group was 7.4 (sem 3.05) and 1.2 (sem 0.43) mg/d, respectively. Mean intake for the total group was 4.5 (sem 1.89) mg/d. Main food sources of isoflavones for the vegetarian group were soya milk (plain), meat-substitute foods containing textured vegetable protein and soya protein isolate, soya mince, wholemeal bread and rolls, white bread and rolls, croissants and pitta breads, beans, raisins and soya sauce. Main food sources of isoflavones for the omnivorous group were soya yogurts, wholemeal bread and rolls, white bread and rolls, garlic bread, nan bread and brown bread, sultanas and scones.

Adult↗

Learning style and personality type.

To investigate the relations between the Myers-Briggs Type Indicator and the Gregorc Style Delineator and to examine the construct validity of the Style Delineator, 41 undergraduate students preparing to be teachers were given both tests. Observed differences in learning styles by personality type partially support the construct validity of the Style Delineator. Judging individuals (n = 25) tended to perceive themselves as concrete sequential thinkers as opposed to perceptive individuals (n = 16) who thought of themselves as concrete random thinkers. Feeling types (n = 29) tended to prefer random modes of thinking.

Adult↗

Development and testing of the pain opioid analgesics beliefs scale in Taiwanese cancer patients.

The purpose of the study was to develop and preliminarily test the feasibility, validity, reliability, and factor structures of the Pain Opioid Analgesics Beliefs Scale-Cancer (POABS-CA) in hospitalized adults diagnosed with cancer in Taiwan. This scale was developed in three phases. In Phase I, item development was based on qualitative analysis as well as a review of the literature. Face validity, content validity, and feasibility were also evaluated. In Phase II, internal consistency reliability was further tested in 42 subjects with pain. In Phase III, test-retest reliability, internal consistency, and essential construct validity were further assessed in a sample of 361 hospitalized cancer patients with pain. The POABS-CA evolved from testing as a 10-item 5-point Likert-type instrument. Higher scores indicated more negative beliefs regarding opioids and their use in managing pain. Satisfactory face validity and content validity were found. The POABS-CA was also shown to be a reliable and stable pain belief scale, with Cronbach's alpha and test-retest reliability of 0.70 and 0.94, respectively. Two factors, namely pain endurance beliefs and negative effect beliefs, were extracted from the principal component factor analysis to support the construct validity. In conclusion, preliminary evidence indicates the POABS-CA is a reliable, stable, valid and easily applied scale for assessing beliefs regarding opioid use for cancer pain. Further studies should test this scale in different populations to increase its applications in cancer pain management.

Adult↗

Development and validation of the Chinese Quality of Life Instrument.

BACKGROUND: This paper describes the development of the Chinese Quality of Life Instrument (ChQOL) which is a self-report health status instrument. Chinese Medicine relies very much on asking subjective feelings of patients in the process of diagnosis and monitoring of treatment. For thousands of years, Chinese Medicine practitioners have accumulated a good wealth of experiences in asking questions about health of their patients based on the concept of health in Chinese Medicine. These experiences were then transformed into questions for the ChQOL. It is believed that ChQOL can contribute to the existing Patient Report Outcome measures. This paper outlines the concept of health and disease in Traditional Chinese Medicine, the building of the conceptual framework of the ChQOL, the steps of drafting, selecting and validating the items, and the psychometric properties of the ChQOL. METHODS: The development of the ChQOL was based on the concept of health in Traditional Chinese Medicine with a theory driven approach. Based on the results of literature review, the research team developed an initial model of health which encompassed the concept of health in TCM. An expert panel was then invited to comment and give suggestions for improvement of the initial model. According to their suggestions, the model was refined and a set of initial items for the ChQOL was drafted. The refined model, together with the key domains, facets and initial items of the ChQOL were then mailed to a sample of about 100 Chinese medicine practitioners throughout Mainland China for their comments and advice. A revised set of items were developed for linguistic testing by a convenience sample consisting of both healthy people and people who attended Chinese Medicine treatment. After that, an item pool was developed for field-testing. Field test was conducted on a convenience sample of healthy and patient subjects to determine the construct validity and psychometric properties of the ChQOL. RESULTS: Construct validity was established by various methods, i.e. the internal consistency in all facets and domains were good; the correlation between facets to domain, and domains to overall ChQOL correlation were high; confirmatory factor analysis showed that the structure fitness of all facets, domain and overall structure were good with CFI > 0.9. Test-retest reliability was also good, especially in the domain scores with ICC value ranging from 0.83 to 0.90. No ceiling or floor effect was noted which indicated that ChQOL can be applied to subjects with a wide range of health status. Most facet scores, domain scores and the overall CHQOL scores were able to discriminate groups of subjects with known differences in health status. The ChQOL had mild positive convergence with the other generic health related QOL measures, i.e. the WHOQOL-100 and the SF-36, with moderate correlations. CONCLUSION: In conclusion, the study indicated that the ChQOL is conceptually valid with satisfactory psychometric properties. It can provide additional information on health and QOL on top of the existing generic health related QOL measures. Furthermore, it forms basis for further testing and applications in clinical trials.

Adolescent↗

Acute hemorrhage in dogs: construction and validation of models to quantify blood loss.

We examined the ability of commonly used clinical parameters to quantify acute hemorrhage in dogs. Eight animals were bled 40 ml/kg body wt over 100 min. Ten hemodynamic and 20 blood laboratory parameters were obtained every 10 min to construct, with use of linear regression analysis, models that quantify blood loss. During model construction, the best indicator of quantity of hemorrhage was arterial base deficit [ABD; coefficient of variation (CV) 35%]. This model was more accurate (P < 0.05) than 27 others (CV range 43 to 63%) and similar to systolic (CV 40%) and mean (CV 40%) arterial pressures. In validation studies in 10 additional animals, our best models based on ABD and systolic and mean arterial pressures each unexpectedly showed a significant (P < 0.05) decrease in accuracy (CV 86, 57, and 60%, respectively) attributable to large baseline (before hemorrhage) variability among animals. To eliminate this variability, models based on changes from baseline measurements were investigated. The best predictor of change in blood volume was change in ABD (CV 27%). This model was significantly (P < 0.05) more accurate than any of 27 others (CV range 36 to 65%) and similar to change in venous base deficit and venous pH (each CV 31%). When validated, acid-base models such as ABD, venous pH, and arterial bicarbonate were the best predictors of volume change (CV range 28 to 40%). With the use of multivariate analysis, pairwise combinations of single parameter models (n = 465) improved prediction errors only minimally. In summary, most commonly used hemodynamic and blood indexes could not be validated as accurate measurements in quantifying hemorrhage. In contrast, changes in acid-base parameters were validated as moderately accurate predictors of blood volume changes and therefore may have utility in the assessment of patients with ongoing hemorrhage.

Acid-Base Equilibrium↗

The definition and assessment of analytic process: can analysts agree?

Although analytic process (AP) is a core concept in psychoanalytic theory and practice and has emerged as an important variable in outcome studies, there is no consensus regarding its definition and operationalisation. This paper describes the development and validation of the Columbia Analytic Process Scale (CAPS), a rating scale developed to evaluate the presence or absence of AP in a single psychoanalytic session transcript for purposes of an outcome study. Definitions of interrater reliability and construct validity are reviewed and two studies designed to evaluate these important aspects of the CAPS are presented. The results demonstrate that the CAPS has adequate interrater reliability (kappa = .5). To establish construct validity the plan was to compare the CAPS rating of AP to clinical consensus. However, when a group of ten senior training and supervising analysts at Columbia were asked to rate five psychoanalytic session transcripts, no clinical consensus could be established. Statistical analysis of the pattern of the analysts' clinical ratings showed that the largest portion of the variance was accounted for by the error term of a two-way ANOVA. The implication of this finding is that the construct of AP itself is ill-defined. The results of this study suggest that the commonly used term AP has less consensually held meanings than analysts tend to believe; the impact of lack of definition of key terms on clinical and research pursuits within psychoanalysis is discussed.

Analysis of Variance↗

Case-finding for depressive and exhausted mood in the general population: reliability and validity of a symptom-driven diagnostic scale. Results from the prospective MONICA/KORA Augsburg Study.

PURPOSE: Depressed and exhausted mood warrants epidemiological scrutiny as a cardiovascular risk factor. We evaluated the reliability and validity of a symptom-driven diagnostic scale. METHODS: To assess a depressed mood, items were derived from an extended battery of psychosocial questionnaires in a population-based study including 11,949 subjects aged 25 to 74 years. RESULTS: Eight items from the 24-item von Zerssen checklist were extracted by factor analysis resulting in an approximately normally distributed scale (range 0-24; mean=8.23, SD 4.76). Median for men was 8.00 and 10.00 for women. Its internal consistency was high (Cronbach's alpha 0.88). Test-retest reliability of a sub-sample was 0.83. Determining concurrent validity, correlation coefficients against a single depression questionnaire in 8237 subjects (p < 0.001) and SF-36 subscales (vitality and mental health) (both p < 0.0001) in 4226 subjects proved to be significant. Construct validity was confirmed by significant associations (all p < 0.001) with sleeping complaints, social isolation, and unhappiness. Test values for men above the 80th percentile exhibited significant hazard ratios for subsequent total mortality (80th percentile: HR 2.17, 95% CI: 1.31-13.55). CONCLUSION: The scale comprises eight items describing motivational depletion, decreased vitality, irritability, and an anxious mood with sufficient internal and external reliability, concurrent and construct validity. Its normal distribution allows a graduated analysis of different thresholds. The instrument may be particularly useful to identify exhausted and depressed mood of otherwise apparently healthy subjects in the general population.

Adult↗

The benzodiazepine dependence questionnaire: development, reliability and validity.

BACKGROUND: A short self-report questionnaire was developed to assess dependence on benzodiazepines (BZDs), the Benzodiazepine Dependence Questionnaire (BDEPQ). The BDEPQ is the first scale to assess dependence on BZDs comprehensively, as all existing scales focus exclusively on withdrawal symptoms. METHOD: To evaluate its internal consistency and construct validity, 302 regular BZD users were recruited from media advertisements and assessed on a number of measures. The BDEPQ was compared with measures of depression, anxiety, sleep quality, BZD withdrawal symptoms and neuroticism to assess its construct validity. A 3-4 month follow-up was conducted to assess the ability of the BDEPQ to predict changes in BZD consumption and future BZD withdrawal. RESULTS: The BDEPQ was found to have high internal consistency and to be relatively stable over the follow-up period. Three subscales were identified, each with good internal consistency and temporal stability. The BDEPQ was able to predict the severity of withdrawal symptoms. CONCLUSION: The BDEPQ was found to be a reliable and valid self-report instrument for the assessment of BZD dependence in samples approximating the general population of people using BZDs.

Adult↗

Reliability and validity of shoulder tightness measurement in patients with stiff shoulders.

The purposes of this study were (1) to examine intratester and intertester reliability of measurement of anterior and posterior shoulder tightness in patients with stiff shoulders (SS), and (2) to assess construct validity by determining the relations between shoulder tightness, shoulder range of motion (ROM), and self-report measures of functional limitation. Anterior and posterior shoulder tightness were measured by two testers in below-chest abduction and cross-chest adduction tests with an inclinometer, respectively, in 16 patients with SS. Both the intratester and intertester reliability for shoulder tightness measurements were good (intratester ICC=0.84 and 0.91; intertester ICC=0.82 and 0.89). The limit of intra-tester and inter-tester agreement (mean, -0.3+/-4.4 degrees ) was acceptable as compared to the standard deviations of the measurements (range, 6.2-7.4 degrees ). Significant relationships between internal rotation and posterior shoulder tightness (R2=0.448, P=0.002), external rotation and anterior shoulder tightness (R2=0.499, P=0.003), and functional disabilities and posterior shoulder tightness (R2=0.432, P=0.006) were found. Significant correlations between shoulder internal rotation and cross-chest adduction, shoulder external rotation and below-chest abduction were observed, indicating that internal and external rotations might be related to posterior and anterior shoulder stiffness. The study also revealed significant relationship between functional disabilities and cross-chest adduction. Below-chest abduction and cross-chest adduction were found to provide reliable data. The construct validity of the abduction and adduction tests is supported by the relationship among these measurements, shoulder ROM, and functional disabilities in patients with SS.

Adult↗

A measure of stages of change in fruit and vegetable consumption among fourth- and fifth-grade school children: reliability and validity.

OBJECTIVE: We developed, pilot-tested, and field-applied a stages of change questionnaire regarding fruit and vegetable (F&V) consumption among fourth- and fifth-grade students. METHODS: The design included cross-sectional assessment of internal consistency and construct validity, and 2-week and 7-week longitudinal assessment of test-retest reliability. Subjects included 134 students from one school for pilot-testing and 252 from two schools for field application. Thirty-two questions from McConnaughy et al's stages of change questionnaire were adapted and pilot-tested; minor revisions were made for field application. Statistical analyses included principal components analysis to identify subscales; cluster analysis to identify subgroups within students; Cronbach's alpha coefficient to assess internal consistencies; Pearson product-moment correlations to assess test-retest reliabilities; and oneway ANOVA's by F&V stages of change clusters with actual F&V consumption, F&V self-efficacy subscales, F&V preferences, and F&V outcome expectations subscales to determine construct validity. RESULTS: Principal components analysis from the field application indicated two subscales (precontemplation and beyond precontemplation) accounting for 39.5% of variance. Cluster analysis indicated 6 interpretable clusters; 2 (n = 63) provided responses inconsistent with the stages of change theory and 4 (n = 189) provided responses consistent with the theory. Internal consistencies and test-retest reliabilities were acceptable. Students in the "beyond precontemplation" clusters had higher levels of self-efficacy and outcome expectations regarding eating F&V. CONCLUSIONS: Measuring stages of change other than the precontemplation stage in F&V consumption among elementary school children is problematic. Perhaps the theoretical concept does not apply to children, or elementary school children lack the ability to comprehend the questions measuring the concept, or the approach used was not entirely appropriate.

Attitude to Health↗

Reliability and validity of the adolescent health profile-types.

OBJECTIVES: The purpose of this study was to demonstrate the preliminary reliability and validity of a set 13 profiles of adolescent health that describe distinct patterns of health and health service requirements on four domains of health. METHODS: Reliability and validity were tested in four ethnically diverse population samples of urban and rural youths aged 11 to 17-years-old in public schools (N = 4,066). The reliability of the classification procedure and construct validity were examined in terms of the predicted and actual distributions of age, gender, race, socioeconomic status, and family type. School achievement, medical conditions, and the proportion of youths with a psychiatric disorder also were examined as tests of construct validity. RESULTS: The classification method was shown to produce consistent results across the four populations in terms of proportions of youths assigned with specific sociodemographic characteristics. Variations in health described by specific profiles showed expected relations to sociodemographic characteristics, family structure, school achievement, medical disorders, and psychiatric disorders. CONCLUSIONS: This taxonomy of health profile-types appears to effectively describe a set of patterns that characterize adolescent health. The profile-types provide a unique and practical method for identifying subgroups having distinct needs for health services, with potential utility for health policy and planning. Such integrative reporting methods are critical for more effective utilization of health status instruments in health resource planning and policy development.

Adolescent↗

Validity, factor structure, and clinical relevance of the AUSCAN Osteoarthritis Hand Index.

OBJECTIVE: The Australian/Canadian (AUSCAN) Osteoarthritis Hand Index is a self-report assessment of pain, stiffness, and function in patients with hand osteoarthritis (OA). Small studies have confirmed the reliability, construct validity, and responsiveness of this measure, but the factor structure has not been examined. In this study, we examined the clinimetric properties and clinical relevance of the AUSCAN index in a large sample of patients with familial hand OA. METHODS: The study group comprised 700 patients (80% female, mean age 69 years) who were part of a study on the genetics of generalized OA. All patients had radiographic hand OA bilaterally. The analyses examined internal consistency, factor structure, and relationships of the subscales to grip and pinch strength and a single-item pain measure. RESULTS: Internal consistency was high for the total AUSCAN index and the subscales (Cronbach's alpha = 0.93-0.96). The AUSCAN function subscale had the strongest correlation with grip and pinch strength, and the pain subscale had the strongest correlation with the single-item pain measure, thus supporting the construct validity of these subscales. Factor analysis showed that all pain and function items clearly loaded on the subscale they were intended to measure. Each 1-unit increase in the AUSCAN function subscale was associated with a clinically relevant decrease in hand strength. CONCLUSION: The results of this study strongly confirm the clinimetric properties of the AUSCAN index, including the validity of specific subscales. Results indicate that the AUSCAN index can measure meaningful changes in pain, stiffness, and function.

Aged↗