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PubMed2005

Psychometric properties of the DUKE Health Profile-adolescent version (DHP-A): a generic instrument for adolescents.

PURPOSE: Quality of life in general population of adolescents has been scarcely documented. The study was aimed at evaluating the psychometric properties of the DUKE Health Profile-Adolescent version (DHP-A), an adaptation from the adult version. MATERIAL AND METHOD: Feasibility and construct validity were assessed in a sample of 618 adolescents from school settings. Test-retest reliability was assessed in another sample of 100 adolescents at 2 weeks interval. Construct validity was assessed in groups by gender, age and existence of a health problem. RESULTS: The DHP-A, a short instrument of HRQOL, easy to administer, proved its ability to discriminate between boys and girls, with or without a health problem, for all of health and dysfunction dimensions (p < 0.05). Its reliability is also acceptable for three health dimensions and anxiety, depression (ICC = 0.68-0.72), moderate for social, perceived health, self-esteem and pain (ICC = 0.43-0.59), and debatable for disability (ICC = 0.22) (single item). CONCLUSION: The initial testing of the adolescent version (DHP-A) indicates that the psychometric properties are acceptable and will provide a useful tool for the assessment of health status in adolescents. Three single-item dimensions (perceived health, pain and disability) should be interpreted with caution.

Adolescent↗

PubMed1995

Interview protocols and ergonomics checklist for analysing overexertion back accidents among nursing personnel.

No documented strategy, including preventive strategies, for systematic investigation of overexertion back accidents among nursing personnel has yet been published. One aim of the present study was to develop standardized instruments for the systematic investigation of back accidents among nursing personnel in order to develop preventive strategies. Another aim was to produce a screening tool that could easily be used for identifying potential overexertion back accident hazards. Two structured interview protocols were developed, one for the injured person and one for the supervisor. An ergonomics checklist was designed for the most important spaces according to accident statistics: patient's room, corridor, toilet, and also one for 'other space', eg X-ray and treatment rooms. The instruments were developed by frequent discussions and adjustments in a task force of researchers and occupational health personnel. The protocols were tested in two steps before a final version was established. The construct validity and interobserver reliability of the checklist were tested by ten ergonomists, who checked a patient's room, a toilet and a corridor with some known hazards. The constructed validity agreement was 90% in 19 of 26 items in the checklist. The interobserver reliability had the same figures as the validity for all items in the checklist. The interview protocols and checklist appear to be suitable for systematic investigation of overexertion back accidents.

Journal Article↗

PubMed2005

Psychometric properties of the 'Processes of Change' scale for alcohol misuse and its short form (POC-20).

UNLABELLED: Regarding the processes of change, one of the core constructs of the transtheoretical model of intentional behavior change (TTM), extensive research has been done in the field of smoking. However, little is known about the processes of change for alcohol misuse and their measurement. This study's goals were to investigate the psychometric properties of the German Processes of Change (POC) scale and to refine a short version. METHOD: A sample of 653 non-treatment seeking general hospital patients with alcohol problems was used. Construct validity of the POC was analyzed using confirmatory factor analysis. As another validity aspect the use of processes of change across the stages of change was investigated. RESULTS: Internal consistency of the POC-20 ranged between r=.57 and .94. Construct validity was also good (CFI=.94). In line with TTM postulates subjects in later stages reported more behavioral processes compared to individuals in earlier stages. CONCLUSION: Findings indicated superiority of the POC-20 over the long version and good validity of the measure in a high per capita consumption nation.

Adult↗

PubMed2001

Validity of the EK scale: a functional assessment of non-ambulatory individuals with Duchenne muscular dystrophy or spinal muscular atrophy.

BACKGROUND AND PURPOSE: The EK scale comprises ten categories (EK 1-10), each contributing to an overall picture of function in the non-ambulatory stage of Duchenne muscular dystrophy (DMD). The purpose of the present study was to investigate content and construct validity of the EK scale as a tool to discriminate between levels of functional ability in individuals with DMD or spinal muscular atrophy (SMA) who were non-ambulatory. METHOD: Data from a sample of 56 subjects with DMD and 38 with SMA, who were non-ambulatory, were obtained from four separate studies. The relationship of functional ability by use of the EK scale and (1) muscle strength, (2) contractures, (3) forced vital capacity and (4) years of wheelchair dependency were assessed. All items of the EK scale were used except the one representing severe hypoventilation. RESULTS: Regression analyses showed that the EK sum was the most significant explanatory variable (p < 0.05) of all variables measured to explain muscle strength in both DMD and SMA subjects. The individual categories of EK (1-10) all contributed as significant explanatory variables (p < 0.05) to the other variables measured. CONCLUSIONS: The categories and items of the EK scale were relevant and valid as means of discriminating between levels of functional performance in the population studied which was evidence of content and construct validity.

Activities of Daily Living↗

PubMed2001

Properties of the 15D and EQ-5D utility measures in a community sample of people with epilepsy.

To perform economic evaluation studies in epilepsy using utilities, such as cost-utility analyses, it is necessary to have reliable and valid instruments for eliciting people's preferences. The objective of this study was to assess the reliability and validity of two multiattribute utility measures in a community sample of 397 people with epilepsy. We assessed the test-retest reliability of individual questionnaire items and aggregate scores. Additionally, construct validity was assessed by correlating items of the EQ-5D with items of the 15D health status questionnaire, and discriminant validity was assessed by comparing scores for known groups. The test-retest reliabilities for the individual items of the 15D (weighted kappa 0.59-0.90, except mobility with only 0.28) and the EQ-5D (weighted kappa 0.49-0.86) were acceptable. For the composite utility scores the test-retest reliability was better (intraclass correlation coefficient 0.93 for both 15D and the EQ-5D). Spearman's rank correlations between EQ-5D single item scores and corresponding 15D single item scores were high (rho 0.34-0.79) and generally higher than the associations between non-corresponding items. Some EQ-5D and 15D items discriminated well between patients according to seizure status, psychiatric comorbidity and working status; less well after antiepileptic drug use and neurologic comorbidity. Both the EQ-5D and 15D were reliable instruments and showed properties supporting the construct validity of both measures.

Adult↗

PubMed1996

Premature Infant Pain Profile: development and initial validation.

OBJECTIVE: Inadequate assessment of pain in premature infants is a persistent clinical problem. The objective of this research was to develop and validate a measure for assessing pain in premature infants that could be used by both clinicians and researchers. DESIGN: The Premature Infant Pain Profile (PIPP) was developed and validated using a prospective and retrospective design. Indicators of pain were identified from clinical experts and the literature. Indicators were retrospectively tested using four existing data sets. PATIENTS AND SETTINGS: Infants of varying gestational ages undergoing different painful procedures from three different settings were utilized to develop and validate the measure. METHODS AND RESULTS: The largest data set (n = 124) was used to develop the PIPP. The development process included determining the factor structure of the data, developing indicators and indicator scales and establishing internal consistency. The remaining three data sets were utilized to establish beginning construct validity. CONCLUSIONS: The PIPP is a newly developed pain assessment measure for premature infants with beginning content and construct validity. The practicality and feasibility for using the PIPP in clinical practice will be determined in prospective research in the clinical setting.

Gestational Age↗

PubMedDate not supplied

Clinical trials in psychosocial medicine: methodologic and statistical considerations. Part III. Assessing measurement techniques in psychosocial oncology.

The focus of the paper is on methodologic issues in assessing the validity of measurement techniques used in psychosocial oncology. Practical problems involved in assessing the validity of approaches, measures, and methods used in psychosocial oncology are outlined and briefly discussed. Techniques for partially addressing these problem areas are presented. Data from a study on the quantification of hope are examined in a multitrait-multimethod matrix assessment of construct validation which showed that little confidence can be placed in the validity of present methods of assessing "hope." Following a discussion of alternative statistical approaches to analyzing a multitrait-multimethod matrix for construct validity, the potential applicability of this approach to clinical oncology is presented through a hypothetical study on quantifying tumor types.

Clinical Trials as Topic↗

PubMed2001

Normative studies with the Scale for Interpersonal Behaviour (SIB): II. US students. A cross-cultural comparison with Dutch data.

The Scale for Interpersonal Behaviour (SIB), a multidimensional, self-report measure of state assertiveness, was administered to a nationwide sample of 2375 undergraduates enrolled at 11 colleges and universities across the USA. The SIB was developed in the Netherlands for the independent assessment of both distress associated with self-assertion in a variety of social situations and the likelihood of engaging in a specific assertive response. This is done with four factorially-derived, first-order dimensions: (i) Display of negative feelings (Negative assertion); (ii) Expression of and dealing with personal limitations; (iii) Initiating assertiveness; and (iv) Praising others and the ability to deal with compliments/praise of others (Positive assertion). The present study was designed to determine the cross-national invariance of the original Dutch factors and the construct validity of the corresponding dimensions. It also set out to develop norms for a nationwide sample of US students. The results provide further support for the reliability, factorial and construct validity of the SIB. Compared to their Dutch equivalents, US students had meaningfully higher distress in assertiveness scores on all SIB scales (medium to large effect sizes), whereas differences on the performance scales reflected small effect sizes. The cross-national differences in distress scores were hypothesized to have originated from the American culture being more socially demanding with respect to interpersonal competence than the Dutch, and from the perceived threats and related cognitive appraisals that are associated with such demands.

Adolescent↗

PubMed2001

The Work Limitations Questionnaire.

OBJECTIVE: The objective of this work was to develop a psychometrically sound questionnaire for measuring the on-the-job impact of chronic health problems and/or treatment ("work limitations"). RESEARCH DESIGN: Three pilot studies (focus groups, cognitive interviews, and an alternate forms test) generated candidate items, dimensions, and response scales. Two field trials tested the psychometric performance of the questionnaire (studies 1 and 2). To test recall error, study 1 subjects were randomly assigned to 2 different questionnaire groups, a questionnaire with a 4-week reporting period completed once or a 2-week version completed twice. Responses were compared with data from concurrent work limitation diaries (the gold standard). To test construct validity, we compared questionnaire scores of patients with those of healthy job-matched control subjects. Study 2 was a cross-sectional mail survey testing scale reliability and construct validity. SUBJECTS: The study subjects were employed individuals (18-64 years of age) from several chronic condition groups (study 1, n = 48; study 2, n = 121) and, in study 1, 17 healthy matched control subjects. MEASURES: Study 1 included the assigned questionnaires and weekly diaries. Study 2 included the new questionnaire, SF-36, and work productivity loss items. RESULTS: In study 1, questionnaire responses were consistent with diary data but were most highly correlated with the most recent week. Patients had significantly higher (worse) limitation scores than control subjects. In study 2, 4 scales from a 25-item questionnaire achieved Cronbach alphas of > or = 0.90 and correlated with health status and self-reported work productivity in the hypothesized manner (P < or = 0.05). CONCLUSIONS: With 25 items, 4 dimensions (limitations handling time, physical, mental-interpersonal, and output demands), and a 2-week reporting period, the Work Limitations Questionnaire demonstrated high reliability and validity.

Adult↗

PubMed2004

The development and application of an instrument for assessing resident competence during preanesthesia consultation.

In this study, we aimed to construct, validate, and apply an instrument for assessing resident performance at outpatient preanesthesia consultation (PAC). A focus group and a Delphi panel of experts defined component items of a typical outpatient PAC, which could be used as indicators of competence. Items were incorporated in a checklist, which was further validated in a sample of consultations performed by board-certified anesthesiologists. The resulting instrument contained 37 items, grouped into five domains (physician-patient relationship, medical history, physical examination, patient education, and preanesthesia records), with high construct validity, high discriminant validity, moderate internal consistency, and high probability of inter-raters agreement. The instrument was applied to evaluate the performance of seven first-year residents at 317 consecutive PAC. Data were analyzed by constructing exponentially weighted moving average charts for domain and total scores. Statistically significant differing levels of performance could be consistently detected. Applying exponentially weighted moving average charts to the sequential analysis of the developed checklist scores can reliably assess resident performance at the devised criteria. The Preanesthesia Consultation Scoring Checklist is a potentially useful instrument for both formative and summative assessment of residents during their training in processes involved in outpatient preanesthesia evaluation.

Anesthesia↗

PubMed2003

Assessment of disease activity.

The objective of this study was to select a simple, feasible and validated core set of variables for the assessment of disease activity in systemic sclerosis. The subcommittee members extensively reviewed the studies in which the disease activity had been assessed, and analysed the construct validity and the feasibility of the criteria used in each study. The subcommittee members agreed on the possible use of either the European Scleroderma Study Group (ESSG) criteria for disease activity in SSc or the evaluation of selected cytokines and cell activation markers, found to be associated with distinct organ system involvement in recent studies. Despite the potential usefulness of cytokines and activation markers, most participants in the plenary session retained that their evaluation is not feasible in a number of centres, and their construct validity has not yet been assessed. The ESSG criteria for disease activity can be used for the time being to assess disease activity in clinical investigation studies as well as in clinical practice.

Biomarkers↗

PubMed2004

Assessing organisational development in primary medical care using a group based assessment: the Maturity Matrix.

OBJECTIVE: To design and develop an instrument to assess the degree of organisational development achieved in primary medical care organisations. DESIGN: An iterative development, feasibility and validation study of an organisational assessment instrument. SETTING: Primary medical care organisations. PARTICIPANTS: Primary care teams and external facilitators. MAIN OUTCOME MEASURES: Responses to an evaluation questionnaire, qualitative process feedback, hypothesis testing, and quantitative psychometric analysis (face and construct validity) of the results of a Maturity Matrix assessment in 55 primary medical care organisations. RESULTS: Evaluations by 390 participants revealed high face validity with respect to its usefulness as a review and planning tool at the practice level. Feedback from facilitators suggests that it helped practices to prioritise their organisational development. With respect to construct validity, there was some support for the hypothesis that training and non-training status affected the degree and pattern of organisational development. The size of the organisation did not have a significant impact on the degree of organisational development. CONCLUSION: This practice based facilitated group evaluation method was found to be both useful and enjoyable by the participating organisations. Psychometric validation revealed high face validity. Further developments are in place to ensure acceptability for summative work (benchmarking) and formative feedback processes (quality improvement).

Benchmarking↗

PubMed1996

Development of a measure of physical function for patients with bone and soft tissue sarcoma.

Patients undergoing limb salvage surgery for bone and soft tissue sarcoma of the extremities experience significant physical disability as a result of life-preserving treatment. The existing health status measures do not adequately evaluate physical function from the patient's perspective. This paper presents the developmental studies (item selection, reduction, reliability, validity and responsiveness) of a new measure, The Toronto Extremity Salvage Score (TESS). Patients with bone and soft tissue sarcoma (76 upper and 83 lower extremity) were randomly selected and mailed the TESS. Patients rated the severity and importance of physical disabilities; the response options included a 'not applicable' category and open-ended questions that allowed patients to suggest additional items for inclusion in the questionnaire. Therefore, patient perceptions were used to determine item content. Difficulty and importance frequencies were calculated and items rated 'totally unimportant' or 'not applicable' by 30% of the sample were eliminated. Extra items identified 30% of the time were added to the questionnaire. Internal consistency was evaluated by Cronbach's alpha. Test-retest reliability and validity were evaluated on subsequent patient samples. The intraclass correlation coefficient (ICC) was calculated for test-retest reliability and correlations with The Musculoskeletal Tumour Society Rating Scale (MSTS) were calculated for construct validity. Standardized effect sizes were calculated as a measure of responsiveness. Fifty upper extremity and sixty-six lower extremity patients responded to the mailed questionnaire. No items were eliminated based on importance or not applicable ratings. Sporting activities were identified as additional items in both the upper and lower extremity questionnaire. High internal consistency was demonstrated: 0.94 for the lower and 0.92 for the upper extremity questionnaires respectively. Test-retest reliability was evaluated at multiple time-points and the intraclass correlation coefficient was greater than 0.87 in all instances. Construct validity was shown by a moderate correlation with the MSTS. The effect sizes were large demonstrating responsiveness. The use of patients' perceptions in determining the content of the TESS has resulted in a reliable and valid measure that is able to detect change over time.

Activities of Daily Living↗

PubMed2006

The Community Balance and Mobility Scale--a balance measure for individuals with traumatic brain injury.

OBJECTIVE: To provide evidence for the validity and reliability of a new outcome measure of balance, the Community Balance and Mobility Scale, developed for the ambulatory individual with traumatic brain injury. DESIGN: A validity and reliability study. SETTING: Acute care, in- and outpatient rehabilitation and day hospital settings. SUBJECTS: Two convenience samples (n=36, 32) of ambulatory patients with traumatic brain injury. MAIN MEASURES: The content and construct validity, test-retest, inter- and intra-rater reliability and internal consistency of the Community Balance and Mobility Scale. RESULTS: Content validity was demonstrated by the involvement of patients with traumatic brain injury (n=7) and clinicians (n=17) in the process of item generation and by physical therapists' ratings of item relevance. Further support is the correlation of the Community Balance and Mobility Scale scores with physical therapists' global balance ratings of the patient (r=0.62). Construct validity was supported by the ability of the measure to differentiate between patients along the continuum of care and also by comparisons with maximal walking velocity (r=0.64). Patients who scored greater than or less than 50 on the balance measure demonstrated significantly different Community Integration Questionnaire scores (P=0.004). The Community Balance and Mobility Scale demonstrated intraclass correlation coefficients (ICCs) of 0.977, 0.977, 0.975 and Cronbach's alpha of 0.96 for intra-, inter-, test-retest reliability and internal consistency, respectively. CONCLUSION: The Community Balance and Mobility Scale is a valid and reliable outcome measure for the ambulatory individual with traumatic brain injury.

Adult↗

PubMed2004

Use of modified Northwick Park Neck Pain Questionnaire in patients with postirradiation neck disability: validation study.

BACKGROUND: No available measure exists for postirradiation neck disability. Adoption of the Chinese Northwick Park Neck Pain Questionnaire (NPQ) for patients with postirradiation neck disability was examined in this study. METHODS: Eight physiotherapists and five patients were invited to test the validity of the content. Forty-three patients with neck disability were recruited to evaluate test-retest reliability and internal consistency. The level of neck discomfort, range of neck motion and maximal isometric neck muscle strength, and SF-36 health score were measured for construct validity testing. RESULTS: The questionnaire had good content validity, a high degree of test-retest reliability, internal consistency (intraclass correlation coefficient [ICC], 0.94; Cronbach's alpha, 0.88), and good construct validity. NPQ correlated significantly with most of the subscores of SF-36 (r(s), -0.43 to - 0.71) and numeric rating scale (r(s) = 0.69). CONCLUSION: The modified Chinese NPQ was found to be reliable and valid for the evaluation of postirradiation neck disability.

Adult↗

PubMed2005

Evaluating the patient safety indicators: how well do they perform on Veterans Health Administration data?

BACKGROUND: The Patient Safety Indicators (PSIs), an administrative data-based tool developed by the Agency for Healthcare Research and Quality, are increasingly being used to screen for potential in-hospital patient safety problems. Although the Veterans Health Administration (VA) is a national leader in patient safety, accurate information on the epidemiology of patient safety events in the VA is still unavailable. OBJECTIVES: Our objectives were to: (1) apply the AHRQ PSI software to VA administrative data to identify potential instances of compromised patient safety; (2) determine occurrence rates of PSI events in the VA; and (3) examine the construct validity of the PSIs. METHODS: We examined differences between observed and risk-adjusted PSI rates in the VA, compared VA and non-VA PSI rates, and investigated the construct validity of the PSIs by examining correlations of the PSIs with other outcomes of VA hospitalizations. RESULTS: We identified 11,411 PSI events in the VA nationwide in FY'01. Observed PSI rates per 1000 discharges ranged from 0.007 for "transfusion reaction" to 155.5 for "failure to rescue." There were significant, although small, differences between VA and non-VA risk-adjusted PSI rates. Hospitalizations with PSI events had longer lengths of stay, higher mortality, and higher costs than those without PSI events. CONCLUSIONS: Our results suggest that the PSIs may be useful as a patient safety screening tool in the VA. Our PSI rates were consistent with the national incidence of low rates; however, differences between VA and non-VA rates suggest that inadequate case-mix adjustment may be contributing to these findings.

Aged↗

PubMedDate not supplied

Measurement of Type A behavior in preschoolers.

The purpose of this study was to investigate the psychometric properties of the Matthews Youth Test of Health (MYTH) and its subscales of Hostility, Competitiveness, Impatience, and Leadership when used with preschoolers. The MYTH was completed by 13 teachers on 155 preschool children in a cross-sectional study and on sub-samples of this original group who were followed during a 2-year longitudinal study. These results were used to investigate internal consistency and test-retest reliability of the MYTH. Construct validity was evaluated by factor analysis as well as by examining the relationship of the MYTH scale and its subscales to cardiovascular reactivity, self-esteem, and locus of control. Construct validity was further assessed by testing for a predicted difference between boys and girls on the MYTH.

Blood Pressure↗

PubMed2005

The reliability, validity, and preliminary responsiveness of the Eye Allergy Patient Impact Questionnaire (EAPIQ).

BACKGROUND: The Eye Allergy Patient Impact Questionnaire (EAPIQ) was developed based on a pilot study conducted in the US and focus groups with eye allergy sufferers in Europe. The purpose of this study was to present the results of the psychometric validation of the EAPIQ. METHODS: One hundred forty six patients from two allergy clinics completed the EAPIQ twice over a two-week period during the fall and winter allergy seasons, along with concurrent measures of health status, work productivity, and utility. Construct validity, reliability (internal consistency and test-retest), concurrent, known-group, and clinical validities, and responsiveness of the EAPIQ were assessed. Known-group validity was assessed by comparing EAPIQ scale scores between patients grouped according to their self-rating of ocular allergy severity (no symptoms, very mild, mild, moderate, severe, very severe). Clinical validity was assessed by assessing differences in EAPIQ scores between groups of patients rated by their clinician as non-symptomatic, mild, moderate, and severe. RESULTS AND DISCUSSION: Results from the validation study suggested the deletion of 14 of 43 items (including embedded questions) that required patients to complete the percentage of time they were troubled by something (daily activity limitations/emotional troubles). These items yielded a significant amount of missing or inconsistent data (50%). The resulting factor analysis suggested four domains: symptoms, daily life impact, psychosocial impact, and treatment satisfaction. When included as separate scales, the symptom-bother and symptom-frequency scales were highly correlated (> 0.9). As a consequence, and due to superior discriminative validity, the symptom bother and frequency items were summed. All items met the tests for item convergent validity (item-scale correlation = 0.4). The success rate for item discriminant validity testing was 97% (item-scale correlation greater with own scale than with any other). The criterion for internal consistency reliability (alpha coefficient > or = 0.70) was met for all EAPIQ scales (range 0.89-0.93), as was the criterion for test-retest reliability (intraclass correlation [ICC] > or = 0.70). Largely moderate correlations between the scales of the EAPIQ and the mini Rhinoconjunctivitis Quality of Life Questionnaire (miniRQLQ) and low correlations with the Health Utilities Index 2/3 (HUI2/3) were indicative of satisfactory concurrent validity. The EAPIQ symptoms, Daily Life Impact, and Psychosocial Impact scales were able to distinguish between patients differing in eye allergy symptom severity, as rated by patients and clinicians, providing evidence of satisfactory known-group and clinical validities, respectively. Preliminary analyses indicated the EAPIQ Symptoms, Daily Life Impact, and Psychosocial Impact scales to be responsive to changes in eye allergies. CONCLUSION: Following item reduction, construct validity, reliability, concurrent validity, known-group validity, and preliminary responsiveness were satisfactory for the EAPIQ in this population of ocular allergy patients.

Adult↗