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PubMed2004

Reliability and validity of the Functional Rating Index in older people with low back pain: preliminary report.

BACKGROUND AND AIMS: The Functional Rating Index (FRI) was developed to provide an assessment instrument which has not only clinical usefulness but also quantifies the patient's current state of pain and dysfunction in a reliable and valid manner for spinal conditions. There is no study on the FRI applied to older people with low back pain (LBP). The primary aim of this study was to evaluate the validity and reliability of the FRI in older people with LBP. METHODS: A total of 76 subjects aged 65 to 90 years with LBP, of which 37 were cognitively intact and were followed up on a second occasion, were assessed by the FRI, numeric rating scale (NRS), Roland Morris Questionnaire (RMQ) and spinal movement test. Reliability was assessed by statistical analysis of test results for test-retest and internal consistency. To assess construct validity, the FRI was compared with the RMQ. Concurrent validity was assessed using the NRS and spinal mobility test. RESULTS: The FRI demonstrated high internal consistency, with alpha=0.921 for test and alpha=0.901 for retest. Item-scale correlations were between 0.549-0.871. Test-retest correlation was 0.913 (p=0.000). There was very good construct validity between the FRI and the RMQ for test (r=0.663, p<0.000) and retest (r=0.603, p<0.000). The FRI showed high correlation with the NRS (r=0.701, p<0.000 for test; r=0.743, p<0.000 for retest) and no correlation with the spinal movement test (r=0.173, p=0.307 for test; r=0.024, p=0.888 for retest). CONCLUSIONS: In this preliminary report, the FRI appears to be easy to administer, seems to have significant validity and reliability, and may be useful in geriatric assessment of older people with LBP.

Aged↗

PubMedDate not supplied

Fruit and vegetable shopping practices and social support scales: A validation.

OBJECTIVE: To assess the psychometric characteristics of new scales of shopping practices and social support for purchasing fruits and vegetables. DESIGN: Participants were recruited in front of diverse grocery stores. Telephone data collection was done on 2 occasions, separated by 6 weeks. PARTICIPANTS: 166 food shoppers with children at home participated. MAIN OUTCOME MEASURES: New scales of food shopping practices and social support for purchasing fruits and vegetables were psychometrically analyzed and related to a measure of home fruit or vegetable availability as a test of construct validity. ANALYSIS: Both classical test and item response theory procedures were used. Correlations related the new measures to home fruit and vegetable availability. RESULTS: Single dimension scales were specified for fruit and vegetable shopping practices (35% of the variance), fruit purchase social support (53% of the variance), and vegetable purchase social support (52% of the variance). Item response theory difficulty estimates varied from -0.64 to 0.73 for fruit and vegetable shopping practices, from -0.55 to 0.33 for fruit purchase social support, and from -0.55 to 0.34 for vegetable social support. Each scale significantly correlated with home fruit and vegetable availability (construct validity), even after controlling for social desirability of response (0.19 for shopping practices, 0.37 for fruit purchasing social support, and 0.28 for vegetable purchasing social support). Person separation reliability was 0.80 for food shopping practices, 0.74 for fruit purchasing social support, and 0.73 for vegetable purchasing social support. CONCLUSION: The scales performed well. IMPLICATIONS FOR RESEARCH AND PRACTICE: These scales are now available to help better understand fruit and vegetable shopping practices, fruit purchase social support, and vegetable purchase social support.

Adult↗

PubMed2005

Behavioral interactions in the perioperative environment: a new conceptual framework and the development of the perioperative child-adult medical procedure interaction scale.

BACKGROUND: The authors suggest that research in the area of parental presence during induction of anesthesia should shift to emphasize what parents actually do during induction, rather than focusing simply on their presence. As a first step, the authors aimed to develop a behavioral coding system that would measure child and adult interactions in the perioperative environment. METHODS: The authors enrolled 45 parents and children (aged 2-12 yr) undergoing elective surgery and general anesthesia. A multidisciplinary team examined videotapes and transcriptions of interactions between children, parents, and medical personnel in the holding room and operating room. The team used an existing scale, the Child-Adult Medical Procedure Interaction Scale, as the prototype for the development of a new perioperative behavioral coding system. The research team conducted extensive revisions to the original scale and added multiple codes to the original scale, including nonverbal codes. Interrater reliability was assessed using weighted kappa statistics. Construct validity was also examined. RESULTS: The final Perioperative Child-Adult Medical Procedure Interaction Scale contains 40 codes in four domains. Analyses showed excellent reliability overall for verbal and nonverbal codes. Kappa values averaged 0.87 for verbal codes characterizing adult vocalizations, 0.92 for verbal codes characterizing child vocalizations, and 0.88 for nonverbal codes. Construct validity was demonstrated by finding the hypothesized associations between certain scale codes and children's anxiety (P = 0.0001). CONCLUSION: Showing excellent reliability, the Perioperative Child-Adult Medical Procedure Interaction Scale is an appropriate tool for assessing child-adult behavioral interaction during the perioperative period. When sequential analyses are conducted and target behaviors are identified, empirically based parent preparation programs can be developed.

Anesthesia↗

PubMedDate not supplied

Technical and technological skills assessment in laparoscopic surgery.

OBJECTIVES: Surgical appraisal and revalidation are key components of good surgical practice and training. Assessing technical skills in a structured manner is still not widely used. Laparoscopic surgery also requires the surgeon to be competent in technological aspects of the operation. METHODS: Checklists for generic, specific technical, and technological skills for laparoscopic cholecystectomies were constructed. Two surgeons with >12 years postgraduate surgical experience assessed each operation blindly and independently on DVD. The technological skills were assessed in the operating room. RESULTS: One hundred operations were analyzed. Eight trainees and 10 consultant surgeons were recruited. No adverse events occurred due to technical or technological skills. Mean interrater reliability was kappa=0.88, P=<0.05. Construct validity for both technical and technological skills between trainee and consultant surgeons were significant, Mann-Whitney P=<0.05. CONCLUSIONS: Our study demonstrates that technical and technological skills can be measured to assess performance of laparoscopic surgeons. This technical and technological assessment tool for laparoscopic surgery seems to have face, content, concurrent, and construct validities and could be modified and applied to any laparoscopic operation. The tool has the possibility of being used in surgical training and appraisal. We aim to modify and apply this tool to advanced laparoscopic operations.

Adult↗

PubMed2004

Reliability and validity of the Norwegian version of the Functional Outcomes of Sleep Questionnaire.

The aim of this study was to validate the Norwegian version of a self-administered 30-item quality of life questionnaire designed to assess disorders of excessive sleepiness, the Functional Outcomes of Sleep Questionnaire (FOSQ). In total 226 patients previously evaluated for obstructive sleep apnea were included in the study. The patients received a postal questionnaire with the FOSQ, the Short Form 36 (SF-36) questionnaire, and a scale for assessment of excessive daytime sleepiness, the Epworth sleepiness scale (ESS). Among the 178 respondents, all five subscales of the FOSQ showed good internal consistency reliability (Cronbach's alpha = 0.84-0.93). Test-retest on average 18 days apart was satisfactory with intraclass correlation coefficients ranging from 0.61 to 0.86. The pattern of Spearman's rank correlation coefficients between FOSQ scales and related and unrelated scales SF-36 scales gave support to the construct validity of the FOSQ. In conclusion, the Norwegian translation of the FOSQ showed satisfactory internal consistency reliability, test-retest reliability and construct validity, in line with the original version.

Activities of Daily Living↗

PubMed2006

Development and validation of the Edmonton Ankylosing Spondylitis Metrology Index.

OBJECTIVE: Assessment of spinal and hip mobility has been recommended by the Assessments in Ankylosing Spondylitis (AS) Working Group for clinical trials and record keeping, although suggested measures primarily reflect structural damage. Our objective was to validate a simple, 4-item composite measure of spinal and hip mobility, the Edmonton AS Metrology Index (EDASMI). METHODS: We assessed the EDASMI and the Bath AS Metrology Index (BASMI) using a total of 263 patients from 3 countries: Canada (n = 205), Australia (n = 29), and Colombia (n = 29). Intra- and interobserver reliability were assessed in a subset of 44 patients. Construct validity with respect to disease activity (Bath AS Disease Activity Index [BASDAI]), function (Bath AS Functional Index [BASFI]), and structural damage (modified Stoke AS Spinal Score [mSASSS]) was analyzed using correlation and hierarchical regression. Responsiveness was assessed in a subset of 33 patients who received either anti-tumor necrosis factor alpha therapy (n = 26) or pamidronate (n = 7) over 24 weeks. RESULTS: In contrast to the EDASMI, BASMI scores covered a limited range, with 70% of patients demonstrating a score < or =3 (range 0-10) and 4 of 5 individual measures demonstrating substantial floor effects. Both measures were highly reliable (intraclass correlation coefficient >0.90) and demonstrated similar construct validity (EDASMI correlated with disease duration [0.52], BASDAI [0.24], BASFI [0.61], Bath Ankylosing Spondylitis Radiology Index [0.79], mSASSS [0.75]; P < 0.001 for all). The change in EDASMI score was significant after 24 weeks of therapy (standardized response mean 0.40; P = 0.03), but change in the BASMI was not significant. CONCLUSION: The EDASMI is a simple, rapid, and reliable tool for the assessment of spinal mobility in AS that is responsive to therapeutic intervention.

Adult↗

PubMed2001

Reliability, validity, and responsiveness of four knee outcome scales for athletic patients.

BACKGROUND: Many patient-based knee-rating scales are available for the evaluation of athletic patients. However, there is little information on the measurement properties of these instruments and therefore no evidence to support the use of one questionnaire rather than another. The goal of the present study was to determine the reliability, validity, and responsiveness of four knee-rating scales commonly used for the evaluation of athletic patients: the Lysholm scale, the subjective components of the Cincinnati knee-rating system, the American Academy of Orthopaedic Surgeons sports knee-rating scale, and the Activities of Daily Living scale of the Knee Outcome Survey. METHODS: All patients in the study had a disorder of the knee and were active in sports (a Tegner score of 4 points). Forty-one patients who had a knee disorder that had stabilized and who were not receiving treatment were administered all four questionnaires at baseline and again at a mean of 5.2 days (range, two to fourteen days) later to test reliability. Forty-two patients were administered the scales at baseline and at a minimum of three months after treatment to test responsiveness. The responses of 133 patients at baseline were studied to test construct validity. RESULTS: The reliability was high for all scales, with the intraclass correlation coefficient ranging from 0.88 to 0.95. As for construct validity, the correlations among the knee scales ranged from 0.70 to 0.85 and those between the knee scales and the physical component scale of the Short Form-36 (SF-36) and the patient and clinician severity ratings ranged from 0.59 to 0.77. Responsiveness, measured with the standardized response mean, ranged from 0.8 for the Cincinnati knee-rating system to 1.1 for the Activities of Daily Living scale. CONCLUSIONS: All four scales satisfied our criteria for reliability, validity, and responsiveness, and all are acceptable for use in clinical research.

Adolescent↗

PubMed1992

Using cerebral dominance for education programs.

Instructional methods in today's classroom are sometimes based on the notion of cerebral dominance. However, the link between hemispheric laterality and education practice is highly questionable. One instrument used by teachers to assess individual differences in cerebral dominance is a paper-and-pencil survey called Your Style of Learning and Thinking (SOLAT; Torrance, Reynolds, Riegel, & Ball, 1977). In this study, the authors explored the psychometric properties of the SOLAT in three phases. In the first phase, the authors examined SOLAT's construct validity. Contrary to cerebral dominance theory, a principal factor analysis revealed a seven-factor solution. The second phase was conducted to determine the SOLAT's internal consistency and test-retest reliability coefficients. As expected, these analyses generated low to moderate correlations. In the final phase, the authors further examined the SOLAT's construct validity by comparing the performance of brain-injured versus normal adults. With one exception, there were no significant differences. The results of this study did not support the notion of hemisphericity, at least not as measured by the SOLAT. Therefore, educators should not use the SOLAT to categorize students in terms of their preferred mode of processing information.

Adult↗

PubMed1989

A questionable questionnaire: a rejoinder to Marks.

In a recent article Marks argues that two previous articles in this journal in 1986 and 1988, questioning the construct validity of the Vividness of Visual Imagery Questionnaire, should be dismissed due to methodological flaws and overwhelming evidence to the contrary. In this response to Marks, the methodologies of the two studies in question are clarified and defended. Research and other evidence supporting the two Chara studies are presented. It is concluded that the construct validity of the imagery questionnaire has not been established and that further investigations of the questionnaire, and particularly its rating scale, are warranted.

Humans↗

PubMed2001

Validation of the Childhood Health Assessment Questionnaire in the juvenile idiopathic myopathies. Juvenile Dermatomyositis Disease Activity Collaborative Study Group.

OBJECTIVE: To examine the validity of the Childhood Health Assessment Questionnaire (CHAQ) in patients with juvenile idiopathic inflammatory myopathy (IIM). METHODS: One hundred fifteen patients were enrolled in a multicenter collaborative study, during which subjects were assessed twice, 7-9 months apart. Physical function was measured using the CHAQ. Internal reliability was assessed using adjusted item-total correlations and item endorsement rates. Construct validity was assessed by comparing predicted and actual correlations of the CHAQ with other measures of physical function and disease activity. Responsiveness was assessed by calculating effect size (ES) and standardized response mean (SRM) in a group of a priori defined "improvers." RESULTS: Item-total correlations were high (rs range = 0.35-0.81), suggesting all items were related to overall physical function. Manual muscle testing and the Childhood Myositis Assessment Scale correlated moderate to strongly with the CHAQ (r = -0.64 and -0.75, both p < 0.001). Moderate correlations were also seen with the physician global assessment of disease activity (rs = 0.58, p < 0.001), parent global assessment of overall health (rs = -0.65, p < 0.001), Steinbrocker function class (rs = 0.69, p < 0.001), and global skin activity (rs = 0.40, p < 0.001), while global disease damage and skin damage had low correlations (rs = 0.13 and 0.07, p > or =0.17). Responsiveness of the CHAQ was high, with ES = 1.05 and SRM = 1.20. CONCLUSION: In this large cohort of patients with juvenile IIM, the CHAQ exhibited internal reliability, construct validity, and strong responsiveness. We conclude that the CHAQ is a valid measure of physical function in juvenile IIM, appropriate for use in therapeutic trials, and potentially in the clinical care of these patients.

Adolescent↗

PubMed2001

[Validation of methods assessing the quality of life in patients with stable angina pectoris].

The aim of the study was evaluation of the validity, reliability and sensitivity of the Seattle Angina Questionnaire (SAQ) and Disease Effect Profile (DEP) translated into Russian by the authors in assessment of life quality (LQ) of patients with stable angina of effort (SAE). The examination of 106 SAE (functional class II-IV) patients demonstrated that LQ by SAQ and DEP correlated with the evidence by the Medico-Social Questionnaire of the Cardiological Research Centre. The constructive validity of SAQ and DEP was examined using factor analysis. All the SAQ sections but one and 7 of 11 sections of DEP were valid. Reproducibility was 0.938 and 0.906, respectively (p < 0.05), Cronbach's alpha was 0.56 and 0.94, respectively. According to SAQ, adequate choice of therapy improves LQ in SAE patients with functional class III but not in functional class II or IV. According to DEP LQ remained unchanged irrespective of the therapy. Thus, Russian translation of SAQ and DEP has proved its internal, external and constructive validity, is integral and reproducible. In addition, SAQ is sensitive to changes in LQ in SAE.

Angina Pectoris↗

PubMed2006

Development and testing of the spiritual needs inventory for patients near the end of life.

PURPOSE/OBJECTIVES: To develop and test an instrument to measure the spiritual needs of patients near the end of life. DESIGN: Instrumentation methodology. SETTING: One inpatient and five outpatient hospices. SAMPLE: 62 female and 38 male hospice patients with a mean age of 67 years; most were Caucasian, Protestant, and dying of cancer. METHODS: Items for the Spiritual Needs Inventory (SNI) were developed from a qualitative study of spiritual needs of dying patients. Data were analyzed for internal consistency using Cronbach's alpha and item-to-total correlations and for content and construct validity using factor analysis. MAIN RESEARCH VARIABLES: Spiritual needs and life satisfaction. FINDINGS: The total scale alpha of the 27-item SNI was 0.81. Item-to-total correlations ranged from 0.07-0.65, resulting in seven items being eliminated. A principal component factor analysis with a promax oblique rotation was used to estimate content and construct validity. A total of 17 items comprised the five-factor solution. Cronbach's alpha for the revised SNI was 0.85. CONCLUSIONS: The SNI is a valid and reliable measurement of spiritual needs of patients near the end of life. Further psychometric testing of this newly developed instrument is warranted. IMPLICATIONS FOR NURSING: Nurses must recognize the spiritual needs of all patients, particularly those near the end of life. The SNI may be useful in the clinical setting as well as in future studies of spiritual needs of patients.

Adult↗

PubMed2006

[PIPEQ--a method for measurement of user satisfaction in mental health services].

BACKGROUND: This study describes the development and testing of the Psychiatric In-Patient Experiences Questionnaire (PIPEQ). MATERIAL AND METHODS: Questionnaire development was based on a literature review, qualitative interviews with patients, and expert opinion. The questionnaire was tested in a postal survey among inpatients at three community health centres affiliated with the psychiatric clinic of Stavanger University hospital during spring 2005. 244 patients received the questionnaire; either they got the questionnaire by mail after discharge or at the institution before discharge. RESULTS: 68 (28%) patients responded to the questionnaire. Items had low levels of missing data. Factor analysis showed that 11 widely applicable items contribute to a measure of overall experiences. Item-total correlations ranged from 0.55 to 0.82. Cronbach's alpha exceeded the criterion of 0.9. Construct validity was supported by comparisons with variables related to patient experience, including overall satisfaction, extent of patient say in the medication decision, necessity of coercion, and mental health status. INTERPRETATION: The PIPEQ is a brief instrument that covers important aspects of health care experience for psychiatric inpatients and has good evidence for internal reliability and construct validity.

Adult↗

PubMed1996

Further validation of constructs from the selective reminding test.

The Selective Reminding Test (SRT) partitions recall into three classes. Short-Term Recall (STR), Random Long-Term Recall (RLTR), and Consistent Long-Term Recall (CLTR). Examination of conditional probabilities of delayed recall or recognition of individual words as a function of their memory status at the end of a standard 12-word, 12-trial test showed that Buschke's (1973) operational definitions of STR, RLTR, and CLTR have excellent predictive validity.

Adult↗

PubMed2002

[The Spanish version of Skindex-29. An instrument for measuring quality of life in patients with cutaneous diseases].

BACKGROUND: Quality-of-life studies aim to measure objectively how patient life is affected by disease. Generation of a novel instrument is more expensive and time-consuming than adapting a test already existing in another language. Skindex-29 is a widely validated American instrument to measure quality of life in patients with cutaneous disease. A study of the psychometric properties of the Spanish version of Skindex-29 is presented. PATIENTS AND METHOD: The test was administered to adults in an outpatient dermatological clinic. Age, sex and disease were registered for each patient. Three groups were studied: healthy people, patients with inflammatory skin disease and patients with isolated or tumoral lesions. Construct validity, internal consistency, reproducibility at 72 hours, responsiveness and feasibility were evaluated. RESULTS: Responses of 318 patients were analyzed; 65% were women, with a mean age of 36 years. Validity construction was demonstrated, with significant differences between healthy people and patients as well as between both groups of patients. Reliability was also demonstrated, with Cronbach's coefficient alpha values above 0.84 and intraclass correlation values above 0.7. The test showed responsiveness to clinical change. The percentage of non-response was low, and floor and ceiling effects were adequate. CONCLUSION: The Spanish version of Skindex-29 constitutes an instrument with validity, reliability, and sensitivity to change to measure the effects of cutaneous conditions on quality of life of Spanish patients.

Adult↗

PubMed1997

A spurious correlation between hospital mortality and complication rates: the importance of severity adjustment.

OBJECTIVES: When two outcome measures, such as mortality and complication rates, are intended to measure the same underlying quantity (in this case hospital quality of care), one expects they will be highly correlated. In addition, as data quality improves, one expects the correlation will increase. The authors show that these expectations are, in a significant way, mistaken. METHODS: The authors study two outcomes (hospital mortality and complication rates after surgery) using three predictive models that vary in adjustment for severity of illness. RESULTS: Two hospital rankings, based on each of the two outcomes, are well correlated when not adjusted for severity. However, as clinical data are added to the models, the correlation tends to disappear. The authors explain this based on assumptions regarding the relative size of the partial correlations between mortality, complication rate, and severity covariates. CONCLUSIONS: Before claims of construct validity can be made, investigators must show that correlations between outcomes purporting to measure quality of care are sustained after adequate correction for severity. Most importantly, it should be recognized that inadequately controlled confounding variables may lead to a spurious high correlation between an accepted and a new outcome measure, and a false sense of adequate construct validity.

Adult↗

PubMed2005

Use of the QOL-AD for measuring quality of life in people with severe dementia--the LASER-AD study.

BACKGROUND: Health-related quality of life (HR-QOL) scales are particularly important in older people as global outcome measures for interventions. It is known that people with mild to moderate dementia can provide valid assessments of their own QOL, but it is unclear whether these instruments are useful in those with severe dementia. OBJECTIVE: We examined the usefulness of the QOL scale in Alzheimer's disease (QOL-AD) in people with severe dementia by considering the ability of older people with a Mini-Mental State Examination (MMSE) score of <12 and their caregivers to complete this scale, as well as its construct validity and internal consistency. METHODS: Data were collected from people with Alzheimer's disease and their caregivers using a range of instruments measuring cognition, mood, behaviour, QOL and functional ability. RESULTS: Of 79 participants and their caregivers, 41 (52%) could complete the QOL-AD. Cognition and functional abilities were significantly higher in the completers than in the non-completers (P < 0.001). The QOL-AD showed internal consistency and construct validity as it correlated with ability to look after self, fewer limitations due to physical health, positive mood status and low levels of apathy. CONCLUSIONS: There is evidence for the validity and reliability of the QOL-AD in people with MMSE scores of 3-11, as well as the practicality of administering the scale in this population. The scale is unlikely to generate useful information for people with MMSE scores of <3. QOL does not decrease as cognition worsens. This throws into question most people's assumption that decreasing cognition worsens QOL. We consider that it may be important to inform the public of this, as living wills are used increasingly in our culture.

Aged↗

PubMed2002

An assessment of the validity and reliability of the SOGS-RA.

The present is a validation study seeking to determine the degree of confidence that can be placed on inferences about problem gambling among adolescents in the Atlantic provinces, based on their South Oaks Gambling Screen-Revised for Adolescents (SOGS-RA) scores. The major source of data was a 1998 survey of 13,549 students in junior and high school of the public school systems of the 4 Atlantic provinces of Canada. The SOGS-RA was found to have adequate stability and internal consistency reliability. Statistically significant gender differences were demonstrated relative to endorsement and construct validity. Regarding the latter, this study shows that the existing cut-point of the SOGS-RA score for problem gambling identifies as problem gamblers, markedly different proportions of male than female daily gamblers. Regarding construct validity in relation to the Atlantic Alcohol and Drug Risk Continua, this study suggests that while statistically highly significant, the association between problem gambling and substance-related problems may be of low clinical significance. Regarding criterion validity, there is an urgent need to perform the types of enquiry that will allow clarification about how adolescent problem gambling is conceptualized, by adults versus adolescents, by males versus females, and from a clinical versus a public or population health perspective.

Adolescent↗