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The chinese version of the decisional balance scale: further validation.

BACKGROUND: Although the Decisional Balance Scale (DBS) has been established to have sound psychometric properties, the reliability and validity of this instrument have not been evaluated in different populations. OBJECTIVES: The aim of this study was to conduct psychometric validations for the Chinese version of the DBS (CDBS). METHODS: This research project was designed as a descriptive cross-sectional study. The CDBS was administered to children in Grades 5-9 (ages 11-17 years, n = 952) recruited from elementary and junior high schools in northern Taiwan. A random cluster sampling method was used. RESULTS: The pros and cons subscales were supported by Cronbach's alpha coefficients of .88 and .85, respectively. Item-to-subtotal correlation coefficients for the subscales were above .48. The results from confirmatory factor analysis, used to assess the construct validity of the CDBS, indicated that the two-factor structure was the best fit for the CDBS when it was used with Taiwanese adolescents (comparative fit index = .96). The contrasted group approach affirmed the construct validity of the pros and the cons of the CDBS. The validity and reliability of the CDBS were supported by the psychometric test results of this study. DISCUSSION: The CDBS is congruent with the culture of Taiwanese adolescents. However, to expand the usefulness of this tool across cultures, the CDBS should continue to be tested with other Chinese-speaking populations and settings.

Adolescent↗

Development of a reliable and valid questionnaire to test the prostate cancer knowledge of men with the disease.

Several prostate cancer knowledge questionnaires exist but none have demonstrated both reliability and validity when used by men with the disease. This study aims to develop a reliable and valid knowledge questionnaire for men with prostate cancer. After developing a 40-item Prostate Cancer Knowledge Questionnaire (PCKQ-40) in phase I, it was piloted in phase II with 391 medical students. This resulted in the reduction of the tool by removing items of poor discriminatory value. A balance between true and false items and content domains was also maintained in the reduced scale. The PCKQ-12 had a moderate internal consistency. Phase III of the study assessed the reliability and construct validity of the tool by measuring the prostate cancer knowledge levels of men with prostate cancer (n=28), men with other cancers (n=10) and men without cancer (n=84). Men with prostate cancer achieved significantly higher PCKQ-12 scores compared with men without cancer, supporting the construct validity of the tool. The tool's reliability was also confirmed with a moderate internal consistency. This study provides some evidence for the reliability and validity of the PCKQ-12 and supports its use with men with prostate cancer in further research.

Adolescent↗

Menopausal Sexual Interest Questionnaire (MSIQ): a unidimensional scale for the assessment of sexual interest in postmenopausal women.

A panel of experts formulated relevant domains of sexual function with a focus on sexual interest and desire. The resulting 10-item scale, the Menopausal Sexual Interest Questionnaire (MSIQ), was examined for reliability (internal consistency and test-retest repeatability), construct validity (concurrent, convergent, and discriminant), sensitivity, and specificity in a clinical trial. A principal components analysis identified three factors (desire, responsiveness, and satisfaction) with eigenvalues > 1. A high degree of internal consistency was observed for each of the three domains. Test-retest repeatability correlation coefficients for domain scores were all highly significant. The MSIQ demonstrated adequate construct validity, with all three domains showing a high degree of sensitivity and with two of the three exhibiting specificity to the effects of treatment.

Adult↗

Homology in behavioural pharmacology: an approach to animal models of human cognition.

The distinction in biology between homology and analogy is examined for possible application to studies in behavioural pharmacology. It is argued that the concept of homology is central to understanding the 'construct validity' of animal models of human cognition. It is suggested that we capitalize on known correspondences across species in brain structure and development which may mediate homologous behavioural functions. Manipulation of specific receptors in defined areas may be achieved by local and systemic administration of drugs with relatively specific actions; this will complement an alternative criterion of construct validity, based on clinical treatments. This argument will be illustrated by a critique of successful extrapolations across species that are sometimes initiated by work in animals and sometimes by work in humans, especially in the clinical setting. The examples used will include analyses of spatial working memory, spatial attention and attentional set-shifting, studied in rats, monkeys and humans.

Animals↗

Development of an aviation safety locus of control scale.

INTRODUCTION: Individual differences in locus of control have be shown to be associated with differential risk for accident involvement among industrial and hospital workers. Previous research has also de onstrated that pilots are higher on internality than externality. HYPOTHESIS: This study was performed to assess individual differences on a new scale developed to assess locus of control with respect to aviation safe It was hypothesized that pilots would exhibit higher levels of internalility than externality on this new scale. METHODS: An existing safety locuss of control scale was modified to place the items in an aviation context, and the items were administered to a sample of approximately 480 pilots. Internality and externality subscales were created, and construct valid was assessed by correlating these subscales with measures of resignation and involvement in hazardous aviation events. RESULTS: The subscales exhibited acceptable internal consistency, and were negatively correlated (r = -0.419, p < 0.001). Consistent with previous research, pilots exhibited substantially higher internality than externality. Correlation the subscales with the measures of resignation and involvement hazardous events supported the construct validity of the scale. DISCUSSION: Differences exist among pilots on the Aviation Safety Locusof Control scale that may be associated with increased accident risk. In its present form, the new scale might be employed as a self-awareness exercise for pilots or as a covariate in research investigating the effect of other factors on accident involvement.

Accidents, Aviation↗

Assessing the validity of an animal model of deficient sensorimotor gating in schizophrenic patients.

Psychiatric researchers need specific animal models to better understand the neurobiology of schizophrenia. Prepulse inhibition (PPI), the reduction in startle produced by a prepulse stimulus, is diminished in schizophrenic patients. Theoretically, deficient PPI in schizophrenic patients reflects a loss of sensorimotor gating that may lead to sensory flooding and cognitive fragmentation. In rats, PPI is disrupted by systemic administration of dopamine agonists or by manipulations of neural circuitry linking the limbic cortex, striatum, pallidum, and pontine reticular formation. This loss of PPI in rats may be a useful model for studying the neurobiology of impaired sensorimotor gating in schizophrenic patients. We assessed the face, predictive, and construct validity of this animal model. Face validity was supported: stimulus manipulations produced parallel changes in PPI in humans and rats, and the dopamine agonist apomorphine disrupted PPI in rats, mimicking PPI deficits in schizophrenics. Predictive validity was supported: the ability of antipsychotics to restore PPI in apomorphine-treated rats correlated with clinical antipsychotic potency (rs = .991) and D2-receptor affinity (rs = .893). Antipsychotics that restore PPI in apomorphine-treated rats include "typical" antipsychotics and the "atypical" antipsychotic clozapine. Construct validity was supported: PPI was disrupted in rats when dopamine was infused into the nucleus accumbens; this effect was blocked by haloperidol. The loss of PPI in dopamine-activated rats may be a valid animal model of sensorimotor gating deficits in schizophrenic patients. This model may help us understand the neurobiology of cognitive deficits in schizophrenic patients.

Acoustic Stimulation↗

Validation of an index of the quality of review articles.

The objective of this study was to assess the validity of an index of the scientific quality of research overviews, the Overview Quality Assessment Questionnaire (OQAQ). Thirty-six published review articles were assessed by 9 judges using the OQAQ. Authors reports of what they had done were compared to OQAQ ratings. The sensibility of the OQAQ was assessed using a 13 item questionnaire. Seven a priori hypotheses were used to assess construct validity. The review articles were drawn from three sampling frames: articles highly rated by criteria external to the study, meta-analyses, and a broad spectrum of medical journals. Three categories of judges were used to assess the articles: research assistants, clinicians with research training and experts in research methodology, with 3 judges in each category. The sensibility of the index was assessed by 15 randomly selected faculty members of the Department of Clinical Epidemiology and Biostatistics at McMaster. Authors' reports of their methods related closely to ratings from corresponding OQAQ items: for each criterion, the mean score was significantly higher for articles for which the authors responses indicated that they had used more rigorous methods. For 10 of the 13 questions used to assess sensibility the mean rating was 5 or greater, indicating general satisfaction with the instrument. The primary shortcoming noted was the need for judgement in applying the index. Six of the 7 hypotheses used to test construct validity held true. The OQAQ is a valid measure of the quality of research overviews.

Humans↗

French translation and validation of 3 functional disability scales for neck pain.

OBJECTIVE: To translate and assess the reliability and the construct validity of 3 functional disability scales for neck pain. DESIGN: Reliability and validity study. SETTING: Tertiary care teaching hospital and outpatient clinic. PARTICIPANTS: One hundred one patients (mean age, 49 y). INTERVENTION: French translations were obtained by using the "translation-backward translation" method. Adaptations were made after a pilot study. MAIN OUTCOME MEASURES: Impairment outcome measures (visual analog scale [VAS] pain, neck range of motion, morning stiffness, score of neck sensitivity, radiologic score of Kellgren) and patients' perceived handicap (VAS) were recorded at the baseline visit. Three functional disability scales (Neck Disability Index [NDI], Neck Pain and Disability Scale [NPDS], Northwick Park Neck Pain Questionnaire [NPQ]) were recorded twice, at baseline visit and 24 hours later. Reliability was assessed by using the intraclass correlation coefficient (ICC) and the Bland and Altman method. Construct (convergent and divergent) validity was investigated by using the Spearman rank correlation coefficient and a factor analysis was performed. RESULTS: Test-retest was excellent for the NPDS and NDI (ICC =.91,.93, respectively) and good for the NPQ (ICC =.84). The Bland and Altman method showed no systematic trend. Expected convergent and divergent validity were observed only for the NPDS; 3 main factors were extracted by factor analysis and explained 78% of the cumulative variance. CONCLUSION: The 3 translated scales are valid, but the NPDS seems to have the best construct validity.

Adult↗

International validation of ReQuest in patients with endoscopy-negative gastro-oesophageal reflux disease.

BACKGROUND: Reflux Questionnaire (ReQuest), a newly developed gastro-oesophageal reflux disease-sensitive scale, can be used to reliably evaluate the effect of treatment on gastro-oesophageal reflux disease symptoms. AIM: International validation of this scale, in patients suffering from endoscopy-negative gastro-oesophageal reflux disease. METHODS: In this open, multicentre and multinational clinical trial 840 endoscopy-negative gastro-oesophageal reflux disease patients received pantoprazole 20 mg daily for 28 days. The long and short versions of ReQuest were completed both in the pre-treatment and treatment phases. For scale development an item reduction analysis was performed. Internal consistency, test-retest reliability and responsiveness were calculated for psychometric analysis. Construct validity was evaluated by comparison with the Gastrointestinal Symptom Rating Scale and the Psychological General Well-being questionnaire by means of correlation coefficients. RESULTS: Factor analyses confirmed the content validity of both long and short version of ReQuest. Psychometric calculations proved high internal consistency (Cronbach's alpha: 0.9), test-retest reliability [Intraclass Correlation Coefficient: 0.9 (long vs. long) and 0.8 (short vs. short)], and responsiveness (Responsiveness Index 320.3) of the scale, for which also good construct validity was achieved (correlation coefficient: Gastrointestinal Symptom Rating Scale -0.6; Psychological General Well-being -0.4). CONCLUSION: ReQuest proved valid, reliable, and responsive in this multinational clinical trial to evaluate treatment response in endoscopy-negative gastro-oesophageal reflux disease patients.

Adult↗

Factor structure of the Dementia Mood Assessment Scale in a cohort of community-dwelling elderly.

We examined the factor structure of the 28-item Dementia Mood Assessment Scale (DMAS), an instrument to assess depressive symptoms in older adults with cognitive impairment, in a cohort of 165 community-dwelling elderly with varying degrees of cognitive impairment. Factor analysis using principal components analysis and varimax rotation was performed to explore the presence of subscales and examine construct validity. A five-factor structure involving all 28 items accounting for 63.2% of the variance in the DMAS scores was derived. Factors were named: Depressed Affect, Environmental Interaction, Diurnal Patterns, Agitation/Suspicion, and Somatic Indicators. This factor structure reflects the often differing presentations of depressive symptoms in older adults with varying degrees of cognitive function and establishes the construct validity of the DMAS in this population. We conclude that the DMAS may be used for differentiated clinical assessment of depressive symptoms along major dimensions of depressive illness in this cohort of elderly.

Aged↗

Chronicity of psychological strain in occupational settings and the accuracy of the General Health Questionnaire.

This article examines the proposition that the traditional scoring method of the General Health Questionnaire (GHQ) underestimates the number of respondents classified as "cases." A revised "chronic" scoring method (the CGHQ) is used and demonstrates superior construct validity and greater sensitivity. A comparison of the CGHQ and GHQ also shows the CGHQ to be a superior criterion measure. These claims are demonstrated by survey data gathered from 3 occupational samples (Ns=11,637, 2,253, and 2,124). Results show that the CGHQ is more appropriate as a screening instrument for psychological morbidity. Tests of construct validity also favor the CGHQ with only a slight advantage for predictive validity in terms of variance explained. The more desirable statistical properties of the CGHQ result in a reduction of significant interaction terms and are strongly recommended in future studies as a means of controlling Type I errors when tests of moderation are examined.

Adult↗

Psychosocial morbidity in prostate cancer: II. A comparison of patients and partners.

OBJECTIVE: To assess psychometrically a new questionnaire for measuring the psychosocial morbidity in patients with prostate cancer and in their partners, and to compare the morbidity of patients and their partners. PATIENTS AND METHODS: A sequential sample of patients with any stage of prostate cancer and attending general urology outpatient clinics was identified. The questionnaire was administered to 135 patients and their partners in their homes. The Hospital Anxiety and Depression Scale (HADS) questionnaire was also administered to permit construct validation of the new measure. Test-retest reliability was calculated by re-administering the questionnaire to 60 individuals. The hypothetical general cancer distress and social subscales of the questionnaire were also tested for internal consistency. Psychosocial morbidity scores obtained by the patients and partners were compared. RESULTS: The questionnaire had good test-retest reliability and construct validity when tested against the HADS. The general cancer distress and social subscales were internally consistent. General cancer distress was highly prevalent and significantly more severe in partners than in patients. There was some degree of general cancer distress in 47% of patients and 76% of partners, whereas severe distress was detected in 11% and 30%, respectively. Social morbidity was limited and of equal severity between the groups. Treatment-related worries and concerns about pain and physical limitation were more common among partners than patients, whereas there was no difference for worries about urinary symptoms. Sexual concerns were the least prevalent and were more of a problem for patients than partners. CONCLUSION: Psychosocial morbidity in prostate cancer is highly prevalent, not only among patients but particularly among their partners. The new questionnaire showed adequate psychometric properties for use in identifying individuals with significant psychosocial morbidity. Applying the questionnaire should permit emotional and informational support to be targeted at the most vulnerable.

Aged↗

The development of a handicap assessment questionnaire: the Impact on Participation and Autonomy (IPA).

OBJECTIVE: To report on the feasibility and psychometric properties in terms of homogeneity and construct validity of a newly developed handicap questionnaire focusing on person-perceived handicaps: the Impact on Participation and Autonomy (IPA). DESIGN: Cross-sectional. SETTING, subjects and outcome measure: One hundred consecutive individuals from the outpatient clinic of the department of rehabilitation of an academic hospital administered the new questionnaire IPA. RESULTS: The results show good homogeneity and construct validity of the IPA. Factor analysis showed that the scale consists of four factors, explaining 68% of the total variance: social relationships, autonomy in self-care, mobility and leisure, and family role. Homogeneity of the four subscales was considered good, Cronbach's alpha ranged from 0.84 (family role) to 0.87 (social relationships). Feasibility in terms of the number of missing values and administration time needed was satisfactory. CONCLUSION: The first results suggest that the IPA promises to be a useful handicap questionnaire. Further research is needed to establish test-retest reliability, convergent validity and responsiveness to change.

Activities of Daily Living↗

A measure of critical care nurses' post-code stress.

AIM: The purpose of this research was to develop an instrument to measure critical care nurses' post-code stress and then to examine the psychometric properties. BACKGROUND: Critical care nurses experience stress from multiple sources. One source of stress may arise from participation in resuscitation attempts and this has been labelled post-code stress; however, no means exist for measuring this source of stress. DESIGN/METHOD: In phase 1, 47 items were developed and submitted to a panel of experts for content validity. Based on content experts' ratings, 20 items were retained for phase 2 instrument testing. To test the instrument, a convenience sample of critical care nurses was obtained from four institutions in north-eastern United States. Each nurse received the Post-Code Stress Scale and completed it anonymously. A subsample completed the Post-Code Stress Scale a second time to assess stability reliability. The Nursing Stress Scale was also administered to assess construct validity. RESULTS/FINDINGS: An exploratory principal components factor analysis with varimax rotation suggested five dimensions to post-code stress. These five dimensions accounted for 66% of the variance and indicated that stress arose from feeling discomposed, oppressed, uncertain, burdened and morally conflicted. The Pearson product moment correlation between the Post-Code Stress Scale and the Nursing Stress Scale was 0.46, providing preliminary evidence of construct validity. Internal consistency reliability estimates for the five-factor subscales ranged from 0.57 to 0.77 with only one factor being <0.70. The internal consistency reliability estimate for the final 14 items on the scale was 0.79. CONCLUSIONS: The instrument shows promise as a measure of post-code stress based on the evidence obtained in this study; however, further psychometric testing is warranted.

Adult↗

Development and validation of an improving prescribing in the elderly tool.

OBJECTIVE: To apply recently published consensus panel guidelines to a series of hospital inpatient charts to develop and validate a brief screening tool for potentially inappropriate prescriptions in the elderly. SETTING: A 400-bed acute care hospital in London, Ontario. METHODS: Three hundred and sixty-one consecutive inpatient charts, 185 from a clinical teaching unit (CTU) and 176 from a geriatric assessment unit (GAU) were examined for potentially inappropriate prescriptions as listed by McLeod et al. The potentially inappropriate prescribing practices detected were used to develop the Improving Prescribing in the Elderly Tool (IPET). Construct validity was examined by looking for a predicted difference in the rate of potentially inappropriate prescriptions between the CTU and the GAU. Interrater reliability was determined by applying the IPET to a new series of 100 charts. RESULTS: Forty-two of 361 individuals (12.5%) had 45 potentially inappropriate prescriptions representing 14 different potential drug/disease interactions; these were used to construct the IPET. A demonstrated difference in the rate of potentially inappropriate prescriptions between the CTU and GAU indicated construct validity. The interrater reliability of the IPET (kappa) when applied to a new series of 100 charts was 1.0. INTERPRETATION: The IPET is a brief, reliable and valid tool based on the published literature that may be used to screen for potentially inappropriate prescriptions in the elderly.

Aged↗

Validity and reliability of the Short Form-36 in cervical spondylotic myelopathy.

OBJECT: Validity (the extent to which a test measures what it is intended to measure) and reliability (the stability and reproducibility of measures of the same concept over time or across methods of gathering data) are important characteristics of any outcomes instrument. Generic outcomes instruments are designed for use in any population; however, their validity and reliability in particular diseases should be verified to ensure their appropriateness for use in that disease. In this study the authors assessed the validity and reliability of the Medical Outcomes Study Short Form-36 (SF-36), a generic outcomes instrument, in a population of patients with cervical spondylotic myelopathy (CSM). METHODS: The SF-36 was administered to a cohort of patients with CSM on an outpatient basis. Symptom-related data derived from a structured interview and physical examination findings were used to classify cases according to the myelopathy scales of Nurick, Cooper, Harsh, and a Western modification of the Japanese Orthopaedic Association (JOA). Construct validity was assessed by determining whether SF-36 scores varied in accordance with predefined hypotheses relating to the myelopathy scores by using the Cuzick nonparametric test for trend. The reliability of the SF-36 scores was assessed using Cronbach alpha. Eighty-eight patients with CSM completed the SF-36 and interview. Construct validity was demonstrated by confirming the hypothesized relationship between SF-36 scales and the myelopathy scales of Nurick (p < or = 0.003), Cooper leg subscale (p < or = 0.012, except the general health perceptions domain [p = 0.091]), Harsh (p < or = 0.016), and the motor component of the modified JOA (p < or = 0.006). Reliability was demonstrated for all eight SF-36 domain scales and the physical component and mental component summary scales, in which Cronbach alpha satisfied the Nunnally criterion of 0.7. CONCLUSIONS: The SF-36 provides valid and reliable data on patients with CSM.

Activities of Daily Living↗

A new measure of contemporary life stress: development, validation, and reliability of the CRISYS.

OBJECTIVE: To develop and validate a measure of contemporary life stressors. STUDY SETTING: Three interview studies: Study 1 (pilot), 32 caregivers receiving case management services for a child with chronic illness; Study 2 (validation), 311 caregivers of children receiving general pediatric care at a university clinic; Study 3 (reliability), 17 caregivers of children with a complex medical diagnosis. STUDY DESIGN: Study 1: item development via discussions with case managers; piloted with caregivers. Study 2 examined psychometric properties of the measure and correlated it with the CES-D, a measure of depressive symptomatology and the PRQ85-Part 2, a measure of perceived social support, to establish its convergent construct validity. Study 3 established the test-retest reliability of the measure over two weeks by correlating two administrations of the index. DATA COLLECTION: Face-to-face interviews in homes (Study 1) or in clinic waiting rooms (Studies 2 and 3) and by telephone (Study 3 retest). PRINCIPAL FINDINGS: The CRISYS is a flexible, multidimensional tool that demonstrates strong face, content, and construct validity, and excellent test-retest reliability. The format is easy to use and well accepted by respondents and is suitable for low-income populations. CONCLUSIONS: Researchers will find the CRISYS useful when evaluating the success of a clinical model or a healthcare system, and the effectiveness of an insurance plan or a government program. Clinicians may also find that the CRISYS is an effective screen for family needs.

Adult↗

The Copenhagen Neck Functional Disability Scale: a study of reliability and validity.

OBJECTIVE: To determine whether a newly developed disability scale for patients with neck pain demonstrated acceptable reliability and validity. METHODS: Testing was conducted using three different samples of patients with neck pain (n = 162). Test-retest reliability of the scale was carried out on the same day with one sample (n = 39), and between-day reliability was carried out with another (n = 21). Differential item functioning with regard to the influence of gender and age was carried out with these two patient groups, as was construct validity. Responsiveness was measured using patients participating in a clinical trial involving patients with chronic neck pain (n = 102). Additionally, scale scores were compared with a wide range of physical measurements using the patients in the clinical trial. RESULTS: Short-term, between-day and postal questionnaire reliability coefficients were all extremely high. The Cronbach's alpha coefficient for internal consistency was 0.9 for the entire scale, and the coefficients for individual items were all greater than 0.88. Disability scale scores correlated strongly to pain scores as well as to doctor and patient global assessments, indicating good construct validity. Relative changes in disability scores demonstrated a moderately strong correlation to changes in pain scores after treatment. Scale scores correlated weakly to all physical measurements. CONCLUSIONS: The disability scale demonstrated excellent practicality and reliability. The scale accurately reflects patient perceptions regarding functional status and pain as well as doctor's global assessment and is responsive to change over long periods of time. We feel that this scale can be a valuable tool for the assessment of patients in future clinical trials and quality of care studies.

Adult↗