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PubMedDate not supplied

Development of a Flexilevel Scale for use with computer-adaptive testing for assessing shoulder function.

In a 5-year study, a self-report measure of shoulder function-the Flexilevel Scale of Shoulder Function (FLEX-SF)-was developed by use of item response theory. A large pool of candidate items (N = 68) was developed. A questionnaire that included the 68 items, another scale of shoulder function, and clinical and demographic questions were administered to 400 persons with shoulder complaints. Patients' responses to the 68 items were calibrated by use of Andrich's rating scale model. Thirty-three items were selected from the pool and subdivided into three overlapping testlets targeting low, medium, and high shoulder function. A table translates raw scores on testlets to a common mathematical metric. The validity and reliability of the FLEX-SF was evaluated in a longitudinal study of 199 patients. The FLEX-SF scores were highly reliable and exhibited excellent validity (including responsiveness). We report on a simulation of a computer-adaptive test of shoulder function. This simulation is based on the developmental items we tested for use in the FLEX-SF. The results indicate that greater measurement efficiency can be achieved with a computer-adaptive test format.

Computer Simulation↗

PubMed2000

Development of an Infrequency-Psychopathology scale for the MMPI-A: the Fp-A Scale.

This article describes the development and initial validation of the Infrequency-Psychopathology scale, Fp-A, for the MMPI-A (Butcher et al., 1992). The scale parallels the Infrequency-Psychopathology scale, F(p), that has been developed for the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). Results demonstrated that the 40-item Fp-A scale is superior to the F scale at discriminating between faking-bad and accurate reports of psychopathology, although the improvement over F was modest, particularly when compared to the improvement found for the F(p) scale. The difference seemed to reflect the superiority of the MMPI-A F scale to the MMPI-2 F scale. Even so, the findings suggest that the identification of overreporting on the MMPI-A could potentially be enhanced by using Fp-A as an adjunct to the F scale.

Adolescent↗

PubMed2006

The development and validation of the Concise Outpatient Department User Satisfaction Scale.

OBJECTIVE: To develop and validate a concise scale for measuring outpatient satisfaction suitable across specialties and cultures. DESIGN: & SETTING: Item generation adopted a concept-driven approach, and 10 candidate items were administered together with a battery of validation items and scales in a cross-sectional survey at a government-aided Chinese medicine specialized outpatient department in Hong Kong. PARTICIPANTS: About 344 consenting patients or their accompanying caregivers were recruited upon their first visit at the clinic and interviewed one month thereafter. RESULTS: The overall response rate was 79%. After deleting one item (physician's manner and attitude) for its redundancy suggested by interitem correlations, exploratory factor analysis yielded two factors, General Service and Case Physician, explaining 75% of variance of the remaining nine items. The internal consistency coefficients of the whole scale and the two subscales were higher than 0.90. Criterion-related validity was supported by high correlations with three anchor items, overall satisfaction, intended future reutilization, and recommendation to others (r = 0.38-0.85). Significant correlations with compliance and negative affects provided preliminary evidence for construct validity. CONCLUSION: The psychometric properties of the resulting 9-item scale supported its usefulness in measuring outpatient satisfaction. Further validation studies in various specialties and countries are suggested to make future cross-cultural comparisons possible.

Adult↗

PubMed1994

Evaluation of the MOS SF-36 physical functioning scale (PF-10): I. Unidimensionality and reproducibility of the Rasch item scale.

Indexes developed to measure physical functioning as an essential component of general health status are often based on sets of hierarchically-structured items intended to represent a broad underlying concept. Rasch Item Response Theory (IRT) provides a methodology to examine the hierarchical structure, unidimensionality, and reproducibility of item positions (calibrations) along a scale. Data gathered on the 10-item Physical Functioning Scale (PF-10) from a large sample of Medical Outcomes Study patients (N = 3445) were used to examine the hierarchical order, unidimensionality, and reproducibility of item calibrations. Rasch-IRT analyses generated an empirical item hierarchy, confirmed the unidimensionality of the PF-10 for most patients, and established the reproducibility of item calibrations across patient populations and repeated tests. These findings support the content validity of the PF-10 as a measure of physical functioning and suggest that valid Rasch-IRT summary scores could be generated as an alternative to the current Likert summative scores. Unidimensionality and reproducibility of the item scale are essential prerequisites for the development of Rasch-based person measures of physical functioning that can be used across populations and over repeated tests.

Activities of Daily Living↗

PubMed1997

The development and application of a scale of acculturation.

As Australia is one of the most multicultural societies in the world, acculturation of migrants and changes in migrants' health status should be an important focus of public health research. The absence of an accepted measure of acculturation is one barrier to exploring the relationship between acculturation and health. This paper presents data from a study of 851 Arabic-speaking adults attending 20 Arabic-speaking general practitioners in Canterbury, Sydney. An eight-item scale assessing acculturation was developed with a structural equation modelling program (LISREL). This acculturation scale was based on similar scales used with Hispanic populations, was theoretically grounded and had high internal consistency and criterion-related validity. To show the application of a scale of acculturation, patients' preferences for participation in medical decision making, according to level of acculturation, were examined. After adjustment for age, sex and highest level of formal education, significant inverse associations between acculturation and preferences for patient (versus family) involvement in medical decision making were found. Mechanisms for how acculturation affects health need to be explored.

Acculturation↗

PubMed2004

Psychometric properties of the Brief Life Satisfaction Scales.

The development, psychometric characteristics, and clinical utility of a brief measure of life satisfaction, the Brief Life Satisfaction Scales (BLSS), are presented. Factor analysis of the 10-item scale yielded three factors: self-satisfaction, interpersonal satisfaction, and social role satisfaction. Reliability (internal consistency and retest) and validity (concurrent, construct, discriminant, known group, predictive, and incremental) were adequate to good. Clinical uses of the BLSS and additional studies are discussed.

Adolescent↗

PubMed1999

A scale to assess activities of daily living in persons affected by leprosy.

The aim of this study was to develop a scale for identifying disability among people in the rural areas of developing countries. The studies were carried out in the Green Pastures Hospital and the leprosy field programme of the Western Region of Nepal. With the help of staff experienced in working with people with disability, a 68-question questionnaire was made, based on the International Classification of Impairments, Activities and Participation (ICIDH-2). A survey was carried out of 269 people affected by leprosy who had impairments, as well as a sample of those who were unimpaired. The survey results were used to develop the questionnaire into a scale, using standard scale development methods. This included checking of criterion validity, discrimination and reliability and stability using weighted kappa statistics. Of the 68 questions, 38 were included in the second draft of the instrument. Eight questions were added to identify difficulty in relationships, about the use of aids and about occupation and employment. The sum score of the scale against the expert score gave a Spearman correlation coefficient of 0.72. Intra- and inter-interviewer reliability coefficients were 0.77 (95% CI 0.73-0.81) and 0.61 (95% CI 0.56-0.67), respectively. The stability test gave an overall kappa of 0.76 (95% CI 0.70-0.82). Four questions with particularly poor results were omitted from the final draft of the instrument. An interview-based instrument was developed for identifying limitations in activities of daily living (disability) in people living in a rural setting in a developing country--the Green Pastures Activity Scale (GPAS). The scale performed well during validity and reliability testing. It consists of 34 activity questions, five relationship questions, and three questions on the use of aids, occupation and employment.

Activities of Daily Living↗

PubMed2006

Predicting survival within the lung cancer histopathological hierarchy using a multi-scale genomic model of development.

BACKGROUND: The histopathologic heterogeneity of lung cancer remains a significant confounding factor in its diagnosis and prognosis-spurring numerous recent efforts to find a molecular classification of the disease that has clinical relevance. METHODS AND FINDINGS: Molecular profiles of tumors from 186 patients representing four different lung cancer subtypes (and 17 normal lung tissue samples) were compared with a mouse lung development model using principal component analysis in both temporal and genomic domains. An algorithm for the classification of lung cancers using a multi-scale developmental framework was developed. Kaplan-Meier survival analysis was conducted for lung adenocarcinoma patient subgroups identified via their developmental association. We found multi-scale genomic similarities between four human lung cancer subtypes and the developing mouse lung that are prognostically meaningful. Significant association was observed between the localization of human lung cancer cases along the principal mouse lung development trajectory and the corresponding patient survival rate at three distinct levels of classical histopathologic resolution: among different lung cancer subtypes, among patients within the adenocarcinoma subtype, and within the stage I adenocarcinoma subclass. The earlier the genomic association between a human tumor profile and the mouse lung development sequence, the poorer the patient's prognosis. Furthermore, decomposing this principal lung development trajectory identified a gene set that was significantly enriched for pyrimidine metabolism and cell-adhesion functions specific to lung development and oncogenesis. CONCLUSIONS: From a multi-scale disease modeling perspective, the molecular dynamics of murine lung development provide an effective framework that is not only data driven but also informed by the biology of development for elucidating the mechanisms of human lung cancer biology and its clinical outcome.

Adenocarcinoma↗

PubMed1998

Development of the Alexithymia Scale for Children: a preliminary study.

The Alexithymia Scale for Children-Teacher Form was developed with a sample of 286 elementary schoolchildren. The validity and reliability of the measure were supported by factor analytic structure, relatively high internal consistency, test-retest correlation over 2 mo., and correlations of .24 to .39 with scores on the Yatabe-Guilford Personality Test. Factor analysis yielded two factors related to alexithymia, Difficulty in Describing Feelings and Difficulty Relating to Others. Alexithymia constructs such as a paucity of fantasy life and externally oriented thinking were not recorded.

Affective Symptoms↗

PubMed1977

[The development of children following intra-uterine transfusions in severe Rh-erythroblastosis (author's transl)].

The development of 18 children who had received 1--3 intra-uterine transfusions (IUT) because of severe Rh-erythroblatosis was followed over the first few years of life and finally checked when they were 2--6 years old. All of them were premature, 2 were born with hydrops, 1 with pre-hydrops. There were many other perinatal riskfactors (asphyxia, trouble with respiration, acidosis, severe anemia, hyperbilirubinemia). Examination (general and neurologic) was supplemented by EEG and psychologic testing )Kramer test, Vineland maturity scale, Denver development scales). No child showed signs of severe cerebral damage. 2 children had unequivocal pathologic signs (slight to medium spastic diplegia or hemipegia with corresponding focal findings in EEG). 3 further children showed minimal cerebral signs without disability. Development of intelligence was notably good throughout. Observations showed abnormal neurologi-signs more often during the first 2 years of life than later. Psychologic examinations, too, showed clear improvement with age. Results are satisfactory and confirm that IUT as a prenatal treatment with very severe Rh-Erythroblastosis is justified.

Age Factors↗

PubMed1979

Toward developing a relative value scale for medical and surgical services.

A methodology has been developed to determine the relative values of surgical procedures and medical office visits on the basis of resource costs. The time taken to perform the service and the complexity of that service are the most critical variables. Inter-specialty differences in the opportunity costs of training and overhead expenses are also considered. Results indicate some important differences between the relative values based on resource costs and existing standards, prevailing Medicare charges, and California Relative Value Study values. Most dramatic are discrepancies between existing reimbursement levels and resource cost values for office visits compared to surgical procedures. These vary from procedure to procedure and specialty to specialty but indicate that, on the average, office visits are undervalued (or surgical procedures overvalued) four- to five-fold. After standardizing the variations in the complexity of different procedures, the hourly reimbursement rate in 1978 ranged from $40 for a general practitioner to $200 for surgical specialists.

Fee Schedules↗

PubMed1982

Development of a large scale baboon breeding program.

A unique 6-acre corral facility and defined program for large-scale breeding of baboons, Papio sp, was developed. The colony produced approximatley 200 infants, with known biological characteristics, per year. This program served as a national resource, and provided domestically reared animals for biomedical research investigators in the United States.

Animal Husbandry↗

PubMed2005

Inteins and affinity resin substitutes for protein purification and scale up.

The development of self-cleaving fusion-tag technology has greatly simplified the purification of recombinant proteins at laboratory scale. The self-cleaving capability of these tags has recently been combined with additional purification tags to generate novel and convenient protein purification methods at a variety of scales. In this review, we describe some of these methods, and provide a rudimentary economic analysis of hypothetical large-scale applications. This work is expected to provide a rough outline for the evaluation of these methods for large-scale bioprocessing of a variety of products.

Journal Article↗

PubMed2004

Validity and reliability of a questionnaire to measure the impact of lower urinary tract symptoms on quality of life: the Leicester Impact Scale.

AIMS: To develop a condition specific quality of life measure for males and females with urinary storage symptoms of urgency, frequency, nocturia and incontinence. MATERIALS AND METHODS: A sample of community dwelling males and females aged 40 years or more who were taking part in an epidemiological study provided data for development and validation of the scale. Questions were developed from literature review and discussions with clinicians and patients. Inclusion of items was dependent on levels of missing data and principal components analysis. Validity was assessed by comparison with the Hospital Anxiety and Depression Scale, the Bradburn Negative Affect Scale and single questions concerning the problematic nature of symptoms. Construct validity was assessed by comparing cases and non-cases, and patients with different symptom patterns. Test-retest and inter-rater reliability statistics were calculated for individual items. Responsiveness to change was measured in subjects taking part in a randomised controlled trial of a nursing intervention. RESULTS: The scale showed high levels of internal consistency and measures of construct validity were as hypothesised. Test-retest and inter-rater reliability was moderate to excellent. The distribution of scores was skewed with low levels of impact but the questionnaire was responsive to conservative treatments in patients receiving a nursing intervention. CONCLUSIONS: The questionnaire proved to be a valid and reliable interviewer administered instrument for measuring impact of urinary symptoms.

Aged↗

PubMed1995

Development of the perceptions of racism scale.

Racism may be a factor in low-birth-weight (LBW) and preterm delivery in African American childbearing women. Because no satisfactory measure of racism existed, the Perception of Racism Scale (PRS) was developed. The PRS was pilot tested on 109 participants from churches and community organizations. The scale was then used in a study of 136 childbearing women to investigate LBW and preterm delivery. Twenty items rated on a 4-point Likert-type scale were scored with 1 as the lowest and 4 as the highest perception of racism. Alpha reliabilities were .88 for the pilot and .91 for the study. Content validity was strengthened by expert panel critique. Reliability, content validity, and construct validity were demonstrated and no undue participant burden was observed. The scale is an effective instrument to measure perceptions of racism by African American women.

Adolescent↗

PubMed2000

Development and validation of a scale measuring attitudes toward smoking.

The authors developed the Smoking Attitudes Scale (SAS) and administered it to 2 samples of U.S. students who were smokers or nonsmokers. Exploratory and confirmatory factor analysis with LISREL (K. G. Jöreskog & D. Sörbom, 1989) methodology revealed that the SAS consists of 4 factors. The overall instrument possesses good internal consistency and adequate construct validity as well.

Adult↗

PubMed1997

Development and validation of a social functioning scale, the Social Adaptation Self-evaluation Scale.

The Social Adaptation Self-evaluation Scale (SASS) is a 21-item newly developed scale for the evaluation of patient social motivation and behaviour in depression. The scale was submitted to a validation procedure based on the data from a general population survey in 4000 individuals and from two controlled studies comparing the new selective noradrenaline reuptake inhibitor (NARI), reboxetine, with placebo and/or fluoxetine in 549 patients with major depression. The scale was shown to be valid, reliable and sensitive to change. The results of the multivariate analyses allowed the identification of three principal factors and five clusters. In view of its simplicity of use, and of its peculiar characteristic of investigating patient perspective on self and environment perception and on social motivation and behaviour, the scale represents a useful additional tool for the evaluation of social functioning in depression and will facilitate the development of new antidepressants with differential effects in this domain in depressed patients.

Adrenergic Uptake Inhibitors↗

PubMedDate not supplied

Scales for evaluation of End-of-Life Care in Dementia.

Systematic evaluation of end-of-life care in dementia has been hampered by a lack of instruments to specifically address those issues that are unique for persons who are dying with dementia. This study evaluated psychometric properties of three scales designed to measure outcomes of care of persons suffering from terminal dementia. A survey of family caregivers whose loved one died during the past year was conducted using a questionnaire that included questions regarding satisfaction with care, physical and emotional symptoms that occurred during the last 90 days of the care recipient's life, and comfort during the dying process. Three scales were developed based on responses from 156 questionnaires: Satisfaction with Care at the End-of-Life in Dementia (SWC-EOLD), Symptom Management at the End-of-Life in Dementia (SM-EOLD) with Physical and Psychological Symptoms subscales, and Comfort Assessment in Dying with Dementia (CAD-EOLD) with four subscales: Physical Distress, Dying Symptoms, Emotional Distress, and Well Being. The three scales developed and evaluated in this study can be used as outcome measures in studies investigating effectiveness of interventions aimed to improve end-of-life care for individuals with dementia.

Aged↗