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PubMed2004

Relative efficiency and validity properties of a visual analogue vs a categorical scaled version of the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index: Spanish versions.

OBJECTIVE: To compare the performance of visual analogue (VAS) vs categorical (CT) scaled versions of the three subscales (pain, stiffness and difficulty) of the WOMAC Index in patients with knee osteoarthritis. MATERIAL AND METHODS: Patients with knee OA (at least grade II of Kellgren & Lawrence classification) were treated for a 6-weeks period with an NSAID. The following measures were applied at baseline and after treatment: VAS and CT WOMAC scales, Lequesne Index, pain on VAS, and global assessment by patient and observer. Construct Validity was determined by correlation of each of the subscale scores with the other outcomes both at baseline and after treatment (Pearson's test); responsiveness comparing baseline vs final status by Wilcoxon's test; reliability by analysis of the internal consistency using Cronbach's alpha at baseline and after the treatment period; and test-retest reliability by Kendall's Tau-c statistics. Finally, correlation and analysis of the relative efficiency (RE) between the subscales of both formats were tested. RESULTS: Seventy-three (8 men and 65 women) patients with a mean disease duration from first diagnosis of 69 months (3 to 254) completed the study. The following were the observed values for the instruments' psychometric properties: (1) construct validity: correlations ranged from 0.30 to 0.84 for VAS and 0.27 to 0.77 for CT subscales; (2) responsiveness: achieved P values for the pain, stiffness and difficulty scales were P<0.0001, P=0.002 and P<0.0001 in VAS and P=0.003, P<0.0001 and P=0.001 in CT format respectively; (3) internal consistency: the obtained Cronbach's alpha coefficients ranged from 0.71 to 0.97 for the VAS and 0.64 to 0.95 for the CT subscales; (4) test-retest reliability: correlation coefficients ranged from 0.36 to 0.76 for VAS and 0.34 to 0.52 for CT subscales; and (5) the relative efficiency of the subscales in VAS vs CT format were 2.20, 0.91 and 1.91 for pain, stiffness and difficulty respectively. Significant correlations between subscales in both formats ranging from 0.72 to 0.86 were observed. CONCLUSION: We have shown that both the VAS version of WOMAC have adequate evaluative and discriminative properties. We found the pain and physical function scales in VAS format and the stiffness scale in CT format to have a slightly better performance in this sample.

Adult↗

PubMed1996

Neuropsychological assessment of severely demeted elderly: the severe cognitive impairment profile.

BACKGROUND: Although the assessment of cognitive functioning in the late stages of Alzheimer's Disease (AD) is important for identifying abilities that may improve communication and interactions with severely impaired patients in clinical and institutional settings and for assessing the efficacy of pharmacologic agents and behavioral interventions for the treatment of AD, few adequate instruments exist for measuring the cognitive capacities of these severely demented individuals. OBJECTIVES: To evaluate the reliability and validity of the Severe Cognitive Impairment Profile (SCIP), a measure of neuropsychological functioning in severely demented patients, and compare it with other available instruments. DESIGN AND METHODS: We administered the Mattis Dementia Rating Scale (DRS), Mini-Mental State Examination (MMSE), SCIP, and Severe Impairment Battery (SIB) to 41 severely demented patients with AD participating in an AD research center. We used (1) Spearman rank correlation coefficients to assess interrater and test-retest reliability and construct validity of the SCIP; (2) one-way analysis of variance with post hoc comparisons to examine performance on the SCIP and the SIB at different levels of dementia severity; and (3) descriptive statistics to establish the sensitivity of the SCIP to cognitive functioning in a subgroup of very severely demented patients. RESULTS: Interrater and test-retest reliability correlation coefficients were highly significant for total SCIP score (r=0.99 and r=0.96, respectively) as well as for all SCIP subscales. High correlations were also found between SCIP scores and two widely used tests of global cognitive functioning, the DRS (r=0.91) and the MMSE (r=0.84), suggesting good construct validity. The SCIP was able to significantly differentiate between four groups of severely impaired patients divided by level of dementia severity, while the SIB was unable to differentiate between the less severely demented groups. A subgroup of 16 very severely demented patients (DRS score, <50 points) obtained an average of 45% of total possible points on the SCIP, compared with an average of 1% and 21% of total possible points on the MMSE and DRS, respectively. After approximately 1 year of decline, 12 severely demented patients with AD were able to correctly answer an average of more than 58% of the items on the SCIP, compared with only 30% on the DRS and 20% on the MMSE. CONCLUSIONS: The SCIP is a reliable, valid measure of neuropsychological functioning in severely demented patients with AD with the ability to avoid both floor and ceiling effects and to evaluate a wider range of cognitive abilities than other tests used with severely impaired individuals.

Aged↗

PubMed1996

Can we achieve accountability for long-term outcomes?

OBJECTIVE: To explore options for the development of a set of indicators to assess the long-term outcomes achieved by all people with a given disabling condition in a given population. DATA SOURCES: The review draws on empirical studies of predictive indicators, theoretical literature on long-term recovery processes, and literature from administrative science on the use of indicators in accountability systems. STUDY SELECTION: Studies were selected that explicitly sought to relate short-term and long-term outcomes or that explored the mediating factors in the relationship between impairment, disability, and handicap. DATA EXTRACTION: The focus of the review is on (1) empirical evidence of the relationship between short- and long-term outcomes, particularly in causal claims, and (2) theoretical analyses of the factors that mediate this relationship. DATA SYNTHESIS: Evidence is presented that certain outcome states can be considered thresholds that make the outcome usable and, hence, sustainable or that create the opportunity for further improvement. Such thresholds could meet the construct validity criteria necessary for measures that are to be used as indicators in an accountability system. The interaction between psychological and physical factors in setting thresholds means that both objective and subjective indicators are required in an indicator system. CONCLUSIONS: It may well be possible to develop a parsimonious set of population-based outcome indicators for people with disabilities. The key safeguards required are construct validity and the involvement of people with disabilities in both the development and use of the indicators.

Clinical Competence↗

PubMed2006

Factor analysis of the Revised Piper Fatigue Scale in a caregiver sample.

The Revised Piper Fatigue Scale (R-PFS) is an instrument designed to measure subjective fatigue that was developed in samples with physical illness. Its psychometric properties in nonclinical samples are unknown. The purpose of this study was to examine the psychometric properties of the R-PFS in a sample of caregivers of stroke survivors. The convenience sample of 132 caregivers was primarily women (74%), White (71%), college-educated (73%), and employed (52%), with a mean age of 56.7 years (SD = 13.71). Internal consistency reliabilities for the four R-PFS subscales and the total scale were excellent, ranging from .90 to .97. Principal axis factor analysis with oblique rotation was conducted to examine construct validity of the R-PFS. A three-factor solution explained 75.9% of the common variance. Two factors totally replicated the behavioral/severity and affective meaning subscales of the R-PFS. The third factor incorporated a combination of Piper's sensory and cognitive/mood subscales and appeared to summarize how fatigue makes the caregiver feel. The R-PFS demonstrated strong internal consistency reliability and construct validity in this sample. However, data suggest that caregivers may perceive certain feelings associated with fatigue as conceptually similar when these feelings are conceptually distinct in Piper's breast cancer sample. The study supports the need for psychometric evaluation of instruments developed in clinical populations prior to their use in nonclinical populations.

Adult↗

PubMed2005

Factor analysis and validity of the Conners Parent and Teacher Rating Scales in childhood cancer survivors.

OBJECTIVE: To examine the factor structure of the Conners Parent Rating Scale-Revised: Short Form (CPRS-R:S) and the Conners Teacher Rating Scale-Revised: Short Form (CTRS-R:S) in children who are long-term survivors of acute lymphocytic leukemia (ALL) or brain tumors (BT)and who have received central nervous system directed treatment. METHOD: Parents and teachers of 150 long-term survivors completed the CPRS-R:S or CTRS-R:S as part of a screening battery. The data were submitted to a maximum likelihood confirmatory factor analysis to test the construct validity of the scales and the forms were compared. The CPRS-R:S was also compared to selected subscales of the Achenbach Child Behavior Checklist (CBCL) for further validation. RESULTS: The analyses demonstrated an adequate fit of the original three-factor structure of the CTRS-R:S [oppositional, cognitive problems/inattention, hyperactivity]. The analyses of the CPRS-R:S suggested a less adequate fit of the original three-factor structure but principal components factor analysis yielded a three-factor solution with factors similar to those of Conners' original factor structure. Significant correlations were found between the CPRS-R:S and the selected subscales of the CBCL. CONCLUSIONS: These findings support the similar construct validity of the original CTRS-R:S and CPRS-R:S. Although significantly correlated, the CPRS-R:S and CTRS-R:S are not interchangeable in the assessment of survivors of childhood cancer.

Antineoplastic Agents↗

PubMed2003

Measuring continuity of care for clients of public mental health systems.

OBJECTIVES: The aims of this research were to generate a set of time-variant measures of continuity of outpatient care using administrative data, and to evaluate the validity of these measures for persons in the community with serious mental illness (SMI) who use public mental health services. DATA SOURCES: Individuals with SMI were identified using multistage random sampling from shelters, streets, and public mental health clinics in Houston, Texas. STUDY DESIGN: The study design was observational, cross-sectional, and retrospective. Based on a review of the literature, five distinct conceptual dimensions of continuity of care were defined: timeliness, intensity, comprehensiveness, stability, and coordination. Repeated measures of continuity were generated for each day of the year. Construct validity was assessed by comparing continuity for housed persons and homeless persons based on the assumption that homelessness is a risk factor for low continuity of outpatient care. DATA COLLECTION: Subjects were interviewed to collect sociodemographic and clinical information. Service use was retrospectively tracked through the administrative records of multiple public sector agencies. PRINCIPAL FINDINGS: All five continuity measures demonstrated good construct validity by the fact that homelessness was significantly (p < 0.001) and substantially associated with lower continuity of care. DISCUSSION: The five continuity-of-care measures are relatively easy and inexpensive to generate using administrative data. The five continuity-of-care measures may be useful for identifying individuals at risk for poor outcomes and for evaluating the ability of public service systems to keep clients engaged in care over time.

Adult↗

PubMed2003

Health-related quality of life in children with epilepsy: development and validation of self-report and parent proxy measures.

PURPOSE: To answer a need to include and measure accurately the impact and burden of epilepsy as outcomes of interventions with affected children, we developed and validated self-report and parent-proxy respondent health-related quality of life (HRQL) instruments for preadolescent children with epilepsy. METHODS: We combined qualitative and quantitative research methods. Items were extracted from focus group discussions involving children with epilepsy and their parents. We created scales formatted with alternative paired options of forced responses and used factor analysis to generate relevant subscales and reduce the number of items. We checked internal consistency, assessed test-retest reliability 10-14 days apart, and documented construct validity. RESULTS: A sample of 381 children with epilepsy, age 6-15 years, and their parents independently completed a 67-item questionnaire, from which we chose five items for each subscale. The measures share four subscales, but each measure has an additional distinct subscale. The children and parents could discern differences and report differentially between the various aspects of the HRQL. Internal consistency measured with Cronbach's alpha was acceptable for all subscales; construct validity has been demonstrated from the testing of several hypotheses. Test-retest reliability examined with the intraclass correlation coefficient was satisfactory for the parents and for children age 8 years and older. The correlations between the mothers' and children's responses was poor to moderate. CONCLUSIONS: The data demonstrate sound psychometric properties for both related measures, which are easy to administer for children with epilepsy who are 8 years and older and their parents. The subscales encompass HRQL dimensions judged most important by children with epilepsy for the self-report measure and by parents for the proxy response measure. The parent-proxy measure should be useful as a complement to the child self-report measure in evaluating the validity of parental assessment of the child's health status; in longitudinal outcome research; and in HRQL assessment of children who are unable to respond independently.

Adolescent↗

PubMed1997

Development of a health-related quality of life instrument for use in children with spina bifida.

The objective of this study was to develop a spina bifida health-related quality of life (HRQOL) instrument. Items were generated through semistructured interviews, and reduced by frequency-importance product ranking. Validity was assessed by correlating the HRQOL score with a global question concerning the child's well-being using the Spearman's rank coefficient, and the Piers-Harris Children's Self-Concept Scale (P-H) using the Pearson correlation coefficient. Reproducibility was assessed at 2-week intervals using the intra-class correlation coefficient (ICC). Field testing was undertaken in a larger sample to evaluate item-total correlation, internal consistency and construct validity. Patients taking part in the study were 329 children and adolescents with spina bifida attending two treatment centres. Over 600 items were generated. These were reduced to 47 questions and 50 questions, for children and adolescents respectively. The correlation between the HRQOL score and the global question was r = 0.57, and with the P-H was 0.26 (children). These values for adolescents were 0.63, and 0.89, respectively. Reproducibility was ICC = 0.78 (children) and 0.96 (adolescents). Following field testing, the questionnaire was further reduced to 44 questions (children) and 47 questions (adolescents) by eliminating questions with an item- total correlation less than 0.20. Cronbach's alphas for the final instrument were 0.93 (children) and 0.94 (adolescents), and construct validity correlations were 0.63 (children) and 0.37 (adolescents). The spina bifida HRQOL instrument has good measurement properties and may be used as a discriminative instrument. Assessment of responsiveness is necessary before using it to evaluate therapy in clinical trials.

Adolescent↗

PubMed2003

Development and measurement properties of the Orthotics and Prosthetics Users' Survey (OPUS): a comprehensive set of clinical outcome instruments.

The need to measure and evaluate orthotics and prosthetics (O&P) practice has received growing recognition in the past several years. Reliable and valid self-report instruments are needed that can help facilities evaluate patient outcomes. The objective of this project was to develop a set of self-report instruments that assess functional status, quality of life, and satisfaction with devices and services that can be used in an orthotics and prosthetics clinic. Selecting items from a variety of existing instruments, the authors developed and revised four instruments that differentiate patients with varying levels of lower limb function, quality of life, and satisfaction with devices and services. Evidence of construct validity is provided by hierarchies of item difficulty that are consistent with clinical experience. For example, with the lower limb function instrument, running one block was much more difficult than walking indoors. The instruments demonstrate adequate internal consistency (0.88 for lower limb function, 0.88 for quality of life, 0.74 for service satisfaction, 0.78 for device satisfaction). The next steps in their research programme are to evaluate sensitivity and construct validity. The Orthotics and Prosthetics Users' Survey (OPUS) is a promising self-report instrument which may, with further development, allow orthotic and prosthetic practitioners to evaluate the quality and effectiveness of their services as required by accreditation standards such as those of the American Board for Certification in Orthotics and Prosthetics that mandate quality assessment.

Humans↗

PubMed2000

Development of a health status measure for older African-American women with type 2 diabetes.

OBJECTIVE: To develop a health status measure in older African-American women with type 2 diabetes. RESEARCH DESIGN AND METHODS: African-American women, age > or =40 years with type 2 diabetes, were recruited from central North Carolina to participate in three sequential phases: 1) Seven focus groups were convened and transcripts evaluated to generate questions and identify plausible domains; 2) Ten one-on-one cognitive response interviews were performed to ensure clarity and cultural appropriateness of the questions; and 3) 217 women participated in psychometric evaluation to establish the internal consistency and validity of the instrument. RESULTS: Three broad categories--mental, physical, and social well-being--captured important issues generated during the focus groups. "My diabetes" was added during the cognitive response interviews as a way of separating the impact of diabetes from coexisting issues that affect health status. The response option was changed from a six- to a four-point Likert scale to accommodate subject preference. Using principal components and subsequent promax rotation, we identified two hierarchical domains (mental and social well-being) and a physical symptom index. The internal consistency (Cronbach's alpha) of the mental and social well-being subscales are 0.83 and 0.93, respectively. A priori hypothesized correlations between subscales along with each subscale and glycated hemoglobin, diabetes duration, physical activity, and a perceived health competence scale helped establish the construct validity of the instrument. CONCLUSIONS: A culturally appropriate disease-specific health status measure for older African-American women with type 2 diabetes has been developed. We have established the internal consistency, construct validity, and factor analytic properties of the measure. This measure should prove useful for investigators who seek a health status instrument that addresses issues germane to African-American women with type 2 diabetes.

Adult↗

PubMed1998

Validation of the Arabic version of the Health Assessment Questionnaire (HAQ) in patients with rheumatoid arthritis.

UNLABELLED: Several instruments for measuring functional status in rheumatic diseases have been developed and validated. However, none is as yet available in Arabic. OBJECTIVE: To translate the Health Assessment Questionnaire (HAQ) from English to Arabic and to test the metrological properties, reliability, and validity of the Arabic version. METHODS: The study included 41 consecutive patients seen at the outpatient rheumatology clinic of a large teaching hospital in Kuwait for rheumatoid arthritis meeting 1987 American College of Rheumatology criteria. The HAQ was translated from English to Arabic by three translators who were aware of the intended use of the questionnaire. The translated questionnaire was administered to each patient during two clinic visits seven to ten days apart. Test-retest reliability was assessed based on the intraclass correlation coefficient. Internal consistency of individual items with the overall score was assessed using Cronbach's alpha coefficient. Construct validity was evaluated by determining Spearman's correlation between the Arabic HAQ score and disease activity variables. RESULTS: There were 34 women and seven men, with a median age of 38 years and a median disease duration of 5.3 years. Test-retest reliability was 0.81, internal consistency was 0.93, and construct validity ranged from 0.5 (erythrocyte sedimentation rate) to 0.75 (pain). CONCLUSION: The HAQ-A retains the characteristics of the original American version, and is a reliable and valid instrument for measuring functional disability in Arabic-speaking patients with rheumatoid arthritis.

Activities of Daily Living↗

PubMed1998

Towards a cross-species pharmacology of sensorimotor gating: effects of amantadine, bromocriptine, pergolide and ropinirole on prepulse inhibition of acoustic startle in rats.

Animal models in behavioral pharmacology can be evaluated based on their face, predictive and construct validity. A further level of validity may be achieved if a model is reproduced precisely across species--from laboratory animal to human--using identical conditions and manipulations to elicit identical behavioral changes. Under circumstances in which a model achieves 'homologous' validity, it should be possible to demonstrate that the same pharmacological agents produce parallel changes in the same behavior (as distinct from the clinical condition that the animal behaviors are hypothesized to model), when studied in laboratory animals and in humans. Studies have demonstrated that the disruption of sensorimotor gating of the startle reflex, measured by prepulse inhibition (PPI), in rats by dopamine agonists exhibits face, predictive and construct validity for the relative loss of PPI in schizophrenia patients. To assess the homologous validity of this model, and to expand its utility in understanding the pathophysiology of sensorimotor gating deficits and in developing novel antipsychotic agents to reverse these deficits, it will be important to study PPI across species, comparing response profiles to identical pharmacological manipulations. In the present studies, we report that PPI in rats is reduced in a dose-dependent manner by four dopamine agonists that can be administered with relative ease to humans. We also report that the PPI-disruptive effects of the clinically useful dopamine agonist pergolide are reversed by both typical and atypical antipsychotics. These studies establish a foundation for pursuing human pharmacological studies of PPI, and for extrapolating the substantial neurochemical and neurophysiological information from animal studies of PPI, towards understanding the neural basis for deficient sensorimotor gating in specific neuropsychiatric disorders.

Acoustic Stimulation↗

PubMed2006

The reliability and validity of a matrix to assess the completed reflective personal development plans of general practitioners.

INTRODUCTION: We wished to determine whether assessors could make reliable and valid judgements about the quality of completed reflective personal development plans (PDPs) for the purpose of accrediting UK general practitioners (GPs) for a postgraduate education allowance using a marking matrix, and secondly, to plan a feasible model of PDP assessment in the context of forthcoming GP appraisal/revalidation that would overcome the main sources of error identified from this study. METHODS: Within generalisability theory, a variance components analysis on PDP scores estimated reliability and the effect on them of varying, for example, the number of assessors. We investigated the construct validity of the matrix through its internal consistency and detection of differences in the quality of PDPs. RESULTS: For a single PDP and one assessor, 37.6% of the variance in scores was due to true differences in the quality of the PDP. Between 5 and 7 PDP assessors are needed to achieve summative reliability of greater than 0.8. While increasing the number of judges is important, reliability could also be improved by addressing assessor subjectivity. Construct validity was demonstrated, as the matrix distinguished between good, satisfactory and poor PDPs, and it had good internal consistency. CONCLUSION: PDP assessment has reasonable summative characteristics for the purpose of assessing GPs' reflective continuing professional development. If doctors could include their PDPs within their revalidation folders as evidence of their reflections on pursuing better clinical performance, we have described a reliable, valid and feasible method of external assessment.

Accreditation↗

PubMedDate not supplied

Design and validation of a new scale to assess the functional ability in children with juvenile idiopathic arthritis (JIA).

OBJECTIVE: The assessment of the functional ability is one of the items of the core set to define improvements in patients with JIA, CHAQ being the most used scale already validated in 32 countries. The aim of this study was to design and validate a new scale named CAPFUN (capacidad funcional = functional ability) to assess functional ability in children with JIA. METHODS: This scale includes 20 items, 8 of upper limbs, 8 of lower limbs, 3 combined, and 1 of cervical spine, developed in two steps according with OMERACT. Each item is scored: 0 when it is impossible to be performed, 1 when it is performed incompletely or with difficulties, and 2 when it is well performed. Seventy three patients with JIA according to ILAR criteria were assessed: 25 boys (34.2%) and 48 girls (65.8%) whose aver-age age was 12.8 years (95% CI 11.8 - 13.8) and the time from disease onset was 5.02 years (95% CI 3.9 - 6.1). For validation purposes, it was applied to 91 healthy children and adolescents. In every patient, correlation with active joints count and functional class according to Steinbrocker was assessed and with CHAQ in 31 patients in this series. RESULTS: The CAPFUN index obtained in all healthy children was 2. Patients' media CAPFUN index was 1.54 (95%CI 1.38 - 1.68). The CAPFUN index for Steinbrocker's class I was 1.84 +/- 1.8; for class II 1.60 +/- 1.5 and for class III 0.91 +/- 1 (F 24.1 p < 0.001). CAPFUN showed significant correlation with CHAQ (Spearman coefficient -0.79 p < 0.001), with active joints count (Spearman coefficient -0.72 p < 0.001) and with Steinbrocker functional classes (Spearman coefficient -0.69 p < 0.001). This scale showed a good internal reliability (alpha coefficient equal to 0.94), its construct validity is demonstrated by its good correlation with Steinbrocker's scale and with CHAQ. CONCLUSION: CAPFUN is a new instrument in order to assess functional ability in children with JIA. This scale showed a good internal reliability. Construct validity is demonstrated by its high correlation with Steinbrocker's scale and with CHAQ. This study demonstrates the usefulness of CAPFUN for the assessment of functional ability in children with JIA.

Activities of Daily Living↗

PubMed2002

Development, reliability, and validity of the expectations regarding aging (ERA-38) survey.

PURPOSE: To develop a reliable and valid instrument to measure older adults' expectations regarding aging. DESIGN AND METHODS: Using focus groups, cognitive interviews, and multitrait scaling analysis, we developed a 38-item survey to measure expectations regarding aging (ERA-38). The survey consisted of 10 scales, each representing a domain of expectations. We mailed the survey to 588 English-speaking patients aged 65 years and older cared for by University of California, Los Angeles-affiliated physicians. RESULTS: Four hundred twenty-nine participants (73%) completed the survey. The mean age was 76 years; 54% were women. Most were White (76%). All scales other than Pain demonstrated good internal consistency reliability (alpha > or =.73) and item discrimination (> or =.80). Sixty-eight percent of respondents stated that all or most of the ERA-38 addressed things that were important. Construct validity was supported by correlations with age, activities of daily living, the Medical Outcomes Study Short Form-12 physical and mental component scores, and the Geriatric Depression Scale. IMPLICATIONS: Considerable support for the reliability and construct validity of the ERA-38 was obtained in this field study of 429 older adults. This instrument should be useful to investigators interested in measuring expectations regarding aging among older adults.

Aged↗

PubMed2003

Validity and reliability of patient reported outcomes used in psoriasis: results from two randomized clinical trials.

BACKGROUND: Two Phase III randomized controlled clinical trials were conducted to assess the efficacy, safety, and tolerability of weekly subcutaneous administration of efalizumab for the treatment of psoriasis. Patient reported measures of psoriasis-related functionality and health-related quality of life and of psoriasis-related symptom assessments were included as part of the trials. OBJECTIVE: To assess the reliability, validity, and responsiveness of the patient reported outcome measures that were used in the trials - the Dermatology Life Quality Index (DLQI), the Psoriasis Symptom Assessment (PSA) Scale, and two itch measures, a Visual Analog Scale (VAS) and the National Psoriasis Foundation (NPF) itch measure. METHODS: Subjects aged 18 to 70 years with moderate to severe psoriasis for at least 6 months were recruited into the two clinical trials (n = 1095). Internal consistency reliability was evaluated for all patient reported outcomes at baseline and at 12 weeks. Construct validity was evaluated by relations among the different patient reported outcomes and between the patient reported outcomes and the clinical assessments (Psoriasis Area and Severity Index; Overall Lesion Severity Scale; Physician's Global Assessment of Change) assessed at baseline and at 12 weeks, as was the change over the course of the 12 week portion of the trial. RESULTS: Internal consistency reliability ranged from 0.86 to 0.95 for the patient reported outcome measures. The patient reported outcome measures were all shown to have significant construct validity with respect to each other and with respect to the clinical assessments. The four measures also demonstrated significant responsiveness to change in underlying clinical status of the patients over the course of the trial, as measured by the independently assessed clinical outcomes. CONCLUSIONS: The DLQI, the PSA, VAS, and the NPF are considered useful tools for the measurement of dermatology-related limitations of functional ability and the frequency, severity and impact of psoriasis symptoms on patients' lives and psoriasis-related quality of life.

Adolescent↗

PubMed1999

The WOMB (Women's views of birth) antenatal satisfaction questionnaire: development, dimensions, internal reliability, and validity.

BACKGROUND: Antenatal services continue to change, stimulated by the Changing Childbirth report. Women's views should be an important component of assessing the quality of such services. To date, no published quantitative multidimensional assessment instrument has been available to measure their satisfaction with care. AIM: To develop a valid, reliable, multidimensional questionnaire to assess quality of antenatal care. METHOD: A multidimensional satisfaction questionnaire was developed using psychometric methods. Following fieldwork to pilot a questionnaire, three successive versions of it were given by midwives to pregnant women in their final trimester in nine trusts in the old South Western region of England. Their replies were analysed by principal components analysis (PCA) with varimax rotation; internal reliability was assessed by Cronbach's alpha. Face, content, and construct validity were all assessed during development. RESULTS: Out of 196 women, 134 (68.4%) returned the pilot questionnaires. One hundred and seventy-two (57.3%) out of 300 women returned version 1 of the WOMB (WOMen's views of Birth) antenatal satisfaction questionnaire proper, 283 (56.6%) out of 500 returned version 2, and 328 (65.6%) out of 500 returned the final development version. This final version consisted of 11 dimensions in addition to a general satisfaction one. These were [Cronbach's alpha]: five related to antenatal clinic characteristics (travelling to clinic [0.75], waiting at clinic [0.90], clinic environment [0.69], timing of appointment [0.78], car parking [0.85]), three 'professional' characteristics (professional competence [0.80], knowing carers [0.79], information provided [0.81]), antenatal classes [0.76], social support from other pregnant women [0.83], checking for the baby's heart beat [0.63]. There were significant moderate correlations (range = 0.24 to 0.77) between individual dimensions and the general satisfaction dimension. Women's dimension scores were significantly related to age, parity, social class, and best educational achievement. CONCLUSION: This multidimensional satisfaction instrument has good face, content, and construct validity, and excellent internal reliability. It could be used to generally assess antenatal services or to screen them to detect areas where further in-depth qualitative enquiry is merited. Its sensitivity to change over time, external reliability, and transferability to non-Caucasian groups needs to be assessed.

Adult↗

PubMed2003

Psychometric properties of the Chinese version of the Mini-Mental Adjustment to Cancer (MINI-MAC) scale.

The psychometric properties of a Chinese version of the Mini-Mental Adjustment to Cancer scale (Mini-MAC) were examined among 115 Chinese cancer patients in Hong Kong. The five subscales from the original Mini-MAC (Anxious Preoccupation, Helpless-Hopeless, Fighting Spirit, Fatalism, Cognitive Avoidance) had acceptable internal reliabilities (Cronbach's alpha ranged from 0.65 to 0.88) and construct validities in our sample. Factor analysis suggested three factors: (1) Negative Emotion (alpha=0.91) contained items of the Anxious Preoccupation and the Helpless-Hopeless subscales of the original Mini-MAC, (2) Positive Attitude (alpha=0.77) combined the Fighting Spirit and the Fatalism subscales of the original version, and (3) Cognitive Avoidance (alpha=0.65) which was identical to the Cognitive Avoidance subscale of the original Mini-MAC. Construct validities of the novel factors were shown by their correlations with HADS Anxiety and Depression scores in the predicted directions. It was concluded that both the 5-factor model from the original Mini-MAC and the 3-factor model from the present study were valid in Hong Kong Chinese cancer patients. The results were discussed in terms of the meaning of the original Mini-MAC factors and cultural differences in coping functions between Chinese and UK cancer patients.

Adaptation, Psychological↗