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PubMed1989

Internal and external validity in two studies that compared treatment methods.

Research comparing the effectiveness of two treatments offers both strengths and weaknesses for occupational therapy. Although it is worthwhile to determine which of two treatments works best for a particular problem, methodological problems may arise that preclude a valid conclusion. To draw valid conclusions from research, criteria for internal validity and external validity must be satisfied. The two preceding articles in this issue are examples of studies that used between-groups experimental methodology to compare the effectiveness of two different treatments. This paper evaluates the above-mentioned studies on the basis of principles of internal and external validity. One of these studies (Jongbloed, Stacey, & Brighton, 1989) was truly experimental, whereas the other study (Groves & Rider, 1989) was quasi-experimental. Results from both studies were similar because, in each study, both of the treatment groups improved, but there were no significant differences between treatments. Absence of a true control group in both studies presented limitations on the conclusion that both treatments worked equally well.

Analysis of Variance↗

PubMed1992

A validity study of the posture and fine motor assessment of infants.

This study investigated the concurrent and construct validity of the Posture and Fine Motor Assessment of Infants (PFMAI) (Case-Smith, 1991). The subjects were 90 infants, 65 of whom were healthy and full-term and 25 of whom were premature and had medical risk factors. Concurrent validity was investigated through administration of the Peabody Developmental Motor Scales (Folio & Fewell, 1983) and the PFMAI (n = 25). Strong positive correlations resulted between the Peabody Gross Motor scale and PFMAI Posture scale and between the Peabody Fine Motor scale and PFMAI Fine Motor scale. Concurrent validity was also measured through correlation scores on the Bayley Scales of Infant Development (Bayley, 1969) with scores on the PFMAI. The correlations between the Bayley Motor scale and the PFMAI Posture scale and between the Bayley Mental scale and the PFMAI Fine Motor scale were high. Construct validity was estimated through an evaluation of how accurately the PFMAI discriminated between the premature subjects and the full-term subjects. A discriminant analysis indicated that the PFMAI accurately classified 78% of the subjects as being either premature or full-term (i.e., 80% of the full-term subjects and 72% of the premature subjects). When the premature subjects were categorized as low-risk or high-risk according to their medical histories, the PFMAI accurately classified 66.7% of the total subject population as full-term, low-risk premature, or high-risk premature. These results indicate that the PFMAI has the adequate reliability and validity necessary for use as a clinical and a research instrument.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain Damage, Chronic↗

PubMed2003

Ensuring content validity in instrument development: challenges and innovative approaches.

The challenges of developing new and valid instruments specific for use in nursing research and practice can be complex and varied. In this paper we identify a number of innovative approaches for achieving content validity based on our instrument development work. These approaches include ways of identifying the conceptual domain, the role of literature reviews and key experts, processes used to confirm content validity and clarity of content, feasibility of the validity process and exploration of pertinent ethical issues. The review of key issues covered here may provide guidance for nurses and researchers in developing sound and content valid instruments.

Ethics, Nursing↗

PubMed1999

Validation of a questionnaire for assessing physical work load.

OBJECTIVES: Reliable, valid, and compatible methods are required for exploring the complex interactive effects of psychosocial and physical stressors on complaints and disorders. An instrument for assessing physical work load that integrates information from a biomechanical model of lumbar load is presented and validated. METHODS: Four hundred and fifty-five people working in nursing homes for elderly people in Germany filled out the developed questionnaire 3 times within 1 year. Test-retest reliability was calculated, and validity was checked several times. Relationships with other, theoretically related and unrelated variables were examined. RESULTS: The test-retest reliability of the questionnaire measures was about 0.65. The convergent and discriminant validity was satisfactory, and the questionnaire was able to separate professional subgroups with different physical work loads. The Spearman rank-order correlations between physical load and musculoskeletal complaints were about 0.30. CONCLUSIONS: The method developed in this study is a reliable and valid instrument for assessing physical work load. The integration of statistical methods from psychological testing and theory in the development of methods exploring the effects of physical work load is advocated.

Adult↗

PubMed2026

Development and Validation of a Multimodal Clinical, Pathologic, and Genomic Model for Breast Cancer Recurrence.

PURPOSE: To develop and validate a multimodal recurrence-risk model integrating histology, genomic testing, and clinical variables. METHODS: We developed AI-Path, a whole-slide image biomarker for recurrence prediction trained in CALGB 9344, and validated it in three independent cohorts: TAILORx, a multi-site Chicago cohort, and the MDX-BRCA cohort. We then integrated AI-Path with Oncotype DX Recurrence Score (RS), tumor size, and nodal status into a Cox model, PathClinRS, fit using 60% of cases from TAILORx, with the remaining 40% held out for validation. The primary end point was distant recurrence-free interval. Performance was assessed using Harrell's concordance index (C-index) and Kaplan-Meier analyses. RESULTS: A total of 12,418 patients were included. In TAILORx, AI-Path outperformed RS for distant recurrence (C-index, 0.682 vs 0.647; P = .038), driven by superior prediction of late recurrence (0.656 vs 0.567; P < .001). In node-negative disease, PathClinRS outperformed RSClin in the TAILORx fitting (0.72 vs 0.70; P = .016) and validation sets (0.74 vs 0.70; P = .004). In node-positive disease, PathClinRS outperformed RSClinN+ in Chicago (0.94 vs 0.74; P < .001) and MDX-BRCA (0.71 vs 0.66; P = .004) cohorts. Compared with NATALEE eligibility, PathClinRS identified nearly twice as many high-risk node-negative patients while maintaining a comparable 10-year distant recurrence risk (16.7% vs 16.6% per NATALEE eligibility in TAILORx fitting; 21.0% vs 19.4% in TAILORx validation). PathClinRS identified 68% of intermediate risk premenopausal patients as low-risk with no evidence of chemotherapy benefit, compared to only 36% identified as low risk by standard clinicopathologic criteria. CONCLUSION: Digital histopathology provides prognostic information complementary to genomic assays and has the potential to personalize therapy beyond existing clinicogenomic tools.

Journal Article↗

PubMed1999

[First validation of the French version of the Gastrointestinal Quality of Life Index (GIQLI)].

AIM: Gastrointestinal quality of life index (GIQLI) was initiated in Germany. The aim of this study was to validate its French version (translation). METHODS: The questionnaire includes 36 items asking about symptoms, physical status, emotions, social dysfunction, and effects of medical treatment. The questionnaire has been applied to 615 persons: 335 healthy individuals and 280 patients. Responsiveness and absolute and relative scores were calculated in both groups. Psychometric analysis was done by measuring the validity (convergent and discriminant) and internal consistency. RESULTS: The responsiveness was 93%. The mean score was 126 for healthy individuals and 96 for patients (P < 0.00001). The validity of the questionnaire (both convergent and discriminant) and the internal consistency were demonstrated. Clinical validity was also suggested by the differences between healthy individuals and patients. CONCLUSION: This study allowed the psychometric validation of the French version of GIQLI. This index could be used in France as a reliable method for measuring quality of life related to gastrointestinal diseases.

Adult↗

PubMed1999

[The validation of a questionnaire for measuring the organizational climate in health centers].

OBJECTIVE: To check the reliability and to analyse the validity of a questionnaire on organisational atmosphere (OA). DESIGN: Crossover and observational. SETTING: Primary care teams (PCTs). PARTICIPANTS: Two questionnaires were offered to all the doctors, nurses and social workers (548 professionals) from the 29 PCTs in an autonomous community. One questionnaire was on the OA and the other was a subjective assessment of satisfaction with the structure and functioning of their own team. MEASUREMENTS AND MAIN RESULTS: When the results were analysed (initial factorial analysis), 3 items with only slight discrimination were eliminated from the OA questionnaire. Construction validity (factorial analysis with varimax method), reliability of the questionnaire (Cronbach's alpha and Spearman-Brown coefficient) and of criterion (correlation between OA and variables in the subjective assessment questionnaire) were calculated. The overall response rate was 77.5% (402 professionals). Three dimensions which explained 57% of total variability and which confirmed adequate construction validity were identified: team-work, cohesion and commitment. "Team-work" comprised 9 items and explained 27.18% of total variability. "Cohesion" had 7 items, which explained 16.55% of variability. Lastly, "Commitment" explained 13.47% of variability, with 5 items. The validity of criterion was adequate (close correlation between OA and subjective assessment of structure and operation). Reliability was high (0.89 alpha and 0.92 Spearman-Brown for the entire questionnaire and > 0.7 for the dimensions). CONCLUSIONS: The reliability and validity of the adapted questionnaire are sufficient and permit its routine primary care use in our health system to be recommended.

Community Health Centers↗

PubMed1999

[Validation of the Spanish version of the Liebowitz social anxiety scale, social anxiety and distress scale and Sheehan disability inventory for the evaluation of social phobia].

BACKGROUND: Social phobia is an anxiety disorder of increasing interest in clinical psychiatric practice and research. The questionnaires most widely used in the psychometric evaluation of these patients are: Liebowitz Social Anxiety Scale (LSAS), Social Anxiety and Distress Scale (SADS) and Sheehan Disability Inventory (SDI). The objective of this study was to evaluate the validity and reproducibility of the Spanish versions. SUBJECTS AND METHODS: Convergent validity was analysed by correlating patients' scores on the LSAS, SADS and SDI with scores on the Global Activity Evaluation Scale (GAES), the Hamilton Anxiety Scale (HAM-A) and the Visual Analogue Scale (VAS) of the EuroQol. Validity of the internal structure was examined by analysing the correlations between the different sub-escales of the questionnaires. Internal consistency was analysed using Cronbach's alpha and Kuder-Richardson coefficients. Discriminative capability was analysed by comparing LSAS, SADS and SDI scores of patients with social phobia with scores from healthy subjects, and with that obtained on the HAM-A and the EuroQol VAS. Reproducibility was analysed by re-testing patients after 15 days. RESULTS: 57 patients and 57 healthy subjects were recruited in 4 psychiatric centres. The three questionnaires showed an adequate convergent validity with the GAES, the HAM-A and the EuroQol VAS (r = -0.24-0.40 and r = 0.29-0.52). The LSAS and SDI questionnaires showed a homogenous internal structure in terms of correlation between sub-scales (r = -0.61-0.93 for LSAS, and r = -0.04-0.61 for SDI). All the sub-scales of the questionnaires showed an adequate internal consistency (with coefficients between 0.72 and 0.88). The questionnaires discriminated between groups of patients with different levels of symptom severity and self-perceived overall health. They also discriminated between patients with social phobia and healthy subjects (area under the Receiver's Operating Characteristics curves = 0.95-0.99). All sub-scales from the questionnaires showed adequate reproducibility (with intraclass correlation coefficients between 0.63 and 0.88). CONCLUSIONS: The Spanish versions of the LSAS, SADS and SDI questionnaires have shown adequate validity and reproducibility for use in clinical research and the clinical assessment of patients with social phobia in Spain.

Adolescent↗

PubMedDate not supplied

Reliability and validity of a rating scale for post-stroke psychiatric symptoms. SKETCH Study Group.

Reliability and validity of a rating scale for post-stroke psychiatric symptoms were examined by the videotape method. The scale comprised 10 items categorized into two symptom domains of decreased spontaneity and impaired emotion. Also, two items for global assessment of the two symptom domains were added. Each item had seven anchor points from 0, representing no impairment, to 6, corresponding to complete impairment. Face validity of the scale was confirmed through the questionnaire survey. Nine neurologists independently assessed psychiatric symptoms in 30 videotaped post-stroke patients. Weighted kappa coefficients of more than 0.5 were noted for all the items except for one item. Data from three cerebral metabolism enhancers trials were used to examine the validity. Changes in severity in the Global Change Scale (GCS) from the baseline to the final assessment was assessed by raters' impression in these trials. Factorial validity of the scale was confirmed by the factor analysis. GCS in the three trials were considerably related to the summed scores of the items in the two categories. Namely, in the box plot figures, boxes of the middle 50% of data well differentiated the adjacent categories of GCS. However, overlap from vertical bars was observed. These results suggest reliability and validity of the scale.

Adult↗

PubMed2000

Alberta infant motor scale: reliability and validity when used on preterm infants in Taiwan.

BACKGROUND AND PURPOSE: The goal of this study was to examine the reliability and validity of measurements obtained with the Alberta Infant Motor Scale (AIMS) for evaluation of preterm infants in Taiwan. SUBJECTS: Two independent groups of preterm infants were used to investigate the reliability (n=45) and validity (n=41) for the AIMS. METHODS: In the reliability study, the AIMS was administered to the infants by a physical therapist, and infant performance was videotaped. The performance was then rescored by the same therapist and by 2 other therapists to examine the intrarater and interrater reliability. In the validity study, the AIMS and the Bayley Motor Scale were administered to the infants at 6 and 12 months of age to examine criterion-related validity. RESULTS: Intraclass correlation coefficients (ICCs) for intrarater and interrater reliability of measurements obtained with the AIMS were high (ICC=.97-.99). The AIMS scores correlated with the Bayley Motor Scale scores at 6 and 12 months (r=.78 and.90), although the AIMS scores at 6 months were only moderately predictive of the motor function at 12 months (r=.56). CONCLUSION AND DISCUSSION: The results suggest that measurements obtained with the AIMS have acceptable reliability and concurrent validity but limited predictive value for evaluating preterm Taiwanese infants.

Child Development↗

PubMed2000

Validity of symptom and clinical measures of asthma severity for primary outpatient assessment of adult asthma.

BACKGROUND: Symptom and pulmonary function measures of asthma severity are used for severity classification in practice guidelines. However, there is limited methodological evidence in support of their validity and utility. AIM: To validate initial symptom and forced expiratory volume (FEV1) measures of asthma severity with the subsequent risks of exacerbations resulting in emergency room (ER) visits, hospitalisation, and sickness absence from work. In addition, symptom-based measures of change in asthma severity were also evaluated against the concurrent risks of asthma exacerbations. METHOD: A cohort of 361 adult asthmatic patients in general outpatient clinics was studied. At initial interview, frequencies of asthmatic symptoms and nocturnal exacerbations, FEV1, and a severity score combining these measures, were recorded. At re-interview in the third year, the frequencies of asthma exacerbations resulting in ER visits, hospitalisation, and sickness absence, and a self-assessed global measure of change in severity and serially-assessed change in symptom frequencies, were measured. RESULTS: All individual symptom and FEV1 measures were strongly related to the subsequent risks of ER visits, hospitalisation, and sick absence. A severity score of more than 3 (moderate to severe asthma) and self-assessed change in asthma severity were most strongly and significantly associated with greatly increased risks of all outcomes. Individual symptoms and FEV1 measures alone did not show high sensitivities, but the severity score combining these measures gave much more satisfactory validity. Perhaps not surprisingly, self-assessed change in asthma appeared to give the most satisfactory validity. CONCLUSION: These results support the validity and clinical utility of a simple clinical score based on symptom and FEV1 measures, and self-assessed measure of change in severity, for risk classification in contemporary clinical practice guidelines.

Adult↗

PubMed1999

Pediatric asthma quality of life questionnaire: validation in children from Singapore.

"Quality of Life" is a multidimensional measure encompassing the physical, emotional and social functioning of the child. The asthma specific questionnaire contains 23 questions (items) in three areas (domains) of activity, symptoms and emotions. The objective of the present study was to validate the Paediatric Asthma Quality of Life Questionnaire "PAQLQ"(copyright 1991 McMaster University). If the questionnaire is valid, a change in the child's asthma will be accompanied by a change in the "Quality of Life" questionnaire score. The questionnaire was administered twice over four weeks and the child's asthma status was assessed concurrently. Two groups were thus identified; Group A = unchanged asthma, Group B = changed asthma. Forty-seven children, aged 7 to 14 years, completed the study. Reliability of the questionnaire shows an intraclass-correlation coefficient of only 0.71. Cross-sectional construct validity was demonstrated by a significant correlation between the whole questionnaire and the clinical asthma score (p<0.001) but not in the separate domains. Longitudinal construct validity was also demonstrated by the significant correlation between change in the total questionnaire score, but not separate domains, with change in the child's asthma score (p<0.05). Responsiveness was shown by a significant difference in the magnitude of the change in the questionnaire score between the two groups (p<0.001), but again not in the separate domains. It was concluded that the questionnaire was validated as a whole but not in as convincing a manner, as has been done by others, and we are therefore in a position to advise caution in its application in our population.

Activities of Daily Living↗

PubMed2000

Measuring quality of life of Chinese cancer patients: A validation of the Chinese version of the Functional Assessment of Cancer Therapy-General (FACT-G) scale.

BACKGROUND: Few cancer specific quality-of-life (QoL) measures from the West have been translated for use with Chinese-speaking patients, and no substantial validation of these translations with adequately large cohorts has been published previously, to the authors' knowledge. The Functional Assessment of Cancer Therapy-General (FACT-G) is a well-validated QoL instrument that is specific to cancer patients. The scale was translated into Chinese and the psychometric properties of this translated scale (FACT-G [Ch]) were tested with a Chinese sample in Hong Kong, China. METHODS: A total of 1262 Chinese cancer patients were selected in 3 samples from 5 Hong Kong regional hospitals. Quantitative and qualitative data were used to assess the cultural equivalence, factor structure, reliability, and validity of the FACT-G (Ch). RESULTS: Focus group discussions indicated that the FACT-G was seen as covering QoL domains identified as important and relevant to Chinese cancer patients, though in some respects it was seen as having limited scope in this sample. Psychometrically, the factor structure of the FACT-G deviated from that of the original work. The FACT-G (Ch) had acceptable reliability (Cronbach alpha 0.85). The convergent validity of the FACT-G (Ch) with a generic QoL measure (WHOQOL-BREF[HK]) was 0.72 (P < 0.001), and divergent validity showed low correlations of less than 0.15 (P < 0.05) with non-QoL measures. CONCLUSIONS: Focus group data indicated that the FACT-G translation into Chinese was seen as a conceptually relevant and moderately sufficient QoL measure. Psychometrically, the instrument had acceptable properties, but conceptual differences from the original version were suggested. Although more work is needed to increase its adequacy, the translated scale has reasonable utility for use with Chinese populations in clinical settings.

Adult↗

PubMedDate not supplied

Application of bacteriophages as surrogates for mammalian viruses: a case for use in filter validation based on precedents and current practices in medical and environmental virology.

Infectivity-based assays are the assays of choice for the detection of pathogenic mammalian viruses. While it is intuitively appropriate to conduct testing and validation studies with the known viral burden or a closely related mammalian species, logistic considerations often dictate otherwise. Consequently, bacteriophages have served as suitable surrogates for mammalian viruses in both medical and environmental virology applications. The wide range of bacteriophages available offers a powerful analytical tool amenable to several different applications: filter validation studies (where removal is based on size exclusion), investigations into virus contamination control issues, evaluation of barrier materials, etc. There is a considerable body of evidence to suggest and support the use of bacteriophages as surrogates for mammalian viruses. Use of appropriately sized bacteriophages provides an innocuous, efficacious and expeditious method for economical testing and validation of viral clearance capabilities of virus removal filters, thus facilitating performance of filter validation studies in biopharmaceuticals under product- and process-specific conditions in an overall effort towards ensuring the virological safety of biologicals. This paper discusses the limitations associated with mammalian virus assays and provides a rationale for the use of bacteriophages as surrogates for mammalian viruses. Data from published literature documenting applicability of bacteriophages in filter validation studies, especially when removal is based on size exclusion, is reviewed along with examples of studies from the fields of medical and environmental virology.

Bacteriophages↗

PubMed2000

[Intermittent claudication and quality of life. Psychometric validation of the French version of the CLAU-S questionnaire].

CLAU-S is a disease-specific quality of life (QoL) scale for patients with intermittent claudication due to peripheral arterial disease of the lower limbs. Initially developed in Germany, the scale has been translated into French according to classical forward/backward methodology. The objective of this study was to test the validity of the French version of CLAU-S. In its current format, the CLAU-S scale evaluates 5 dimensions: "Daily Living"; "Pain"; "Social Life"; "Disease-specific anxiety"; and "Mood", for a total of 47 items. The QoL scores and clinical findings in 157 patients with intermittent claudication were analysed. Validation of the convergence and discriminatory power of the scale were confirmed. Analysis of structural validity showed grouping of items in accordance with initial scale construction and a clear separation between the different dimensions. Analysis of the internal reliability of the questionnaire confirmed the good internal coherence of these dimensions. Reproducibility of the scores over time was confirmed by test-retest analysis. In addition to the actual validation of CLAU-S, a new, innovative mathematical technique called Structural Modelling Equations was used on this QoL instrument. It related the causal structure of the QoL components in peripheral arterial disease of the lower limbs (stage 2). An indisputable causal relationship was demonstrated between clinical parameters, particularly walking distance, and the QoL components. The classical symptom-deficit-disability causal structure of disease- specific QoL questionnaires was also studied. In particular, we found an essential relationship between the Daily Living dimension and, to a lesser extent, the Social Life activities and Disease- specific anxiety dimension, and QoL. The Pain dimension proved to be an explanatory variable of the other QoL components without being directly related to QoL. Finally, the Mood dimension was a resultant variable of QoL and not an explanatory variable of QoL. This study therefore enabled validation of the psychometric properties of the French version of CLAU-S and also demonstrated the complementary roles of walking distance and QoL in the management of patients with intermittent claudication.

Activities of Daily Living↗

PubMedDate not supplied

[Validation and reliability of the 1,000 meter aerobic test].

BACKGROUND: In humans, measurement of maximum oxygen uptake is important because it is related to cardiovascular health. In Mexico there is scanty information in nationals and unfortunately such a data has been gathered from laboratory and field indirect methods ignoring reliability, validation and cross validation. PURPOSE: This study was designed to determine the validity and reliability of the 1,000 meters walk-run test in adults. METHODS: Fifty-one healthy subjects (31 men and 20 women) participated in four maximal tests; two in a laboratory on a treadmill for direct measurement of VO2max (L1 and L2) and twice in a track for distance walk-run time in 1,000 meters (C1 and C2). Values were analyzed by interclass correlation, Pearson product moment and "t" test. RESULTS: The VO2max in L1 y L2 were 2.67 and 2.70 L.min-1, (R = 0.97) and 44.2 and 46.2 mL.kg-1.min-1, meanwhile VO2max estimated from field were 44.2 and 46.2 mL.kg-1.min-1, (R = 0.98). Pearson correlation obtained from all subjects between laboratory and field test was of r = 0.88, without significant difference (P > 0.05). From those data we development the following equation: VO2max = 71.66-5.85 (t), where 71.66 and 5.85 are constants and t is the time employ in performing the test, R = -0.86, (p < 0.05). CONCLUSION: The 1,000 meters distance walk-run for time is highly reliable and valid test for estimation of VO2max in Mexican people. The test is safe, easy and short and can be administrated with a minimal amount of equipment. We propose its utilization in other population in order to perform cross validation.

Adult↗

PubMed2000

How valid are utilization review tools in assessing appropriate use of acute care beds?

BACKGROUND: Despite their widespread acceptance, utilization review tools, which were designed to assess the appropriateness of care in acute care hospitals, have not been well validated in Canada. The aim of this study was to assess the validity of 3 such tools--ISD (Intensity of service, Severity of illness, Discharge screens), AEP (Appropriateness Evaluation Protocol) and MCAP (Managed Care Appropriateness Protocol)--as determined by their agreement with the clinical judgement of a panel of experts. METHODS: The cases of 75 patients admitted to an acute cardiology service were reviewed retrospectively. The criteria of each utilization review tool were applied by trained reviewers to each day the patients spent in hospital. An abstract of each case prepared in a day-by-day format was evaluated independently by 3 cardiologists, using clinical judgement to decide the appropriateness of each day spent in hospital. RESULTS: The panel considered 92% of the admissions and 67% of the subsequent hospital days to be appropriate. The ISD underestimated the appropriateness rates of admission and subsequent days; the AEP and MCAP overestimated the appropriateness rate of subsequent days in hospital. The kappa statistic of overall agreement between tool and panel was 0.45 for ISD, 0.24 for MCAP and 0.25 for AEP, indicating poor to fair validity of the tools. INTERPRETATION: Published validation studies had average kappa values of 0.32-0.44 (i.e., poor to fair) for admission days and for subsequent days in hospital for the 3 tools. The tools have only a low level of validity when compared with a panel of experts, which raises serious doubts about their usefulness for utilization review.

Angina, Unstable↗

PubMed2000

Measurements used to characterize the foot and the medial longitudinal arch: reliability and validity.

BACKGROUND AND PURPOSE: Abnormality in the structure of the medial longitudinal arch of the foot is commonly thought to be a predisposing factor to injury. The purpose of this investigation was to compare the reliability and validity of several measurements used to characterize various aspects of the foot, including the medial longitudinal arch. SUBJECTS: One hundred two feet (both feet of 51 subjects) were measured to establish a reference database. From this group, a subset of 20 feet (both feet of 10 subjects) was used to determine intertester and intratester reliability. Radiographs of a further subset of 10 feet (right feet of 10 subjects) were used to determine validity. METHODS: Five foot measurements were taken in 2 stance conditions: 10% of weight bearing and 90% of weight bearing. RESULTS: Intraclass correlation coefficients (ICCs) for intertester and intratester measurements were between.480 and.995. The most reliable method of characterizing arch type in 10% of weight bearing between testers was dividing navicular height by foot length in 10% of weight bearing. However, this measure yielded highly unreliable measurements in 90% of weight bearing. The most valid measurements were navicular height divided by truncated foot length, navicular height divided by foot length in 10% of weight bearing, and navicular height divided by foot length in 90% of weight bearing. Dorsum height at 50% of foot length divided by truncated foot length showed relatively high intertester reliability (ICC=.811 in 10% of weight bearing, ICC=.848 in 90% of weight bearing) and validity (ICC=.844 in 10% of weight bearing, ICC=.851 in 90% of weight bearing). CONCLUSION AND DISCUSSION: These data suggest that, of the measures tested, the most reliable and valid method of clinically assessing arch height across 10% and 90% of weight bearing was dividing the dorsum height at 50% of foot length by truncated foot length.

Adult↗