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At least 19 recordsLinked to original sources

[Self-rating scales in schizophrenia: validity assessment of the Paranoid-Depression Scale (PD-S), the Frankfurt Self-feeling Scale (FBS) and of two visual analogy scales].

AIM: To assess the validity of the Paranoid-Depressivity Scale (PD-S, Paranoid-Depresivitäts-Skala), the Frankfurt Self-feeling Scale (FBS, Frankfurter Befindlichkeitsskala), and of two visual analogy scales: the Sense of Illness Scale (WAC) and the Self-feeling Scale (WAS). METHOD: 210 patients with schizophrenia of various clinical courses. Diagnostic validity was evaluated by comparing the results of self-rating with clinical assessment using the CGI, KOSS-C, BPRS, and KOSS-W scales. Content validity was evaluated by analysis of the results' correlation with given clinical and social-demographic variables. Theoretical (construct) validity was evaluated through factorial analysis with Varimax rotation of the principal elements. RESULTS: The correlation between the self-rating scales and the clinical assessment scales was moderate in the case of questionnaire scales and low for the visual analogy scales. Scales of a similar type were found to correlate to a very high degree. Correlation with clinical assessment depended significantly on the phase and degree of disorder--it was lower in periods of exacerbation and higher during remission. The results of the complex questionnaire scales en somme, correlate better with symptoms considered as typical for schizophrenia, than with others, whereas the isolated self-rating constructs (paranoid, depressive) correlate well with the appropriate dimensions of clinical assessment. There was no significant correlation between the clinical symptoms and dimensions, and the results of self-rating using the two visual analogy scales. Factorial analysis revealed that the internal structure of the basic constructs of the questionnaire scales (general attitude, mood, self-feeling) was based on a very rational concept, as well as the fact that the factors isolated have a rational foundation within the theoretical and clinical picture of schizophrenic disorders. CONCLUSIONS: The validity of self-rating scales remains a complex question; analysis of diagnostic, content and theoretical validity seems to confine this method to the role of a complementary, albeit interesting, diagnostic tool; the extent and importance of this role, however, is still to be investigated.

Adult↗

[Self-rating scales in schizophrenia: assessment of the practical applicability of the Paranoid-Depression Scale (PD-S), the Frankfurt Self-feeling Scale (FBS) and of two visual analogue scales].

AIM: To assess the practical feasibility of the Paranoid-Depressivity Scale (PD-S, Paranoid-Depresivitäts-Skala), the Frankfurt Self-feeling Scale (FBS, Frankfurter Befindlichkeitsskala), and two visual analogy scales of: sense of illness (WAC) and self-feeling (WAS). METHOD: 210 patients with schizophrenia of various clinical courses. All patients in the study group were required to complete each scale twice, at 48 hr intervals. For statistical analysis, two sets of data were singled out (1) the relationship between refusal/inability to complete the scale repeatedly and the selected clinical variables; (2) observations made by the doctor, while the patient was completing the scales. RESULTS: Statistical analysis revealed, that clinical factors like restlessness, autism, maladaptation, recurrence/remission and lower educational status imply a significantly lower readiness of the patient towards completion of self-rating scales. The visual analogy scales were those more readily--and easily--completed by the patients; their interpretation, however, is difficult. Given this, the authors of this paper decided to shorten the questionnaire scales, which reducing the whole to aspects of vital diagnostic relevance. Whether this operation would influence the scales' diagnostic value, required ex-post analysis, which was subsequently performed. Summary analysis revealed that the application of the shortening of the PD-S and FBS had no significant impact on these scales' reliability and validity indices; furthermore, it resulted in a significant decline in the number of ambiguities and thus improved the comprehensiveness of the questionnaire's structure. Also, a significant increase in concordance between the self-rating results and the clinicians' diagnoses was observed. CONCLUSIONS: Visual analogy scales are the more readily and easily applied in practice; a comprehensive interpretation is, however, virtually impossible. On the other hand, the PD-S and FBS are the more difficult for the patients to complete, due to their length, but their interpretation does not constitute a major problem. Ex-post analysis reveals, that shortening the complex questionnaires to their core aspects does not affect their psychometric value negatively; in fact--the contrary. The latter statement, however, requires verification in prospective studies.

Adult↗

[Self-rating scales in schizophrenia: assessment of the reliability of the Paranoid-Depressive Scale (PD-S) Frankfurt Self-feeling Scale (FBS). and two visual analogy scales].

AIM: To assess the reliability of the Paranoid-Depressive Scale (PD-S, Paranoid-Depresivitäts-Skala), the Frankfurt Self-feeling Scale (FBS, Frankfurter Befindlichkeitsskala), and of two visual analogy scales of a sense of illness (WAC) and of self-feeling (WAS). MATERIAL: 210 patients with schizophrenia of various clinical courses. METHOD: All patients in the study group were required to complete each scale twice (test-retest) at 48hr intervals, in order to assess each method's reproducibility. In addition, the two complex questionnaire scales were analysed for internal coherence. RESULTS: Spearman's rho correlation coefficient for reproducibility was found to be very high for all the scales. Also, the Cronbach's alpha coefficient for internal coherence was found to be acceptably high for both complex questionnaire scales, with reference to the scales as a whole, as well as to their dimensions (paranoid and depression dimensions of the PD-S). CONCLUSION: Patients suffering from schizophrenia can reliably use the above-mentioned scales.

Adolescent↗

A comparison of the reproducibility and the sensitivity to change of visual analogue scales, Borg scales, and Likert scales in normal subjects during submaximal exercise.

OBJECTIVE: To assess which subjective scale, the visual analogue scale (VAS), the Borg CR10 (Borg) scale, or the Likert scale (LS), if any, is decidedly more reproducible and sensitive to change in the assessment of symptoms. DESIGN: Prospective clinical study. SETTING: Exercise laboratory. PARTICIPANTS: Twenty-three physically active male subjects (mean +/- SD age of 30 +/- 4 years old) were recruited. INTERVENTION: Each subject attended the exercise laboratory on four occasions at intervals of 1 week. Three subjective scales were used: (1) the VAS (continuous scale); (2) the Borg scale (12 fixed points); and (3) the Likert scale (LS; 5 fixed points). Four identical submaximal tests were given (2 min at 60% maximum oxygen uptake [VO(2)max] and 6 min at 70% VO(2)max). Two tests were undertaken to assess the reproducibility of scores that were obtained with each subjective scale. Two other tests were undertaken to assess the sensitivity of each scale to a change in symptom perception: a double-blind treatment with propranolol, 80 mg, (ie, active therapy; to increase the sensation of breathlessness and general fatigue during exercise) or matching placebo. The subjective scale scores were measured at 1 min 30 s, 5 min 30 s, and 7 min 15 s of exercise. Reproducibility was defined as the proportion of total variance (ie, between-subject plus within-subject variance) explained by the between-subject variance given as a percentage. Sensitivity was defined as the effect of the active drug therapy over the variation within subjects. RESULTS: Overall, the VAS performed best in terms of reproducibility for breathlessness and general fatigue, with reproducibility coefficients as high as 78%. For sensitivity, the VAS was best for breathlessness (ratio, 2.7) and the Borg scale was most sensitive for general fatigue (ratio, 3.0). The relationships between the respective psychological and physiologic variables were reasonably stable throughout the testing procedure, with overall typical correlations of 0.73 to 0.82 CONCLUSION: This study suggests that subjective scales can reproducibly measure symptoms during steady-state exercise and can detect the effect of a drug intervention. The VAS and Borg scales appear to be the best subjective scales for this purpose.

Adrenergic beta-Antagonists↗

Comparison of the Vineland Social Maturity Scale, the Vineland Adaptive Behavior Scales--survey form, and the Bayley Scales of Infant Development with infants evaluated for developmental delay.

The Vineland Adaptive Behavior Scales is an extensive revision of the Vineland Social Maturity Scale; however, research comparing the two scales with different populations and measures of intelligence is limited. The Vineland Adaptive Behavior Scales--Survey Form, the Vineland Social Maturity Scale, and the mental scale of the Bayley Scales of Infant Development were administered to 44 infants referred for evaluation of developmental delay. The differences between means were compared and shared variance examined. The Vineland Adaptive Behavior Scales--Survey Form scores were significantly higher than those of the Vineland Social Maturity Scale and the Bayley Mental Development Index. No significant differences were found between the means of the Vineland Social Maturity Scale and the Bayley Scales of Infant Development--Mental Development Index. Correlations were .59 between the Bayley Index and scores on the Vineland--Survey Form and .72 between the Bayley Index and the Vineland Social Maturity Scale. Between versions of the Vineland scale r = .39. Implications for diagnosis and educational classification are discussed.

Developmental Disabilities↗

[Japan Coma Scale as a grading scale of subarachnoid hemorrhage: a way to determine the scale].

BACKGROUND: The grading scale for subarachnoid hemorrhage (SAH) with inter-grade outcome differences is essential for evaluating the effectiveness of newly developed therapeutic modalities. Although Hunt's grade and WFNS scale have been widely used, these grading scales do not meet this requirement. We previously proposed a revised WFNS scale based solely on the Glasgow Coma Scale (GCS) that has intergrade outcome differences of high-level significance. The Japan Coma Scale (JCS) has been long and widely used in Japan. The purpose of this study is to show whether it is possible to determine a reasonable SAH grading scale based on the JCS and to show a way to determine an SAH grading scale. PATIENTS AND METHODS: We retrospectively analyzed 1398 consecutive cases of aneurysmal SAH operated on within Day 7 of the latest onset. The preoperative JCS and GCS were evaluated just before the surgery and the Glasgow Outcome Scale (GOS), analyzed with numerical transformation (1 = dead to 5 = good recovery), was estimated at 6 months after the onset. All 510 possible combinations of scores of JCS were statistically tested under the following 2 assumptions; (1) JCS = 0 and JCS = 100 fall into a single independent grade. (2) No other single JCS score should fall into a single grade. RESULTS: The outcome differences between JCS 0 and 1, and 100 and 200 are significant. The outcome difference between JCS 30 and 100 is relatively higher than any other set of 2 scores of JCS. Only 5 combinations are practical among the candidates to be analyzed. Out of 510 combinations, the following combination shows the highest inter-grade outcome differences; I (JCS = 0, n = 375, mean GOS = 4.78) II (JCS = 1, 2; n = 310; mean GOS = 4.47) III (JCS = 3-30; n = 476; mean GOS = 3.96) IV (JCS = 100; n = 96; mean GOS = 3.10) V (JCS = 200, 300; n = 141; mean GOS = 2.33). In JCS, the mean outcome of JCS = 3 is worse than those of JCS = 10, 20, and 30. The outcome difference between JCS 0 and 1 is only significant in patients over 60 years old. CONCLUSION: Taking all the 510 possible combinations of JCS into consideration, we obtained a reasonable combination containing 5 grades. Although this grading scale showed good inter-grade outcome differences, JCS is not preferable to GCS as a consciousness evaluation system in the acute phase of SAH. We emphasize the importance of this way to determine a grading scale with a combinatorial approach, which can be applicable for re-evaluating the grading scales in the future.

Age Factors↗

Evaluation of the Revised Faces Pain Scale, Verbal Descriptor Scale, Numeric Rating Scale, and Iowa Pain Thermometer in older minority adults.

The purpose of this study was to determine the reliability and validity of selected pain intensity scales including the Faces Pain Scale Revised (FPS-R), Verbal Descriptor Scale (VDS), Numeric Rating Scale (NRS), and Iowa Pain Thermometer (IPT) with a cognitively impaired minority sample. A descriptive correlational design was used, and a convenience sample of 68 participants, admitted to acute care facilities in the South, with an average Mini Mental Status Exam score of 23 comprised the sample. Thirty-two percent of the participants were males, and 68% were females. The majority (74%) of the sample consisted of African-American participants with the exception that 16% were Hispanic and 10% were Asian. An overwhelming majority of participants were able to use all of the tools. Concurrent validity was supported with correlations ranging from 0.56 to 0.90. The lowest correlations were found between the FPS-R and the other scales, suggesting that the FPS-R may be measuring a broader construct incorporating pain. Test-retest reliability was supported with coefficients ranging from 0.77 to 0.89. In terms of pain scale preference, the Numeric Rating Scale (33%) was the preferred scale in the cognitively intact group and the FPS-R (54%) was the preferred scale in the cognitively impaired group. When race and cognitive status were considered, African-Americans and Hispanics preferred the FPS-R. Severely, moderately, and mildly impaired participants also preferred the FPS-R. The findings of this study support the use of these scales with older cognitively impaired minority adults.

Black or African American↗

Is the reliability of a visual analog scale higher than an ordinal scale? An experiment with the GRBAS scale for the perceptual evaluation of dysphonia.

Perceptual evaluation of 14 pathological voices was performed by 29 listeners using the GRBAS scale. To evaluate scale effects on the judgments, 2 versions of the scale were presented: the original 4-point scale and a visual analog scale. Each listener used the same voice samples for both versions of the scale with an interval of 2 weeks. Agreement was found to be higher with the original 4-point scale than with the visual analog version for all scale items G, R, B, A and S. Although a visual analog scale seems to enable a finer judgment of voice quality, this study showed that, with increased freedom of judgment, the interrater agreement decreased considerably. Therefore, we recommend the use of the original 4-point version of the GRBAS scale.

Adolescent↗

Concurrent validity of the Bayley Scales of Infant Development II (BSID-II) Motor Scale and the Peabody Developmental Motor Scale II (PDMS-2) in 12-month-old infants.

PURPOSE: This study was designed to examine concurrent validity of the Peabody Developmental Motor Scale II (PDMS-2) and the Bayley Scales of Infant Development II (BSID-II) Motor Scale. METHODS: The PDMS-2 and the BSID-II Motor Scale were administered to fifteen 12-month-old infants who were developing typically. PDMS-2 raw scores were converted to the Gross Motor Quotient (GMQ), the Fine Motor Quotient (FMQ), and the Total Motor Quotient (TMQ). BSID-II raw scores were converted to the Psychomotor Development Index (PDI). Age equivalent scores were obtained for all PDMS-2 Gross and Fine Motor Subscales and for the BSID-II Motor Scale and compared using the Pearson Product-Moment Correlation Coefficient. RESULTS: Low correlations were found between the PDMS-2 FMQ, GMQ, TMQ, and the PDI of the BSID-II. Low correlations were found between age equivalent scores of the PDMS-2 subtests for grasp, stationary, and Visual Motor Integration and the BSID-II Motor Scale. A low negative correlation was found between age equivalent scores of the PMDS-2 subtest for Object Manipulation and the BSID-II Motor Scale. A high correlation (r = 0.71, P < 0.05) was found between age equivalent scores of the PDMS-2 subtest for locomotion and the BSID-II Motor Scale. CONCLUSIONS: There is a lack of concurrent validity between the PDMS-2 standard scores and standard scores of the BSID-II Motor Scale and a lack of agreement between age equivalent scores of the BSID-II Motor Scale and the PDMS-2 subtests except for Locomotion. The investigators caution about using only one standard score or age equivalent score for decisions about the need for early intervention for children at 12 months of age when using the BSID-II or the PDMS-2.

Child Development↗

Concurrent validity of the Bayley Scales of Infant Development II Motor Scale and the Peabody Developmental Motor Scales in two-year-old children.

Concurrent validity of the Bayley Scales of Infant Development, Second Edition (BSID II) Motor Scale and the Peabody Developmental Motor Scales (PDMS) was examined by administering both tests to 38 two-year-old Native American children. A correlation analysis of age equivalent scores indicated very good to high correlation for the BSID II Motor Scale with the PDMS Fine Motor Scale (PDFMS) (r = .87) and the PDMS Gross Motor Scale (PDGMS) (r = .83). A correlation analysis of standard scores showed poor to unacceptable correlation between the BSID II Motor Scale with the PDFMS (r = .64) and the PDGMS (r = .49); further, there was poor agreement between the classifications of significantly delayed, mildly delayed, and within normal limits performance on each test. The PDFMS tended to classify children lower than the BSID II Motor Scale. The scores of the relatively younger children within each of the PDMS 6-month age categories agreed less between the tests than did the scores of the relatively older children. In conclusion, this study provides evidence for the concurrent validity of the BSID II Motor Scale and the PDMS for age equivalent scores, but not for standard scores of 2-year-old children. Professionals must be aware of the strengths and limitations of the BSID II and the PDMS, and choose appropriately to avoid denial of or over-referral for services for young children.

Child Development↗

A comparative study of the Reaction Level Scale (RLS85) with Glasgow Coma Scale (GCS) and Edinburgh-2 Coma Scale (modified) (E2CS(M)).

In this work a new coma scale for the assessment of responsiveness in acute brain disorders, constructed near the year 1985 by Scandinavian investigators, the Reaction Level Scale (RLS85), is compared with two other coma scales namely: (i) the Glasgow Coma Scale: (GCS); (ii) the Edinburgh-2 Coma Scale, after modification: (E2CS(M)). The study proceeded in the form of a statistical analysis of assessments made on 46 patients according to RLS85 and GCS (i.e., when comparison was with GCS) and on 28 patients according to RLS85 and E2CS(M). In all 74 cases two physicians participating as "observers" carried out the assessments. They were both contacting the patient--not together but--successively within a time interval of less than 20'. Hence the data appeared as "pairwise" observations for any of the three scales above. The results of the analysis, arising from a rather strict statistical reasoning, can be summarized as follows: (1) The rank correlation coefficient r(s) between: (i) RLS85 and GCS sum score, (ii) RLS85 and E2CS(M), was found to be at a satisfactory level meaning that all three scales indicate almost the same "ranking order of severity". (2) Reliability was compared by taking into account as to what extent the two observers agreed on RLS85 and--simultaneously--disagreed on the other scale. The "sign" test was applied and as a result RLS85 proved to be more reliable than; (i) GCS (EMY profile), (ii) GCS sum score, and (iii) E2CS(M), in all the above mentioned at a high level of significance. (3) Apart from the test above, some values of the index kappa (kappa) of interobserver agreement were calculated. Those corresponding to RLS85 are considerably higher. In particular the overall value based on 74 pairwise assessments amounted to kappa = 0.733 associated with a standard error sigma(kappa) = 0.061. This was a satisfactory result regarding the features of RLS85. (4) As far as coverage is concerned, again--by the "sign" test--the predominance of RLS85 versus GCS (EMY profile) was accepted.

Acute Disease↗

CHOP Infant Coma Scale ("Infant Face Scale"): a novel coma scale for children less than two years of age.

The Glasgow Coma Scale (GCS) is the most frequently used tool worldwide for assessing the severity of neurologic injury after brain trauma, although applying this scale to infants and younger children can be problematic. The CHOP Infant Coma Scale, or Infant Face Scale (IFS), is a novel scale for children under 2 years of age which differs from other pediatric coma scales in the following ways: (1) it relies on objective behavioral observations; (2) it assesses cortical as well as brainstem function; (3) it parallels the GCS in scoring but is based on infant-appropriate behaviors; and (4) it can be applied to intubated patients. We report the results of a prospective study designed to compare interrater reliability between the IFS and GCS in children less than 2 years of age. Seventy-five hospitalized children less than 2 years of age were assessed simultaneously by a pair of observers, representing a spectrum of health care professionals, who scored the children using both the IFS and GCS. Interrater reliability for each pair of observers for each scale was assessed using the kappa statistic. A second series of 10 infants in the intensive care unit with specific diagnoses of acute traumatic or hypoxic/ischemic brain injury were similarly assessed. In the 75 hospitalized infants with a variety of diagnoses, interrater reliability for the GCS was in the "almost perfect," "slight," and "fair" range for the eye-opening, motor, and verbal subtests, respectively. In contrast, the IFS showed interrater reliability in the "almost perfect," "substantial," and "almost perfect" ranges for the three subtests. When applied to infants in an intensive care unit with acute traumatic brain injury or hypoxia/ischemia, the GCS interrater reliability scores were in the "fair" range, while the IFS scores were in the "almost perfect" range. The IFS demonstrates improved interrater reliability in direct comparison to the GCS, particularly in the "verbal/face" component where most pediatric coma scales are deficient. The IFS may prove to be a simple and practical bedside index of brain injury severity in children less than two years of age.

Brain Injuries↗

Choice of response scale for health measurement: comparison of 4, 5, and 7-point scales and visual analog scale.

To compare the feasibility of response scales with different numbers of steps for measuring health status, we assessed the ease of completing 4, 5, and 7-point scales and a visual analog scale. Four forms of the questionnaire, each of which consisted of the same ten questions about health status, but with a different type of scale among the four above mentioned, were given to 48 patients with a variety of conditions and diagnoses. The forms were attached together and the order in which they were presented was systematically varied considering permutations of forms. Respondents were asked to complete the forms following the order of the sheets. The 5-point scale form was most commonly chosen as the easiest to complete, and item omission was least frequent with this form. Similar high- reliability results in terms of Cronbach's alpha were achieved for each of the four forms. An additional survey among 153 patients confirmed the results of the first survey. The selection of the easiest scale to complete varied by sex (men preferred the 7-point scale), but was not affected by the conditions or diagnoses of the patients. The study suggests that the 5-point scale is most useful for measuring health status.

Chi-Square Distribution↗

Abnormal Involuntary Movement Scale (AIMS) and Extrapyramidal Symptom Rating Scale (ESRS): cross-scale comparison in assessing tardive dyskinesia.

Assessing tardive dyskinesia (TD) has been complicated by the use of different research criteria and rating scales. We studied concordance between two commonly used scales, the Abnormal Involuntary Movement Scale (AIMS) and Extrapyramidal Symptom Rating Scale (ESRS), to study interscale concordance and criteria to define TD. Patients with schizophrenia or schizoaffective disorder (N = 374) were rated at baseline with both scales. Linear and logistic regression models explored relationships between scale ratings and mapped scores for corresponding items. TD was defined as at least mild in > or = 2 anatomical areas, or moderate or greater symptoms in > or = 1 area at baseline. Logistic regression was used to find simplified criteria for predicting AIMS-defined TD by ESRS scores. There was a strong association on corresponding item ratings. "Mild" was defined as AIMS score of 2 and ESRS 2 or 3, and "moderate or greater" as AIMS score > or = 3 and ESRS > or = 4. Using these criteria, there was 96.0% (359/374) agreement between AIMS- and ESRS-defined TD cases. The ESRS Clinical Global Impressions of severity of dyskinesia (CGI-SD) best predicted AIMS-defined TD. An ESRS CGI-SD > or = 4 (95% CI: 3.61, 4.76) was associated with > or = 95% probability of AIMS-defined TD. High concordance between the scales for dyskinesia scores was found. Findings suggest that the ESRS CGI-SD score can serve as a simplified criterion for identifying AIMS-defined TD, and may be a useful tool for future research-based TD analyses, when occurring in the context of a full movement disorder assessment.

Adolescent↗

Small-scale field experiments accurately scale up to predict density dependence in reef fish populations at large scales.

Field experiments provide rigorous tests of ecological hypotheses but are usually limited to small spatial scales. It is thus unclear whether these findings extrapolate to larger scales relevant to conservation and management. We show that the results of experiments detecting density-dependent mortality of reef fish on small habitat patches scale up to have similar effects on much larger entire reefs that are the size of small marine reserves and approach the scale at which some reef fisheries operate. We suggest that accurate scaling is due to the type of species interaction causing local density dependence and the fact that localized events can be aggregated to describe larger-scale interactions with minimal distortion. Careful extrapolation from small-scale experiments identifying species interactions and their effects should improve our ability to predict the outcomes of alternative management strategies for coral reef fishes and their habitats.

Animals↗

Concurrent validity of the Bayley Scales of Infant Development II Motor Scale and the Peabody Developmental Motor Scales-2 in children with developmental delays.

PURPOSE: The purpose of this study was to explore concurrent validity of the age equivalent and standard scores of the Bayley Scales of Infant Development II (BSID II) Motor Scale and the Peabody Developmental Motor Scales-2 (PDMS-2), including correlations and clinical agreement between the scores of the two tests. METHODS: One hundred ten children aged three to 41 months who were referred to an early childhood evaluation program because of concerns about their development were administered both the BSID II Motor Scale and the PDMS-2 as part of their developmental evaluations. RESULTS: The correlation coefficients were high to very high for age-equivalent scores, and the Locomotion Subscale had the closest agreement with the BSID II Motor Scale age equivalent. The correlation coefficients were moderate to high for standard scores, and there was only slight agreement between the tests for standard score categories. More than 75% of the 70 children in this study whose scores on the BSID II supported eligibility for services based on scores at least two SD below the mean of the test would not have qualified for services if the PDMS-2 standard scores alone were used to assess their eligibility. Approximately half the children who showed appropriate total motor performance on the PDMS-2 were classified as delayed on the BSID II Motor Scale. CONCLUSIONS: The study supports concurrent validity of the tests only for certain subscale age-equivalent scores, particularly the BSID II Motor Scale with the PDMS-2 Locomotion Subscale. The current findings suggest that the standard scores show poor agreement and have low concurrent validity. There are marked differences in the standard scores of the two tests that may affect a child's eligibility for services in some states, and therapists should be cautious when making clinical decisions based solely on standard scores of one test.

Journal Article↗

The profile elevation scale and the impairment scale: two new summary scales for the Luria-Nebraska Neuropsychological Battery.

Two new clinical summary scales have been developed for the Luria-Nebraska Neuropsychological Battery. The scales were constructed in a derivation/ crossvalidation design with a sample of 459 mixed brain impaired patients and 135 non-brain impaired persons. Preliminary evidence suggests that the Profile Elevation scale and the Impairment scale are psychometrically viable, produce additional information to what is offered by the current clinical summary scales, and deserve further investigation. Interpretations are suggested for the two new scales and supported by two neurosurgical case examples. The scales are also expected to offer the possibility of quick screening devices.

Adult↗

Evaluating the reliability of multi-item scales: a non-parametric approach to the ordered categorical structure of data collected with the Swedish version of the Tampa Scale for Kinesiophobia and the Self-Efficacy Scale.

OBJECTIVE: To compare the ability of a rank-invariant non-parametric method with that of kappa statistics to evaluate the reliability of the Swedish version of the Tampa Scale for Kinesiophobia and the Self-Efficacy Scale by identifying systematic and random disagreement. The aim was, further, to compare 2 different statistical approaches to obtain a global value from multi-item scales. DESIGN: A test-retest study. SUBJECTS: A total of 46 patients with whiplash-associated disorders were enrolled and 39 (85%) completed the test-retest assessment. METHODS: Data from the multi-item scales were summarized using both sum and median scores. Paired data were evaluated with a rank-invariant statistical method to identify systematic and random disagreement. Data were also evaluated with kappa statistics. RESULTS: The non-parametric approach demonstrated that the Swedish version of the Tampa Scale for Kinesiophobia and the Self-Efficacy Scale are reliable for patients with whiplash-associated disorders. In contrast to the rank-invariant method, kappa statistics provided no information on disagreement between the 2 test occasions. Median scoring improved reliability due to lack of disagreement while the sum scores method was characterized by random individual disagreement. CONCLUSION: This study has increased understanding of the advantages and limitations of 2 non-parametric statistical methods and, it is hoped, will contribute to the development of reliable measurements.

Fear↗