Can items used in 4-year-old well-child visits predict children's health and school outcomes?

Science.gov (United States)

Smithers, Lisa G; Chittleborough, Catherine R; Stocks, Nigel; Sawyer, Michael G; Lynch, John W

2014-08-01

To examine whether items comprising a preschool well-child check for use by family doctors in Australia with 4-5-year old children predicts health and academic outcomes at 6-7 years. The well-child check includes mandatory (anthropometry, eye/vision, ear/hearing, dental, toileting, allergy problems) and non-mandatory (processed food consumption, low physical activity, motor, behaviour/mood problems) items. The predictive validity of mandatory and non-mandatory items measured at 4-5 years was examined using data from the Longitudinal Study of Australian Children. Outcomes at 6-7 years included overweight/obesity, asthma, health care/medication needs, general health, mental health problems, quality of life, teacher-reported mathematics and literacy ability (n = 2,280-2,787). Weight or height >90th centile at 4-5 years predicted overweight/obesity at 6-7 years with 60% sensitivity, 79% specificity and 40% positive predictive value (PPV). Mood/behaviour problems at 4-5 predicted mental health problems at 6-7 years with 86% sensitivity, 40% specificity and 8% PPV. Non-mandatory items improved the discrimination between children with and without mental health problems at 6-7 years (area under the receiver operating characteristic curve 0.75 compared with 0.69 for mandatory items only), but was weak for most outcomes. Items used in a well-child health check were moderate predictors of overweight/obesity and mental health problems at 6-7 years, but poor predictors of other health and academic outcomes.

Outcomes of Asthma Education: Results of a Multisite Evaluation

Directory of Open Access Journals (Sweden)

Wilma M Hopman

2004-01-01

Full Text Available BACKGROUND: This observational study compared the effectiveness of a standardized adult asthma education program administered in a variety of sites and practice settings on health care utilization, absenteeism, amount of leisure time missed and quality of life (using the Medical Outcomes Study 36-Item Short Form 1.0 [SF-36].

Lisfranc injuries: patient- and physician-based functional outcomes.

LENUS (Irish Health Repository)

O'Connor, P A

2012-02-03

The purpose of this study was to assess functional outcome of patients with a Lisfranc fracture dislocation of the foot by applying validated patient- and physician-based scoring systems and to compare these outcome tools. Of 25 injuries sustained by 24 patients treated in our institution between January 1995 and June 2001, 16 were available for review with a mean follow-up period of 36 (10-74) months. Injuries were classified according to Myerson. Outcome instruments used were: (a) Medical Outcomes Study 36-Item Short Form Health Survey (SF-36), (b) Baltimore Painful Foot score (PFS) and (c) American Orthopedic Foot and Ankle Society (AOFAS) mid-foot scoring scale. Four patients had an excellent outcome on the PFS scale, seven were classified as good, three fair and two poor. There was a statistically significant correlation between the PFS and Role Physical (RP) element of the SF-36.

Item response theory, computerized adaptive testing, and PROMIS: assessment of physical function.

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Fries, James F; Witter, James; Rose, Matthias; Cella, David; Khanna, Dinesh; Morgan-DeWitt, Esi

2014-01-01

Patient-reported outcome (PRO) questionnaires record health information directly from research participants because observers may not accurately represent the patient perspective. Patient-reported Outcomes Measurement Information System (PROMIS) is a US National Institutes of Health cooperative group charged with bringing PRO to a new level of precision and standardization across diseases by item development and use of item response theory (IRT). With IRT methods, improved items are calibrated on an underlying concept to form an item bank for a "domain" such as physical function (PF). The most informative items can be combined to construct efficient "instruments" such as 10-item or 20-item PF static forms. Each item is calibrated on the basis of the probability that a given person will respond at a given level, and the ability of the item to discriminate people from one another. Tailored forms may cover any desired level of the domain being measured. Computerized adaptive testing (CAT) selects the best items to sharpen the estimate of a person's functional ability, based on prior responses to earlier questions. PROMIS item banks have been improved with experience from several thousand items, and are calibrated on over 21,000 respondents. In areas tested to date, PROMIS PF instruments are superior or equal to Health Assessment Questionnaire and Medical Outcome Study Short Form-36 Survey legacy instruments in clarity, translatability, patient importance, reliability, and sensitivity to change. Precise measures, such as PROMIS, efficiently incorporate patient self-report of health into research, potentially reducing research cost by lowering sample size requirements. The advent of routine IRT applications has the potential to transform PRO measurement.

Minimum clinically important difference in lumbar spine surgery patients: a choice of methods using the Oswestry Disability Index, Medical Outcomes Study questionnaire Short Form 36, and pain scales.

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Copay, Anne G; Glassman, Steven D; Subach, Brian R; Berven, Sigurd; Schuler, Thomas C; Carreon, Leah Y

2008-01-01

The impact of lumbar spinal surgery is commonly evaluated with three patient-reported outcome measures: Oswestry Disability Index (ODI), the physical component summary (PCS) of the Short Form of the Medical Outcomes Study (SF-36), and pain scales. A minimum clinically important difference (MCID) is a threshold used to measure the effect of clinical treatments. Variable threshold values have been proposed as MCID for those instruments despite a lack of agreement on the optimal MCID calculation method. This study has three purposes. First, to illustrate the range of values obtained by common anchor-based and distribution-based methods to calculate MCID. Second, to determine a statistically sound and clinically meaningful MCID for ODI, PCS, back pain scale, and leg pain scale in lumbar spine surgery patients. Third, to compare the discriminative ability of two anchors: a global health assessment and a rating of satisfaction with the results of the surgery. This study is a review of prospectively collected patient-reported outcomes data. A total of 454 patients from a large database of surgeries performed by the Lumbar Spine Study Group with a 1-year follow-up on either ODI or PCS were included in the study. Preoperative and 1-year postoperative scores for ODI, PCS, back pain scale, leg pain scale, health transition item (HTI) of the SF-36, and Satisfaction with Results scales. ODI, SF-36, and pain scales were administered before and 1 year after spinal surgery. Several candidate MCID calculation methods were applied to the data and the resulting values were compared. The HTI of the SF-36 was used as the anchor and compared with a second anchor (Satisfaction with Results scale). Potential MCID calculations yielded a range of values: fivefold for ODI, PCS, and leg pain, 10-fold for back pain. Threshold values obtained with the two anchors were very similar. The minimum detectable change (MDC) appears as a statistically and clinically appropriate MCID value. MCID values

Do illness perceptions predict health outcomes in primary care patients? A 2-year follow-up study

DEFF Research Database (Denmark)

Frostholm, Lisbeth; Ørnbøl, Eva; Christensen, Kaj Aage Sparle

2007-01-01

OBJECTIVE: Little is known about whether illness perceptions affect health outcomes in primary care patients. The aim of this study was to examine if patients' illness perceptions were associated with their self-rated health in a 2-year follow-up period. METHODS: One thousand seven hundred eighty...... at follow-up for the whole group of patients. Patients presenting with MUS had more negative illness perceptions and lower mental and physical components subscale of the SF-36 scores at all time points. CONCLUSIONS: Patients' perception of a new or recurrent health problem predicts self-reported physical......-five primary care patients presenting a new or recurrent health problem completed an adapted version of the illness perception questionnaire and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) at baseline and 3, 12, and 24 months' follow-up. Linear regressions were performed for (1) all...

Individuals with knee impairments identify items in need of clarification in the Patient Reported Outcomes Measurement Information System (PROMIS®) pain interference and physical function item banks - a qualitative study.

Science.gov (United States)

Lynch, Andrew D; Dodds, Nathan E; Yu, Lan; Pilkonis, Paul A; Irrgang, James J

2016-05-11

The content and wording of the Patient Reported Outcome Measurement Information System (PROMIS) Physical Function and Pain Interference item banks have not been qualitatively assessed by individuals with knee joint impairments. The purpose of this investigation was to identify items in the PROMIS Physical Function and Pain Interference Item Banks that are irrelevant, unclear, or otherwise difficult to respond to for individuals with impairment of the knee and to suggest modifications based on cognitive interviews. Twenty-nine individuals with knee joint impairments qualitatively assessed items in the Pain Interference and Physical Function Item Banks in a mixed-methods cognitive interview. Field notes were analyzed to identify themes and frequency counts were calculated to identify items not relevant to individuals with knee joint impairments. Issues with clarity were identified in 23 items in the Physical Function Item Bank, resulting in the creation of 43 new or modified items, typically changing words within the item to be clearer. Interpretation issues included whether or not the knee joint played a significant role in overall health and age/gender differences in items. One quarter of the original items (31 of 124) in the Physical Function Item Bank were identified as irrelevant to the knee joint. All 41 items in the Pain Interference Item Bank were identified as clear, although individuals without significant pain substituted other symptoms which interfered with their life. The Physical Function Item Bank would benefit from additional items that are relevant to individuals with knee joint impairments and, by extension, to other lower extremity impairments. Several issues in clarity were identified that are likely to be present in other patient cohorts as well.

Better assessment of physical function: item improvement is neglected but essential.

Science.gov (United States)

Bruce, Bonnie; Fries, James F; Ambrosini, Debbie; Lingala, Bharathi; Gandek, Barbara; Rose, Matthias; Ware, John E

2009-01-01

Physical function is a key component of patient-reported outcome (PRO) assessment in rheumatology. Modern psychometric methods, such as Item Response Theory (IRT) and Computerized Adaptive Testing, can materially improve measurement precision at the item level. We present the qualitative and quantitative item-evaluation process for developing the Patient Reported Outcomes Measurement Information System (PROMIS) Physical Function item bank. The process was stepwise: we searched extensively to identify extant Physical Function items and then classified and selectively reduced the item pool. We evaluated retained items for content, clarity, relevance and comprehension, reading level, and translation ease by experts and patient surveys, focus groups, and cognitive interviews. We then assessed items by using classic test theory and IRT, used confirmatory factor analyses to estimate item parameters, and graded response modeling for parameter estimation. We retained the 20 Legacy (original) Health Assessment Questionnaire Disability Index (HAQ-DI) and the 10 SF-36's PF-10 items for comparison. Subjects were from rheumatoid arthritis, osteoarthritis, and healthy aging cohorts (n = 1,100) and a national Internet sample of 21,133 subjects. We identified 1,860 items. After qualitative and quantitative evaluation, 124 newly developed PROMIS items composed the PROMIS item bank, which included revised Legacy items with good fit that met IRT model assumptions. Results showed that the clearest and best-understood items were simple, in the present tense, and straightforward. Basic tasks (like dressing) were more relevant and important versus complex ones (like dancing). Revised HAQ-DI and PF-10 items with five response options had higher item-information content than did comparable original Legacy items with fewer response options. IRT analyses showed that the Physical Function domain satisfied general criteria for unidimensionality with one-, two-, three-, and four-factor models

Validation of the alcohol use item banks from the Patient-Reported Outcomes Measurement Information System (PROMIS).

Science.gov (United States)

Pilkonis, Paul A; Yu, Lan; Dodds, Nathan E; Johnston, Kelly L; Lawrence, Suzanne M; Daley, Dennis C

2016-04-01

The Patient-Reported Outcomes Measurement Information System (PROMIS) includes five item banks for alcohol use. There are limited data, however, regarding their validity (e.g., convergent validity, responsiveness to change). To provide such data, we conducted a prospective study with 225 outpatients being treated for substance abuse. Assessments were completed shortly after intake and at 1-month and 3-month follow-ups. The alcohol item banks were administered as computerized adaptive tests (CATs). Fourteen CATs and one six-item short form were also administered from eight other PROMIS domains to generate a comprehensive health status profile. After modeling treatment outcome for the sample as a whole, correlates of outcome from the PROMIS health status profile were examined. For convergent validity, the largest correlation emerged between the PROMIS alcohol use score and the Alcohol Use Disorders Identification Test (r=.79 at intake). Regarding treatment outcome, there were modest changes across the target problem of alcohol use and other domains of the PROMIS health status profile. However, significant heterogeneity was found in initial severity of drinking and in rates of change for both abstinence and severity of drinking during follow-up. This heterogeneity was associated with demographic (e.g., gender) and health-profile (e.g., emotional support, social participation) variables. The results demonstrated the validity of PROMIS CATs, which require only 4-6 items in each domain. This efficiency makes it feasible to use a comprehensive health status profile within the substance use treatment setting, providing important prognostic information regarding abstinence and severity of drinking. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Clinically important deterioration in patients undergoing lumbar spine surgery: a choice of evaluation methods using the Oswestry Disability Index, 36-Item Short Form Health Survey, and pain scales: clinical article.

Science.gov (United States)

Gum, Jeffrey L; Glassman, Steven D; Carreon, Leah Y

2013-11-01

Health-related quality of life (HRQOL) measures have become the mainstay for outcome appraisal in spine surgery. Clinically meaningful interpretation of HRQOL improvement has centered on the minimum clinically important difference (MCID). The purpose of this study was to calculate clinically important deterioration (CIDET) thresholds and determine a CIDET value for each HRQOL measure for patients undergoing lumbar fusion. Seven hundred twenty-two patients (248 males, 127 smokers, mean age 60.8 years) were identified with complete preoperative and 1-year postoperative HRQOLs including the Oswestry Disability Index (ODI), 36-Item Short Form Health Survey (SF-36), and numeric rating scales (0-10) for back and leg pain following primary, instrumented, posterior lumbar fusion. Anchor-based and distribution-based methods were used to calculate CIDET for each HRQOL. Anchor-based methods included change score, change difference, and receiver operating characteristic curve analysis. The Health Transition Item, an independent item of the SF-36, was used as the external anchor. Patients who responded "somewhat worse" and "much worse" were combined and compared with patients responding "about the same." Distribution-based methods were minimum detectable change and effect size. Diagnoses included spondylolisthesis (n = 332), scoliosis (n = 54), instability (n = 37), disc pathology (n = 146), and stenosis (n = 153). There was a statistically significant change (p < 0.0001) for each HRQOL measure from preoperatively to 1-year postoperatively. Only 107 patients (15%) reported being "somewhat worse" (n = 81) or "much worse" (n = 26). Calculation methods yielded a range of CIDET values for ODI (0.17-9.06), SF-36 physical component summary (-0.32 to 4.43), back pain (0.02-1.50), and leg pain (0.02-1.50). A threshold for clinical deterioration was difficult to identify. This may be due to the small number of patients reporting being worse after surgery and the variability across

Measuring everyday functional competence using the Rasch assessment of everyday activity limitations (REAL) item bank.

Science.gov (United States)

Oude Voshaar, Martijn A H; Ten Klooster, Peter M; Vonkeman, Harald E; van de Laar, Mart A F J

2017-11-01

Traditional patient-reported physical function instruments often poorly differentiate patients with mild-to-moderate disability. We describe the development and psychometric evaluation of a generic item bank for measuring everyday activity limitations in outpatient populations. Seventy-two items generated from patient interviews and mapped to the International Classification of Functioning, Disability and Health (ICF) domestic life chapter were administered to 1128 adults representative of the Dutch population. The partial credit model was fitted to the item responses and evaluated with respect to its assumptions, model fit, and differential item functioning (DIF). Measurement performance of a computerized adaptive testing (CAT) algorithm was compared with the SF-36 physical functioning scale (PF-10). A final bank of 41 items was developed. All items demonstrated acceptable fit to the partial credit model and measurement invariance across age, sex, and educational level. Five- and ten-item CAT simulations were shown to have high measurement precision, which exceeded that of SF-36 physical functioning scale across the physical function continuum. Floor effects were absent for a 10-item empirical CAT simulation, and ceiling effects were low (13.5%) compared with SF-36 physical functioning (38.1%). CAT also discriminated better than SF-36 physical functioning between age groups, number of chronic conditions, and respondents with or without rheumatic conditions. The Rasch assessment of everyday activity limitations (REAL) item bank will hopefully prove a useful instrument for assessing everyday activity limitations. T-scores obtained using derived measures can be used to benchmark physical function outcomes against the general Dutch adult population.

Psychometric properties of the PROMIS Physical Function item bank in patients receiving physical therapy.

Directory of Open Access Journals (Sweden)

Martine H P Crins

Full Text Available The Patient-Reported Outcomes Measurement Information System (PROMIS is a universally applicable set of instruments, including item banks, short forms and computer adaptive tests (CATs, measuring patient-reported health across different patient populations. PROMIS CATs are highly efficient and the use in practice is considered feasible with little administration time, offering standardized and routine patient monitoring. Before an item bank can be used as CAT, the psychometric properties of the item bank have to be examined. Therefore, the objective was to assess the psychometric properties of the Dutch-Flemish PROMIS Physical Function item bank (DF-PROMIS-PF in Dutch patients receiving physical therapy.Cross-sectional study.805 patients >18 years, who received any kind of physical therapy in primary care in the past year, completed the full DF-PROMIS-PF (121 items.Unidimensionality was examined by Confirmatory Factor Analysis and local dependence and monotonicity were evaluated. A Graded Response Model was fitted. Construct validity was examined with correlations between DF-PROMIS-PF T-scores and scores on two legacy instruments (SF-36 Health Survey Physical Functioning scale [SF36-PF10] and the Health Assessment Questionnaire Disability-Index [HAQ-DI]. Reliability (standard errors of theta was assessed.The results for unidimensionality were mixed (scaled CFI = 0.924, TLI = 0.923, RMSEA = 0.045, 1th factor explained 61.5% of variance. Some local dependence was found (8.2% of item pairs. The item bank showed a broad coverage of the physical function construct (threshold-parameters range: -4.28-2.33 and good construct validity (correlation with SF36-PF10 = 0.84 and HAQ-DI = -0.85. Furthermore, the DF-PROMIS-PF showed greater reliability over a broader score-range than the SF36-PF10 and HAQ-DI.The psychometric properties of the DF-PROMIS-PF item bank are sufficient. The DF-PROMIS-PF can now be used as short forms or CAT to measure the level of

Development of a Mechanical Engineering Test Item Bank to promote learning outcomes-based education in Japanese and Indonesian higher education institutions

Directory of Open Access Journals (Sweden)

Jeffrey S. Cross

2017-11-01

Full Text Available Following on the 2008-2012 OECD Assessment of Higher Education Learning Outcomes (AHELO feasibility study of civil engineering, in Japan a mechanical engineering learning outcomes assessment working group was established within the National Institute of Education Research (NIER, which became the Tuning National Center for Japan. The purpose of the project is to develop among engineering faculty members, common understandings of engineering learning outcomes, through the collaborative process of test item development, scoring, and sharing of results. By substantiating abstract level learning outcomes into concrete level learning outcomes that are attainable and assessable, and through measuring and comparing the students’ achievement of learning outcomes, it is anticipated that faculty members will be able to draw practical implications for educational improvement at the program and course levels. The development of a mechanical engineering test item bank began with test item development workshops, which led to a series of trial tests, and then to a large scale test implementation in 2016 of 348 first semester master’s students in 9 institutions in Japan, using both multiple choice questions designed to measure the mastery of basic and engineering sciences, and a constructive response task designed to measure “how well students can think like an engineer.” The same set of test items were translated from Japanese into to English and Indonesian, and used to measure achievement of learning outcomes at Indonesia’s Institut Teknologi Bandung (ITB on 37 rising fourth year undergraduate students. This paper highlights how learning outcomes assessment can effectively facilitate learning outcomes-based education, by documenting the experience of Japanese and Indonesian mechanical engineering faculty members engaged in the NIER Test Item Bank project.First published online: 30 November 2017

Item response theory analysis applied to the Spanish version of the Personal Outcomes Scale.

Science.gov (United States)

Guàrdia-Olmos, J; Carbó-Carreté, M; Peró-Cebollero, M; Giné, C

2017-11-01

The study of measurements of quality of life (QoL) is one of the great challenges of modern psychology and psychometric approaches. This issue has greater importance when examining QoL in populations that were historically treated on the basis of their deficiency, and recently, the focus has shifted to what each person values and desires in their life, as in cases of people with intellectual disability (ID). Many studies of QoL scales applied in this area have attempted to improve the validity and reliability of their components by incorporating various sources of information to achieve consistency in the data obtained. The adaptation of the Personal Outcomes Scale (POS) in Spanish has shown excellent psychometric attributes, and its administration has three sources of information: self-assessment, practitioner and family. The study of possible congruence or incongruence of observed distributions of each item between sources is therefore essential to ensure a correct interpretation of the measure. The aim of this paper was to analyse the observed distribution of items and dimensions from the three Spanish POS information sources cited earlier, using the item response theory. We studied a sample of 529 people with ID and their respective practitioners and family member, and in each case, we analysed items and factors using Samejima's model of polytomic ordinal scales. The results indicated an important number of items with differential effects regarding sources, and in some cases, they indicated significant differences in the distribution of items, factors and sources of information. As a result of this analysis, we must affirm that the administration of the POS, considering three sources of information, was adequate overall, but a correct interpretation of the results requires that it obtain much more information to consider, as well as some specific items in specific dimensions. The overall ratings, if these comments are considered, could result in bias. © 2017

The relationship between early changes in the HAMD-17 anxiety/somatization factor items and treatment outcome among depressed outpatients.

Science.gov (United States)

Farabaugh, Amy; Mischoulon, David; Fava, Maurizio; Wu, Shirley L; Mascarini, Alessandra; Tossani, Eliana; Alpert, Jonathan E

2005-03-01

The 17-item Hamilton Rating Scale for Depression (HAMD-17) Anxiety/Somatization factor includes six items: Anxiety (psychic), Anxiety (somatic), Somatic Symptoms (gastrointestinal), Somatic Symptoms (general), Hypochondriasis and Insight. This study examines the relationship between early changes (defined as those observed between baseline and week 1) in these HAMD-17 Anxiety/Somatization Factor items and treatment outcome among major depressive disorder (MDD) patients who participated in a study comparing the antidepressant efficacy of a standardized extract of hypericum with both placebo and fluoxetine. Following a 1-week, single-blind washout, patients with MDD diagnosed by the Structured Clinical Interview for DSM-IV (SCID) were randomized to 12 weeks of double-blind treatment with hypericum extract (900 mg/day), fluoxetine (20 mg/day) or placebo. The relationship between early changes in HAMD-17 anxiety/somatization factor items and treatment outcome was assessed separately for patients who received study treatment (hypericum or fluoxetine) versus placebo with a logistic regression method. One hundred and thirty-five patients (female 57%, mean age=37.3+/-11.0 years; mean baseline HAMD-17=19.7+/-3.2 years) were randomized to double-blind treatment and were included in the intent-to-treat (ITT) analyses. After adjusting for baseline HAMD-17 scores and for multiple comparisons with the Bonferroni correction, patients who remitted (HAMD-17 score Somatic Symptoms (General) scores than non-remitters. No other significant differences in early changes were noted for the remaining items between remitters versus non-remitters who received active treatment. For patients treated with placebo, early change was not predictive of remission for any of the items after Bonferroni correction. In conclusion, the presence of early improvement on the HAMD-17 item concerning fatigue and general somatic symptoms is significantly predictive of achieving remission at endpoint with

Varying the item format improved the range of measurement in patient-reported outcome measures assessing physical function.

Science.gov (United States)

Liegl, Gregor; Gandek, Barbara; Fischer, H Felix; Bjorner, Jakob B; Ware, John E; Rose, Matthias; Fries, James F; Nolte, Sandra

2017-03-21

Physical function (PF) is a core patient-reported outcome domain in clinical trials in rheumatic diseases. Frequently used PF measures have ceiling effects, leading to large sample size requirements and low sensitivity to change. In most of these instruments, the response category that indicates the highest PF level is the statement that one is able to perform a given physical activity without any limitations or difficulty. This study investigates whether using an item format with an extended response scale, allowing respondents to state that the performance of an activity is easy or very easy, increases the range of precise measurement of self-reported PF. Three five-item PF short forms were constructed from the Patient-Reported Outcomes Measurement Information System (PROMIS®) wave 1 data. All forms included the same physical activities but varied in item stem and response scale: format A ("Are you able to …"; "without any difficulty"/"unable to do"); format B ("Does your health now limit you …"; "not at all"/"cannot do"); format C ("How difficult is it for you to …"; "very easy"/"impossible"). Each short-form item was answered by 2217-2835 subjects. We evaluated unidimensionality and estimated a graded response model for the 15 short-form items and remaining 119 items of the PROMIS PF bank to compare item and test information for the short forms along the PF continuum. We then used simulated data for five groups with different PF levels to illustrate differences in scoring precision between the short forms using different item formats. Sufficient unidimensionality of all short-form items and the original PF item bank was supported. Compared to formats A and B, format C increased the range of reliable measurement by about 0.5 standard deviations on the positive side of the PF continuum of the sample, provided more item information, and was more useful in distinguishing known groups with above-average functioning. Using an item format with an extended

Multimodal Outcome Prognostication After Cardiac Arrest and Targeted Temperature Management: Analysis at 36 °C.

Science.gov (United States)

Tsetsou, Spyridoula; Novy, Jan; Pfeiffer, Christian; Oddo, Mauro; Rossetti, Andrea O

2018-02-01

Targeted temperature management (TTM) represents the standard of care in comatose survivors after cardiac arrest (CA) and may be applied targeting 33° or 36 °C. While multimodal prognostication has been extensively tested for 33 °C, scarce information exists for 36 °C. In this cohort study, consecutive comatose adults after CA treated with TTM at 36 °C between July 2014 and October 2016 were included. A combination of neurological examination, electrophysiological features, and serum neuron-specific enolase (NSE) was evaluated for outcome prediction at 3 months (mortality; good outcome defined as cerebral performance categories (CPC) score of 1-2, poor outcome defined as CPC 3-5). We analyzed 61 patients. The presence of two or more predictors out of, unreactive electroencephalogram (EEG) background, epileptiform EEG, absent pupillary and/or corneal reflex, early myoclonus, bilaterally absent cortical somatosensory evoked potentials, and serum NSE >75 μg/l, had a high specificity for predicting mortality (positive predictive value [PPV] = 1.00, 95% CI 0.87-1.00) and poor outcome (PPV = 1.00, 95% CI 0.80-1.00). Reactive EEG background was highly sensitive for predicting good outcome (0.95, 95% CI 0.74-0.99). Prediction of outcome after CA and TTM targeting 36 °C seems valid in adults using the same features tested at 33 °C. A reactive EEG under TTM appears highly sensitive for good outcome.

Cross-cultural differences in knee functional status outcomes in a polyglot society represented true disparities not biased by differential item functioning.

Science.gov (United States)

Deutscher, Daniel; Hart, Dennis L; Crane, Paul K; Dickstein, Ruth

2010-12-01

Comparative effectiveness research across cultures requires unbiased measures that accurately detect clinical differences between patient groups. The purpose of this study was to assess the presence and impact of differential item functioning (DIF) in knee functional status (FS) items administered using computerized adaptive testing (CAT) as a possible cause for observed differences in outcomes between 2 cultural patient groups in a polyglot society. This study was a secondary analysis of prospectively collected data. We evaluated data from 9,134 patients with knee impairments from outpatient physical therapy clinics in Israel. Items were analyzed for DIF related to sex, age, symptom acuity, surgical history, exercise history, and language used to complete the functional survey (Hebrew versus Russian). Several items exhibited DIF, but unadjusted FS estimates and FS estimates that accounted for DIF were essentially equal (intraclass correlation coefficient [2,1]>.999). No individual patient had a difference between unadjusted and adjusted FS estimates as large as the median standard error of the unadjusted estimates. Differences between groups defined by any of the covariates considered were essentially unchanged when using adjusted instead of unadjusted FS estimates. The greatest group-level impact was <0.3% of 1 standard deviation of the unadjusted FS estimates. Complete data where patients answered all items in the scale would have been preferred for DIF analysis, but only CAT data were available. Differences in FS outcomes between groups of patients with knee impairments who answered the knee CAT in Hebrew or Russian in Israel most likely reflected true differences that may reflect societal disparities in this health outcome.

Psychometric Consequences of Subpopulation Item Parameter Drift

Science.gov (United States)

Huggins-Manley, Anne Corinne

2017-01-01

This study defines subpopulation item parameter drift (SIPD) as a change in item parameters over time that is dependent on subpopulations of examinees, and hypothesizes that the presence of SIPD in anchor items is associated with bias and/or lack of invariance in three psychometric outcomes. Results show that SIPD in anchor items is associated…

Psychometric properties of the Neck OutcOme Score, Neck Disability Index, and Short Form-36 were evaluated in patients with neck pain.

Science.gov (United States)

Juul, Tina; Søgaard, Karen; Davis, Aileen M; Roos, Ewa M

2016-11-01

To assess reliability, construct validity, responsiveness, and interpretability for Neck OutcOme Score (NOOS), Neck Disability Index (NDI), and Short Form-36 (SF-36) in neck pain patients. Internal consistency was assessed by Cronbach alpha. Test-retest reliability was evaluated by intraclass correlation coefficient (ICC), and measurement error was estimated from the standard error of measurement. Responsiveness was assessed as standardized response mean (SRM) and interpretability from the minimal important difference (MID). Construct validity was tested correlating subscale scores from NOOS and SF-36 and NDI items. At baseline, 196 neck pain patients were included. Cronbach α was adequate for most NOOS subscales, NDI, and SF-36 with few exceptions. Good to excellent reliability was found for NOOS subscales (ICC 0.88-0.95), for NDI, and for SF-36 with few exceptions. For NOOS, minimal detectable changes varied between 1.1 and 1.9, and construct validity was supported. SRMs were higher for NOOS subscales (0.19-0.42), compared to SF-36 and NDI. MID values varied between 15.0 and 24.1 for NOOS subscales. In conclusion, the NOOS is a reliable, valid, and responsive measure of self-reported disability in neck pain patients, performing at least as well or better than the commonly used SF-36 and NDI. Copyright © 2016 Elsevier Inc. All rights reserved.

Evaluating Questionnaires Used to Assess Self-Reported Physical Activity and Psychosocial Outcomes Among Survivors of Adolescent and Young Adult Cancer: A Cognitive Interview Study.

Science.gov (United States)

Wurz, Amanda; Brunet, Jennifer

2017-09-01

Physical activity is increasingly being studied as a way to improve psychosocial outcomes (e.g., quality of life, self-efficacy, physical self-perceptions, self-esteem, body image, posttraumatic growth) among survivors of adolescent and young adult (AYA) cancer. Assessing levels of and associations between self-reported physical activity and psychosocial outcomes requires clear, appropriate, and relevant questionnaires. To explore how survivors of AYA cancer interpreted and responded to the following eight published questionnaires: Leisure Time Exercise Questionnaire, Exercise Self-Efficacy Scale, Physical Self-Description Questionnaire, Rosenberg Global Self-Esteem Scale, Multidimensional Body-Self Relations Questionnaire, Posttraumatic Growth Inventory, Functional Assessment of Cancer Therapy-General (FACT-G), RAND 36-Item Health Survey 1.0 (RAND-36), cognitive interviews were conducted with three men and four women age 18-36 years who were diagnosed with cancer at age 16-35 years. Initially, the first seven questionnaires listed above were assessed. Summaries of the interviews were prepared and compared across participants. Potential concerns were identified with the FACT-G; thus, a second interview was conducted with participants to explore the clarity, appropriateness, and relevance of the RAND-36. Concerns identified for the FACT-G related mostly to the lack of relevance of items pertaining to cancer-specific aspects of quality of life given that participants were posttreatment. No or few concerns related to comprehension and/or structure/logic were identified for the other questionnaires. In general, the questionnaires assessed were clear, appropriate, and relevant. Participants' feedback suggested they could be used to assess self-reported physical activity and varied psychosocial outcomes in studies with survivors of AYA cancer, either with or without slight modifications.

Intermediate Term (3-6 Years Post Surgery) Outcome of ...

African Journals Online (AJOL)

Post-operatively, the 5 eyes had VA ranging from 6/60 to NLP, after a variable follow-up period of 3-6 years. Complications included development of tough vascularized retroprosthetic membrane (4 eyes) and infective endophthalmitis in one eye. Conclusion: The intermediate-term outcome of keratoprosthesis surgery in ...

Aging, culture, and memory for socially meaningful item-context associations: an East-West cross-cultural comparison study.

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Yang, Lixia; Li, Juan; Spaniol, Julia; Hasher, Lynn; Wilkinson, Andrea J; Yu, Jing; Niu, Yanan

2013-01-01

Research suggests that people in Eastern interdependent cultures process information more holistically and attend more to contextual information than do people in Western independent cultures. The current study examined the effects of culture and age on memory for socially meaningful item-context associations in 71 Canadians of Western European descent (35 young and 36 older) and 72 native Chinese citizens (36 young and 36 older). All participants completed two blocks of context memory tasks. During encoding, participants rated pictures of familiar objects. In one block, objects were rated either for their meaningfulness in the independent living context or their typicality in daily life. In the other block, objects were rated for their meaningfulness in the context of fostering relationships with others or for their typicality in daily life. The encoding in each block was followed by a recognition test in which participants identified pictures and their associated contexts. The results showed that Chinese outperformed Canadians in context memory, though both culture groups showed similar age-related deficits in item and context memory. The results suggest that Chinese are at an advantage in memory for socially meaningful item-context associations, an advantage that continues from young adulthood into old age.

Validation of the Spanish version of the Hip Outcome Score: a multicenter study.

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Seijas, Roberto; Sallent, Andrea; Ruiz-Ibán, Miguel Angel; Ares, Oscar; Marín-Peña, Oliver; Cuéllar, Ricardo; Muriel, Alfonso

2014-05-13

The Hip Outcome Score (HOS) is a self-reported questionnaire evaluating the outcomes of treatment interventions for hip pathologies, divided in 19 items of activities of daily life (ADL) and 9 sports' items. The aim of the present study is to translate and validate HOS into Spanish. A prospective and multicenter study with 100 patients undergoing hip arthroscopy was performed between June 2012 and January 2013. Crosscultural adaptation was used to translate HOS into Spanish. Patients completed the questionnaire before and after surgery. Feasibility, reliability, internal consistency, construct validity (correlation with Western Ontario and McMaster Universities Osteoarthritis Index), ceiling and floor effects and sensitivity to change were assessed for the present study. Mean age was 45.05 years old. 36 women and 64 men were included. Feasibility: 13% had at least one missing item within the ADL subscale and 17% within the sport subscale. Reliability: the translated version of HOS was highly reproducible with intraclass correlation coefficient of 0.95 for ADL and 0.94 for the sports subscale. Internal consistency was confirmed with Cronbach's alpha >0.90 in both subscales. Construct validity showed statistically significant correlation with WOMAC. Ceiling effect was observed in 6% and 12% for ADL and sports subscale, respectively. Floor effect was found in 3% and 37% ADL and sports subscale, respectively. Large sensitivity to change was shown in both subscales. The translated version of HOS into Spanish has shown to be feasible, reliable and sensible to changes for patients undergoing hip arthroscopy. This validated translation of HOS allows for comparisons between studies involving either Spanish- or English-speaking patients. Prognostic study, Level I.

Reliability and construct validity of the Spanish version of the 6-item CTS symptoms scale for outcomes assessment in carpal tunnel syndrome.

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Rosales, Roberto S; Martin-Hidalgo, Yolanda; Reboso-Morales, Luis; Atroshi, Isam

2016-03-03

The purpose of this study was to assess the reliability and construct validity of the Spanish version of the 6-item carpal tunnel syndrome (CTS) symptoms scale (CTS-6). In this cross-sectional study 40 patients diagnosed with CTS based on clinical and neurophysiologic criteria, completed the standard Spanish versions of the CTS-6 and the disabilities of the arm, shoulder and hand (QuickDASH) scales on two occasions with a 1-week interval. Internal-consistency reliability was assessed with the Cronbach alpha coefficient and test-retest reliability with the intraclass correlation coefficient, two way random effect model and absolute agreement definition (ICC2,1). Cross-sectional precision was analyzed with the Standard Error of the Measurement (SEM). Longitudinal precision for test-retest reliability coefficient was assessed with the Standard Error of the Measurement difference (SEMdiff) and the Minimal Detectable Change at 95 % confidence level (MDC95). For assessing construct validity it was hypothesized that the CTS-6 would have a strong positive correlation with the QuickDASH, analyzed with the Pearson correlation coefficient (r). The standard Spanish version of the CTS-6 presented a Cronbach alpha of 0.81 with a SEM of 0.3. Test-retest reliability showed an ICC of 0.85 with a SRMdiff of 0.36 and a MDC95 of 0.7. The correlation between CTS-6 and the QuickDASH was concordant with the a priori formulated construct hypothesis (r 0.69) CONCLUSIONS: The standard Spanish version of the 6-item CTS symptoms scale showed good internal consistency, test-retest reliability and construct validity for outcomes assessment in CTS. The CTS-6 will be useful to clinicians and researchers in Spanish speaking parts of the world. The use of standardized outcome measures across countries also will facilitate comparison of research results in carpal tunnel syndrome.

Reliability and validity of the foot and ankle outcome score: a validation study from Iran.

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Negahban, Hossein; Mazaheri, Masood; Salavati, Mahyar; Sohani, Soheil Mansour; Askari, Marjan; Fanian, Hossein; Parnianpour, Mohamad

2010-05-01

The aims of this study were to culturally adapt and validate the Persian version of Foot and Ankle Outcome Score (FAOS) and present data on its psychometric properties for patients with different foot and ankle problems. The Persian version of FAOS was developed after a standard forward-backward translation and cultural adaptation process. The sample included 93 patients with foot and ankle disorders who were asked to complete two questionnaires: FAOS and Short-Form 36 Health Survey (SF-36). To determine test-retest reliability, 60 randomly chosen patients completed the FAOS again 2 to 6 days after the first administration. Test-retest reliability and internal consistency were assessed using intraclass correlation coefficient (ICC) and Cronbach's alpha, respectively. To evaluate convergent and divergent validity of FAOS compared to similar and dissimilar concepts of SF-36, the Spearman's rank correlation was used. Dimensionality was determined by assessing item-subscale correlation corrected for overlap. The results of test-retest reliability show that all the FAOS subscales have a very high ICC, ranging from 0.92 to 0.96. The minimum Cronbach's alpha level of 0.70 was exceeded by most subscales. The Spearman's correlation coefficient for convergent construct validity fell within 0.32 to 0.58 for the main hypotheses presented a priori between FAOS and SF-36 subscales. For dimensionality, the minimum Spearman's correlation coefficient of 0.40 was exceeded by most items. In conclusion, the results of our study show that the Persian version of FAOS seems to be suitable for Iranian patients with various foot and ankle problems especially lateral ankle sprain. Future studies are needed to establish stronger psychometric properties for patients with different foot and ankle problems.

Is there regional variation in the SF-36 scores of Canadian adults?

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Hopman, Wilma M; Berger, Claudie; Joseph, Lawrence; Towheed, Tanveer; Anastassiades, Tassos; Tenenhouse, Alan; Poliquin, Suzette; Brown, Jacques P; Murray, Timothy M; Adachi, Jonathan D; Hanley, David A; Papadimitropoulos, Emmanuel A

2002-01-01

Canadian normative data for the Medical Outcomes Study 36-item short form (SF-36) have recently been published. However, there is evidence from other countries to suggest that regional variation in health-related quality of life (HRQOL) may exist. We therefore examined the SF-36 data from nine Canadian centres for evidence of systematic differences. Bayesian hierarchical modelling was used to compare the differences in the eight SF-36 domains and the two summary component scores within each of the age and gender strata across the nine sites. Five domains and the two summary component scores showed little clinically important variation. Other than a small number of exceptions, there was little overall evidence of HRQOL differences across most domains and across most sites. Our finding of only a few small differences suggests that there is no need to develop region-specific Canadian normative data for the SF-36 health survey.

Dialysate temperature of 36 °C: association with clinical outcomes.

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Gray, Kathryn S; Cohen, Dena E; Brunelli, Steven M

2018-02-01

Dialysate cooling, either individualized based upon patient body temperature, or to a standardized temperature below 37 °C, has been proposed to minimize hemodynamic insults and improve outcomes among hemodialysis patients. However, low dialysate temperatures (35-35.5 °C) are associated with patient discomfort, and individualized dialysate cooling is difficult to operationalize. Here, we tested whether a standardized dialysate temperature of 36 °C (dT36) was associated with improved clinical outcomes compared to the default temperature of 37 °C (dT37). Because patients with known hemodynamic instability may be selectively prescribed dT36, we minimized selection bias by considering only incident adult in-center hemodialysis patients who, between Jan 2011 and Dec 2013 received their first-ever hemodialysis treatment at a large dialysis organization. Exposure status was based on the treatment order for this first-ever treatment. 313 dT36 patients were identified and propensity-score matched (1:5) to 1565 dT37 controls. Death, hospitalization, and missed hemodialysis treatments were considered from the date of first-ever hemodialysis treatment until the earliest of death, loss to follow-up, crossover (month in which prescribed dialysate temperature was consistent with patient's exposure group for 36 °C. Individualized dialysate cooling may provide a more reliable approach to achieve the hemodynamic benefits associated with reduced dialysate temperature.

Clinical Validation of the Nursing Outcome "Swallowing Status" in People with Stroke: Analysis According to the Classical and Item Response Theories.

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Oliveira-Kumakura, Ana Railka de Souza; de Araujo, Thelma Leite; Costa, Alice Gabrielle de Sousa; Cavalcante, Tahissa Frota; Lopes, Marcos Venícios de Oliveira; Carvalho, Emilia Campos

2017-09-19

To validate clinically the nursing outcome "Swallowing status". The adjustment of the nursing outcome was investigated according to the Classical and Item Response Theories. The models were compared regarding information loss, goodness-of-fit, and differential item functioning. Stability and internal consistency were examined. The nursing outcome has the best fit in the generalized partial credit model with different discrimination parameters. Strong correlations among the scores of each indicator were observed. There was no differential item functioning of the outcome indicators. The scale presented high internal consistency (Cronbach's α = .954) and stability (and > .800). This study presents a valid nursing outcome. Most accurate monitoring of sensitivity to an intervention. Validar clinicamente o resultado de enefermagem "Estado da Deglutição". MÉTODOS: O ajustamento do resultado foi investigado de acordo com as teorias Clássica e de Resposta ao Item. Os modelos foram comparados assumindo parâmetros de itens cruzados de igual discriminação. Investigaram-se as propriedades de bondade do ajuste, funcionamento diferencial dos itens, estabilidade e consistência interna. O resultado se ajustou melhor a partir do Modelo de crédito parcial generalizado, o qual demonstrou unidimensionalidade do resultado e forte correlação entre os escores de cada indicador. Não houve funcionamento diferencial dos indicadores. A consistência interna para a escala global (Cronbach's α = .954) e a estabilidade (>.800) mantiveram-se elevadas. CONCLUSÃO: O estudo apresenta um resultado de enfermagem válido. RELEVÂNCIA PARA A PRÁTICA CLÍNICA: Maior acurácia para monitorar a sensibilidade da intervenção. © 2017 NANDA International, Inc.

The utility of single-item readiness screeners in middle school.

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Lewis, Crystal G; Herman, Keith C; Huang, Francis L; Stormont, Melissa; Grossman, Caroline; Eddy, Colleen; Reinke, Wendy M

2017-10-01

This study examined the benefit of utilizing one-item academic and one-item behavior readiness teacher-rated screeners at the beginning of the school year to predict end-of-school year outcomes for middle school students. The Middle School Academic and Behavior Readiness (M-ABR) screeners were developed to provide an efficient and effective way to assess readiness in students. Participants included 889 students in 62 middle school classrooms in an urban Missouri school district. Concurrent validity with the M-ABR items and other indicators of readiness in the fall were evaluated using Pearson product-moment correlation coefficients, with the academic readiness item having medium to strong correlations with other baseline academic indicators (r=±0.56 to 0.91) and the behavior readiness item having low to strong correlations with baseline behavior items (r=±0.20 to 0.79). Next, the predictive validity of the M-ABR items was analyzed with hierarchical linear regressions using end-of-year outcomes as the dependent variable. The academic and behavior readiness items demonstrated adequate validity for all outcomes with moderate effects (β=±0.31 to 0.73 for academic outcomes and β=±0.24 to 0.59 for behavioral outcomes) after controlling for baseline demographics. Even after controlling for baseline scores, the M-ABR items predicted unique variance in almost all outcome variables. Four conditional probability indices were calculated to obtain an optimal cut score, to determine ready vs. not ready, for both single-item M-ABR scales. The cut point of "fair" yielded the most acceptable values for the indices. The odd ratios (OR) of experiencing negative outcomes given a "fair" or lower readiness rating (2 or below on the M-ABR screeners) at the beginning of the year were significant and strong for all outcomes (OR=2.29 to OR=14.46), except for internalizing problems. These findings suggest promise for using single readiness items to screen for varying negative end

Translation, cross-cultural adaptation, and psychometric properties of the German version of the hip disability and osteoarthritis outcome score.

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Blasimann, Angela; Dauphinee, Sharon Wood; Staal, J Bart

2014-12-01

Clinical measurement. To translate and cross-culturally adapt the Hip disability and Osteoarthritis Outcome Score (HOOS) from English into German, and to study its psychometric properties in patients after hip surgery. There is no specific hip questionnaire in German that not only measures symptoms and function but also contains items about hip-related quality of life. The translation and cross-cultural adaptation involved forward translation, harmonization, cognitive debriefing, back translation, and comparison to the original HOOS following international guidelines. The German version was tested in 51 Swiss inpatients 8 weeks after different types of hip surgery, mainly total hip replacement. The mean age of the participants was 62.5 years, and the age range was from 27 to 87 years. Thirty (58.8%) of the participants were women. Internal consistency and test-retest reliability were estimated using Cronbach alpha and intraclass correlation coefficients for agreement. For construct validity, total scores of the German HOOS were correlated with those of the Western Ontario and McMaster Universities Osteoarthritis Index. The HOOS was also compared to the Medical Outcomes Study 36-Item Short-Form Health Survey. Cronbach alpha values for all German HOOS subscales were between .87 and .93. For test-retest reliability, the intraclass correlation coefficient for agreement was 0.85 for the total scores of the German HOOS. The Spearman rho for the Medical Outcomes Study 36-Item Short-Form Health Survey physical functioning subscale compared to the sum of all HOOS subscales was 0.71, and that for the Medical Outcomes Study 36-Item Short-Form Health Survey physical component summary was 0.97. The German HOOS has demonstrated adequate reliability and validity. Use of the German HOOS is recommended for assessment of patients after hip surgery, with the proviso that additional psychometric testing should be done in future research.

Overview of classical test theory and item response theory for the quantitative assessment of items in developing patient-reported outcomes measures.

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Cappelleri, Joseph C; Jason Lundy, J; Hays, Ron D

2014-05-01

The US Food and Drug Administration's guidance for industry document on patient-reported outcomes (PRO) defines content validity as "the extent to which the instrument measures the concept of interest" (FDA, 2009, p. 12). According to Strauss and Smith (2009), construct validity "is now generally viewed as a unifying form of validity for psychological measurements, subsuming both content and criterion validity" (p. 7). Hence, both qualitative and quantitative information are essential in evaluating the validity of measures. We review classical test theory and item response theory (IRT) approaches to evaluating PRO measures, including frequency of responses to each category of the items in a multi-item scale, the distribution of scale scores, floor and ceiling effects, the relationship between item response options and the total score, and the extent to which hypothesized "difficulty" (severity) order of items is represented by observed responses. If a researcher has few qualitative data and wants to get preliminary information about the content validity of the instrument, then descriptive assessments using classical test theory should be the first step. As the sample size grows during subsequent stages of instrument development, confidence in the numerical estimates from Rasch and other IRT models (as well as those of classical test theory) would also grow. Classical test theory and IRT can be useful in providing a quantitative assessment of items and scales during the content-validity phase of PRO-measure development. Depending on the particular type of measure and the specific circumstances, the classical test theory and/or the IRT should be considered to help maximize the content validity of PRO measures. Copyright © 2014 Elsevier HS Journals, Inc. All rights reserved.

47 CFR 36.224 - Extraordinary items-Account 7600.

Science.gov (United States)

2010-10-01

..., REVENUES, EXPENSES, TAXES AND RESERVES FOR TELECOMMUNICATIONS COMPANIES 1 Operating Revenues and Certain... account of an operating nature are apportioned on a basis consistent with the nature of these items. ...

Deep brain stimulation and responsiveness of the Persian version of Parkinson's disease questionnaire with 39-items.

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Shahidi, Gholam Ali; Ghaempanah, Zeinab; Khalili, Yasaman; Nojomi, Marzieh

2014-10-06

Assessment of quality-of-life (QOF) as an outcome measure after deep brain stimulation (DBS) surgery in patients with Parkinson's disease (PD) need a valid, reliable and responsive instrument. The aim of the current study was to determine responsiveness of validated Persian version of PD questionnaire with 39-items (PDQ-39) after DBS surgery in patients with PD. Eleven patients with PD, who were candidate for DBS operation between May 2012 and June 2013 were assessed. PDQ-39 and short-form questionnaire with 36-items (SF-36) were used. To assess responsiveness of PDQ-39 standardized response mean (SRM) was used. Mean age was 51.8 (8.8) and all of the patients, but just one were male (10 patients). Mean duration of the disease was 8.7 (2.1) years. Eight patients were categorized as moderate using Hoehn and Yahr (H and Y) classification. All patients had a better H and Y score compared with the baseline evaluation (3.09 vs. 0.79). The amount of SRM was above 0.70 for all domains means a large responsiveness for PDQ-39. Persian version of PDQ-39 has an acceptable responsiveness and could be used to assess as an outcome measure to evaluate the effect of therapies on PD.

Validity of the SF-36 five-item Mental Health Index for major depression in functionally impaired, community-dwelling elderly patients.

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Friedman, Bruce; Heisel, Marnin; Delavan, Rachel

2005-11-01

To examine criterion and construct validity of the five-item Mental Health Index (MHI-5) of the 36-item Short Form health survey (SF-36) in relation to the presence of major depression in functionally impaired, community-dwelling elderly patients and of eight subsamples defined by cognitive functioning, levels of functional impairment, and proxy report versus self-report. Cross-sectional observational. Nineteen counties in western New York, West Virginia, and Ohio. One thousand four hundred forty-four functionally impaired, community-dwelling Medicare beneficiaries aged 65 and older who participated in the Medicare Primary and Consumer-Directed Care Demonstration. MHI-5, Mini-International Neuropsychiatric Interview Major Depressive Episode (MINI-MDE) module. The MHI-5 demonstrated sufficient criterion validity (area under the receiver operating characteristic curve=0.837; sensitivity=78.7% and specificity=72.1% using a cutpoint of 59/60) with respect to the presence of depression for the entire sample. A significant correlation between MHI-5 scores and presence of major depression as identified using the MINI-MDE (Spearman correlation=-0.426, Pvalidity. Additional evidence is provided by decline in mean MHI-5 score as level of formal education and number of close friends and relatives decreased. All eight subsamples demonstrated similar criterion and construct validity. A Cronbach alpha of 0.794 demonstrated internal consistency reliability. This study provides evidence for adequate criterion and construct validity of the MHI-5 in relation to the presence of major depression among functionally impaired, community-dwelling elderly Medicare patients.

Aging, Culture, and Memory for Socially Meaningful Item-Context Associations: An East-West Cross-Cultural Comparison Study

Science.gov (United States)

Yang, Lixia; Li, Juan; Spaniol, Julia; Hasher, Lynn; Wilkinson, Andrea J.; Yu, Jing; Niu, Yanan

2013-01-01

Research suggests that people in Eastern interdependent cultures process information more holistically and attend more to contextual information than do people in Western independent cultures. The current study examined the effects of culture and age on memory for socially meaningful item-context associations in 71 Canadians of Western European descent (35 young and 36 older) and 72 native Chinese citizens (36 young and 36 older). All participants completed two blocks of context memory tasks. During encoding, participants rated pictures of familiar objects. In one block, objects were rated either for their meaningfulness in the independent living context or their typicality in daily life. In the other block, objects were rated for their meaningfulness in the context of fostering relationships with others or for their typicality in daily life. The encoding in each block was followed by a recognition test in which participants identified pictures and their associated contexts. The results showed that Chinese outperformed Canadians in context memory, though both culture groups showed similar age-related deficits in item and context memory. The results suggest that Chinese are at an advantage in memory for socially meaningful item-context associations, an advantage that continues from young adulthood into old age. PMID:23593288

Aging, culture, and memory for socially meaningful item-context associations: an East-West cross-cultural comparison study.

Directory of Open Access Journals (Sweden)

Lixia Yang

Full Text Available Research suggests that people in Eastern interdependent cultures process information more holistically and attend more to contextual information than do people in Western independent cultures. The current study examined the effects of culture and age on memory for socially meaningful item-context associations in 71 Canadians of Western European descent (35 young and 36 older and 72 native Chinese citizens (36 young and 36 older. All participants completed two blocks of context memory tasks. During encoding, participants rated pictures of familiar objects. In one block, objects were rated either for their meaningfulness in the independent living context or their typicality in daily life. In the other block, objects were rated for their meaningfulness in the context of fostering relationships with others or for their typicality in daily life. The encoding in each block was followed by a recognition test in which participants identified pictures and their associated contexts. The results showed that Chinese outperformed Canadians in context memory, though both culture groups showed similar age-related deficits in item and context memory. The results suggest that Chinese are at an advantage in memory for socially meaningful item-context associations, an advantage that continues from young adulthood into old age.

Transcranial magnetic stimulation (TMS) for major depression: a multisite, naturalistic, observational study of quality of life outcome measures in clinical practice.

Science.gov (United States)

Janicak, Philip G; Dunner, David L; Aaronson, Scott T; Carpenter, Linda L; Boyadjis, Terrence A; Brock, David G; Cook, Ian A; Lanocha, Karl; Solvason, Hugh B; Bonneh-Barkay, Dafna; Demitrack, Mark A

2013-12-01

Transcranial magnetic stimulation (TMS) is an effective and safe therapy for major depressive disorder (MDD). This study assessed quality of life (QOL) and functional status outcomes for depressed patients after an acute course of TMS. Forty-two, U.S.-based, clinical TMS practice sites treated 307 outpatients with a primary diagnosis of MDD and persistent symptoms despite prior adequate antidepressant pharmacotherapy. Treatment parameters were based on individual clinical considerations and followed the labeled procedures for use of the approved TMS device. Patient self-reported QOL outcomes included change in the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the EuroQol 5-Dimensions (EQ-5D) ratings from baseline to end of the acute treatment phase. Statistically significant improvement in functional status on a broad range of mental health and physical health domains was observed on the SF-36 following acute TMS treatment. Similarly, statistically significant improvement in patient-reported QOL was observed on all domains of the EQ-5D and on the General Health Perception and Health Index scores. Improvement on these measures was observed across the entire range of baseline depression symptom severity. These data confirm that TMS is effective in the acute treatment of MDD in routine clinical practice settings. This symptom benefit is accompanied by statistically and clinically meaningful improvements in patient-reported QOL and functional status outcomes.

Low back pain: what determines functional outcome at six months? An observational study

Directory of Open Access Journals (Sweden)

Peers Charles E

2010-10-01

Full Text Available Abstract Background The rise in disability due to back pain has been exponential with escalating medical and societal costs. The relative contribution of individual prognostic indicators to the pattern of recovery remains unclear. The objective of this study was to determine the prognostic value of demographic, psychosocial, employment and clinical factors on outcome in patients with low back pain Methods A prospective cohort study with six-month follow-up was undertaken at a multidisciplinary back pain clinic in central London employing physiotherapists, osteopaths, clinical psychologists and physicians, receiving referrals from 123 general practitioners. Over a twelve-month period, 593 consecutive patients referred from general practice with simple low back pain were recruited. A baseline questionnaire was developed to elicit information on potential prognostic variables. The primary outcome measures were change in 24-item Roland Morris disability questionnaire score at six months as a measure of low back related functional disability and the physical functioning scale of the SF-36, adjusted for baseline scores. Results Roland Morris scores improved by 3.8 index points (95% confidence interval 3.23 to 4.32 at six months and SF-36 physical functioning score by 10.7 points (95% confidence interval 8.36 to 12.95. Ten factors were linked to outcome yet in a multiple regression model only two remained predictive. Those with episodic rather than continuous pain were more likely to have recovered at six months (odds ratio 2.64 confidence interval 1.25 to 5.60, while those that classified themselves as non-white were less likely to have recovered (0.41 confidence interval 0.18 to 0.96. Conclusions Analysis controlling for confounding variables, demonstrated that participants showed greater improvement if their episodes of pain during the previous year were short-lived while those with Middle Eastern, North African and Chinese ethnicity demonstrated

Capturing and missing the patient's story through outcome measures: A thematic comparison of patient-generated items in PSYCHLOPS with CORE-OM and PHQ-9.

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Sales, Célia Md; Neves, Inês Td; Alves, Paula G; Ashworth, Mark

2017-11-22

There is increasing interest in individualized patient-reported outcome measures (I-PROMS), where patients themselves indicate the specific problems they want to address in therapy and these problems are used as items within the outcome measurement tool. This paper examined the extent to which 279 items reported in an I-PROM (PSYCHLOPS) added qualitative information which was not captured by two well-established outcome measures (CORE-OM and PHQ-9). Comparison of items was only conducted for patients scoring above the "caseness" threshold on the standardized measures. 107 patients were participating in therapy within addiction and general psychiatric clinical settings. Almost every patient (95%) reported at least one item whose content was not covered by PHQ-9, and 71% reported at least one item not covered by CORE-OM. Results demonstrate the relevance of individualized outcome assessment for capturing data describing the issues of greatest concern to patients, as nomothetic measures do not always seem to capture the whole story. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

The PROMIS Physical Function item bank was calibrated to a standardized metric and shown to improve measurement efficiency.

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Rose, Matthias; Bjorner, Jakob B; Gandek, Barbara; Bruce, Bonnie; Fries, James F; Ware, John E

2014-05-01

To document the development and psychometric evaluation of the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) item bank and static instruments. The items were evaluated using qualitative and quantitative methods. A total of 16,065 adults answered item subsets (n>2,200/item) on the Internet, with oversampling of the chronically ill. Classical test and item response theory methods were used to evaluate 149 PROMIS PF items plus 10 Short Form-36 and 20 Health Assessment Questionnaire-Disability Index items. A graded response model was used to estimate item parameters, which were normed to a mean of 50 (standard deviation [SD]=10) in a US general population sample. The final bank consists of 124 PROMIS items covering upper, central, and lower extremity functions and instrumental activities of daily living. In simulations, a 10-item computerized adaptive test (CAT) eliminated floor and decreased ceiling effects, achieving higher measurement precision than any comparable length static tool across four SDs of the measurement range. Improved psychometric properties were transferred to the CAT's superior ability to identify differences between age and disease groups. The item bank provides a common metric and can improve the measurement of PF by facilitating the standardization of patient-reported outcome measures and implementation of CATs for more efficient PF assessments over a larger range. Copyright © 2014. Published by Elsevier Inc.

Randomised controlled trial of a healthy lifestyle intervention among smokers with psychotic disorders: Outcomes to 36 months.

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Baker, Amanda L; Richmond, Robyn; Kay-Lambkin, Frances J; Filia, Sacha L; Castle, David; Williams, Jill M; Lewin, Terry J; Clark, Vanessa; Callister, Robin; Palazzi, Kerrin

2018-03-01

People living with psychotic disorders (schizophrenia spectrum and bipolar disorders) have high rates of cardiovascular disease risk behaviours, including smoking, physical inactivity and poor diet. We report cardiovascular disease risk, smoking cessation and other risk behaviour outcomes over 36 months following recruitment into a two-arm randomised controlled trial among smokers with psychotic disorders. Participants ( N = 235) drawn from three sites were randomised to receive nicotine replacement therapy plus (1) a Healthy Lifestyles intervention delivered over approximately 9 months or (2) a largely telephone-delivered intervention (designed to control for nicotine replacement therapy provision, session frequency and other monitoring). The primary outcome variables were 10-year cardiovascular disease risk and smoking status, while the secondary outcomes included weekly physical activity, unhealthy eating, waist circumference, psychiatric symptomatology, depression and global functioning. Significant reductions in cardiovascular disease risk and smoking were detected across the 36-month follow-up period in both intervention conditions, with no significant differences between conditions. One-quarter (25.5%) of participants reported reducing cigarettes per day by 50% or more at multiple post-treatment assessments; however, few (8.9%) managed to sustain this across the majority of time points. Changes in other health behaviours or lifestyle factors were modest; however, significant improvements in depression and global functioning were detected over time in both conditions. Participants experiencing worse 'social discomfort' at baseline (e.g. anxiety, mania, poor self-esteem and social disability) had on average significantly worse global functioning, lower scores on the 12-Item Short Form Health Survey physical scale and significantly greater waist circumference. Although the telephone-delivered intervention was designed as a comparison condition, it

Influence of the wording of evaluation items on outcome-based evaluation results for large-group teaching in anatomy, biochemistry and legal medicine.

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Anders, Sven; Pyka, Katharina; Mueller, Tjark; von Streinbuechel, Nicole; Raupach, Tobias

2016-11-01

Student learning outcome is an important dimension of teaching quality in undergraduate medical education. Measuring an increase in knowledge during teaching requires repetitive objective testing which is usually not feasible. As an alternative, student learning outcome can be calculated from student self-ratings. Comparative self-assessment (CSA) gain reflects the performance difference before and after teaching, adjusted for initial knowledge. It has been shown to be a valid proxy measure of actual learning outcome derived from objective tests. However, student self-ratings are prone to a number of confounding factors. In the context of outcome-based evaluation, the wording of self-rating items is crucial to the validity of evaluation results. This randomized trial assessed whether including qualifiers in these statements impacts on student ratings and CSA gain. First-year medical students self-rated their initial (then-test) and final (post-test) knowledge for lectures in anatomy, biochemistry and legal medicine, respectively, and 659 questionnaires were retrieved. Six-point scales were used for self-ratings with 1 being the most positive option. Qualifier use did not affect then-test ratings but was associated with slightly less favorable post-test ratings. Consecutively, mean CSA gain was smaller for items containing qualifiers than for items lacking qualifiers (50.6±15.0% vs. 56.3±14.6%, p=0.079). The effect was more pronounced (Cohen's d=0.82) for items related to anatomy. In order to increase fairness of outcome-based evaluation and increase the comparability of CSA gain data across subjects, medical educators should agree on a consistent approach (qualifiers for all items or no qualifiers at all) when drafting self-rating statements for outcome-based evaluation. Copyright © 2016 Elsevier GmbH. All rights reserved.

A patient-based questionnaire to assess outcomes of foot surgery: validation in the context of surgery for hallux valgus.

Science.gov (United States)

Dawson, Jill; Coffey, Jane; Doll, Helen; Lavis, Grahame; Cooke, Paul; Herron, Mark; Jenkinson, Crispin

2006-09-01

A patient-based outcome measure with good measurement properties is urgently needed for use in clinical trials of foot surgery. We evaluated an existing foot pain and disability questionnaire (the Manchester Foot Pain and Disability Questionnaire) for its suitability as an outcome measure in the context of hallux valgus corrective surgery. Interviews with patients led to initial changes, resulting in 20 candidate questionnaire items with five response categories each. These were tested in a prospective study of 100 patients (representing 138 foot operations) undergoing hallux valgus corrective surgery. Analysis of underlying factor structure, dimensionality, internal reliability, construct validity and responsiveness of the questionnaire items in relation to (i) SF-36 general health survey and (ii) American Orthopaedic Foot & Ankle Society (AOFAS) hallux clinical scale resulted in a final 16 item questionnaire (the 'Manchester-Oxford Foot Questionnaire' (MOXFQ)), consisting of three domains/scales: 'Walking/standing' (seven items), 'Pain' (five items) and 'Social interaction' (four items) each having good measurement properties. All three domains were unidimensional. The new 16-item MOXFQ has good measurement properties in the context of outcomes assessment of surgery for hallux valgus. Future studies should assess the MOXFQ in the context of surgery for other foot and ankle conditions.

Using automatic item generation to create multiple-choice test items.

Science.gov (United States)

Gierl, Mark J; Lai, Hollis; Turner, Simon R

2012-08-01

Many tests of medical knowledge, from the undergraduate level to the level of certification and licensure, contain multiple-choice items. Although these are efficient in measuring examinees' knowledge and skills across diverse content areas, multiple-choice items are time-consuming and expensive to create. Changes in student assessment brought about by new forms of computer-based testing have created the demand for large numbers of multiple-choice items. Our current approaches to item development cannot meet this demand. We present a methodology for developing multiple-choice items based on automatic item generation (AIG) concepts and procedures. We describe a three-stage approach to AIG and we illustrate this approach by generating multiple-choice items for a medical licensure test in the content area of surgery. To generate multiple-choice items, our method requires a three-stage process. Firstly, a cognitive model is created by content specialists. Secondly, item models are developed using the content from the cognitive model. Thirdly, items are generated from the item models using computer software. Using this methodology, we generated 1248 multiple-choice items from one item model. Automatic item generation is a process that involves using models to generate items using computer technology. With our method, content specialists identify and structure the content for the test items, and computer technology systematically combines the content to generate new test items. By combining these outcomes, items can be generated automatically. © Blackwell Publishing Ltd 2012.

Dutch-Flemish translation of nine pediatric item banks from the Patient-Reported Outcomes Measurement Information System (PROMIS)®.

Science.gov (United States)

Haverman, Lotte; Grootenhuis, Martha A; Raat, Hein; van Rossum, Marion A J; van Dulmen-den Broeder, Eline; Hoppenbrouwers, Karel; Correia, Helena; Cella, David; Roorda, Leo D; Terwee, Caroline B

2016-03-01

The Patient-Reported Outcomes Measurement Information System (PROMIS(®)) is a new, state-of-the-art assessment system for measuring patient-reported health and well-being of adults and children. It has the potential to be more valid, reliable, and responsive than existing PROMs. The items banks are designed to be self-reported and completed by children aged 8-18 years. The PROMIS items can be administered in short forms or through computerized adaptive testing. This paper describes the translation and cultural adaption of nine PROMIS item banks (151 items) for children in Dutch-Flemish. The translation was performed by FACITtrans using standardized PROMIS methodology and approved by the PROMIS Statistical Center. The translation included four forward translations, two back-translations, three independent reviews (at least two Dutch, one Flemish), and pretesting in 24 children from the Netherlands and Flanders. For some items, it was necessary to have separate translations for Dutch and Flemish: physical function-mobility (three items), anger (one item), pain interference (two items), and asthma impact (one item). Challenges faced in the translation process included scarcity or overabundance of possible translations, unclear item descriptions, constructs broader/smaller in the target language, difficulties in rank ordering items, differences in unit of measurement, irrelevant items, or differences in performance of activities. By addressing these challenges, acceptable translations were obtained for all items. The Dutch-Flemish PROMIS items are linguistically equivalent to the original USA version. Short forms are now available for use, and entire item banks are ready for cross-cultural validation in the Netherlands and Flanders.

Item Difficulty in the Evaluation of Computer-Based Instruction: An Example from Neuroanatomy

Science.gov (United States)

Chariker, Julia H.; Naaz, Farah; Pani, John R.

2012-01-01

This article reports large item effects in a study of computer-based learning of neuroanatomy. Outcome measures of the efficiency of learning, transfer of learning, and generalization of knowledge diverged by a wide margin across test items, with certain sets of items emerging as particularly difficult to master. In addition, the outcomes of…

The importance of rating scale design in the measurement of patient-reported outcomes using questionnaires or item banks.

Science.gov (United States)

Khadka, Jyoti; McAlinden, Colm; Gothwal, Vijaya K; Lamoureux, Ecosse L; Pesudovs, Konrad

2012-06-26

To investigate the effect of rating scale designs (question formats and response categories) on item difficulty calibrations and assess the impact that rating scale differences have on overall vision-related activity limitation (VRAL) scores. Sixteen existing patient-reported outcome instruments (PROs) suitable for cataract assessment, with different rating scales, were self-administered by patients on a cataract surgery waiting list. A total of 226 VRAL items from these PROs in their native rating scales were included in an item bank and calibrated using Rasch analysis. Fifteen item/content areas (e.g., reading newspapers) appearing in at least three different PROs were identified. Within each content area, item calibrations were compared and their range calculated. Similarly, five PROs having at least three items in common with the Visual Function (VF-14) were compared in terms of average item measures. A total of 614 patients (mean age ± SD, 74.1 ± 9.4 years) participated. Items with the same content varied in their calibration by as much as two logits; "reading the small print" had the largest range (1.99 logits) followed by "watching TV" (1.60). Compared with the VF-14 (0.00 logits), the rating scale of the Visual Disability Assessment (1.13 logits) produced the most difficult items and the Cataract Symptom Scale (0.24 logits) produced the least difficult items. The VRAL item bank was suboptimally targeted to the ability level of the participants (2.00 logits). Rating scale designs have a significant effect on item calibrations. Therefore, constructing item banks from existing items in their native formats carries risks to face validity and transmission of problems inherent in existing instruments, such as poor targeting.

Few items in the thyroid-related quality of life instrument ThyPRO exhibited differential item functioning

DEFF Research Database (Denmark)

Watt, Torquil; Grønvold, Mogens; Hegedüs, Laszlo

2014-01-01

To evaluate the extent of differential item functioning (DIF) within the thyroid-specific quality of life patient-reported outcome measure, ThyPRO, according to sex, age, education and thyroid diagnosis.......To evaluate the extent of differential item functioning (DIF) within the thyroid-specific quality of life patient-reported outcome measure, ThyPRO, according to sex, age, education and thyroid diagnosis....

Influence of Lumbar Lordosis on the Outcome of Decompression Surgery for Lumbar Canal Stenosis.

Science.gov (United States)

Chang, Han Soo

2018-01-01

Although sagittal spinal balance plays an important role in spinal deformity surgery, its role in decompression surgery for lumbar canal stenosis is not well understood. To investigate the hypothesis that sagittal spinal balance also plays a role in decompression surgery for lumbar canal stenosis, a prospective cohort study analyzing the correlation between preoperative lumbar lordosis and outcome was performed. A cohort of 85 consecutive patients who underwent decompression for lumbar canal stenosis during the period 2007-2011 was analyzed. Standing lumbar x-rays and 36-item short form health survey questionnaires were obtained before and up to 2 years after surgery. Correlations between lumbar lordosis and 2 parameters of the 36-item short form health survey (average physical score and bodily pain score) were statistically analyzed using linear mixed effects models. There was a significant correlation between preoperative lumbar lordosis and the 2 outcome parameters at postoperative, 6-month, 1-year, and 2-year time points. A 10° increase of lumbar lordosis was associated with a 5-point improvement in average physical scores. This correlation was not present in preoperative scores. This study showed that preoperative lumbar lordosis significantly influences the outcome of decompression surgery on lumbar canal stenosis. Copyright © 2017 Elsevier Inc. All rights reserved.

Qualitative Development and Content Validation of the PROMIS Pediatric Sleep Health Items.

Science.gov (United States)

Bevans, Katherine B; Meltzer, Lisa J; De La Motte, Anna; Kratchman, Amy; Viél, Dominique; Forrest, Christopher B

2018-04-25

To develop the Patient Reported Outcome Measurement Information System (PROMIS) Pediatric Sleep Health item pool and evaluate its content validity. Participants included 8 expert sleep clinician-researchers, 64 children ages 8-17 years, and 54 parents of children ages 5-17 years. We started with item concepts and expressions from the PROMIS Sleep Disturbance and Sleep Related Impairment adult measures. Additional pediatric sleep health concepts were generated by expert (n = 8), child (n = 28), and parent (n = 33) concept elicitation interviews and a systematic review of existing pediatric sleep health questionnaires. Content validity of the item pool was evaluated with item translatability review, readability analysis, and child (n = 36) and parent (n = 21) cognitive interviews. The final pediatric Sleep Health item pool includes 43 items that assess sleep disturbance (children's capacity to fall and stay asleep, sleep quality, dreams, and parasomnias) and sleep-related impairments (daytime sleepiness, low energy, difficulty waking up, and the impact of sleep and sleepiness on cognition, affect, behavior, and daily activities). Items are translatable and relevant and well understood by children ages 8-17 and parents of children ages 5-17. Rigorous qualitative procedures were used to develop and evaluate the content validity of the PROMIS Pediatric Sleep Health item pool. Once the item pool's psychometric properties are established, the scales will be useful for measuring children's subjective experiences of sleep.

The use of bootstrap methods for analysing health-related quality of life outcomes (particularly the SF-36

Directory of Open Access Journals (Sweden)

Campbell Michael J

2004-12-01

Full Text Available Abstract Health-Related Quality of Life (HRQoL measures are becoming increasingly used in clinical trials as primary outcome measures. Investigators are now asking statisticians for advice on how to analyse studies that have used HRQoL outcomes. HRQoL outcomes, like the SF-36, are usually measured on an ordinal scale. However, most investigators assume that there exists an underlying continuous latent variable that measures HRQoL, and that the actual measured outcomes (the ordered categories, reflect contiguous intervals along this continuum. The ordinal scaling of HRQoL measures means they tend to generate data that have discrete, bounded and skewed distributions. Thus, standard methods of analysis such as the t-test and linear regression that assume Normality and constant variance may not be appropriate. For this reason, conventional statistical advice would suggest that non-parametric methods be used to analyse HRQoL data. The bootstrap is one such computer intensive non-parametric method for analysing data. We used the bootstrap for hypothesis testing and the estimation of standard errors and confidence intervals for parameters, in four datasets (which illustrate the different aspects of study design. We then compared and contrasted the bootstrap with standard methods of analysing HRQoL outcomes. The standard methods included t-tests, linear regression, summary measures and General Linear Models. Overall, in the datasets we studied, using the SF-36 outcome, bootstrap methods produce results similar to conventional statistical methods. This is likely because the t-test and linear regression are robust to the violations of assumptions that HRQoL data are likely to cause (i.e. non-Normality. While particular to our datasets, these findings are likely to generalise to other HRQoL outcomes, which have discrete, bounded and skewed distributions. Future research with other HRQoL outcome measures, interventions and populations, is required to

Psychometric properties of the Neck OutcOme Score, Neck Disability Index, and Short Form-36 were evaluated in patients with neck pain

DEFF Research Database (Denmark)

Juul, Tina; Søgaard, Karen; Davis, Aileen M.

2016-01-01

Objective:To assess reliability, construct validity, responsiveness, and interpretability for Neck OutcOme Score (NOOS), Neck Disability Index (NDI), and Short Form–36 (SF-36) in neck pain patients. Study Design and Setting: Internal consistency was assessed by Cronbach alpha. Test-retest reliabi...

An Item Bank for Abuse of Prescription Pain Medication from the Patient-Reported Outcomes Measurement Information System (PROMIS®).

Science.gov (United States)

Pilkonis, Paul A; Yu, Lan; Dodds, Nathan E; Johnston, Kelly L; Lawrence, Suzanne M; Hilton, Thomas F; Daley, Dennis C; Patkar, Ashwin A; McCarty, Dennis

2017-08-01

There is a need to monitor patients receiving prescription opioids to detect possible signs of abuse. To address this need, we developed and calibrated an item bank for severity of abuse of prescription pain medication as part of the Patient-Reported Outcomes Measurement Information System (PROMIS ® ). Comprehensive literature searches yielded an initial bank of 5,310 items relevant to substance use and abuse, including abuse of prescription pain medication, from over 80 unique instruments. After qualitative item analysis (i.e., focus groups, cognitive interviewing, expert review, and item revision), 25 items for abuse of prescribed pain medication were included in field testing. Items were written in a first-person, past-tense format, with a three-month time frame and five response options reflecting frequency or severity. The calibration sample included 448 respondents, 367 from the general population (ascertained through an internet panel) and 81 from community treatment programs participating in the National Drug Abuse Treatment Clinical Trials Network. A final bank of 22 items was calibrated using the two-parameter graded response model from item response theory. A seven-item static short form was also developed. The test information curve showed that the PROMIS ® item bank for abuse of prescription pain medication provided substantial information in a broad range of severity. The initial psychometric characteristics of the item bank support its use as a computerized adaptive test or short form, with either version providing a brief, precise, and efficient measure relevant to both clinical and community samples. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Differential item functioning of the patient-reported outcomes information system (PROMIS®) pain interference item bank by language (Spanish versus English).

Science.gov (United States)

Paz, Sylvia H; Spritzer, Karen L; Reise, Steven P; Hays, Ron D

2017-06-01

About 70% of Latinos, 5 years old or older, in the United States speak Spanish at home. Measurement equivalence of the PROMIS ® pain interference (PI) item bank by language of administration (English versus Spanish) has not been evaluated. A sample of 527 adult Spanish-speaking Latinos completed the Spanish version of the 41-item PROMIS ® pain interference item bank. We evaluate dimensionality, monotonicity and local independence of the Spanish-language items. Then we evaluate differential item functioning (DIF) using ordinal logistic regression with item response theory scores estimated from DIF-free "anchor" items. One of the 41 items in the Spanish version of the PROMIS ® PI item bank was identified as having significant uniform DIF. English- and Spanish-speaking subjects with the same level of pain interference responded differently to 1 of the 41 items in the PROMIS ® PI item bank. This item was not retained due to proprietary issues. The original English language item parameters can be used when estimating PROMIS ® PI scores.

Comparing response options for the International Outcome Inventory for Hearing Aids (IOI-HA) and for Alternative Interventions (IOI-AI) daily-use items.

Science.gov (United States)

Laplante-Lévesque, Ariane; Hickson, Louise; Worrall, Linda

2012-10-01

This study investigated how clients quantify use of hearing rehabilitation. Comparisons focused on the daily-use item of the International Outcome Inventory for Hearing Aids (IOI-HA), and for Alternative Interventions (IOI-AI). Adults with hearing impairment completed the original versions of the IOI-HA and the IOI-AI daily-use item which has five numerical response options (e.g. 1-4 hours/day) and a modified version with five word response options (e.g. 'Sometimes'). Respondents completed both IOI versions immediately after intervention completion and three months later. In total, 64 people who had obtained hearing aids completed both IOI-HA versions and 27 people who had participated in communication programs completed both IOI-AI versions. Participants reported higher scores on the modified (word) daily-use item than on the original (number) daily-use item. Participants who completed the IOI-AI did so significantly more than participants who completed the IOI-HA. This was true both after intervention completion and three months later. This study showed that comparisons between IOI-HA and IOI-AI daily-use item scores should be made with caution. Word daily-use response options are recommended for the IOI-AI (i.e. Never; Rarely; Sometimes; Often; and Almost always).

Losing Items in the Psychogeriatric Nursing Home

Directory of Open Access Journals (Sweden)

J. van Hoof PhD

2016-09-01

Full Text Available Introduction: Losing items is a time-consuming occurrence in nursing homes that is ill described. An explorative study was conducted to investigate which items got lost by nursing home residents, and how this affects the residents and family caregivers. Method: Semi-structured interviews and card sorting tasks were conducted with 12 residents with early-stage dementia and 12 family caregivers. Thematic analysis was applied to the outcomes of the sessions. Results: The participants stated that numerous personal items and assistive devices get lost in the nursing home environment, which had various emotional, practical, and financial implications. Significant amounts of time are spent on trying to find items, varying from 1 hr up to a couple of weeks. Numerous potential solutions were identified by the interviewees. Discussion: Losing items often goes together with limitations to the participation of residents. Many family caregivers are reluctant to replace lost items, as these items may get lost again.

Evaluating HIV Knowledge Questionnaires Among Men Who Have Sex with Men: A Multi-Study Item Response Theory Analysis.

Science.gov (United States)

Janulis, Patrick; Newcomb, Michael E; Sullivan, Patrick; Mustanski, Brian

2018-01-01

Knowledge about the transmission, prevention, and treatment of HIV remains a critical element in psychosocial models of HIV risk behavior and is commonly used as an outcome in HIV prevention interventions. However, most HIV knowledge questions have not undergone rigorous psychometric testing such as using item response theory. The current study used data from six studies of men who have sex with men (MSM; n = 3565) to (1) examine the item properties of HIV knowledge questions, (2) test for differential item functioning on commonly studied characteristics (i.e., age, race/ethnicity, and HIV risk behavior), (3) select items with the optimal item characteristics, and (4) leverage this combined dataset to examine the potential moderating effect of age on the relationship between condomless anal sex (CAS) and HIV knowledge. Findings indicated that existing questions tend to poorly differentiate those with higher levels of HIV knowledge, but items were relatively robust across diverse individuals. Furthermore, age moderated the relationship between CAS and HIV knowledge with older MSM having the strongest association. These findings suggest that additional items are required in order to capture a more nuanced understanding of HIV knowledge and that the association between CAS and HIV knowledge may vary by age.

Evaluation of the validity of the Foot Function Index in measuring outcomes in patients with foot and ankle disorders.

Science.gov (United States)

SooHoo, Nelson F; Samimi, David B; Vyas, Raj M; Botzler, Tin

2006-01-01

There is uncertainty regarding which outcomes tools should be used to report the results of treatment for patients with foot and ankle disorders. This study evaluates the validity of the Foot Function Index (FFI) by examining its level of correlation to the Medical Outcomes Study Short Form-36 (SF-36). The SF-36 is an extensively validated outcomes tool that has been used as a benchmark in examining the validity of several orthopaedic outcomes tools. Seventy-three patients were recruited at a tertiary referral foot and ankle practice. Patients completed packets which included informed consent forms, the FFI, and the SF-36 questionnaires. The questionnaires were scored and Pearson correlation coefficients were determined between the three domains of the FFI and the eight SF-36 sub-scales, as well as the two SF-36 summary scales. Sixty-nine patients completed an adequate number of items to be included in the study. The mean age of the patient sample was 46 (range 16 to 82) years and 44 were women (64%). Twenty-one patients (30%) had conditions affecting the forefoot, while 48 patients (70%) had conditions affecting the ankle or hindfoot. All three FFI domains had moderate to high levels of correlation to many of the SF-36 scales. The Disability domain of the FFI had the most consistent level of correlation to the SF-36 with Pearson coefficients in the range of -0.23 to -0.69. The Activity Limitation (r=-0.28 to -0.64) and Pain domains (r=-0.10 to -0.61) also demonstrated moderate levels of correlation to several of the SF-36 scales. The consistently moderate to high levels of correlation of the FFI to the SF-36 seen in this study support the FFI as a valid measure of health status. This suggests that the FFI is a reasonable method to monitor patient outcomes. Future studies should focus on determining if the FFI improves responsiveness to clinical change when used in combination with generic instruments like the SF-36.

The Long-Term Conditions Questionnaire: conceptual framework and item development.

Science.gov (United States)

Peters, Michele; Potter, Caroline M; Kelly, Laura; Hunter, Cheryl; Gibbons, Elizabeth; Jenkinson, Crispin; Coulter, Angela; Forder, Julien; Towers, Ann-Marie; A'Court, Christine; Fitzpatrick, Ray

2016-01-01

To identify the main issues of importance when living with long-term conditions to refine a conceptual framework for informing the item development of a patient-reported outcome measure for long-term conditions. Semi-structured qualitative interviews (n=48) were conducted with people living with at least one long-term condition. Participants were recruited through primary care. The interviews were transcribed verbatim and analyzed by thematic analysis. The analysis served to refine the conceptual framework, based on reviews of the literature and stakeholder consultations, for developing candidate items for a new measure for long-term conditions. Three main organizing concepts were identified: impact of long-term conditions, experience of services and support, and self-care. The findings helped to refine a conceptual framework, leading to the development of 23 items that represent issues of importance in long-term conditions. The 23 candidate items formed the first draft of the measure, currently named the Long-Term Conditions Questionnaire. The aim of this study was to refine the conceptual framework and develop items for a patient-reported outcome measure for long-term conditions, including single and multiple morbidities and physical and mental health conditions. Qualitative interviews identified the key themes for assessing outcomes in long-term conditions, and these underpinned the development of the initial draft of the measure. These initial items will undergo cognitive testing to refine the items prior to further validation in a survey.

Development of an item bank and computer adaptive test for role functioning

DEFF Research Database (Denmark)

Anatchkova, Milena D; Rose, Matthias; Ware, John E

2012-01-01

Role functioning (RF) is a key component of health and well-being and an important outcome in health research. The aim of this study was to develop an item bank to measure impact of health on role functioning.......Role functioning (RF) is a key component of health and well-being and an important outcome in health research. The aim of this study was to develop an item bank to measure impact of health on role functioning....

Using classical test theory, item response theory, and Rasch measurement theory to evaluate patient-reported outcome measures: a comparison of worked examples.

Science.gov (United States)

Petrillo, Jennifer; Cano, Stefan J; McLeod, Lori D; Coon, Cheryl D

2015-01-01

To provide comparisons and a worked example of item- and scale-level evaluations based on three psychometric methods used in patient-reported outcome development-classical test theory (CTT), item response theory (IRT), and Rasch measurement theory (RMT)-in an analysis of the National Eye Institute Visual Functioning Questionnaire (VFQ-25). Baseline VFQ-25 data from 240 participants with diabetic macular edema from a randomized, double-masked, multicenter clinical trial were used to evaluate the VFQ at the total score level. CTT, RMT, and IRT evaluations were conducted, and results were assessed in a head-to-head comparison. Results were similar across the three methods, with IRT and RMT providing more detailed diagnostic information on how to improve the scale. CTT led to the identification of two problematic items that threaten the validity of the overall scale score, sets of redundant items, and skewed response categories. IRT and RMT additionally identified poor fit for one item, many locally dependent items, poor targeting, and disordering of over half the response categories. Selection of a psychometric approach depends on many factors. Researchers should justify their evaluation method and consider the intended audience. If the instrument is being developed for descriptive purposes and on a restricted budget, a cursory examination of the CTT-based psychometric properties may be all that is possible. In a high-stakes situation, such as the development of a patient-reported outcome instrument for consideration in pharmaceutical labeling, however, a thorough psychometric evaluation including IRT or RMT should be considered, with final item-level decisions made on the basis of both quantitative and qualitative results. Copyright © 2015. Published by Elsevier Inc.

Long-Term Outcomes of Patients with Lumbar Disc Herniation Treated with Percutaneous Discectomy: Comparative Study with Microendoscopic Discectomy

International Nuclear Information System (INIS)

Liu Wengui; Wu Xiaotao; Guo Jinhe; Zhuang Suyang; Teng Gaojun

2010-01-01

We assessed the long-term outcomes of patients with lumbar disc herniation treated with percutaneous lumbar discectomy (PLD) or microendoscopic discectomy (MED). A retrospective study was performed in consecutive patients with lumbar disc herniation treated with PLD (n = 129) or MED (n = 101) in a single hospital from January 2000 to March 2002. All patients were followed up with MacNab criteria and self-evaluation questionnaires comprising the Oswestry Disability Index and Medical Outcomes Study 36-Item Short-Form Health Survey. Several statistical methods were used for analyses of the data, and a p value of <0.05 was considered to be statistically significant. A total of 104 patients (80.62%) with PLD and 82 patients (81.19%) with MED were eligible for analyses, with a mean follow-up period of 6.64 ± 0.67 years and 6.42 ± 0.51 years, respectively. There were no significant differences between the two groups in age, number of lesions, major symptoms and physical signs, and radiological findings. According to the MacNab criteria, 75.96% in the PLD group and 84.15% in the MED group achieved excellent or good results, respectively, this was statistically significant (p = 0.0402). With the Oswestry Disability Index questionnaires, the average scores and minimal disability, respectively, were 6.97 and 71.15% in the PLD group and 4.89 and 79.27% in the MED group. Total average scores of Medical Outcomes Study 36-Item Short-Form Health Survey were 75.88 vs. 81.86 in PLD group vs. MED group (p = 0.0582). The cost and length of hospitalization were higher or longer in MED group, a statistically significant difference (both p < 0.0001). Long-term complications were observed in two patients (2.44%) in the MED group, no such complications were observed in the PLD group. Both PLD and MED show an acceptable long-term efficacy for treatment of lumbar disc herniation. Compared with MED patients, long-term satisfaction is slightly lower in the PLD patients; complications

Screening for depression in advanced disease: psychometric properties, sensitivity, and specificity of two items of the Palliative Care Outcome Scale (POS).

Science.gov (United States)

Antunes, Bárbara; Murtagh, Fliss; Bausewein, Claudia; Harding, Richard; Higginson, Irene J

2015-02-01

Depression is common among patients with advanced disease but often difficult to detect. To assess the Palliative care Outcome Scale (POS) (10 items) against the Geriatric Depression Scale (GDS)-10 total score and the Hospital Anxiety and Depression Scale (HADS)-Depression subscale total score and determine if the POS has appropriate items to screen for depression among people with advanced disease. This was a secondary analysis performed on five studies. Four psychometric properties were assessed: data quality, scaling assumptions, acceptability, and internal consistency (reliability). Receiver operating characteristic (ROC) curves were used to determine the area under the curve. Sensitivity, specificity, positive and negative predictive values, false positive and negative rates, and positive and negative likelihood ratios were computed. The overall sample had 416 patients from Germany and England: 144 had cancer and 267 had nonmalignant conditions. Prevalence of depression across the sample was 17.5%. Floor and ceiling effects were rare. Cronbach's alpha coefficients for POS items 7 and 8 summed, GDS-10 and HADS-Depression items varied: 0.61 (heart failure) and 0.80 (cancer). Two items combined (Item 7-feeling depressed and Item 8-feeling good about yourself) consistently presented the highest area under the ROC curve, ranging from 0.76 (95% CI 0.60, 0.93) (Germany, lung cancer) to 0.97 (95% CI 0.91, 1.0) (heart failure), highest negative predictive value, and lowest false negative rate. For the overall sample, the cutoff 2/3 presented a negative predictive value of 89.4% (95% CI 84.7, 92.8) and false negative rate of 10.6 (95% CI 7.2, 15.3). POS items 7 and 8 summed are potentially useful to screen for depression in advanced disease populations. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Evaluation of item candidates for a diabetic retinopathy quality of life item bank.

Science.gov (United States)

Fenwick, Eva K; Pesudovs, Konrad; Khadka, Jyoti; Rees, Gwyn; Wong, Tien Y; Lamoureux, Ecosse L

2013-09-01

We are developing an item bank assessing the impact of diabetic retinopathy (DR) on quality of life (QoL) using a rigorous multi-staged process combining qualitative and quantitative methods. We describe here the first two qualitative phases: content development and item evaluation. After a comprehensive literature review, items were generated from four sources: (1) 34 previously validated patient-reported outcome measures; (2) five published qualitative articles; (3) eight focus groups and 18 semi-structured interviews with 57 DR patients; and (4) seven semi-structured interviews with diabetes or ophthalmic experts. Items were then evaluated during 3 stages, namely binning (grouping) and winnowing (reduction) based on key criteria and panel consensus; development of item stems and response options; and pre-testing of items via cognitive interviews with patients. The content development phase yielded 1,165 unique items across 7 QoL domains. After 3 sessions of binning and winnowing, items were reduced to a minimally representative set (n = 312) across 9 domains of QoL: visual symptoms; ocular surface symptoms; activity limitation; mobility; emotional; health concerns; social; convenience; and economic. After 8 cognitive interviews, 42 items were amended resulting in a final set of 314 items. We have employed a systematic approach to develop items for a DR-specific QoL item bank. The psychometric properties of the nine QoL subscales will be assessed using Rasch analysis. The resulting validated item bank will allow clinicians and researchers to better understand the QoL impact of DR and DR therapies from the patient's perspective.

Item bias detection in the Hospital Anxiety and Depression Scale using structural equation modeling: comparison with other item bias detection methods

NARCIS (Netherlands)

Verdam, M.G.E.; Oort, F.J.; Sprangers, M.A.G.

Purpose Comparison of patient-reported outcomes may be invalidated by the occurrence of item bias, also known as differential item functioning. We show two ways of using structural equation modeling (SEM) to detect item bias: (1) multigroup SEM, which enables the detection of both uniform and

Extending item response theory to online homework

Directory of Open Access Journals (Sweden)

Gerd Kortemeyer

2014-05-01

Full Text Available Item response theory (IRT becomes an increasingly important tool when analyzing “big data” gathered from online educational venues. However, the mechanism was originally developed in traditional exam settings, and several of its assumptions are infringed upon when deployed in the online realm. For a large-enrollment physics course for scientists and engineers, the study compares outcomes from IRT analyses of exam and homework data, and then proceeds to investigate the effects of each confounding factor introduced in the online realm. It is found that IRT yields the correct trends for learner ability and meaningful item parameters, yet overall agreement with exam data is moderate. It is also found that learner ability and item discrimination is robust over a wide range with respect to model assumptions and introduced noise. Item difficulty is also robust, but over a narrower range.

Item Banks for Substance Use from the Patient-Reported Outcomes Measurement Information System (PROMIS®): Severity of Use and Positive Appeal of Use*

Science.gov (United States)

Pilkonis, Paul A.; Yu, Lan; Dodds, Nathan E.; Johnston, Kelly L.; Lawrence, Suzanne; Hilton, Thomas F.; Daley, Dennis C.; Patkar, Ashwin A.; McCarty, Dennis

2015-01-01

Background Two item banks for substance use were developed as part of the Patient-Reported Outcomes Measurement Information System (PROMIS®): severity of substance use and positive appeal of substance use. Methods Qualitative item analysis (including focus groups, cognitive interviewing, expert review, and item revision) reduced an initial pool of more than 5,300 items for substance use to 119 items included in field testing. Items were written in a first-person, past-tense format, with 5 response options reflecting frequency or severity. Both 30-day and 3-month time frames were tested. The calibration sample of 1,336 respondents included 875 individuals from the general population (ascertained through an internet panel) and 461patients from addiction treatment centers participating in the National Drug Abuse Treatment Clinical Trials Network. Results Final banks of 37 and 18 items were calibrated for severity of substance use and positive appeal of substance use, respectively, using the two-parameter graded response model from item response theory (IRT). Initial calibrations were similar for the 30-day and 3-month time frames, and final calibrations used data combined across the time frames, making the items applicable with either interval. Seven-item static short forms were also developed from each item bank. Conclusions Test information curves showed that the PROMIS item banks provided substantial information in a broad range of severity, making them suitable for treatment, observational, and epidemiological research in both clinical and community settings. PMID:26423364

Item-focussed Trees for the Identification of Items in Differential Item Functioning.

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Tutz, Gerhard; Berger, Moritz

2016-09-01

A novel method for the identification of differential item functioning (DIF) by means of recursive partitioning techniques is proposed. We assume an extension of the Rasch model that allows for DIF being induced by an arbitrary number of covariates for each item. Recursive partitioning on the item level results in one tree for each item and leads to simultaneous selection of items and variables that induce DIF. For each item, it is possible to detect groups of subjects with different item difficulties, defined by combinations of characteristics that are not pre-specified. The way a DIF item is determined by covariates is visualized in a small tree and therefore easily accessible. An algorithm is proposed that is based on permutation tests. Various simulation studies, including the comparison with traditional approaches to identify items with DIF, show the applicability and the competitive performance of the method. Two applications illustrate the usefulness and the advantages of the new method.

Three-item Direct Observation Screen (TIDOS) for autism spectrum disorder.

Science.gov (United States)

Oner, Pinar; Oner, Ozgur; Munir, Kerim

2014-08-01

We compared ratings on the Three-Item Direct Observation Screen test for autism spectrum disorders completed by pediatric residents with the Social Communication Questionnaire parent reports as an augmentative tool for improving autism spectrum disorder screening performance. We examined three groups of children (18-60 months) comparable in age (18-24 month, 24-36 month, 36-60 preschool subgroups) and gender distribution: n = 86 with Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.) autism spectrum disorders; n = 76 with developmental delay without autism spectrum disorders; and n = 97 with typical development. The Three-Item Direct Observation Screen test included the following (a) Joint Attention, (b) Eye Contact, and (c) Responsiveness to Name. The parent Social Communication Questionnaire ratings had a sensitivity of .73 and specificity of .70 for diagnosis of autism spectrum disorders. The Three-Item Direct Observation Screen test item Joint Attention had a sensitivity of .82 and specificity of .90, Eye Contact had a sensitivity of .89 and specificity of .91, and Responsiveness to Name had a sensitivity of .67 and specificity of .87. In the Three-Item Direct Observation Screen test, having at least one of the three items positive had a sensitivity of .95 and specificity of .85. Age, diagnosis of autism spectrum disorder, and developmental level were important factors affecting sensitivity and specificity. The results indicate that augmentation of autism spectrum disorder screening by observational items completed by trained pediatric-oriented professionals can be a highly effective tool in improving screening performance. If supported by future population studies, the results suggest that primary care practitioners will be able to be trained to use this direct procedure to augment screening for autism spectrum disorders in the community. © The Author(s) 2013.

C3-6 laminoplasty for cervical spondylotic myelopathy maintains satisfactory long-term surgical outcomes.

Science.gov (United States)

Sakaura, Hironobu; Hosono, Noboru; Mukai, Yoshihiro; Iwasaki, Motoki; Yoshikawa, Hideki

2014-08-01

Study Design Prospective cohort study. Objective To clarify long-term surgical outcomes of C3-6 laminoplasty preserving muscles attached to the C2 and C7 spinous processes in patients with cervical spondylotic myelopathy (CSM). Methods Twenty patients who underwent C3-6 open-door laminoplasty for CSM and who were followed for 8 to 10 years were included in this study. Myelopathic symptoms were assessed using Japanese Orthopaedic Association (JOA) score. Axial neck pain was graded as severe, moderate, or mild. C2-7 angle was measured using lateral radiographs of the cervical spine before surgery and at final follow-up. Results Mean JOA score before surgery (11.7) was significantly improved to 15.2 at the time of maximum recovery (1 year after surgery), declining slightly to 14.9 by the latest follow-up. Late deterioration of JOA score developed in eight patients, but was unrelated to the cervical spine lesions in each case. No patient suffered from prolonged postoperative axial neck pain at final follow-up. The mean C2-7 angle before surgery (13.8 degrees) significantly increased to 19.2 degrees at final follow-up. Conclusions C3-6 laminoplasty preserving muscles attached to the C2 and C7 spinous processes in patients with CSM maintained satisfactory long-term neurologic improvement with significantly reduced frequencies of prolonged postoperative axial neck pain and loss of C2-7 angle after surgery.

An Introduction to Item Response Theory for Patient-Reported Outcome Measurement

Science.gov (United States)

Nguyen, Tam H.; Han, Hae-Ra; Kim, Miyong T.

2015-01-01

The growing emphasis on patient-centered care has accelerated the demand for high-quality data from patient-reported outcome (PRO) measures. Traditionally, the development and validation of these measures has been guided by classical test theory. However, item response theory (IRT), an alternate measurement framework, offers promise for addressing practical measurement problems found in health-related research that have been difficult to solve through classical methods. This paper introduces foundational concepts in IRT, as well as commonly used models and their assumptions. Existing data on a combined sample (n = 636) of Korean American and Vietnamese American adults who responded to the High Blood Pressure Health Literacy Scale and the Patient Health Questionnaire-9 are used to exemplify typical applications of IRT. These examples illustrate how IRT can be used to improve the development, refinement, and evaluation of PRO measures. Greater use of methods based on this framework can increase the accuracy and efficiency with which PROs are measured. PMID:24403095

Gender and Minority Achievement Gaps in Science in Eighth Grade: Item Analyses of Nationally Representative Data. Research Report. ETS RR-17-36

Science.gov (United States)

Qian, Xiaoyu; Nandakumar, Ratna; Glutting, Joseoph; Ford, Danielle; Fifield, Steve

2017-01-01

In this study, we investigated gender and minority achievement gaps on 8th-grade science items employing a multilevel item response methodology. Both gaps were wider on physics and earth science items than on biology and chemistry items. Larger gender gaps were found on items with specific topics favoring male students than other items, for…

Analysis of factors affecting baseline SF-36 Mental Component Summary in Adult Spinal Deformity and its impact on surgical outcomes.

Science.gov (United States)

Mmopelwa, Tiro; Ayhan, Selim; Yuksel, Selcen; Nabiyev, Vugar; Niyazi, Asli; Pellise, Ferran; Alanay, Ahmet; Sanchez Perez Grueso, Francisco Javier; Kleinstuck, Frank; Obeid, Ibrahim; Acaroglu, Emre

2018-03-01

To identify the factors that affect SF-36 mental component summary (MCS) in patients with adult spinal deformity (ASD) at the time of presentation, and to analyse the effect of SF-36 MCS on clinical outcomes in surgically treated patients. Prospectively collected data from a multicentric ASD database was analysed for baseline parameters. Then, the same database for surgically treated patients with a minimum of 1-year follow-up was analysed to see the effect of baseline SF-36 MCS on treatment results. A clinically useful SF-36 MCS was determined by ROC Curve analysis. A total of 229 patients with the baseline parameters were analysed. A strong correlation between SF-36 MCS and SRS-22, ODI, gender, and diagnosis were found (p baseline SF-36 MCS (p baseline SF-36 MCS in an ASD population are other HRQOL parameters such as SRS-22 and ODI as well as the baseline thoracic kyphosis and gender. This study has also demonstrated that baseline SF-36 MCS does not necessarily have any effect on the treatment results by surgery as assessed by SRS-22 or ODI. Level III, prognostic study. Copyright © 2018 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.

Clinical outcome of 36 male patients with primary urethral carcinoma. A single center experience

International Nuclear Information System (INIS)

Thyavihally, Y.B.; Tongaonkar, H.B.; Srivastava, S.K.; Mahantshetty, U.; Kumar, P.; Raibhattanavar, S.G.

2006-01-01

The aim of this study was retrospective analysis of male urethral carcinoma to assess the best therapeutic approach to the management of this tumor. A review of 36 cases of male urethral carcinoma diagnosed and treated at our center was performed. Clinical features, treatment modality and outcomes were analysed. The overall median survival time was 55.16 months. The 5-year overall and disease-free survival rate for the cohort was 49% and 23%, respectively. The 5-year survival is 67% for low-stage versus 33% for high-stage tumors and is significantly different (P=0.001). The survival was 72% for tumors of the distal urethra versus 36% for tumors of the proximal, with a P-value of 0.02. The tumor location and clinicopathological stage were the most important predictors of the disease-free and overall survival. Multimodal approach is necessary for achieving local control especially for proximal and higher stage tumors. (author)

50 CFR 12.36 - Donation or loan.

Science.gov (United States)

2010-10-01

... 50 Wildlife and Fisheries 1 2010-10-01 2010-10-01 false Donation or loan. 12.36 Section 12.36... SEIZURE AND FORFEITURE PROCEDURES Disposal of Forfeited or Abandoned Property § 12.36 Donation or loan. (a... and security for the item. (b) Any donation or loan may be made only after execution of a transfer...

Difference in method of administration did not significantly impact item response

DEFF Research Database (Denmark)

Bjorner, Jakob B; Rose, Matthias; Gandek, Barbara

2014-01-01

assistant (PDA), or personal computer (PC) on the Internet, and a second form by PC, in the same administration. Structural invariance, equivalence of item responses, and measurement precision were evaluated using confirmatory factor analysis and item response theory methods. RESULTS: Multigroup...... levels in IVR, PQ, or PDA administration as compared to PC. Availability of large item response theory-calibrated PROMIS item banks allowed for innovations in study design and analysis.......PURPOSE: To test the impact of method of administration (MOA) on the measurement characteristics of items developed in the Patient-Reported Outcomes Measurement Information System (PROMIS). METHODS: Two non-overlapping parallel 8-item forms from each of three PROMIS domains (physical function...

A Case Study on an Item Writing Process: Use of Test Specifications, Nature of Group Dynamics, and Individual Item Writers' Characteristics

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Kim, Jiyoung; Chi, Youngshin; Huensch, Amanda; Jun, Heesung; Li, Hongli; Roullion, Vanessa

2010-01-01

This article discusses a case study on an item writing process that reflects on our practical experience in an item development project. The purpose of the article is to share our lessons from the experience aiming to demystify item writing process. The study investigated three issues that naturally emerged during the project: how item writers use…

Methodological issues regarding power of classical test theory (CTT and item response theory (IRT-based approaches for the comparison of patient-reported outcomes in two groups of patients - a simulation study

Directory of Open Access Journals (Sweden)

Boyer François

2010-03-01

Full Text Available Abstract Background Patients-Reported Outcomes (PRO are increasingly used in clinical and epidemiological research. Two main types of analytical strategies can be found for these data: classical test theory (CTT based on the observed scores and models coming from Item Response Theory (IRT. However, whether IRT or CTT would be the most appropriate method to analyse PRO data remains unknown. The statistical properties of CTT and IRT, regarding power and corresponding effect sizes, were compared. Methods Two-group cross-sectional studies were simulated for the comparison of PRO data using IRT or CTT-based analysis. For IRT, different scenarios were investigated according to whether items or person parameters were assumed to be known, to a certain extent for item parameters, from good to poor precision, or unknown and therefore had to be estimated. The powers obtained with IRT or CTT were compared and parameters having the strongest impact on them were identified. Results When person parameters were assumed to be unknown and items parameters to be either known or not, the power achieved using IRT or CTT were similar and always lower than the expected power using the well-known sample size formula for normally distributed endpoints. The number of items had a substantial impact on power for both methods. Conclusion Without any missing data, IRT and CTT seem to provide comparable power. The classical sample size formula for CTT seems to be adequate under some conditions but is not appropriate for IRT. In IRT, it seems important to take account of the number of items to obtain an accurate formula.

Are Faculty Predictions or Item Taxonomies Useful for Estimating the Outcome of Multiple-Choice Examinations?

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Kibble, Jonathan D.; Johnson, Teresa

2011-01-01

The purpose of this study was to evaluate whether multiple-choice item difficulty could be predicted either by a subjective judgment by the question author or by applying a learning taxonomy to the items. Eight physiology faculty members teaching an upper-level undergraduate human physiology course consented to participate in the study. The…

Examining item content and structure in health status and health outcomes instruments: toward the development of a grammar for better understanding of the concepts being measured.

Science.gov (United States)

Erickson, Pennifer; Willke, Richard J

2013-06-01

Health outcomes instruments assess diverse health concepts. Although item-level concepts are considered fundamental elements, the field lacks structures for evaluating and organizing them for decision making. This article proposes a grammar using item stems, response options, and recall periods to systematically identify item-level concepts. The grammar uses "core concept," "evaluative component," and "recall period" as intuitive terms for communicating with stakeholders. Better characterization of concepts is necessary for classifying instrument content and linking it to treatment benefit. Items in 2 generic and 21 disease-specific instruments were evaluated to develop and illustrate the use of the grammar. Concepts were assigned International Classification of Functioning, Disability and Health codes for exploring the value that the grammar and a classification system add to the understanding of content across instruments. The 23 instruments include many core concepts; emotional function is the only concept assessed in all instruments. Concepts in disease-specific instruments show obvious patterns; for example, arthritis instruments focus on physical function. The majority of instruments used the same response options across all items, with five-point scales being the most common. Most instruments used one recall period for all items. Shorter recall periods were used for conditions associated with "flares," such as chronic obstructive pulmonary disease and "skin disease." Every diagnosis, however, showed variation across instruments in the recall period used. This analysis indicates the proposed grammar's potential for discerning the conceptual content within and between health outcomes instruments and illustrates its value for improving communication between stakeholders and for making decisions related to treatment benefit. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Assessment of health-related quality of life in spine treatment: conversion from SF-36 to VR-12.

Science.gov (United States)

Gornet, Matthew F; Copay, Anne G; Sorensen, Katrine M; Schranck, Francine W

2018-02-28

Health-related quality-of-life outcomes have been collected with the Medical Outcomes Study (MOS) Short Form 36 (SF-36) survey. Boston University School of Public Health has developed algorithms for the conversion of SF-36 to Veterans RAND 12-Item Health Survey (VR-12) Physical Component Summary (PCS) and Mental Component Summary (MCS) scores. The purpose of the present study is to investigate the conversion of the SF-36 to VR-12 PCS and MCS scores. Preoperative and postoperative SF-36 were collected from patients who underwent lumbar or cervical surgery from a single surgeon between August 1998 and January 2013. Short Form 36 PCS and MCS scores were calculated following their original instructions. The SF-36 answers were then converted to VR-12 PCS and MCS scores following the algorithm provided by the Boston University School of Public Health. The mean score, preoperative to postoperative change, and proportions of patients who reach the minimum detectable change were compared between SF-36 and VR-12. A total of 1,968 patients (1,559 lumbar and 409 cervical) had completed preoperative and postoperative SF-36. The values of the SF-36 and VR-12 mean scores were extremely similar, with score differences ranging from 0.77 to 1.82. The preoperative to postoperative improvement was highly significant (p36 and VR-12 scores. The mean change scores were similar, with a difference of up to 0.93 for PCS and up to 0.37 for MCS. Minimum detectable change (MDC) values were almost identical for SF-36 and VR-12, with a difference of 0.12 for PCS and up to 0.41 for MCS. The proportions of patients whose change in score reached MDC were also nearly identical for SF-36 and VR-12. About 90% of the patients above SF-36 MDC were also above VR-12 MDC. The converted VR-12 scores, similar to the SF-36 scores, detect a significant postoperative improvement in PCS and MCS scores. The calculated MDC values and the proportions of patients whose score improvement reach MDC are similar for

Statistical power as a function of Cronbach alpha of instrument questionnaire items.

Science.gov (United States)

Heo, Moonseong; Kim, Namhee; Faith, Myles S

2015-10-14

In countless number of clinical trials, measurements of outcomes rely on instrument questionnaire items which however often suffer measurement error problems which in turn affect statistical power of study designs. The Cronbach alpha or coefficient alpha, here denoted by C(α), can be used as a measure of internal consistency of parallel instrument items that are developed to measure a target unidimensional outcome construct. Scale score for the target construct is often represented by the sum of the item scores. However, power functions based on C(α) have been lacking for various study designs. We formulate a statistical model for parallel items to derive power functions as a function of C(α) under several study designs. To this end, we assume fixed true score variance assumption as opposed to usual fixed total variance assumption. That assumption is critical and practically relevant to show that smaller measurement errors are inversely associated with higher inter-item correlations, and thus that greater C(α) is associated with greater statistical power. We compare the derived theoretical statistical power with empirical power obtained through Monte Carlo simulations for the following comparisons: one-sample comparison of pre- and post-treatment mean differences, two-sample comparison of pre-post mean differences between groups, and two-sample comparison of mean differences between groups. It is shown that C(α) is the same as a test-retest correlation of the scale scores of parallel items, which enables testing significance of C(α). Closed-form power functions and samples size determination formulas are derived in terms of C(α), for all of the aforementioned comparisons. Power functions are shown to be an increasing function of C(α), regardless of comparison of interest. The derived power functions are well validated by simulation studies that show that the magnitudes of theoretical power are virtually identical to those of the empirical power. Regardless

Dysglycemia, Glycemic Variability, and Outcome After Cardiac Arrest and Temperature Management at 33°C and 36°C

DEFF Research Database (Denmark)

Borgquist, Ola; Wise, Matt P; Nielsen, Niklas

2017-01-01

OBJECTIVES: Dysglycemia and glycemic variability are associated with poor outcomes in critically ill patients. Targeted temperature management alters blood glucose homeostasis. We investigated the association between blood glucose concentrations and glycemic variability and the neurologic outcomes...... of patients randomized to targeted temperature management at 33°C or 36°C after cardiac arrest. DESIGN: Post hoc analysis of the multicenter TTM-trial. Primary outcome of this analysis was neurologic outcome after 6 months, referred to as "Cerebral Performance Category." SETTING: Thirty-six sites in Europe...... and Australia. PATIENTS: All 939 patients with out-of-hospital cardiac arrest of presumed cardiac cause that had been included in the TTM-trial. INTERVENTIONS: Targeted temperature management at 33°C or 36°C. MEASUREMENTS AND MAIN RESULTS: Nonparametric tests as well as multiple logistic regression and mixed...

Randomized controlled trial of early rehabilitation after intracerebral hemorrhage stroke: difference in outcomes within 6 months of stroke.

Science.gov (United States)

Liu, Ning; Cadilhac, Dominique A; Andrew, Nadine E; Zeng, Lingxia; Li, Zongfang; Li, Jin; Li, Yan; Yu, Xuewen; Mi, Baibing; Li, Zhe; Xu, Honghai; Chen, Yangjing; Wang, Juan; Yao, Wanxia; Li, Kuo; Yan, Feng; Wang, Jue

2014-12-01

Mechanisms, acute management, and outcomes for patients who experience intracerebral hemorrhage may differ from patients with ischemic stroke. Studies of very early rehabilitation have been mainly undertaken in patients with ischemic stroke, and it is unknown if benefits apply to those with intracerebral hemorrhage. We hypothesized that early rehabilitation, within 48 hours of stroke, would improve survival and functional outcomes in patients with intracerebral hemorrhage. This was a multicenter, randomized controlled study, with blinded assessment of outcome at 3 and 6 months. Eligible patients were randomized to receive standard care or standard care plus early rehabilitation. Primary outcome includes survival. Secondary outcomes includes health-related quality of life using the 36-item Short Form Questionnaire, function measured with the modified Barthel Index, and anxiety measured with the Zung Self-Rated Anxiety Scale. Two hundred forty-three of 326 patients were randomized (mean age, 59 years; 56% men). At 6 months, patients receiving standard care were more likely to have died (adjusted hazard ratio, 4.44; 95% confidence interval [CI], 1.24-15.87); for morbidity outcomes, a 6-point difference in the Physical Component Summary score of the 36-item Short Form Questionnaire (95% CI, 4.2-8.7), a 7-point difference for the Mental Component Summary score (95% CI, 4.5-9.5), a 13-point difference in Modified Barthel Index scores (95% CI, 6.8-18.3), and a 6-point difference in Self-Rating Anxiety Scale scores (95% CI, 4.4-8.3) was reported in favor of the intervention groups. For the first time, we have shown that commencing rehabilitation within 48 hours of intracerebral hemorrhage improves survival and functional outcomes at 6 months after stroke in hospitalized patients in China. http://www.chictr.org/en. Unique identifier: ChiCTR-TRC-13004039. © 2014 American Heart Association, Inc.

Translation, cross-cultural adaptation and psychometric evaluation of yoruba version of the short-form 36 health survey.

Science.gov (United States)

Mbada, Chidozie Emmanuel; Adeogun, Gafar Atanda; Ogunlana, Michael Opeoluwa; Adedoyin, Rufus Adesoji; Akinsulore, Adesanmi; Awotidebe, Taofeek Oluwole; Idowu, Opeyemi Ayodiipo; Olaoye, Olumide Ayoola

2015-09-14

The Short-Form Health Survey (SF-36) is a valid quality of life tool often employed to determine the impact of medical intervention and the outcome of health care services. However, the SF-36 is culturally sensitive which necessitates its adaptation and translation into different languages. This study was conducted to cross-culturally adapt the SF-36 into Yoruba language and determine its reliability and validity. Based on the International Quality of Life Assessment project guidelines, a sequence of translation, test of item-scale correlation, and validation was implemented for the translation of the Yoruba version of the SF-36. Following pilot testing, the English and the Yoruba versions of the SF-36 were administered to a random sample of 1087 apparently healthy individuals to test validity and 249 respondents completed the Yoruba SF-36 again after two weeks to test reliability. Data was analyzed using Pearson's product moment correlation analysis, independent t-test, one-way analysis of variance, multi trait scaling analysis and Intra-Class Correlation (ICC) at p Yoruba SF-36 ranges between 0.636 and 0.843 for scales; and 0.783 and 0.851 for domains. The data quality, concurrent and discriminant validity, reliability and internal consistency of the Yoruba version of the SF-36 are adequate and it is recommended for measuring health-related quality of life among Yoruba population.

The CORE study protocol: a stepped wedge cluster randomised controlled trial to test a co-design technique to optimise psychosocial recovery outcomes for people affected by mental illness in the community mental health setting

Science.gov (United States)

Palmer, Victoria J; Chondros, Patty; Piper, Donella; Callander, Rosemary; Weavell, Wayne; Godbee, Kali; Potiriadis, Maria; Richard, Lauralie; Densely, Konstancja; Herrman, Helen; Furler, John; Pierce, David; Schuster, Tibor; Iedema, Rick; Gunn, Jane

2015-01-01

Introduction User engagement in mental health service design is heralded as integral to health systems quality and performance, but does engagement improve health outcomes? This article describes the CORE study protocol, a novel stepped wedge cluster randomised controlled trial (SWCRCT) to improve psychosocial recovery outcomes for people with severe mental illness. Methods An SWCRCT with a nested process evaluation will be conducted over nearly 4 years in Victoria, Australia. 11 teams from four mental health service providers will be randomly allocated to one of three dates 9 months apart to start the intervention. The intervention, a modified version of Mental Health Experience Co-Design (MH ECO), will be delivered to 30 service users, 30 carers and 10 staff in each cluster. Outcome data will be collected at baseline (6 months) and at completion of each intervention wave. The primary outcome is improvement in recovery score using the 24-item Revised Recovery Assessment Scale for service users. Secondary outcomes are improvements to user and carer mental health and well-being using the shortened 8-item version of the WHOQOL Quality of Life scale (EUROHIS), changes to staff attitudes using the 19-item Staff Attitudes to Recovery Scale and recovery orientation of services using the 36-item Recovery Self Assessment Scale (provider version). Intervention and usual care periods will be compared using a linear mixed effects model for continuous outcomes and a generalised linear mixed effects model for binary outcomes. Participants will be analysed in the group that the cluster was assigned to at each time point. Ethics and dissemination The University of Melbourne, Human Research Ethics Committee (1340299.3) and the Federal and State Departments of Health Committees (Project 20/2014) granted ethics approval. Baseline data results will be reported in 2015 and outcomes data in 2017. Trial registration number Australian and New Zealand Clinical Trials Registry ACTRN

The CORE study protocol: a stepped wedge cluster randomised controlled trial to test a co-design technique to optimise psychosocial recovery outcomes for people affected by mental illness in the community mental health setting.

Science.gov (United States)

Palmer, Victoria J; Chondros, Patty; Piper, Donella; Callander, Rosemary; Weavell, Wayne; Godbee, Kali; Potiriadis, Maria; Richard, Lauralie; Densely, Konstancja; Herrman, Helen; Furler, John; Pierce, David; Schuster, Tibor; Iedema, Rick; Gunn, Jane

2015-03-24

User engagement in mental health service design is heralded as integral to health systems quality and performance, but does engagement improve health outcomes? This article describes the CORE study protocol, a novel stepped wedge cluster randomised controlled trial (SWCRCT) to improve psychosocial recovery outcomes for people with severe mental illness. An SWCRCT with a nested process evaluation will be conducted over nearly 4 years in Victoria, Australia. 11 teams from four mental health service providers will be randomly allocated to one of three dates 9 months apart to start the intervention. The intervention, a modified version of Mental Health Experience Co-Design (MH ECO), will be delivered to 30 service users, 30 carers and 10 staff in each cluster. Outcome data will be collected at baseline (6 months) and at completion of each intervention wave. The primary outcome is improvement in recovery score using the 24-item Revised Recovery Assessment Scale for service users. Secondary outcomes are improvements to user and carer mental health and well-being using the shortened 8-item version of the WHOQOL Quality of Life scale (EUROHIS), changes to staff attitudes using the 19-item Staff Attitudes to Recovery Scale and recovery orientation of services using the 36-item Recovery Self Assessment Scale (provider version). Intervention and usual care periods will be compared using a linear mixed effects model for continuous outcomes and a generalised linear mixed effects model for binary outcomes. Participants will be analysed in the group that the cluster was assigned to at each time point. The University of Melbourne, Human Research Ethics Committee (1340299.3) and the Federal and State Departments of Health Committees (Project 20/2014) granted ethics approval. Baseline data results will be reported in 2015 and outcomes data in 2017. Australian and New Zealand Clinical Trials Registry ACTRN12614000457640. Published by the BMJ Publishing Group Limited. For

Validity of the mental health subscale of the SF-36 in persons with spinal cord injury

NARCIS (Netherlands)

van Leeuwen, C. M. C.; van der Woude, L. H. V.; Post, M. W. M.

Study design: Cross-sectional study 5 years after discharge from inpatient rehabilitation. Objective: To examine the psychometric properties of the Mental Health subscale (MHI-5) of the 36-Item Short Form Health Survey (SF-36) in persons with spinal cord injury (SCI). Setting: Eight Dutch

Comparison of Maternal and Fetal Outcomes in Pregnancies with Preterm Premature Rupture of Membrane (PPROM Terminating in 34th or 36th Gestational Weeks: A Clinical Trial

Directory of Open Access Journals (Sweden)

Shamsi Abbasalizadeh

2017-04-01

Full Text Available present  study,  we aimed at studying maternal  and  neonatal  outcomes  in  patients with terminated pregnancy in 34th  and  36th  gestational  weeks. Materials and methods: 40 pregnant women, with PPROM who underwent pregnancy termination at 34 group (A or 36 group (B gestational weeks, were included to be evaluated and compared for maternal and neonatal outcomes. Type of delivery, birth complications, chorioamnoionitis, endometritis, sepsis, maternal mortality, infant gender, birth weight, Apgar scores, respiratory distress syndrome, Meconium-stained amniotic fluid, NICU admission, abruption, umbilical cord prolapse, maternal and neonatal outcomes were compared between the two groups.  Results: There was no statistically significant difference between the two groups regarding maternal age, level of education, or gravity. The percentage of cases with birth weight between 1500 and 2500 g was significantly higher in group A P<0.001. Frequency of NICU admission in group A was significantly more than group B (P<0.001. In conclusion: Termination of pregnancy at 36 weeks compared to 34 weeks in pregnant women with PPROM is preferred in terms of neonatal outcomes and it is recommended; also, there might be no preference in terms of  maternal outcomes.

A 5 year prospective study of patient-relevant outcomes after total knee replacement

DEFF Research Database (Denmark)

Nilsdotter, A-K; Toksvig-Larsen, S; Roos, E M

2008-01-01

men, mean age 71 (51-86) assigned for TKR at the Department of Orthopaedics at Lund University Hospital were included in the study. The self-administered questionnaires Knee injury and Osteoarthritis Outcome Score (KOOS) and SF-36 were mailed preoperatively and 6 months, 12 months and at 5 years......OBJECTIVE: To prospectively describe self-reported outcomes up to 5 years after total knee replacement (TKR) in Osteoarthritis (OA) and to study which patient-relevant factors may predict outcomes for pain and physical function (PF). METHODS: 102 consecutive patients with knee OA, 63 women and 39...... postoperatively. RESULTS: Response rate at 5 years was 86%. At 6 months significant improvement was seen in all KOOS and SF-36 scores (P

Association of Haematological and Radiological Findings with Clinical Outcome in Hospitalized Children 2-36 Months Old with Severe Lower Respiratory Tract Infection

International Nuclear Information System (INIS)

Waris, R.; Bhatti, N.; Nisar, Y. B.

2016-01-01

Background: Despite reduction in ld mortality during last decade, lower respiratory tract infection (LRTI) remained number one killer of under-five. The current study aimed to assess the association of haematological and radiological findings with clinical outcome in hospitalized children 2-36 months old with severe LRTI. Methods: In the current cross sectional study, 581 children 2-36 months old with severe LRTI were enrolled and followed at the Children Hospital, Islamabad, between 2011 and 2014. At the time of enrolment, complete history of present illness, anthropometric measurements, blood sample and chest radiograph were obtained. The primary outcome was either early clinical response (within 72 hours) or delayed clinical response (>72 hours). Multivariable logistic regression was performed to examine the association between haematological and radiological findings with clinical outcome, adjusted for potential confounding factors. Results: Of 581 enrolled children, 292 (50.3 percent) children had early, and 289 (49.7 percent) had delayed clinical response. The multivariable logistic regression showed that leucocytosis (OR 1.79, 95 percent CI 1.15-2.79), neutrophilia (OR 1.91, 95 percent CI 1.29-2.84), radiological interstitial pneumonia (OR 2.49, 95 percent CI 1.70-3.64), and lobar consolidation (OR 6.00, 95 percent CI 2.41-14.96) were significantly associated with delayed clinical response, after adjusted for potential confounding factors. Conclusions: Delayed clinical response was significantly associated with abnormal haematological and radiological findings at the time of admission in children 2-36 months old with severe LRTI. Haematological and radiological findings at the time of presentation are useful for predicting delayed clinical response in children 2-36 months old with severe LRTI. (author)

Psychometric evaluation of the pediatric and parent-proxy Patient-Reported Outcomes Measurement Information System and the Neurology and Traumatic Brain Injury Quality of Life measurement item banks in pediatric traumatic brain injury.

Science.gov (United States)

Bertisch, Hilary; Rivara, Frederick P; Kisala, Pamela A; Wang, Jin; Yeates, Keith Owen; Durbin, Dennis; Zonfrillo, Mark R; Bell, Michael J; Temkin, Nancy; Tulsky, David S

2017-07-01

The primary objective is to provide evidence of convergent and discriminant validity for the pediatric and parent-proxy versions of the Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety, Depression, Anger, Peer Relations, Mobility, Pain Interference, and Fatigue item banks, the Neurology Quality of Life measurement system (Neuro-QOL) Cognition-General Concerns and Stigma item banks, and the Traumatic Brain Injury Quality of Life (TBI-QOL) Executive Function and Headache item banks in a pediatric traumatic brain injury (TBI) sample. Participants were 134 parent-child (ages 8-18 years) days. Children all sustained TBI and the dyads completed outcome ratings 6 months after injury at one of six medical centers across the United States. Ratings included PROMIS, Neuro-QOL, and TBI-QOL item banks, as well as the Pediatric Quality of Life inventory (PedsQL), the Health Behavior Inventory (HBI), and the Strengths and Difficulties Questionnaire (SDQ) as legacy criterion measures against which these item banks were validated. The PROMIS, Neuro-QOL, and TBI-QOL item banks demonstrated good convergent validity, as evidenced by moderate to strong correlations with comparable scales on the legacy measures. PROMIS, Neuro-QOL, and TBI-QOL item banks showed weaker correlations with ratings of unrelated constructs on legacy measures, providing evidence of discriminant validity. Our results indicate that the constructs measured by the PROMIS, Neuro-QOL, and TBI-QOL item banks are valid in our pediatric TBI sample and that it is appropriate to use these standardized scores for our primary study analyses.

Developing core economic outcome sets for asthma studies: a protocol for a systematic review.

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Hounsome, Natalia; Fitzsimmons, Deborah; Phillips, Ceri; Patel, Anita

2017-08-11

Core outcome sets are standardised lists of outcomes, which should be measured and reported in all clinical studies of a specific condition. This study aims to develop core outcome sets for economic evaluations in asthma studies. Economic outcomes include items such as costs, resource use or quality-adjusted life years. The starting point in developing core outcome sets will be conducting a systematic literature review to establish a preliminary list of reporting items to be considered for inclusion in the core outcome set. We will conduct literature searches of peer-reviewed studies published from January 1990 to January 2017. These will include any comparative or observational studies (including economic models) and systematic reviews reporting economic outcomes. All identified economic outcomes will be tabulated together with the major study characteristics, such as population, study design, the nature and intensity of the intervention, mode of data collection and instrument(s) used to derive an outcome. We will undertake a 'realist synthesis review' to analyse the identified economic outcomes. The outcomes will be summarised in the context of evaluation perspectives, types of economic evaluation and methodological approaches. Parallel to undertaking a systematic review, we will conduct semistructured interviews with stakeholders (including people with personal experience of asthma, health professionals, researchers and decision makers) in order to explore additional outcomes which have not been considered, or used, in published studies. The list of outcomes generated from the systematic review and interviews with stakeholders will form the basis of a Delphi survey to refine the identified outcomes into a core outcome set. The review will not involve access to individual-level data. Findings from our systematic review will be communicated to a broad range of stakeholders including clinical guideline developers, research funders, trial registries, ethics

Effect of study context on item recollection.

Science.gov (United States)

Skinner, Erin I; Fernandes, Myra A

2010-07-01

We examined how visual context information provided during encoding, and unrelated to the target word, affected later recollection for words presented alone using a remember-know paradigm. Experiments 1A and 1B showed that participants had better overall memory-specifically, recollection-for words studied with pictures of intact faces than for words studied with pictures of scrambled or inverted faces. Experiment 2 replicated these results and showed that recollection was higher for words studied with pictures of faces than when no image accompanied the study word. In Experiment 3 participants showed equivalent memory for words studied with unique faces as for those studied with a repeatedly presented face. Results suggest that recollection benefits when visual context information high in meaningful content accompanies study words and that this benefit is not related to the uniqueness of the context. We suggest that participants use elaborative processes to integrate item and meaningful contexts into ensemble information, improving subsequent item recollection.

Psychometric validation of the dysmenorrhea daily diary (DysDD): a patient-reported outcome for dysmenorrhea.

Science.gov (United States)

Nguyen, Allison M; Arbuckle, Rob; Korver, Tjeerd; Chen, Fang; Taylor, Beverley; Turnbull, Alice; Norquist, Josephine M

2017-08-01

The objective of this study was to evaluate the psychometric properties of the Dysmenorrhea Daily Diary (DysDD), an electronic patient-reported outcome, in a sample of 355 women with primary dysmenorrhea enrolled in a phase IIb, multicenter, randomized, partially blinded, placebo-controlled trial for treatment of dysmenorrhea. Subjects completed the DysDD over three menstrual cycles, one pre-treatment baseline cycle and two treatment cycles. The DysDD was administered alongside the Menstrual Distress Questionnaire (MDQ), the Short-Form 36 Version 2.0 (SF-36v2), and a Global Assessment of Change (GAC). Item response distributions, test-retest reliability, concurrent and known groups validity, responsiveness, and minimally important difference (MID) were evaluated for the DysDD. As expected, item response distributions varied throughout the menstrual period for all items, with the response scales fully utilized. Within-cycle test-retest reliability was adequate (weighted kappa: 0.5-0.7), although between-cycle test-retest was poor (weighted kappa: 0.1-0.5), most likely due to the highly variable nature of dysmenorrhea between cycles rather than limitations of the measure. Correlations with the MDQ and SF-36v2 were low-moderate, but in the predicted direction, supporting concurrent validity. There were significant differences in DysDD scores across severity groups based on pain medication use. The DysDD was responsive to changes in patients' dysmenorrhea with significantly different changes in scores between change groups (p dysmenorrhea.

Psychometric properties of the Centers for Disease Control and Prevention Health-Related Quality of Life (CDC HRQOL items in adults with arthritis

Directory of Open Access Journals (Sweden)

DeVellis Robert

2006-09-01

Full Text Available Abstract Background Measuring health-related quality of life (HRQOL is important in arthritis and the SF-36v2 is the current state-of-the-art. It is only emerging how well the Centers for Disease Control and Prevention (CDC HRQOL measures HRQOL for people with arthritis. This study's purpose is to assess the psychometric properties of the 9-item CDC HRQOL (4-item Healthy Days Core Module and 5-item Healthy Days Symptoms Module in an arthritis sample using the SF-36v2 as a comparison. Methods In Fall 2002, a cross-sectional study acquired survey data including the CDC HRQOL and SF-36v2 from 2 North Carolina populations of adult patients reporting osteoarthritis, rheumatoid arthritis, and fibromyalgia; 2182 (52% responded. The first item of both the CDC HRQOL and the SF-36v2 was general health (GEN. All 8 other CDC HRQOL items ask for the number of days in the past 30 days that respondents experienced various aspects of HRQOL. Exploratory principal components analyses (PCA were conducted on each sample and the combined samples of the CDC HRQOL. The multitrait-multimethod matrix (MTMM was used to compute correlations between each trait (physical health and mental health and between each method of measurement (CDC HRQOL and SF36v2. The relative contribution of the CDC HRQOL in predicting the physical component summary (PCS and the mental component summary (MCS was determined by regressing the CDC HRQOL items on the PCS and MCS scales. Results All 9 CDC HRQOL items loaded primarily onto 1 factor (explaining 57% of the item variance representing a reasonable solution for capturing overall HRQOL. After rotation a 2 factor interpretation for the 9 items was clear, with 4 items capturing physical health (physical, activity, pain, and energy days and 3 items capturing mental health (mental, depression, and anxiety days. All of the loadings for these two factors were greater than 0.70. The CDC HRQOL physical health factor correlated with PCS (r = -.78, p 2

Long-term cognitive outcome of very low birth-weight Saudi preterm infants at the corrected age of 24-36 months.

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Sobaih, Badr H

2018-04-01

To assess infants' cognitive function at the corrected age of 24-36 months, and to identify factors associated with adverse outcome and examine the correlation between Bayley Infants Neurodevelopmental Screener (BINS) score and Gesell Schedule of Child Development (GSCD). Methods: This retrospective study was performed on Saudi very low birth-weight (VLBW)  infants born   in King Khalid University Hospital, Riyadh, Saudi Arabia between 1997 and 2014 by the use of BINS as screening test and GSCD as definitive test. Results: Of 561 enrolled infants, 367 (65.4%) continued to follow-up. Three-hundred and fifteen infants (85.6%) had a normal cognitive function. In addition to lower birth weight (beta = -0.003) (p less than 0.001), male gender (OR =3.9) (p=0.001)and cerebral palsy (OR =33.9) (p less than 0.001) were the strongest factors associated with poor cognitive outcome. Approximately 75.4% of infants with normal BINS score had normal cognitive function and 7.6% of total infants had sever cognitive impairment. Conclusion: The majority of VLBW infants in our center have  normal cognitive function at the corrected age of 24-36 months. Male gender, lower birth weight, and cerebral palsy are major predictors of poor outcome. The BINS scores were correlated with GSCD as a valid predictor for future developmental outcome.

Measurement and control of bias in patient reported outcomes using multidimensional item response theory.

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Dowling, N Maritza; Bolt, Daniel M; Deng, Sien; Li, Chenxi

2016-05-26

Patient-reported outcome (PRO) measures play a key role in the advancement of patient-centered care research. The accuracy of inferences, relevance of predictions, and the true nature of the associations made with PRO data depend on the validity of these measures. Errors inherent to self-report measures can seriously bias the estimation of constructs assessed by the scale. A well-documented disadvantage of self-report measures is their sensitivity to response style (RS) effects such as the respondent's tendency to select the extremes of a rating scale. Although the biasing effect of extreme responding on constructs measured by self-reported tools has been widely acknowledged and studied across disciplines, little attention has been given to the development and systematic application of methodologies to assess and control for this effect in PRO measures. We review the methodological approaches that have been proposed to study extreme RS effects (ERS). We applied a multidimensional item response theory model to simultaneously estimate and correct for the impact of ERS on trait estimation in a PRO instrument. Model estimates were used to study the biasing effects of ERS on sum scores for individuals with the same amount of the targeted trait but different levels of ERS. We evaluated the effect of joint estimation of multiple scales and ERS on trait estimates and demonstrated the biasing effects of ERS on these trait estimates when used as explanatory variables. A four-dimensional model accounting for ERS bias provided a better fit to the response data. Increasing levels of ERS showed bias in total scores as a function of trait estimates. The effect of ERS was greater when the pattern of extreme responding was the same across multiple scales modeled jointly. The estimated item category intercepts provided evidence of content independent category selection. Uncorrected trait estimates used as explanatory variables in prediction models showed downward bias. A

Variation across individuals and items determine learning outcomes from fast mapping.

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Coutanche, Marc N; Koch, Griffin E

2017-11-01

An approach to learning words known as "fast mapping" has been linked to unique neurobiological and behavioral markers in adult humans, including rapid lexical integration. However, the mechanisms supporting fast mapping are still not known. In this study, we sought to help change this by examining factors that modulate learning outcomes. In 90 subjects, we systematically manipulated the typicality of the items used to support fast mapping (foils), and quantified learners' inclination to employ semantic, episodic, and spatial memory through the Survey of Autobiographical Memory (SAM). We asked how these factors affect lexical competition and recognition performance, and then asked how foil typicality and lexical competition are related in an independent dataset. We find that both the typicality of fast mapping foils, and individual differences in how different memory systems are employed, influence lexical competition effects after fast mapping, but not after other learning approaches. Specifically, learning a word through fast mapping with an atypical foil led to lexical competition, while a typical foil led to lexical facilitation. This effect was particularly evident in individuals with a strong tendency to employ semantic memory. We further replicated the relationship between continuous foil atypicality and lexical competition in an independent dataset. These findings suggest that semantic properties of the foils that support fast mapping can influence the degree and nature of subsequent lexical integration. Further, the effects of foils differ based on an individual's tendency to draw-on the semantic memory system. Copyright © 2017 Elsevier Ltd. All rights reserved.

Assessing nicotine dependence in adolescent E-cigarette users: The 4-item Patient-Reported Outcomes Measurement Information System (PROMIS) Nicotine Dependence Item Bank for electronic cigarettes.

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Morean, Meghan E; Krishnan-Sarin, Suchitra; S O'Malley, Stephanie

2018-04-26

Adolescent e-cigarette use (i.e., "vaping") likely confers risk for developing nicotine dependence. However, there have been no studies assessing e-cigarette nicotine dependence in youth. We evaluated the psychometric properties of the 4-item Patient-Reported Outcomes Measurement Information System Nicotine Dependence Item Bank for E-cigarettes (PROMIS-E) for assessing youth e-cigarette nicotine dependence and examined risk factors for experiencing stronger dependence symptoms. In 2017, 520 adolescent past-month e-cigarette users completed the PROMIS-E during a school-based survey (50.5% female, 84.8% White, 16.22[1.19] years old). Adolescents also reported on sex, grade, race, age at e-cigarette use onset, vaping frequency, nicotine e-liquid use, and past-month cigarette smoking. Analyses included conducting confirmatory factor analysis and examining the internal consistency of the PROMIS-E. Bivariate correlations and independent-samples t-tests were used to examine unadjusted relationships between e-cigarette nicotine dependence and the proposed risk factors. Regression models were run in which all potential risk factors were entered as simultaneous predictors of PROMIS-E scores. The single-factor structure of the PROMIS-E was confirmed and evidenced good internal consistency. Across models, larger PROMIS-E scores were associated with being in a higher grade, initiating e-cigarette use at an earlier age, vaping more frequently, using nicotine e-liquid (and higher nicotine concentrations), and smoking cigarettes. Adolescent e-cigarette users reported experiencing nicotine dependence, which was assessed using the psychometrically sound PROMIS-E. Experiencing stronger nicotine dependence symptoms was associated with characteristics that previously have been shown to confer risk for frequent vaping and tobacco cigarette dependence. Copyright © 2018 Elsevier B.V. All rights reserved.

SF-36 total score as a single measure of health-related quality of life: Scoping review.

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Lins, Liliane; Carvalho, Fernando Martins

2016-01-01

According to the 36-Item Short Form Health Survey questionnaire developers, a global measure of health-related quality of life such as the "SF-36 Total/Global/Overall Score" cannot be generated from the questionnaire. However, studies keep on reporting such measure. This study aimed to evaluate the frequency and to describe some characteristics of articles reporting the SF-36 Total/Global/Overall Score in the scientific literature. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses method was adapted to a scoping review. We performed searches in PubMed, Web of Science, SCOPUS, BVS, and Cochrane Library databases for articles using such scores. We found 172 articles published between 1997 and 2015; 110 (64.0%) of them were published from 2010 onwards; 30.0% appeared in journals with Impact Factor 3.00 or greater. Overall, 129 (75.0%) out of the 172 studies did not specify the method for calculating the "SF-36 Total Score"; 13 studies did not specify their methods but referred to the SF-36 developers' studies or others; and 30 articles used different strategies for calculating such score, the most frequent being arithmetic averaging of the eight SF-36 domains scores. We concluded that the "SF-36 Total/Global/Overall Score" has been increasingly reported in the scientific literature. Researchers should be aware of this procedure and of its possible impacts upon human health.

Pulmonary rehabilitation improves only some domains of health-related quality of life measured by the Short Form-36 questionnaire

Directory of Open Access Journals (Sweden)

Chok Limsuwat

2014-01-01

Full Text Available Background: Pulmonary rehabilitation (PR has inconsistent effects on health-related quality of life (HRQL in patients with chronic lung diseases. We evaluated the effect of PR on HRQL outcomes using the 36-item short form of the medical outcomes (SF-36. Methods : We retrospectively reviewed the files of all patients who completed PR in 2010, 2011, and first half of 2012. We collected information on demographics, symptoms, pulmonary function tests, 6-minute walk tests (6-MWT, and responses on the SF-36 survey, including the physical component score (PCS and mental component score (MCS. Results: The study included 19 women and 22 men. The mean age was 69.8 ± 8.5 years. The diagnoses included chronic obstructive pulmonary disease (COPD; n = 31, asthma (n = 3, interstitial lung disease (n = 5, and obstructive sleep apnea (OSA; n = 2. The mean forced expiratory volume-one second (FEV1 was 1.16 ± 0.52 L (against 60.5 ± 15.9% of predicted value. There was a significant improvement in 6-MWT (P < 0.0001. The PCS improved post-PR from 33.8 to 34.5 (P = 0.02; the MCS did not change. Conclusion: These patients had low SF-36 scores compared to the general population; changes in scores after PR were low. These patients may need frequent HRQL assessment during rehabilitation, and PR programs should consider program modification in patients with small changes in mental health.

Association Between a Single General Anesthesia Exposure Before Age 36 Months and Neurocognitive Outcomes in Later Childhood.

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Sun, Lena S; Li, Guohua; Miller, Tonya L K; Salorio, Cynthia; Byrne, Mary W; Bellinger, David C; Ing, Caleb; Park, Raymond; Radcliffe, Jerilynn; Hays, Stephen R; DiMaggio, Charles J; Cooper, Timothy J; Rauh, Virginia; Maxwell, Lynne G; Youn, Ahrim; McGowan, Francis X

2016-06-07

Exposure of young animals to commonly used anesthetics causes neurotoxicity including impaired neurocognitive function and abnormal behavior. The potential neurocognitive and behavioral effects of anesthesia exposure in young children are thus important to understand. To examine if a single anesthesia exposure in otherwise healthy young children was associated with impaired neurocognitive development and abnormal behavior in later childhood. Sibling-matched cohort study conducted between May 2009 and April 2015 at 4 university-based US pediatric tertiary care hospitals. The study cohort included sibling pairs within 36 months in age and currently 8 to 15 years old. The exposed siblings were healthy at surgery/anesthesia. Neurocognitive and behavior outcomes were prospectively assessed with retrospectively documented anesthesia exposure data. A single exposure to general anesthesia during inguinal hernia surgery in the exposed sibling and no anesthesia exposure in the unexposed sibling, before age 36 months. The primary outcome was global cognitive function (IQ). Secondary outcomes included domain-specific neurocognitive functions and behavior. A detailed neuropsychological battery assessed IQ and domain-specific neurocognitive functions. Parents completed validated, standardized reports of behavior. Among the 105 sibling pairs, the exposed siblings (mean age, 17.3 months at surgery/anesthesia; 9.5% female) and the unexposed siblings (44% female) had IQ testing at mean ages of 10.6 and 10.9 years, respectively. All exposed children received inhaled anesthetic agents, and anesthesia duration ranged from 20 to 240 minutes, with a median duration of 80 minutes. Mean IQ scores between exposed siblings (scores: full scale = 111; performance = 108; verbal = 111) and unexposed siblings (scores: full scale = 111; performance = 107; verbal = 111) were not statistically significantly different. Differences in mean IQ scores between sibling pairs were

Cross-diagnostic validity of the SF-36 physical functioning scale in patients with stroke, multiple sclerosis and amyotrophic lateral sclerosis: a study using Rasch analysis

NARCIS (Netherlands)

Dallmeijer, Annet J.; de Groot, Vincent; Roorda, Leo D.; Schepers, Vera P. M.; Lindeman, Eline; van den Berg, Leonard H.; Beelen, Anita; Dekker, Joost

2007-01-01

The aim of this study was to investigate unidimensionality and differential item functioning of the SF-36 physical functioning scale (PF10) in patients with various neurological disorders. Patients: Patients post-stroke (n = 198), with multiple sclerosis (n = 151) and amyotrophic lateral sclerosis

IRTPRO 2.1 for Windows (Item Response Theory for Patient-Reported Outcomes)

Science.gov (United States)

Paek, Insu; Han, Kyung T.

2013-01-01

This article reviews a new item response theory (IRT) model estimation program, IRTPRO 2.1, for Windows that is capable of unidimensional and multidimensional IRT model estimation for existing and user-specified constrained IRT models for dichotomously and polytomously scored item response data. (Contains 1 figure and 2 notes.)

Assessing item fit for unidimensional item response theory models using residuals from estimated item response functions.

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Haberman, Shelby J; Sinharay, Sandip; Chon, Kyong Hee

2013-07-01

Residual analysis (e.g. Hambleton & Swaminathan, Item response theory: principles and applications, Kluwer Academic, Boston, 1985; Hambleton, Swaminathan, & Rogers, Fundamentals of item response theory, Sage, Newbury Park, 1991) is a popular method to assess fit of item response theory (IRT) models. We suggest a form of residual analysis that may be applied to assess item fit for unidimensional IRT models. The residual analysis consists of a comparison of the maximum-likelihood estimate of the item characteristic curve with an alternative ratio estimate of the item characteristic curve. The large sample distribution of the residual is proved to be standardized normal when the IRT model fits the data. We compare the performance of our suggested residual to the standardized residual of Hambleton et al. (Fundamentals of item response theory, Sage, Newbury Park, 1991) in a detailed simulation study. We then calculate our suggested residuals using data from an operational test. The residuals appear to be useful in assessing the item fit for unidimensional IRT models.

36 CFR 1254.28 - What items are not allowed in research rooms?

Science.gov (United States)

2010-07-01

... ADMINISTRATION PUBLIC AVAILABILITY AND USE USING RECORDS AND DONATED HISTORICAL MATERIALS Research Room Rules... papers. (b) You may store personal items at no cost in lockers or other storage facilities in the NARA... replacement fee for lost locker keys. (f) Knives and other sharp objects such as box cutters, razors, or wire...

A Bifactor Multidimensional Item Response Theory Model for Differential Item Functioning Analysis on Testlet-Based Items

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Fukuhara, Hirotaka; Kamata, Akihito

2011-01-01

A differential item functioning (DIF) detection method for testlet-based data was proposed and evaluated in this study. The proposed DIF model is an extension of a bifactor multidimensional item response theory (MIRT) model for testlets. Unlike traditional item response theory (IRT) DIF models, the proposed model takes testlet effects into…

Effect of individual thinking styles on item selection during study time allocation.

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Jia, Xiaoyu; Li, Weijian; Cao, Liren; Li, Ping; Shi, Meiling; Wang, Jingjing; Cao, Wei; Li, Xinyu

2018-04-01

The influence of individual differences on learners' study time allocation has been emphasised in recent studies; however, little is known about the role of individual thinking styles (analytical versus intuitive). In the present study, we explored the influence of individual thinking styles on learners' application of agenda-based and habitual processes when selecting the first item during a study-time allocation task. A 3-item cognitive reflection test (CRT) was used to determine individuals' degree of cognitive reliance on intuitive versus analytical cognitive processing. Significant correlations between CRT scores and the choices of first item selection were observed in both Experiment 1a (study time was 5 seconds per triplet) and Experiment 1b (study time was 20 seconds per triplet). Furthermore, analytical decision makers constructed a value-based agenda (prioritised high-reward items), whereas intuitive decision makers relied more upon habitual responding (selected items from the leftmost of the array). The findings of Experiment 1a were replicated in Experiment 2 notwithstanding ruling out the possible effects from individual intelligence and working memory capacity. Overall, the individual thinking style plays an important role on learners' study time allocation and the predictive ability of CRT is reliable in learners' item selection strategy. © 2016 International Union of Psychological Science.

Long-term mental health outcome in post-conflict settings: Similarities and differences between Kosovo and Rwanda.

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Eytan, Ariel; Munyandamutsa, Naasson; Nkubamugisha, Paul Mahoro; Gex-Fabry, Marianne

2015-06-01

Few studies investigated the long-term mental health outcome in culturally different post-conflict settings. This study considers two surveys conducted in Kosovo 8 years after the Balkans war and in Rwanda 14 years after the genocide. All participants (n = 864 in Kosovo; n = 962 in Rwanda) were interviewed using the posttraumatic stress disorder (PTSD) and major depressive episode (MDE) sections of the Mini International Neuropsychiatric Interview (MINI) and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Proportions of participants who met diagnostic criteria for either PTSD or MDE were 33.0% in Kosovo and 31.0% in Rwanda, with co-occurrence of both disorders in 17.8% of the Rwandan sample and 9.5% of the Kosovan sample. Among patients with PTSD, patterns of symptoms significantly differed in the two settings, with avoidance and inability to recall less frequent and sense of a foreshortened future and increased startle response more common in Rwanda. Significant differences were also observed in patients with MDE, with loss of energy and difficulties concentrating less frequent and suicidal ideation more common in Rwanda. Comorbid PTSD and MDE were associated with decreased SF-36 subjective mental and physical health scores in both settings, but significantly larger effects in Kosovo than in Rwanda. Culturally different civilian populations exposed to mass trauma may differ with respect to their long-term mental health outcome, including comorbidity, symptom profile and health perception. © The Author(s) 2014.

Development and Validation of a Novel Generic Health-related Quality of Life Instrument With 20 Items (HINT-20

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Min-Woo Jo

2017-01-01

Full Text Available Objectives Few attempts have been made to develop a generic health-related quality of life (HRQoL instrument and to examine its validity and reliability in Korea. We aimed to do this in our present study. Methods After a literature review of existing generic HRQoL instruments, a focus group discussion, in-depth interviews, and expert consultations, we selected 30 tentative items for a new HRQoL measure. These items were evaluated by assessing their ceiling effects, difficulty, and redundancy in the first survey. To validate the HRQoL instrument that was developed, known-groups validity and convergent/discriminant validity were evaluated and its test-retest reliability was examined in the second survey. Results Of the 30 items originally assessed for the HRQoL instrument, four were excluded due to high ceiling effects and six were removed due to redundancy. We ultimately developed a HRQoL instrument with a reduced number of 20 items, known as the Health-related Quality of Life Instrument with 20 items (HINT-20, incorporating physical, mental, social, and positive health dimensions. The results of the HINT-20 for known-groups validity were poorer in women, the elderly, and those with a low income. For convergent/discriminant validity, the correlation coefficients of items (except vitality in the physical health dimension with the physical component summary of the Short Form 36 version 2 (SF-36v2 were generally higher than the correlations of those items with the mental component summary of the SF-36v2, and vice versa. Regarding test-retest reliability, the intraclass correlation coefficient of the total HINT-20 score was 0.813 (p<0.001. Conclusions A novel generic HRQoL instrument, the HINT-20, was developed for the Korean general population and showed acceptable validity and reliability.

Beyond the Shadow of a Trait: Understanding Discounting through Item-Level Analysis of Personality Scales

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Charlton, Shawn R.; Gossett, Bradley D.; Charlton, Veda A.

2011-01-01

Temporal discounting, the loss in perceived value associated with delayed outcomes, correlates with a number of personality measures, suggesting that an item-level analysis of trait measures might provide a more detailed understanding of discounting. The current report details two studies that investigate the utility of such an item-level…

7 CFR 2902.36 - Concrete and asphalt release fluids.

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2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Concrete and asphalt release fluids. 2902.36 Section... PROCUREMENT Designated Items § 2902.36 Concrete and asphalt release fluids. (a) Definition. Products that are designed to provide a lubricating barrier between the composite surface materials (e.g., concrete or...

The PROMIS Physical Function item bank was calibrated to a standardized metric and shown to improve measurement efficiency

DEFF Research Database (Denmark)

Rose, Matthias; Bjørner, Jakob; Gandek, Barbara

2014-01-01

OBJECTIVE: To document the development and psychometric evaluation of the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) item bank and static instruments. STUDY DESIGN AND SETTING: The items were evaluated using qualitative and quantitative methods. A total...... response model was used to estimate item parameters, which were normed to a mean of 50 (standard deviation [SD]=10) in a US general population sample. RESULTS: The final bank consists of 124 PROMIS items covering upper, central, and lower extremity functions and instrumental activities of daily living...... to identify differences between age and disease groups. CONCLUSION: The item bank provides a common metric and can improve the measurement of PF by facilitating the standardization of patient-reported outcome measures and implementation of CATs for more efficient PF assessments over a larger range....

Development and validation of the Single Item Trait Empathy Scale (SITES).

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Konrath, Sara; Meier, Brian P; Bushman, Brad J

2018-04-01

Empathy involves feeling compassion for others and imagining how they feel. In this article, we develop and validate the Single Item Trait Empathy Scale (SITES), which contains only one item that takes seconds to complete. In seven studies (N=5,724), the SITES was found to be both reliable and valid. It correlated in expected ways with a wide variety of intrapersonal outcomes. For example, it is negatively correlated with narcissism, depression, anxiety, and alexithymia. In contrast, it is positively correlated with other measures of empathy, self-esteem, subjective well-being, and agreeableness. The SITES also correlates with a wide variety of interpersonal outcomes, especially compassion for others and helping others. The SITES is recommended in situations when time or question quantity is constrained.

PROMIS GH (Patient-Reported Outcomes Measurement Information System Global Health) Scale in Stroke: A Validation Study.

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Katzan, Irene L; Lapin, Brittany

2018-01-01

The International Consortium for Health Outcomes Measurement recently included the 10-item PROMIS GH (Patient-Reported Outcomes Measurement Information System Global Health) scale as part of their recommended Standard Set of Stroke Outcome Measures. Before collection of PROMIS GH is broadly implemented, it is necessary to assess its performance in the stroke population. The objective of this study was to evaluate the psychometric properties of PROMIS GH in patients with ischemic stroke and intracerebral hemorrhage. PROMIS GH and 6 PROMIS domain scales measuring same/similar constructs were electronically collected on 1102 patients with ischemic and hemorrhagic strokes at various stages of recovery from their stroke who were seen in a cerebrovascular clinic from October 12, 2015, through June 2, 2017. Confirmatory factor analysis was performed to evaluate the adequacy of 2-factor structure of component scores. Test-retest reliability and convergent validity of PROMIS GH items and component scores were assessed. Discriminant validity and responsiveness were compared between PROMIS GH and PROMIS domain scales measuring the same or related constructs. Analyses were repeated stratified by stroke subtype and modified Rankin Scale score validity was good with significant correlations between all PROMIS GH items and PROMIS domain scales ( P 0.5) was demonstrated for 8 of the 10 PROMIS GH items. Reliability and validity remained consistent across stroke subtype and disability level (modified Rankin Scale, <2 versus ≥2). PROMIS GH exhibits acceptable performance in patients with stroke. Our findings support International Consortium for Health Outcomes Measurement recommendation to use PROMIS GH as part of the standard set of outcome measures in stroke. © 2017 American Heart Association, Inc.

Comparison of the clinical outcomes between unattended home APAP and polysomnography manual titration in obstructive sleep apnea patients.

Science.gov (United States)

Wongsritrang, Krongthong; Fueangkamloon, Sumet

2013-09-01

To compare the clinical outcomes and determine the difference in therapeutic pressure between Automatic positive airway pressure (APAP) and polysomnography manual titration. Fifty patients of obstructive sleep apnea (OSA), moderate to severe cases, were randomized into two groups of intervention: 95-percentile pressure derived from APAP titration and an optimal pressure derived from manual titration. Clinical outcomes were assessed before and after four weeks. The average 95-percentile pressure derived from APAP titration was 11.7 +/- 0.3 cmH2O with median mask leak 1.3 L/min. The average optimal pressure derived from manual titration was 8.2 +/- 0.3 cmH2O. Pearson correlation analysis showed weak positive correlation (r = 0.336, p = 0.017). The Epworth Sleepiness Score (ESS), Quality of life tests: PSQI (Pittsburg Sleep Quality Index), and SF-36 (Medical Outcomes Study 36-Item Short-Form Health Survey) were improved significantly in both groups, but there were no statistical significant differences between groups. An APAP titration is an effective method of pressure determination for conventional CPAP therapy and shows no difference in clinical outcomes comparing the standard titration.

Using Item Analysis to Assess Objectively the Quality of the Calgary-Cambridge OSCE Checklist

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Tyrone Donnon

2011-06-01

Full Text Available Background:  The purpose of this study was to investigate the use of item analysis to assess objectively the quality of items on the Calgary-Cambridge Communications OSCE checklist. Methods:  A total of 150 first year medical students were provided with extensive teaching on the use of the Calgary-Cambridge Guidelines for interviewing patients and participated in a final year end 20 minute communication OSCE station.  Grouped into either the upper half (50% or lower half (50% communication skills performance groups, discrimination, difficulty and point biserial values were calculated for each checklist item. Results:  The mean score on the 33 item communication checklist was 24.09 (SD = 4.46 and the internal reliability coefficient was ? = 0.77. Although most of the items were found to have moderate (k = 12, 36% or excellent (k = 10, 30% discrimination values, there were 6 (18% identified as ‘fair’ and 3 (9% as ‘poor’. A post-examination review focused on item analysis findings resulted in an increase in checklist reliability (? = 0.80. Conclusions:  Item analysis has been used with MCQ exams extensively. In this study, it was also found to be an objective and practical approach to use in evaluating the quality of a standardized OSCE checklist.

Science Literacy: How do High School Students Solve PISA Test Items?

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Wati, F.; Sinaga, P.; Priyandoko, D.

2017-09-01

The Programme for International Students Assessment (PISA) does assess students’ science literacy in a real-life contexts and wide variety of situation. Therefore, the results do not provide adequate information for the teacher to excavate students’ science literacy because the range of materials taught at schools depends on the curriculum used. This study aims to investigate the way how junior high school students in Indonesia solve PISA test items. Data was collected by using PISA test items in greenhouse unit employed to 36 students of 9th grade. Students’ answer was analyzed qualitatively for each item based on competence tested in the problem. The way how students answer the problem exhibits their ability in particular competence which is influenced by a number of factors. Those are students’ unfamiliarity with test construction, low performance on reading, low in connecting available information and question, and limitation on expressing their ideas effectively and easy-read. As the effort, selected PISA test items can be used in accordance teaching topic taught to familiarize students with science literacy.

Missing data methods for dealing with missing items in quality of life questionnaires. A comparison by simulation of personal mean score, full information maximum likelihood, multiple imputation, and hot deck techniques applied to the SF-36 in the French 2003 decennial health survey.

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Peyre, Hugo; Leplège, Alain; Coste, Joël

2011-03-01

Missing items are common in quality of life (QoL) questionnaires and present a challenge for research in this field. It remains unclear which of the various methods proposed to deal with missing data performs best in this context. We compared personal mean score, full information maximum likelihood, multiple imputation, and hot deck techniques using various realistic simulation scenarios of item missingness in QoL questionnaires constructed within the framework of classical test theory. Samples of 300 and 1,000 subjects were randomly drawn from the 2003 INSEE Decennial Health Survey (of 23,018 subjects representative of the French population and having completed the SF-36) and various patterns of missing data were generated according to three different item non-response rates (3, 6, and 9%) and three types of missing data (Little and Rubin's "missing completely at random," "missing at random," and "missing not at random"). The missing data methods were evaluated in terms of accuracy and precision for the analysis of one descriptive and one association parameter for three different scales of the SF-36. For all item non-response rates and types of missing data, multiple imputation and full information maximum likelihood appeared superior to the personal mean score and especially to hot deck in terms of accuracy and precision; however, the use of personal mean score was associated with insignificant bias (relative bias personal mean score appears nonetheless appropriate for dealing with items missing from completed SF-36 questionnaires in most situations of routine use. These results can reasonably be extended to other questionnaires constructed according to classical test theory.

Assessment of Differential Item Functioning in Health-Related Outcomes: A Simulation and Empirical Analysis with Hierarchical Polytomous Data

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Zahra Sharafi

2017-01-01

Full Text Available Background. The purpose of this study was to evaluate the effectiveness of two methods of detecting differential item functioning (DIF in the presence of multilevel data and polytomously scored items. The assessment of DIF with multilevel data (e.g., patients nested within hospitals, hospitals nested within districts from large-scale assessment programs has received considerable attention but very few studies evaluated the effect of hierarchical structure of data on DIF detection for polytomously scored items. Methods. The ordinal logistic regression (OLR and hierarchical ordinal logistic regression (HOLR were utilized to assess DIF in simulated and real multilevel polytomous data. Six factors (DIF magnitude, grouping variable, intraclass correlation coefficient, number of clusters, number of participants per cluster, and item discrimination parameter with a fully crossed design were considered in the simulation study. Furthermore, data of Pediatric Quality of Life Inventory™ (PedsQL™ 4.0 collected from 576 healthy school children were analyzed. Results. Overall, results indicate that both methods performed equivalently in terms of controlling Type I error and detection power rates. Conclusions. The current study showed negligible difference between OLR and HOLR in detecting DIF with polytomously scored items in a hierarchical structure. Implications and considerations while analyzing real data were also discussed.

Periodontal infection and adverse pregnancy outcomes: a systematic review of epidemiological studies

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Vettore Mario Vianna

2006-01-01

Full Text Available The objective of this systematic review was to evaluate analytical studies on periodontal disease as a possible risk factor for adverse pregnancy outcomes. A literature search of the MEDLINE, SciELO, and LILACS bibliographic databases and CAPES thesis database was conducted up to December 2005, covering epidemiological studies of periodontal disease and adverse pregnancy outcomes. Of the 964 papers identified, 36 analytical studies met the inclusion criteria. Twenty-six epidemiological studies reported associations between periodontal disease and adverse pregnancy outcomes. There was a clear heterogeneity between studies concerning measurement of periodontal disease and selection of type of adverse pregnancy outcome. Therefore no meta-analysis was performed. Most studies did not control for confounders, thus raising serious doubts about their conclusions. The methodological limitations of most studies did not allow conclusions concerning the effects of periodontal disease on adverse pregnancy outcomes. Larger and methodologically rigorous analytical studies using reliable outcomes and exposure measures are recommended.

Exploring differential item functioning in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC

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Pollard Beth

2012-12-01

Full Text Available Abstract Background The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC is a widely used patient reported outcome in osteoarthritis. An important, but frequently overlooked, aspect of validating health outcome measures is to establish if items exhibit differential item functioning (DIF. That is, if respondents have the same underlying level of an attribute, does the item give the same score in different subgroups or is it biased towards one subgroup or another. The aim of the study was to explore DIF in the Likert format WOMAC for the first time in a UK osteoarthritis population with respect to demographic, social, clinical and psychological factors. Methods The sample comprised a community sample of 763 people with osteoarthritis who participated in the Somerset and Avon Survey of Health. The WOMAC was explored for DIF by gender, age, social deprivation, social class, employment status, distress, body mass index and clinical factors. Ordinal regression models were used to identify DIF items. Results After adjusting for age, two items were identified for the physical functioning subscale as having DIF with age identified as the DIF factor for 2 items, gender for 1 item and body mass index for 1 item. For the WOMAC pain subscale, for people with hip osteoarthritis one item was identified with age-related DIF. The impact of the DIF items rarely had a significant effect on the conclusions of group comparisons. Conclusions Overall, the WOMAC performed well with only a small number of DIF items identified. However, as DIF items were identified in for the WOMAC physical functioning subscale it would be advisable to analyse data taking into account the possible impact of the DIF items when weight, gender or especially age effects, are the focus of interest in UK-based osteoarthritis studies. Similarly for the WOMAC pain subscale in people with hip osteoarthritis it would be worthwhile to analyse data taking into account the

Few items in the thyroid-related quality of life instrument ThyPRO exhibited differential item functioning.

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Watt, Torquil; Groenvold, Mogens; Hegedüs, Laszlo; Bonnema, Steen Joop; Rasmussen, Åse Krogh; Feldt-Rasmussen, Ulla; Bjorner, Jakob Bue

2014-02-01

To evaluate the extent of differential item functioning (DIF) within the thyroid-specific quality of life patient-reported outcome measure, ThyPRO, according to sex, age, education and thyroid diagnosis. A total of 838 patients with benign thyroid diseases completed the ThyPRO questionnaire (84 five-point items, 13 scales). Uniform and nonuniform DIF were investigated using ordinal logistic regression, testing for both statistical significance and magnitude (∆R(2) > 0.02). Scale level was estimated by the sum score, after purification. Twenty instances of DIF in 17 of the 84 items were found. Eight according to diagnosis, where the goiter scale was the one most affected, possibly due to differing perceptions in patients with auto-immune thyroid diseases compared to patients with simple goiter. Eight DIFs according to age were found, of which 5 were in positively worded items, which younger patients were more likely to endorse; one according to gender: women were more likely to report crying, and three according to educational level. The vast majority of DIF had only minor influence on the scale scores (0.1-2.3 points on the 0-100 scales), but two DIF corresponded to a difference of 4.6 and 9.8, respectively. Ordinal logistic regression identified DIF in 17 of 84 items. The potential impact of this on the present scales was low, but items displaying DIF could be avoided when developing abbreviated scales, where the potential impact of DIF (due to fewer items) will be larger.

Evaluation of the box and blocks test, stereognosis and item banks of activity and upper extremity function in youths with brachial plexus birth palsy.

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Mulcahey, Mary Jane; Kozin, Scott; Merenda, Lisa; Gaughan, John; Tian, Feng; Gogola, Gloria; James, Michelle A; Ni, Pengsheng

2012-09-01

One of the greatest limitations to measuring outcomes in pediatric orthopaedics is the lack of effective instruments. Computer adaptive testing, which uses large item banks, select only items that are relevant to a child's function based on a previous response and filters items that are too easy or too hard or simply not relevant to the child. In this way, computer adaptive testing provides for a meaningful, efficient, and precise method to evaluate patient-reported outcomes. Banks of items that assess activity and upper extremity (UE) function have been developed for children with cerebral palsy and have enabled computer adaptive tests that showed strong reliability, strong validity, and broader content range when compared with traditional instruments. Because of the void in instruments for children with brachial plexus birth palsy (BPBP) and the importance of having an UE and activity scale, we were interested in how well these items worked in this population. Cross-sectional, multicenter study involving 200 children with BPBP was conducted. The box and block test (BBT) and Stereognosis tests were administered and patient reports of UE function and activity were obtained with the cerebral palsy item banks. Differential item functioning (DIF) was examined. Predictive ability of the BBT and stereognosis was evaluated with proportional odds logistic regression model. Spearman correlations coefficients (rs) were calculated to examine correlation between stereognosis and the BBT and between individual stereognosis items and the total stereognosis score. Six of the 86 items showed DIF, indicating that the activity and UE item banks may be useful for computer adaptive tests for children with BPBP. The penny and the button were strongest predictors of impairment level (odds ratio=0.34 to 0.40]. There was a good positive relationship between total stereognosis and BBT scores (rs=0.60). The BBT had a good negative (rs=-0.55) and good positive (rs=0.55) relationship with

Bilateral Arthrodesis of the Ankle Joint: Self-Reported Outcomes in 35 Patients From the Swedish Ankle Registry.

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Henricson, Anders; Kamrad, Ilka; Rosengren, Björn; Carlsson, Åke

Bilateral ankle arthrodesis is seldom performed, and results concerning the outcome and satisfaction can only sparsely be found in published studies. We analyzed the data from 35 patients who had undergone bilateral ankle arthrodesis in the Swedish Ankle Registry using patient-reported generic and region-specific outcome measures. Of 36 talocrural arthrodeses and 34 tibio-talar-calcaneal arthrodeses, 6 ankles (9%) had undergone repeat arthrodesis because of nonunion. After a mean follow-up period of 47 ± 5 (range 12 to 194) months, the mean scores were as follows: self-reported foot and ankle score, 33 ± 10 (range 4 to 48); the EuroQol Group's EQ-5D ™ score, 0.67 ± 0.28 (range -0.11 to 1), the EuroQol Group's visual analog scale score, 70 ± 19 (range 20 to 95), 36-item Short Form Health Survey (SF-36) physical domain, 39 ± 11 (range 16 to 58); and SF-36 mental domain, 54 ± 14 (range 17 to 71). Patients with rheumatoid arthritis seemed to have similar self-reported foot and ankle scores but possibly lower EQ-5D ™ and SF-36 scores. Those with talocrural arthrodeses scored higher than did those with tibio-talar-calcaneal arthrodeses on the EQ5D ™ and SF-36 questionnaires (p = .03 and p = .04). In 64 of 70 ankles (91%), the patients were satisfied or very satisfied with the outcome. In conclusion, we consider bilateral ankle arthrodesis to be a reasonable treatment for symptomatic hindfoot arthritis, with high postoperative mid-term satisfaction and satisfactory scores on the patient-reported generic and region-specific outcome measures, when no other treatment option is available. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Three-item Direct Observation Screen (TIDOS) for autism spectrum disorder

OpenAIRE

Oner, Pinar; Oner, Ozgur; Munir, Kerim

2013-01-01

We compared ratings on the Three-Item Direct Observation Screen test for autism spectrum disorders completed by pediatric residents with the Social Communication Questionnaire parent reports as an augmentative tool for improving autism spectrum disorder screening performance. We examined three groups of children (18–60 months) comparable in age (18–24 month, 24–36 month, 36–60 preschool subgroups) and gender distribution: n = 86 with Diagnostic and Statistical Manual of Mental Disorders (4th ...

[Survey on the applicability of SF-36 version-2 (SF-36v2) in assessment quality of life among urban residents in Chengdu city].

Science.gov (United States)

Zhao, Longchao; Liu, Zhijun; He, Yan; Li, Ningxiu; Liu, Danping

2014-05-01

To explore the psychometric performances and applicability of SF-36v2 in assessment quality of life among urban residents in Chengdu. During Oct. to Dec., 2012, 2 186 adult urban residents with clear mind and well self-express were recruited in the study by multistage stratified cluster sampling method in Chengdu urban area. The survey questionnaires included general health condition and quality of life, which was adopted the SF-36v2. Internal consistency reliability, test-retest reliability and construct validity were all analyzed as indicators of the psychometric performance. The survey released 2 186 questionnaires, with 2 182 ones returned and 2 178(99.8%) met the data standard. The scores of 8 scales in SF-36v2, including physical function (PF), role-physical (RP), bodily pain (BP), general health (GH), vitality (VT), social function (SF), role-emotion (RE) and mental health (MH), were 89.15 ± 17.56, 85.18 ± 22.52, 76.64 ± 17.80, 64.13 ± 19.56, 70.39 ± 17.31, 86.43 ± 17.35, 87.79 ± 19.24 and 80.61 ± 13.49, respectively; the floor effects were 0.28%, 0.41%, 0.23%, 0.28%, 0.09%, 0.05%, 0.14% and 0.23%, respectively; and the ceiling effects were 51.38%, 60.60%, 58.08%, 0.83%, 2.94%, 50.32%, 64.00% and 3.95%, respectively. The item-convergent validities were all achieved the standard (r = 0.40) except the item MH5 (Have you been happy?), and the total scaling success rate of item-convergent validity was 97.14%. The scales' success rates of item-discriminant validities for the SF, VT and MH scales were 93.75%, 56.25% and 97.50% respectively, while the rates of others were 100.00% and the total success rate was 96.43%. The internal reliability ranged from 0.724 to 0.974 across all the scales, except for SF (r = 0.603) and VT (r = 0.697). The two-week test-retest reliability ranged from 0.610 to 0.845. Within factor analysis, two common factors were confirmed, separately representing physical health and mental health, altogether contributing 64.4% of the

Health-related quality of life outcomes and level of evidence in pediatric neurosurgery.

Science.gov (United States)

Hansen, Daniel; Vedantam, Aditya; Briceño, Valentina; Lam, Sandi K; Luerssen, Thomas G; Jea, Andrew

2016-10-01

OBJECTIVE The emphasis on health-related quality of life (HRQOL) outcomes is increasing, along with an emphasis on evidence-based medicine. However, there is a notable paucity of validated HRQOL instruments for the pediatric population. Furthermore, no standardization or consensus currently exists concerning which HRQOL outcome measures ought to be used in pediatric neurosurgery. The authors wished to identify HRQOL outcomes used in pediatric neurosurgery research over the past 10 years, their frequency, and usage trends. METHODS Three top pediatric neurosurgical journals were reviewed for the decade from 2005 to 2014 for clinical studies of pediatric neurosurgical procedures that report HRQOL outcomes. Similar studies in the peer-reviewed journal Pediatrics were also used as a benchmark. Publication year, level of evidence, and HRQOL outcomes were collected for each article. RESULTS A total of 31 HRQOL studies were published in the pediatric neurosurgical literature over the study period. By comparison, there were 55 such articles in Pediatrics. The number of publications using HRQOL instruments showed a significant positive trend over time for Pediatrics (B = 0.62, p = 0.02) but did not increase significantly over time for the 3 neurosurgical journals (B = 0.12, p = 0.5). The authors identified a total of 46 different HRQOL instruments used across all journals. Within the neurosurgical journals, the Hydrocephalus Outcome Questionnaire (HOQ) (24%) was the most frequently used, followed by the Health Utilities Index (HUI) (16%), the Pediatric Quality of Life Inventory (PedsQL) (12%), and the 36-Item Short Form Health Survey (SF-36) (12%). Of the 55 articles identified in Pediatrics, 22 (40%) used a version of the PedsQL. No neurosurgical study reached above Level 4 on the Oxford Centre for Evidence-Based Medicine (OCEBM) system. However, multiple studies from Pediatrics achieved OCEBM Level 3, several were categorized as Level 2, and one reached Level 1

Test Score Equating Using Discrete Anchor Items versus Passage-Based Anchor Items: A Case Study Using "SAT"® Data. Research Report. ETS RR-14-14

Science.gov (United States)

Liu, Jinghua; Zu, Jiyun; Curley, Edward; Carey, Jill

2014-01-01

The purpose of this study is to investigate the impact of discrete anchor items versus passage-based anchor items on observed score equating using empirical data.This study compares an "SAT"® critical reading anchor that contains more discrete items proportionally, compared to the total tests to be equated, to another anchor that…

Quantification and detoxification of aflatoxin in food items

Energy Technology Data Exchange (ETDEWEB)

Nisa, A. U.; Hina, S.; Ejaz, N. [Pakistan Council of Scientific and Industrial Research Laboratories, Lahore (Pakistan). Dept. of Food and Biotechnology

2013-07-15

The present study was conducted to quantify and detoxify the antitoxins in food items. For this purpose, total 30 samples of food were collected. The samples were quantified using thin layer chromatography (TLC) for the presence of aflatoxin level in food items. Out of them aflatoxins were not found in 10 samples. Remaining 20 aflatoxins +ve samples were treated with various chemical solutions i.e. 0.1% HCl, 0.3%HCl, 0.5% HCI, 10% citric acid, 30% citric acid, 50% calcium hydroxide, 0.2 and 0.3% NaOCl, 96% ethanol and 99% acetone for detoxification. The aflatoxins were reduced to 55.1%, 90.9%, 28.08% and 80.0% in Super Sella rice, Super Basmati rice, Brown rice and White rice, respectively. The aflatoxin level was reduced in maize grain, damaged wheat, peanut, figs and dates upto 31.3 %, 64.3 %, 63.6%, 42.7% and 19.8%, respectively. Aflatoxins were detoxified in cereals Dal Chana, Dal Mash, Dal Masoor, turmeric (Haldi) and Nigela seeds (Kalwangi) upto 70.5%, 83.0%, 46.2%, 82.09% and 36.9%, respectively. Reduction of aflatoxins was carried out 39.7 %,7.l % 39.5% 82.0% and 62.0% in red chilli, makhana, corn flakes, desert (Kheer Mix) and pistachio. The significant results (p = 0.042) of detoxification of aflatoxins in food items were obtained from present study. (author)

Quantification and detoxification of aflatoxin in food items

International Nuclear Information System (INIS)

Nisa, A.U.; Hina, S.; Ejaz, N.

2013-01-01

The present study was conducted to quantify and detoxify the antitoxins in food items. For this purpose, total 30 samples of food were collected. The samples were quantified using thin layer chromatography (TLC) for the presence of aflatoxin level in food items. Out of them aflatoxins were not found in 10 samples. Remaining 20 aflatoxins +ve samples were treated with various chemical solutions i.e. 0.1% HCl, 0.3%HCl, 0.5% HCI, 10% citric acid, 30% citric acid, 50% calcium hydroxide, 0.2 and 0.3% NaOCl, 96% ethanol and 99% acetone for detoxification. The aflatoxins were reduced to 55.1%, 90.9%, 28.08% and 80.0% in Super Sella rice, Super Basmati rice, Brown rice and White rice, respectively. The aflatoxin level was reduced in maize grain, damaged wheat, peanut, figs and dates upto 31.3 %, 64.3 %, 63.6%, 42.7% and 19.8%, respectively. Aflatoxins were detoxified in cereals Dal Chana, Dal Mash, Dal Masoor, turmeric (Haldi) and Nigela seeds (Kalwangi) upto 70.5%, 83.0%, 46.2%, 82.09% and 36.9%, respectively. Reduction of aflatoxins was carried out 39.7 %,7.l % 39.5% 82.0% and 62.0% in red chilli, makhana, corn flakes, desert (Kheer Mix) and pistachio. The significant results (p = 0.042) of detoxification of aflatoxins in food items were obtained from present study. (author)

Validation of Portuguese version of Quality of Erection Questionnaire (QEQ) and comparison to International Index of Erectile Function (IIEF) and RAND 36-Item Health Survey.

Science.gov (United States)

Reis, Ana Luiza; Reis, Leonardo Oliveira; Saade, Ricardo Destro; Santos, Carlos Alberto; Lima, Marcelo Lopes de; Fregonesi, Adriano

2015-01-01

To validate the Quality of Erection Questionnaire (QEQ) considering Brazilian social-cultural aspects. To determine equivalence between the Portuguese and the English QEQ versions, the Portuguese version was back-translated by two professors who are native English speakers. After language equivalence had been determined, urologists considered the QEQ Portuguese version suitable. Men with self-reported erectile dysfunction (ED) and infertile men who had a stable sexual relationship for at least 6 months were invited to answer the QEQ, the International Index of Erectile Function (IIEF) and the RAND 36-Item Health Survey (RAND-36). The questionnaires were presented together and answered without help in a private room. Internal consistency (Cronbach's α), test-retest reliability (Spearman), convergent validity (Spearman correlation) coefficients and known-groups validity (the ability of the QEQ Portuguese version to differentiate erectile dysfunction severity groups) were assessed. We recruited 197 men (167 ED patients and 30 non-ED patients), mean age of 53.3 and median of 55.5 years (23-82 years). The Portuguese version of the QEQ had high internal consistency (Cronbach α=0.93), high stability between test and retest (ICC 0.83, with IC 95%: 0.76-0.88, pPortuguese version presented good psychometric properties and high convergent validity in relation to IIEF. The low correlations between the QEQ and the RAND-36, as well as between the IIEF and the RAND-36 indicated IIEF and QEQ specificity, which may have resulted from the patients' psychological adaptations that minimized the impact of ED on Quality of Life (QoL) and reestablished the well-being feeling.

The Protective Behavioral Strategies for Marijuana Scale: Further examination using item response theory.

Science.gov (United States)

Pedersen, Eric R; Huang, Wenjing; Dvorak, Robert D; Prince, Mark A; Hummer, Justin F

2017-08-01

Given recent state legislation legalizing marijuana for recreational purposes and majority popular opinion favoring these laws, we developed the Protective Behavioral Strategies for Marijuana scale (PBSM) to identify strategies that may mitigate the harms related to marijuana use among those young people who choose to use the drug. In the current study, we expand on the initial exploratory study of the PBSM to further validate the measure with a large and geographically diverse sample (N = 2,117; 60% women, 30% non-White) of college students from 11 different universities across the United States. We sought to develop a psychometrically sound item bank for the PBSM and to create a short assessment form that minimizes respondent burden and time. Quantitative item analyses, including exploratory and confirmatory factor analyses with item response theory (IRT) and evaluation of differential item functioning (DIF), revealed an item bank of 36 items that was examined for unidimensionality and good content coverage, as well as a short form of 17 items that is free of bias in terms of gender (men vs. women), race (White vs. non-White), ethnicity (Hispanic vs. non-Hispanic), and recreational marijuana use legal status (state recreational marijuana was legal for 25.5% of participants). We also provide a scoring table for easy transformation from sum scores to IRT scale scores. The PBSM item bank and short form associated strongly and negatively with past month marijuana use and consequences. The measure may be useful to researchers and clinicians conducting intervention and prevention programs with young adults. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Mental health in early pregnancy is associated with pregnancy outcome in women with pregestational diabetes

DEFF Research Database (Denmark)

Callesen, N F; Secher, A L; Cramon, P

2015-01-01

-related quality of life, anxiety, depression and locus of control were seen in women delivering large or appropriate for gestational age infants. CONCLUSIONS: Poor mental quality of life and the presence of depressive symptoms in early pregnancy were associated with preterm delivery in women with pregestational......AIM: To explore the role of early pregnancy health-related quality of life, anxiety, depression and locus of control for pregnancy outcome in women with pregestational diabetes. METHODS: This was a cohort study of 148 pregnant women with pregestational diabetes (118 with Type 1 diabetes and 30...... with Type 2 diabetes), who completed three internationally validated questionnaires: the 36-item Short-Form Health Survey, the Hospital Anxiety and Depression Scale and the Multidimensional Health Locus of Control survey at 8 weeks. Selected pregnancy outcomes were preterm delivery (

Quality-of-Life Impairments Persist Six Months After Treatment of Graves' Hyperthyroidism and Toxic Nodular Goiter

DEFF Research Database (Denmark)

Cramon, Per; Winther, Kristian Hillert; Watt, Torquil

2016-01-01

treated with antithyroid drugs, radioactive iodine, or surgery. Disease-specific and generic HRQoL were assessed using the thyroid-related patient-reported outcome (ThyPRO) and the Medical Outcomes Study 36-item Short Form (SF-36), respectively, evaluated at baseline and six-month follow-up. The scores...

77 FR 15798 - Notice of Intent To Repatriate Cultural Items: The Colorado College, Colorado Springs, CO

Science.gov (United States)

2012-03-16

... Center) and the Denver Museum of Nature & Science (formerly known as the Denver Museum of Natural History... responsible for the determinations in this notice. History and Description of the Cultural Items The 36... ancestral Puebloan peoples and modern Puebloan peoples based on oral tradition and scientific studies. The...

PROMIS PF CAT Outperforms the ODI and SF-36 Physical Function Domain in Spine Patients.

Science.gov (United States)

Brodke, Darrel S; Goz, Vadim; Voss, Maren W; Lawrence, Brandon D; Spiker, William Ryan; Hung, Man

2017-06-15

The Oswestry Disability Index v2.0 (ODI), SF36 Physical Function Domain (SF-36 PFD), and PROMIS Physical Function CAT v1.2 (PF CAT) questionnaires were prospectively collected from 1607 patients complaining of back or leg pain, visiting a university-based spine clinic. All questionnaires were collected electronically, using a tablet computer. The aim of this study was to compare the psychometric properties of the PROMIS PF CAT with the ODI and SF36 Physical Function Domain in the same patient population. Evidence-based decision-making is improved by using high-quality patient-reported outcomes measures. Prior studies have revealed the shortcomings of the ODI and SF36, commonly used in spine patients. The PROMIS Network has developed measures with excellent psychometric properties. The Physical Function domain, delivered by Computerized Adaptive Testing (PF CAT), performs well in the spine patient population, though to-date direct comparisons with common measures have not been performed. Standard Rasch analysis was performed to directly compare the psychometrics of the PF CAT, ODI, and SF36 PFD. Spearman correlations were computed to examine the correlations of the three instruments. Time required for administration was also recorded. One thousand six hundred seven patients were administered all assessments. The time required to answer all items in the PF CAT, ODI, and SF-36 PFD was 44, 169, and 99 seconds. The ceiling and floor effects were excellent for the PF CAT (0.81%, 3.86%), while the ceiling effects were marginal and floor effects quite poor for the ODI (6.91% and 44.24%) and SF-36 PFD (5.97% and 23.65%). All instruments significantly correlated with each other. The PROMIS PF CAT outperforms the ODI and SF-36 PFD in the spine patient population and is highly correlated. It has better coverage, while taking less time to administer with fewer questions to answer. 2.

A New Functional Health Literacy Scale for Japanese Young Adults Based on Item Response Theory.

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Tsubakita, Takashi; Kawazoe, Nobuo; Kasano, Eri

2017-03-01

Health literacy predicts health outcomes. Despite concerns surrounding the health of Japanese young adults, to date there has been no objective assessment of health literacy in this population. This study aimed to develop a Functional Health Literacy Scale for Young Adults (funHLS-YA) based on item response theory. Each item in the scale requires participants to choose the most relevant term from 3 choices in relation to a target item, thus assessing objective rather than perceived health literacy. The 20-item scale was administered to 1816 university students and 1751 responded. Cronbach's α coefficient was .73. Difficulty and discrimination parameters of each item were estimated, resulting in the exclusion of 1 item. Some items showed different difficulty parameters for male and female participants, reflecting that some aspects of health literacy may differ by gender. The current 19-item version of funHLS-YA can reliably assess the objective health literacy of Japanese young adults.

Normative data and discriminative properties of short form 36 (SF-36 in Turkish urban population

Directory of Open Access Journals (Sweden)

Akvardar Yildiz

2006-10-01

Full Text Available Abstract Background SF-36 has been both translated into different languages and adapted to different cultures to obtain comparable data on health status internationally. However there have been only a limited number of studies focused on the discriminative ability of SF-36 regarding social and disease status in developing countries. The aim of this study was to obtain population norms of the short form 36 (SF-36 health survey and the association of SF-36 domains with demographic and socioeconomic variables in an urban population in Turkey. Methods A cross-sectional study. Face to face interviews were carried out with a sample of households. The sample was systematically selected from two urban Health Districts in Izmir, Turkey. The study group consisted of 1,279 people selected from a study population of 46,290 people aged 18 and over. Results Internal consistencies of the scales were high, with the exception of mental health and vitality. Physical health scales were associated with both age and gender. On the other hand, mental health scales were less strongly associated with age and gender. Women reported poorer health compared to men in general. Social risk factors (employment status, lower education and economic strain were associated with worse health profiles. The SF-36 was found to be capable of discriminating disease status. Conclusion Our findings, cautiously generalisable to urban population, suggest that the SF-36 can be a valuable tool for studies on health outcomes in Turkish population. SF-36 may also be a promising measure for research on health inequalities in Turkey and other developing countries.

Item validity vs. item discrimination index: a redundancy?

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Panjaitan, R. L.; Irawati, R.; Sujana, A.; Hanifah, N.; Djuanda, D.

2018-03-01

In several literatures about evaluation and test analysis, it is common to find that there are calculations of item validity as well as item discrimination index (D) with different formula for each. Meanwhile, other resources said that item discrimination index could be obtained by calculating the correlation between the testee’s score in a particular item and the testee’s score on the overall test, which is actually the same concept as item validity. Some research reports, especially undergraduate theses tend to include both item validity and item discrimination index in the instrument analysis. It seems that these concepts might overlap for both reflect the test quality on measuring the examinees’ ability. In this paper, examples of some results of data processing on item validity and item discrimination index were compared. It would be discussed whether item validity and item discrimination index can be represented by one of them only or it should be better to present both calculations for simple test analysis, especially in undergraduate theses where test analyses were included.

Human Adenovirus 36 Infection Increased the Risk of Obesity

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Xu, Mei-Yan; Cao, Bing; Wang, Dong-Fang; Guo, Jing-Hui; Chen, Kai-Li; Shi, Mai; Yin, Jian; Lu, Qing-Bin

2015-01-01

Abstract Human adenovirus 36 (HAdV-36), as the key pathogen, was supposed and discussed to be associated with obesity. We searched the references on the association between HAdV-36 infection and obesity with the different epidemiological methods, to explore the relationship with a larger sample size by meta-analysis and compare the differences of epidemiological methods and population subsets by the subgroup analyses. We conducted literature search on the association between HAdV-36 infections and obesity in English or Chinese published up to July 1, 2015. The primary outcome was the HAdV-36 infection rate in the obese and lean groups; the secondary outcomes were the BMI level and BMI z-score in the HAdV-36 positive and negative groups. The pooled odds ratio (OR) was calculated for the primary outcome; the standardized mean differences (SMDs) were calculated for the secondary and third outcomes. Prediction interval (PI) was graphically presented in the forest plot of the random effect meta-analyses. Metaregression analysis and subgroup analysis were performed. Finally 24 references with 10,191 study subjects were included in the meta-analysis. The obesity subjects were more likely to be infected with HAdV-36 compared to the lean controls (OR = 2.00; 95%CI: 1.46, 2.74; PI: 0.59, 6.76; P infection for obesity were 1.77 (95%CI: 1.19, 2.63; PI: 0.44, 7.03; P = 0.005) and 2.26 (95%CI: 1.67, 3.07; PI: 1.45, 3.54; P SMD of BMI was 0.28 (95% CI: 0.08, 0.47; PI: −0.53, 1.08; P = 0.006) in the HAdV-36 positive subjects with a high heterogeneity (I2 = 86.5%; P infection was higher than those without HAdV-36 infection (SMD = 0.19; 95%CI: −0.31, 0.70; PI: −2.10, 2.49), which had no significantly statistical difference (P = 0.453). HAdV-36 infection increased the risk of obesity. HAdV-36 also increased the risk of weight gain in adults, which was not observed in children. PMID:26705235

Reliability and validity of the English (Singapore) and Chinese (Singapore) versions of the Short-Form 36 version 2 in a multi-ethnic urban Asian population in Singapore.

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Thumboo, Julian; Wu, Yi; Tai, E-Shyong; Gandek, Barbara; Lee, Jeannette; Ma, Stefan; Heng, Derrick; Wee, Hwee-Lin

2013-11-01

We aimed to evaluate the measurement properties of the Singapore English and Chinese versions of the Short-Form 36 version 2 (SF-36v2) Questionnaire, an improved version of the widely used SF-36, for assessing health-related quality of life (HRQoL) in a multi-ethnic urban Asian population in Singapore. SF-36v2 scores and data on medical history, demographic and lifestyle factors from the Singapore Prospective Study Programme were analyzed. Convergent and divergent validity, internal consistency, floor and ceiling effects, known group validity and factor structure of the SF-36v2 were assessed for the English and Chinese versions, respectively. Complete data for 4,917 participants (45.8 %) out of 10,747 eligible individuals were analyzed (survey language: 4,115 English and 802 Chinese). Item-scale correlations exceeded 0.4 for all items of the English SF-36v2 and for all except one item of the Chinese SF-36v2 (bathe and dress: item-scale correlation: 0.36). In the English SF-36v2, Cronbach's alpha exceeded 0.70 for all scales. In the Chinese SF-36v2, Cronbach's alpha exceeded 0.7 on all scales except social functioning (Cronbach's alpha: 0.68). For known groups validity, respondents with chronic medical conditions expectedly reported lower SF-36v2 score on most English and Chinese SF-36v2 scales. In confirmatory factor analysis, the Singapore three-component model was favored over the United States two-component and Japan three-component models. The English and Chinese SF-36v2 are valid and reliable for assessing HRQoL among English and Chinese-speaking Singaporeans. Test-retest reliability and responsiveness of the English and Chinese SF-36v2 in Singapore remain to be evaluated.

Measuring participation in patients with chronic back pain-the 5-Item Pain Disability Index.

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McKillop, Ashley B; Carroll, Linda J; Dick, Bruce D; Battié, Michele C

2018-02-01

Of the three broad outcome domains of body functions and structures, activities, and participation (eg, engaging in valued social roles) outlined in the World Health Organization's (WHO) International Classification of Functioning, Disability and Health (ICF), it has been argued that participation is the most important to individuals, particularly those with chronic health problems. Yet, participation is not commonly measured in back pain research. The aim of this study was to investigate the construct validity of a modified 5-Item Pain Disability Index (PDI) score as a measure of participation in people with chronic back pain. A validation study was conducted using cross-sectional data. Participants with chronic back pain were recruited from a multidisciplinary pain center in Alberta, Canada. The outcome measure of interest is the 5-Item PDI. Each study participant was given a questionnaire package containing measures of participation, resilience, anxiety and depression, pain intensity, and pain-related disability, in addition to the PDI. The first five items of the PDI deal with social roles involving family responsibilities, recreation, social activities with friends, work, and sexual behavior, and comprised the 5-Item PDI seeking to measure participation. The last two items of the PDI deal with self-care and life support functions and were excluded. Construct validity of the 5-Item PDI as a measure of participation was examined using Pearson correlations or point-biserial correlations to test each hypothesized association. Participants were 70 people with chronic back pain and a mean age of 48.1 years. Forty-four (62.9%) were women. As hypothesized, the 5-Item PDI was associated with all measures of participation, including the Participation Assessment with Recombined Tools-Objective (r=-0.61), Late-Life Function and Disability Instrument: Disability Component (frequency: r=-0.66; limitation: r=-0.65), Work and Social Adjustment Scale (r=0.85), a global

Methodology for the development and calibration of the SCI-QOL item banks.

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Tulsky, David S; Kisala, Pamela A; Victorson, David; Choi, Seung W; Gershon, Richard; Heinemann, Allen W; Cella, David

2015-05-01

To develop a comprehensive, psychometrically sound, and conceptually grounded patient reported outcomes (PRO) measurement system for individuals with spinal cord injury (SCI). Individual interviews (n=44) and focus groups (n=65 individuals with SCI and n=42 SCI clinicians) were used to select key domains for inclusion and to develop PRO items. Verbatim items from other cutting-edge measurement systems (i.e. PROMIS, Neuro-QOL) were included to facilitate linkage and cross-population comparison. Items were field tested in a large sample of individuals with traumatic SCI (n=877). Dimensionality was assessed with confirmatory factor analysis. Local item dependence and differential item functioning were assessed, and items were calibrated using the item response theory (IRT) graded response model. Finally, computer adaptive tests (CATs) and short forms were administered in a new sample (n=245) to assess test-retest reliability and stability. A calibration sample of 877 individuals with traumatic SCI across five SCI Model Systems sites and one Department of Veterans Affairs medical center completed SCI-QOL items in interview format. We developed 14 unidimensional calibrated item banks and 3 calibrated scales across physical, emotional, and social health domains. When combined with the five Spinal Cord Injury--Functional Index physical function banks, the final SCI-QOL system consists of 22 IRT-calibrated item banks/scales. Item banks may be administered as CATs or short forms. Scales may be administered in a fixed-length format only. The SCI-QOL measurement system provides SCI researchers and clinicians with a comprehensive, relevant and psychometrically robust system for measurement of physical-medical, physical-functional, emotional, and social outcomes. All SCI-QOL instruments are freely available on Assessment CenterSM.

An abbreviated Faecal Incontinence Quality of Life Scale for Chinese-speaking population with colorectal cancer after surgery: cultural adaptation and item reduction.

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Hsu, L-F; Hung, C-L; Kuo, L-J; Tsai, P-S

2017-09-01

No instrument is available to assess the impact of faecal incontinence (FI) of quality of life for Chinese-speaking population. The purpose of the study was to adapt the Faecal Incontinence Quality of Life Scale (FIQL) for patients with colorectal cancer, assess the factor structure and reduce the items for brevity. A sample of 120 participants were enrolled. Internal consistency, test-retest reliability, and convergent and contrasted-groups validity were assessed. Construct validity was analysed using an exploratory and confirmatory factor analyses (CFA). The internal consistency (Cronbach's α of the total scale and four subscales = 0.98 and 0.97, 0.96, 0.92, 0.82 respectively), test-retest reliability (intraclass correlation coefficients ≥.98 for all scales with p < .001) and significant correlations of all scales with selected subscales of the Medical Outcomes Study 36-Item Short-Form Health Survey and the Wexner scale suggested satisfactory reliability and validity. The severe FI group (with a Wexner score ≥9) scored significantly lower on the scale than the less severe FI group (with a Wexner score <9) did (p < .001). The CFA supported a two-factor structure and demonstrated an excellent model fit of the 15-item abbreviated version of the FIQL-Chinese. The FIQL-Chinese has satisfactory validity and reliability and the abbreviated version may be more practical and applicable. © 2016 John Wiley & Sons Ltd.

Evaluation of psychometric properties and differential item functioning of 8-item Child Perceptions Questionnaires using item response theory.

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Yau, David T W; Wong, May C M; Lam, K F; McGrath, Colman

2015-08-19

Four-factor structure of the two 8-item short forms of Child Perceptions Questionnaire CPQ11-14 (RSF:8 and ISF:8) has been confirmed. However, the sum scores are typically reported in practice as a proxy of Oral health-related Quality of Life (OHRQoL), which implied a unidimensional structure. This study first assessed the unidimensionality of 8-item short forms of CPQ11-14. Item response theory (IRT) was employed to offer an alternative and complementary approach of validation and to overcome the limitations of classical test theory assumptions. A random sample of 649 12-year-old school children in Hong Kong was analyzed. Unidimensionality of the scale was tested by confirmatory factor analysis (CFA), principle component analysis (PCA) and local dependency (LD) statistic. Graded response model was fitted to the data. Contribution of each item to the scale was assessed by item information function (IIF). Reliability of the scale was assessed by test information function (TIF). Differential item functioning (DIF) across gender was identified by Wald test and expected score functions. Both CPQ11-14 RSF:8 and ISF:8 did not deviate much from the unidimensionality assumption. Results from CFA indicated acceptable fit of the one-factor model. PCA indicated that the first principle component explained >30 % of the total variation with high factor loadings for both RSF:8 and ISF:8. Almost all LD statistic items suggesting little contribution of information to the scale and item removal caused little practical impact. Comparing the TIFs, RSF:8 showed slightly better information than ISF:8. In addition to oral symptoms items, the item "Concerned with what other people think" demonstrated a uniform DIF (p Items related to oral symptoms were not informative to OHRQoL and deletion of these items is suggested. The impact of DIF across gender on the overall score was minimal. CPQ11-14 RSF:8 performed slightly better than ISF:8 in measurement precision. The 6-item short forms

Validation of the italian version of the 15-item Myasthenia Gravis Quality-of-Life questionnaire.

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Raggi, Alberto; Leonardi, Matilde; Ayadi, Roberta; Antozzi, Carlo; Maggi, Lorenzo; Baggi, Fulvio; Mantegazza, Renato

2017-10-01

In this study we assess the Italian version of the 15-item Myasthenia Gravis Quality-of-Life questionnaire (MG-QOL15). The validation protocol included the MG-QOL15, the 36-item Short Form (SF-36), the Besta Neurological Institute Rating Scale for Myasthenia Gravis, and the MG-Composite. We used the Cronbach α to test reliability, the Spearman correlation to test short-term test-retest, the Kruskal-Wallis test to assess differences in MG-QOL15 between patients with different disease severity, and the Wilcoxon signed-rank test to assess sensitivity to change. Seventy-two patients were enrolled in the study. The mean MG-QOL15 score was 15.2 ± 12.2, with α = 0.93 and test-retest correlation = 0.93. Compared with the SF-36, the MG-QOL15 was superior in differentiating patients with different MG types (P = 0.041) and severity (P = 0.004), showed higher sensitivity to change (P = 0.003 for improved and P = 0.024 for worsened patients), and had higher correlations with the MG-Composite (rho = 0.367 vs. -0.213 and -0.154). The Italian version of the MG-QOL15 is valid, reliable, stable, and sensitive to changes. Muscle Nerve 56: 716-720, 2017. © 2016 Wiley Periodicals, Inc.

What proportion of prescription items dispensed in community pharmacies are eligible for the New Medicine Service?

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Wells, Katharine M; Boyd, Matthew J; Thornley, Tracey; Boardman, Helen F

2014-03-07

The payment structure for the New Medicine Service (NMS) in England is based on the assumption that 0.5% of prescription items dispensed in community pharmacies are eligible for the service. This assumption is based on a theoretical calculation. This study aimed to find out the actual proportion of prescription items eligible for the NMS dispensed in community pharmacies in order to compare this with the theoretical assumption. The study also aimed to investigate whether the proportion of prescription items eligible for the NMS is affected by pharmacies' proximity to GP practices. The study collected data from eight pharmacies in Nottingham belonging to the same large chain of pharmacies. Pharmacies were grouped by distance from the nearest GP practice and sampled to reflect the distribution by distance of all pharmacies in Nottingham. Data on one thousand consecutive prescription items were collected from each pharmacy and the number of NMS eligible items recorded. All NHS prescriptions were included in the sample. Data were analysed and proportions calculated with 95% confidence intervals used to compare the study results against the theoretical figure of 0.5% of prescription items being eligible for the NMS. A total of 8005 prescription items were collected (a minimum of 1000 items per pharmacy) of which 17 items were eligible to receive the service. The study found that 0.25% (95% confidence intervals: 0.14% to 0.36%) of prescription items were eligible for the NMS which differs significantly from the theoretical assumption of 0.5%. The opportunity rate for the service was lower, 0.21% (95% confidence intervals: 0.10% to 0.32%) of items, as some items eligible for the NMS did not translate into opportunities to offer the service. Of all the prescription items collected in the pharmacies, 28% were collected by patient representatives. The results of this study show that the proportion of items eligible for the NMS dispensed in community pharmacies is lower than

Study to validate the outcome goal, competencies and educational objectives for use in intensive care orientation programs.

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Boyle, M; Butcher, R; Kenney, C

1998-03-01

Intensive care orientation programs have become an accepted component of intensive care education. To date, however, there have been no Australian-based standards defining the appropriate level of competence to be attained upon completion of orientation. The aim of this study was to validate a set of aims, competencies and educational objectives that could form the basis of intensive care orientation and which would ensure an outcome standard of safe and effective practice. An initial document containing a statement of the desired outcome goal, six competency statements and 182 educational objectives was developed through a review of the orientation programs developed by the investigators. The Delphi technique was used to gain consensus among 13 nurses recognised for their expertise in intensive care education. The expert group rated the acceptability of each of the study items and provided suggestions for objectives to be included. An approval rating of 80 per cent was required to retain each of the study items, with the document refined through three Delphi rounds. The final document contains a validated statement of outcome goal, competencies and educational objectives for intensive care orientation programs.

Development of six PROMIS pediatrics proxy-report item banks.

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Irwin, Debra E; Gross, Heather E; Stucky, Brian D; Thissen, David; DeWitt, Esi Morgan; Lai, Jin Shei; Amtmann, Dagmar; Khastou, Leyla; Varni, James W; DeWalt, Darren A

2012-02-22

Pediatric self-report should be considered the standard for measuring patient reported outcomes (PRO) among children. However, circumstances exist when the child is too young, cognitively impaired, or too ill to complete a PRO instrument and a proxy-report is needed. This paper describes the development process including the proxy cognitive interviews and large-field-test survey methods and sample characteristics employed to produce item parameters for the Patient Reported Outcomes Measurement Information System (PROMIS) pediatric proxy-report item banks. The PROMIS pediatric self-report items were converted into proxy-report items before undergoing cognitive interviews. These items covered six domains (physical function, emotional distress, social peer relationships, fatigue, pain interference, and asthma impact). Caregivers (n = 25) of children ages of 5 and 17 years provided qualitative feedback on proxy-report items to assess any major issues with these items. From May 2008 to March 2009, the large-scale survey enrolled children ages 8-17 years to complete the self-report version and caregivers to complete the proxy-report version of the survey (n = 1548 dyads). Caregivers of children ages 5 to 7 years completed the proxy report survey (n = 432). In addition, caregivers completed other proxy instruments, PedsQL™ 4.0 Generic Core Scales Parent Proxy-Report version, PedsQL™ Asthma Module Parent Proxy-Report version, and KIDSCREEN Parent-Proxy-52. Item content was well understood by proxies and did not require item revisions but some proxies clearly noted that determining an answer on behalf of their child was difficult for some items. Dyads and caregivers of children ages 5-17 years old were enrolled in the large-scale testing. The majority were female (85%), married (70%), Caucasian (64%) and had at least a high school education (94%). Approximately 50% had children with a chronic health condition, primarily asthma, which was diagnosed or treated within 6

Chlorine-36 validation Study at Yucca Mountain, Nevada

International Nuclear Information System (INIS)

J. Paces

2006-01-01

The amount, spatial distribution, and velocity of water percolating through the unsaturated zone (UZ) at Yucca Mountain, Nevada, are important issues for assessing the performance of the proposed deep geologic repository for spent nuclear fuel and high-level radioactive waste. To help characterize the nature and history of UZ flow, isotopic studies were initiated in 1995, using rock samples collected from the Miocene ash-flow tuffs in the Exploratory Studies Facility (ESF), an 8-km-long tunnel constructed along the north-south extent of the repository block, and the Enhanced Characterization of the Repository Block (ECRB) Cross Drift, a 2.5-km-long tunnel constructed across the repository block (Figure 1-1, Sources: Modified from DOE 2002 [Figure 1-14] and USBR 1996). Scientists from Los Alamos National Laboratory (LANL) analyzed for chlorine-36 ( 36 Cl) in salts leached from whole-rock samples collected from tunnel walls and subsurface boreholes, and scientists from the U.S. Geological Survey (USGS) analyzed for isotopes of oxygen, carbon, uranium, lead, thorium, and strontium in secondary minerals collected from subsurface fractures and lithophysal cavities. Elevated values for ratios of 36 Cl to total chloride ( 36 Cl/CL) at the level of the proposed repository indicated that small amounts of water carrying bomb-pulse 36 Cl (i.e., 36 Cl/Cl ratios greater than 1250 x 10 -15 resulting from 36 Cl produced by atmospheric testing of nuclear devices during the 1950s and early 1960s) had percolated through welded and nonwelded tuffs to depths of 200 to 300 meters (m) beneath the land surface over the past 50 years. Because of the implications of short travel times to the performance of the proposed repository, the U.S. Department of Energy (DOE)/Office of Civilian Radioactive Waste Management (OCRWM), Office of Repository Development (ORD), decided to verify the 36 Cl/Cl data with an independent validation study. DOE asked the USGS to design and implement a validation

Chlorine-36 alidation Study at Yucca Mountain, Nevada

Energy Technology Data Exchange (ETDEWEB)

J. Paces

2006-08-28

The amount, spatial distribution, and velocity of water percolating through the unsaturated zone (UZ) at Yucca Mountain, Nevada, are important issues for assessing the performance of the proposed deep geologic repository for spent nuclear fuel and high-level radioactive waste. To help characterize the nature and history of UZ flow, isotopic studies were initiated in 1995, using rock samples collected from the Miocene ash-flow tuffs in the Exploratory Studies Facility (ESF), an 8-km-long tunnel constructed along the north-south extent of the repository block, and the Enhanced Characterization of the Repository Block (ECRB) Cross Drift, a 2.5-km-long tunnel constructed across the repository block (Figure 1-1, Sources: Modified from DOE 2002 [Figure 1-14] and USBR 1996). Scientists from Los Alamos National Laboratory (LANL) analyzed for chlorine-36 ({sup 36}Cl) in salts leached from whole-rock samples collected from tunnel walls and subsurface boreholes, and scientists from the U.S. Geological Survey (USGS) analyzed for isotopes of oxygen, carbon, uranium, lead, thorium, and strontium in secondary minerals collected from subsurface fractures and lithophysal cavities. Elevated values for ratios of {sup 36}Cl to total chloride ({sup 36}Cl/CL) at the level of the proposed repository indicated that small amounts of water carrying bomb-pulse {sup 36}Cl (i.e., {sup 36}Cl/Cl ratios greater than 1250 x 10{sup -15} resulting from {sup 36}Cl produced by atmospheric testing of nuclear devices during the 1950s and early 1960s) had percolated through welded and nonwelded tuffs to depths of 200 to 300 meters (m) beneath the land surface over the past 50 years. Because of the implications of short travel times to the performance of the proposed repository, the U.S. Department of Energy (DOE)/Office of Civilian Radioactive Waste Management (OCRWM), Office of Repository Development (ORD), decided to verify the {sup 36}Cl/Cl data with an independent validation study. DOE asked the USGS

Quantitative ligand and receptor binding studies reveal the mechanism of interleukin-36 (IL-36) pathway activation.

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Zhou, Li; Todorovic, Viktor; Kakavas, Steve; Sielaff, Bernhard; Medina, Limary; Wang, Leyu; Sadhukhan, Ramkrishna; Stockmann, Henning; Richardson, Paul L; DiGiammarino, Enrico; Sun, Chaohong; Scott, Victoria

2018-01-12

IL-36 cytokines signal through the IL-36 receptor (IL-36R) and a shared subunit, IL-1RAcP (IL-1 receptor accessory protein). The activation mechanism for the IL-36 pathway is proposed to be similar to that of IL-1 in that an IL-36R agonist (IL-36α, IL-36β, or IL-36γ) forms a binary complex with IL-36R, which then recruits IL-1RAcP. Recent studies have shown that IL-36R interacts with IL-1RAcP even in the absence of an agonist. To elucidate the IL-36 activation mechanism, we considered all possible binding events for IL-36 ligands/receptors and examined these events in direct binding assays. Our results indicated that the agonists bind the IL-36R extracellular domain with micromolar affinity but do not detectably bind IL-1RAcP. Using surface plasmon resonance (SPR), we found that IL-1RAcP also does not bind IL-36R when no agonist is present. In the presence of IL-36α, however, IL-1RAcP bound IL-36R strongly. These results suggested that the main pathway to the IL-36R·IL-36α·IL-1RAcP ternary complex is through the IL-36R·IL-36α binary complex, which recruits IL-1RAcP. We could not measure the binding affinity of IL-36R to IL-1RAcP directly, so we engineered a fragment crystallizable-linked construct to induce IL-36R·IL-1RAcP heterodimerization and predicted the binding affinity during a complete thermodynamic cycle to be 74 μm The SPR analysis also indicated that the IL-36R antagonist IL-36Ra binds IL-36R with higher affinity and a much slower off rate than the IL-36R agonists, shedding light on IL-36 pathway inhibition. Our results reveal the landscape of IL-36 ligand and receptor interactions, improving our understanding of IL-36 pathway activation and inhibition. © 2018 by The American Society for Biochemistry and Molecular Biology, Inc.

Evaluating the quality of medical multiple-choice items created with automated processes.

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Gierl, Mark J; Lai, Hollis

2013-07-01

Computerised assessment raises formidable challenges because it requires large numbers of test items. Automatic item generation (AIG) can help address this test development problem because it yields large numbers of new items both quickly and efficiently. To date, however, the quality of the items produced using a generative approach has not been evaluated. The purpose of this study was to determine whether automatic processes yield items that meet standards of quality that are appropriate for medical testing. Quality was evaluated firstly by subjecting items created using both AIG and traditional processes to rating by a four-member expert medical panel using indicators of multiple-choice item quality, and secondly by asking the panellists to identify which items were developed using AIG in a blind review. Fifteen items from the domain of therapeutics were created in three different experimental test development conditions. The first 15 items were created by content specialists using traditional test development methods (Group 1 Traditional). The second 15 items were created by the same content specialists using AIG methods (Group 1 AIG). The third 15 items were created by a new group of content specialists using traditional methods (Group 2 Traditional). These 45 items were then evaluated for quality by a four-member panel of medical experts and were subsequently categorised as either Traditional or AIG items. Three outcomes were reported: (i) the items produced using traditional and AIG processes were comparable on seven of eight indicators of multiple-choice item quality; (ii) AIG items can be differentiated from Traditional items by the quality of their distractors, and (iii) the overall predictive accuracy of the four expert medical panellists was 42%. Items generated by AIG methods are, for the most part, equivalent to traditionally developed items from the perspective of expert medical reviewers. While the AIG method produced comparatively fewer plausible

Development of a subjective cognitive decline questionnaire using item response theory: a pilot study.

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Gifford, Katherine A; Liu, Dandan; Romano, Raymond; Jones, Richard N; Jefferson, Angela L

2015-12-01

Subjective cognitive decline (SCD) may indicate unhealthy cognitive changes, but no standardized SCD measurement exists. This pilot study aims to identify reliable SCD questions. 112 cognitively normal (NC, 76±8 years, 63% female), 43 mild cognitive impairment (MCI; 77±7 years, 51% female), and 33 diagnostically ambiguous participants (79±9 years, 58% female) were recruited from a research registry and completed 57 self-report SCD questions. Psychometric methods were used for item-reduction. Factor analytic models assessed unidimensionality of the latent trait (SCD); 19 items were removed with extreme response distribution or trait-fit. Item response theory (IRT) provided information about question utility; 17 items with low information were dropped. Post-hoc simulation using computerized adaptive test (CAT) modeling selected the most commonly used items (n=9 of 21 items) that represented the latent trait well (r=0.94) and differentiated NC from MCI participants (F(1,146)=8.9, p=0.003). Item response theory and computerized adaptive test modeling identified nine reliable SCD items. This pilot study is a first step toward refining SCD assessment in older adults. Replication of these findings and validation with Alzheimer's disease biomarkers will be an important next step for the creation of a SCD screener.

Investigating the Impact of Item Parameter Drift for Item Response Theory Models with Mixture Distributions

Directory of Open Access Journals (Sweden)

Yoon Soo ePark

2016-02-01

Full Text Available This study investigates the impact of item parameter drift (IPD on parameter and ability estimation when the underlying measurement model fits a mixture distribution, thereby violating the item invariance property of unidimensional item response theory (IRT models. An empirical study was conducted to demonstrate the occurrence of both IPD and an underlying mixture distribution using real-world data. Twenty-one trended anchor items from the 1999, 2003, and 2007 administrations of Trends in International Mathematics and Science Study (TIMSS were analyzed using unidimensional and mixture IRT models. TIMSS treats trended anchor items as invariant over testing administrations and uses pre-calibrated item parameters based on unidimensional IRT. However, empirical results showed evidence of two latent subgroups with IPD. Results showed changes in the distribution of examinee ability between latent classes over the three administrations. A simulation study was conducted to examine the impact of IPD on the estimation of ability and item parameters, when data have underlying mixture distributions. Simulations used data generated from a mixture IRT model and estimated using unidimensional IRT. Results showed that data reflecting IPD using mixture IRT model led to IPD in the unidimensional IRT model. Changes in the distribution of examinee ability also affected item parameters. Moreover, drift with respect to item discrimination and distribution of examinee ability affected estimates of examinee ability. These findings demonstrate the need to caution and evaluate IPD using a mixture IRT framework to understand its effect on item parameters and examinee ability.

Investigating the Impact of Item Parameter Drift for Item Response Theory Models with Mixture Distributions.

Science.gov (United States)

Park, Yoon Soo; Lee, Young-Sun; Xing, Kuan

2016-01-01

This study investigates the impact of item parameter drift (IPD) on parameter and ability estimation when the underlying measurement model fits a mixture distribution, thereby violating the item invariance property of unidimensional item response theory (IRT) models. An empirical study was conducted to demonstrate the occurrence of both IPD and an underlying mixture distribution using real-world data. Twenty-one trended anchor items from the 1999, 2003, and 2007 administrations of Trends in International Mathematics and Science Study (TIMSS) were analyzed using unidimensional and mixture IRT models. TIMSS treats trended anchor items as invariant over testing administrations and uses pre-calibrated item parameters based on unidimensional IRT. However, empirical results showed evidence of two latent subgroups with IPD. Results also showed changes in the distribution of examinee ability between latent classes over the three administrations. A simulation study was conducted to examine the impact of IPD on the estimation of ability and item parameters, when data have underlying mixture distributions. Simulations used data generated from a mixture IRT model and estimated using unidimensional IRT. Results showed that data reflecting IPD using mixture IRT model led to IPD in the unidimensional IRT model. Changes in the distribution of examinee ability also affected item parameters. Moreover, drift with respect to item discrimination and distribution of examinee ability affected estimates of examinee ability. These findings demonstrate the need to caution and evaluate IPD using a mixture IRT framework to understand its effects on item parameters and examinee ability.

A Study on the Systematization of Classification Process for NSG Trigger List Items

Energy Technology Data Exchange (ETDEWEB)

Yang, Seunghyo; Tae, Jaewoong; Shin, Donghoon [Korea Institute of Nuclear Nonproliferation and Control/Nuclear Export Control Div., Daejeon (Korea, Republic of)

2013-05-15

In 1978, Nuclear Suppliers Group (NSG) was established to prevent nuclear items from being used for nuclear weapons. NSG drew up the NSG Guidelines (INFCIRC/254) that regulates export control items(so-called NSG trigger list items) and procedures. NSG recommends its member countries to reflect these guidelines on their export control systems and fulfill their obligations. Korea has carried out export controls on nuclear items by reflecting NSG Guidelines on Notice on Trade of Strategic Item of Foreign Trade Act since joining NSG in 1995. Nuclear export control starts with Classification that determines whether export items can be used for strategic items (goods and technologies that can be exclusively used for the manufacture, development and use of WMD). The standard of Classification is based on the NSG Guidelines. However, due to the qualitative characteristics of the Guidelines, there take place lots of difficulties in the Classification. Thus this study aims to suggest the systematic Classification process. Recently, the number of Classification requests is rapidly increasing due to the UAE commercial nuclear power plants and the Jordan reactors export. It is required to provide a more systematic Classification standard and process in order to provide an efficient and consistent Classification. Thus, this study analyzed limitations of EDP which causes difficulties in the process of classification due to its qualitative characteristics. Besides, it established systematic Classification process by quantitatively analyzing EDP. Consequently, it is expected that the results of this study will be used for as actual Classification. It still remains to establish a criterion of detailed information, which is one of the most important in the Classification for technology. Therefore, a further study will be conducted to establish a criterion of detailed information by analyzing Classification cases through the text mining techniques.

A Study on the Systematization of Classification Process for NSG Trigger List Items

International Nuclear Information System (INIS)

Yang, Seunghyo; Tae, Jaewoong; Shin, Donghoon

2013-01-01

In 1978, Nuclear Suppliers Group (NSG) was established to prevent nuclear items from being used for nuclear weapons. NSG drew up the NSG Guidelines (INFCIRC/254) that regulates export control items(so-called NSG trigger list items) and procedures. NSG recommends its member countries to reflect these guidelines on their export control systems and fulfill their obligations. Korea has carried out export controls on nuclear items by reflecting NSG Guidelines on Notice on Trade of Strategic Item of Foreign Trade Act since joining NSG in 1995. Nuclear export control starts with Classification that determines whether export items can be used for strategic items (goods and technologies that can be exclusively used for the manufacture, development and use of WMD). The standard of Classification is based on the NSG Guidelines. However, due to the qualitative characteristics of the Guidelines, there take place lots of difficulties in the Classification. Thus this study aims to suggest the systematic Classification process. Recently, the number of Classification requests is rapidly increasing due to the UAE commercial nuclear power plants and the Jordan reactors export. It is required to provide a more systematic Classification standard and process in order to provide an efficient and consistent Classification. Thus, this study analyzed limitations of EDP which causes difficulties in the process of classification due to its qualitative characteristics. Besides, it established systematic Classification process by quantitatively analyzing EDP. Consequently, it is expected that the results of this study will be used for as actual Classification. It still remains to establish a criterion of detailed information, which is one of the most important in the Classification for technology. Therefore, a further study will be conducted to establish a criterion of detailed information by analyzing Classification cases through the text mining techniques

Patient-Reported Allergies Predict Worse Outcomes After Hip and Knee Arthroplasty: Results From a Prospective Cohort Study.

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Otero, Jesse E; Graves, Christopher M; Gao, Yubo; Olson, Tyler S; Dickinson, Christopher C; Chalus, Rhonda J; Vittetoe, David A; Goetz, Devon D; Callaghan, John J

2016-12-01

Retrospective analyses have demonstrated correlation between patient-reported allergies and negative outcomes after total joint arthroplasty. We sought to validate these observations in a prospective cohort. One hundred forty-four patients undergoing total hip arthroplasty and 302 patients undergoing total knee arthroplasty were prospectively enrolled. Preoperatively, patients listed their allergies and completed the Medical Outcomes Study Short Form 36 (SF-36) and the Charlson Comorbidity Index (CCI) Questionnaire. At a mean of 17 months (range 12-25 months) postoperatively, SF-36, CCI, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were obtained by telephone survey. Regression analysis was used to determine the strength of correlation between patient age, comorbidity burden, and number of allergies and outcome measurements. In 446 patients, 273 reported at least 1 allergy. The number of allergies reported ranged from 0 to 33. Penicillin or its derivative was the most frequently reported allergy followed by sulfa, environmental allergen, and narcotic pain medication. Patients reporting at least 1 allergy had a significantly lower postoperative SF-36 Physical Component Score compared to those reporting no allergies (51.3 vs 49.4, P = .01). The SF-36 postoperative Mental Component Score was no different between groups. Multivariate regression analysis showed that age and patient reported allergies, but not comorbidities, were independently associated with worse postoperative SF-36 Physical Component Summary (PCS) and WOMAC score. Patients with allergies experienced the same improvement in SF-36 PCS as those without an allergy. Comorbidities did not correlate with patient-reported function postoperatively. Patients who report allergies have lower postoperative outcome scores but may experience the same increment in improvement after total joint arthroplasty. Copyright © 2016 Elsevier Inc. All rights reserved.

Answering Fixed Response Items in Chemistry: A Pilot Study.

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Hateley, R. J.

1979-01-01

Presents a pilot study on student thinking in chemistry. Verbal comments of a group of six college students were recorded and analyzed to identify how each student arrives at the correct answer in fixed response items in chemisty. (HM)

A physiotherapy triage assessment service for people with low back disorders: evaluation of short-term outcomes

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Bath B

2012-06-01

Full Text Available Brenna Bath, Punam PahwaCollege of Medicine, University of Saskatchewan, Saskatoon, CanadaPurpose: To determine the short-term effects of physiotherapy triage assessments on self-reported pain, functioning, and general well-being and quality of life in people with low back-related disorders.Methods: Participants with low back–related complaints were recruited from those referred to a spinal triage assessment program delivered by physiotherapists (PTs. Before undergoing the triage assessment, the participants completed a battery of questionnaires covering a range of sociodemographic, clinical, and psychosocial features. The study used the Numeric Pain Rating Scale (NPRS, the Oswestry Disability Index (ODI, and the Medical Outcomes Survey 36-item short-form version 2 (SF-36v2 to assess self-reported pain, function, and quality of life. Baseline measures and variables were analyzed using a descriptive analysis method (ie, proportions, means, medians. Paired samples t-tests or Wilcoxon matched-pair signed-rank tests were used to analyze the overall group differences between the pretest and posttest outcome measures where appropriate.Results: A total of 108 out of 115 (93.9% participants completed the posttest survey. The Physical Component Summary of the SF36v2 was the only measure that demonstrated significant improvement (P < 0.001.Conclusion: A spinal triage assessment program delivered by PTs can be viewed as a complex intervention that may have the potential to affect a wide range of patient-related outcomes. Further research is needed to examine the long-term outcomes and explore potential mechanisms of improvement using a biopsychosocial framework.Keywords: interprofessional practice, quality of life, back pain, orthopedics

Dutch translation and cross-cultural adaptation of the PROMIS® physical function item bank and cognitive pre-test in Dutch arthritis patients.

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Oude Voshaar, Martijn Ah; Ten Klooster, Peter M; Taal, Erik; Krishnan, Eswar; van de Laar, Mart Afj

2012-03-05

Patient-reported physical function is an established outcome domain in clinical studies in rheumatology. To overcome the limitations of the current generation of questionnaires, the Patient-Reported Outcomes Measurement Information System (PROMIS®) project in the USA has developed calibrated item banks for measuring several domains of health status in people with a wide range of chronic diseases. The aim of this study was to translate and cross-culturally adapt the PROMIS physical function item bank to the Dutch language and to pretest it in a sample of patients with arthritis. The items of the PROMIS physical function item bank were translated using rigorous forward-backward protocols and the translated version was subsequently cognitively pretested in a sample of Dutch patients with rheumatoid arthritis. Few issues were encountered in the forward-backward translation. Only 5 of the 124 items to be translated had to be rewritten because of culturally inappropriate content. Subsequent pretesting showed that overall, questions of the Dutch version were understood as they were intended, while only one item required rewriting. Results suggest that the translated version of the PROMIS physical function item bank is semantically and conceptually equivalent to the original. Future work will be directed at creating a Dutch-Flemish final version of the item bank to be used in research with Dutch speaking populations.

Quality of Life in rural and urban populations in Lebanon using SF-36 Health Survey

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Retel-Rude Nathalie

2003-08-01

Full Text Available Abstract Background Measuring health status in a population is important for the evaluation of interventions and the prediction of health and social care needs. Quality of life (QoL studies are an essential complement to medical evaluation but most of the tools available in this area are in English. In order to evaluated QoL in rural and urban areas in Lebanon, the short form 36 health survey (SF-36 was adapted into Arabic. Methods SF-36 was administered in a cross-sectional study, to collect sociodemographic and environmental variables as well as self reported morbidity. We analysed a representative sample containing 1632 subjects, from whom we randomly picked 524 subjects aged 14 years and over. The translation, cultural adaptation and validation of the SF-36 followed the International Quality of Life Assessment methodology. Multivariate analysis (generalized linear model was performed to test the effect of habitat (rural on urban areas on all domains of the SF-36. Results The rate of missing data is very low (0.23% of items. Item level validation supported the assumptions underlying Likert scoring. SF-36 scale scores showed wide variability and acceptable internal consistency (Cronbach's alpha >0.70, factor analysis yielded patterns of factor correlation comparable to that found in the U.S.A and France. Patients resident in rural areas had higher vitality scores than those in urban areas. Older people reported more satisfaction with some domains of life than younger people, except for physical functioning. The QoL of women is poorer than men; certain symptoms and morbidity independently influence the domains of SF-36 in this population. Conclusion The results support the validity of the SF-36 Arabic version. Habitat has a minor influence on QoL, women had a poor QoL, and health problems had differential impact on QoL.

Quality of Life in rural and urban populations in Lebanon using SF-36 Health Survey

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Sabbah, Ibtissam; Drouby, Nabil; Sabbah, Sanaa; Retel-Rude, Nathalie; Mercier, Mariette

2003-01-01

Background Measuring health status in a population is important for the evaluation of interventions and the prediction of health and social care needs. Quality of life (QoL) studies are an essential complement to medical evaluation but most of the tools available in this area are in English. In order to evaluated QoL in rural and urban areas in Lebanon, the short form 36 health survey (SF-36) was adapted into Arabic. Methods SF-36 was administered in a cross-sectional study, to collect sociodemographic and environmental variables as well as self reported morbidity. We analysed a representative sample containing 1632 subjects, from whom we randomly picked 524 subjects aged 14 years and over. The translation, cultural adaptation and validation of the SF-36 followed the International Quality of Life Assessment methodology. Multivariate analysis (generalized linear model) was performed to test the effect of habitat (rural on urban areas) on all domains of the SF-36. Results The rate of missing data is very low (0.23% of items). Item level validation supported the assumptions underlying Likert scoring. SF-36 scale scores showed wide variability and acceptable internal consistency (Cronbach's alpha >0.70), factor analysis yielded patterns of factor correlation comparable to that found in the U.S.A and France. Patients resident in rural areas had higher vitality scores than those in urban areas. Older people reported more satisfaction with some domains of life than younger people, except for physical functioning. The QoL of women is poorer than men; certain symptoms and morbidity independently influence the domains of SF-36 in this population. Conclusion The results support the validity of the SF-36 Arabic version. Habitat has a minor influence on QoL, women had a poor QoL, and health problems had differential impact on QoL. PMID:12952543

A Systematic Approach to Identify Promising New Items for Small to Medium Enterprises: A Case Study

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Sukjae Jeong

2016-11-01

Full Text Available Despite the growing importance of identifying new business items for small and medium enterprises (SMEs, most previous studies focus on conglomerates. The paucity of empirical studies has also led to limited real-life applications. Hence, this study proposes a systematic approach to find new business items (NBIs that help the prospective SMEs develop, evaluate, and select viable business items to survive the competitive environment. The proposed approach comprises two stages: (1 the classification of diversification of SMEs; and (2 the searching and screening of business items. In the first stage, SMEs are allocated to five groups, based on their internal technological competency and external market conditions. In the second stage, based on the types of SMEs identified in the first stage, a set of alternative business items is derived by combining the results of portfolio analysis and benchmarking analysis. After deriving new business items, a market and technology-driven matrix analysis is utilized to screen suitable business items, and the Bruce Merrifield-Ohe (BMO method is used to categorize and identify prospective items based on market attractiveness and internal capability. To illustrate the applicability of the proposed approach, a case study is presented.

Coping and mental health outcomes among Sierra Leonean war-affected youth: Results from a longitudinal study.

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Sharma, Manasi; Fine, Shoshanna L; Brennan, Robert T; Betancourt, Theresa S

2017-02-01

This study explored how coping with war-related traumatic events in Sierra Leone impacted mental health outcomes among 529 youth (aged 10-17 at baseline; 25% female) using longitudinal data from three time points (Time 1 in 2002, Time 2 in 2004, and Time 3 in 2008). We examined two types of coping items (approach and avoidance); used multiple regression models to test their relations with long-term mental health outcomes (internalizing behaviors, externalizing behaviors, adaptive/prosocial behaviors, and posttraumatic stress symptoms); and used mediation analyses to test whether coping explained the relation between previous war exposures (being raped, death of parent(s), or killing/injuring someone during the war) and those outcomes. We found that avoidance coping items were associated with lower internalizing and posttraumatic stress behaviors at Time 3, and provided some evidence of mediating the relation between death of parent(s) during the war and the two outcomes mentioned above. Approach coping was associated with higher Time 3 adaptive/prosocial behaviors, whereas avoidance coping was associated with lower Time 3 adaptive/prosocial behaviors. Avoidance coping may be a protective factor against mental illness, whereas approach coping may be a promotive factor for adaptive/prosocial behaviors in war-affected societies. This study has important implications for designing and implementing mental health interventions for youth in postconflict settings.

Evaluation of Northwest University, Kano Post-UTME Test Items Using Item Response Theory

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Bichi, Ado Abdu; Hafiz, Hadiza; Bello, Samira Abdullahi

2016-01-01

High-stakes testing is used for the purposes of providing results that have important consequences. Validity is the cornerstone upon which all measurement systems are built. This study applied the Item Response Theory principles to analyse Northwest University Kano Post-UTME Economics test items. The developed fifty (50) economics test items was…

Public sector achievement in 36 countries

NARCIS (Netherlands)

Benedikt Goderis

2015-01-01

This report examines the inputs, outputs and outcomes of the public sector in 36 countries (including the EU-28) over the period 1995-2012. We study two sectors – education and health – in some detail, while taking a more general look at the sectors social safety, housing, social security and

The role of attention in item-item binding in visual working memory.

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Peterson, Dwight J; Naveh-Benjamin, Moshe

2017-09-01

An important yet unresolved question regarding visual working memory (VWM) relates to whether or not binding processes within VWM require additional attentional resources compared with processing solely the individual components comprising these bindings. Previous findings indicate that binding of surface features (e.g., colored shapes) within VWM is not demanding of resources beyond what is required for single features. However, it is possible that other types of binding, such as the binding of complex, distinct items (e.g., faces and scenes), in VWM may require additional resources. In 3 experiments, we examined VWM item-item binding performance under no load, articulatory suppression, and backward counting using a modified change detection task. Binding performance declined to a greater extent than single-item performance under higher compared with lower levels of concurrent load. The findings from each of these experiments indicate that processing item-item bindings within VWM requires a greater amount of attentional resources compared with single items. These findings also highlight an important distinction between the role of attention in item-item binding within VWM and previous studies of long-term memory (LTM) where declines in single-item and binding test performance are similar under divided attention. The current findings provide novel evidence that the specific type of binding is an important determining factor regarding whether or not VWM binding processes require attention. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Unidimensionality and reliability under Mokken scaling of the Dutch language version of the SF-36

NARCIS (Netherlands)

Heijden, P.G.M. van der; Buuren, S. van; Fekkes, M.; Radder, J.; Verrips, E.

2003-01-01

The sub-scales of the SF-36 in the Dutch National Study are investigated with respect to unidimensionality and reliability. It is argued that these properties deserve separate treatment. For unidimensionality we use a non-parametric model from item response theory, called the Mokken scaling model,

The use of the SF-36 questionnaire in adult survivors of childhood cancer: evaluation of data quality, score reliability, and scaling assumptions

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Winter David L

2006-10-01

Full Text Available Abstract Background The SF-36 has been used in a number of previous studies that have investigated the health status of childhood cancer survivors, but it never has been evaluated regarding data quality, scaling assumptions, and reliability in this population. As health status among childhood cancer survivors is being increasingly investigated, it is important that the measurement instruments are reliable, validated and appropriate for use in this population. The aim of this paper was to determine whether the SF-36 questionnaire is a valid and reliable instrument in assessing self-perceived health status of adult survivors of childhood cancer. Methods We examined the SF-36 to see how it performed with respect to (1 data completeness, (2 distribution of the scale scores, (3 item-internal consistency, (4 item-discriminant validity, (5 internal consistency, and (6 scaling assumptions. For this investigation we used SF-36 data from a population-based study of 10,189 adult survivors of childhood cancer. Results Overall, missing values ranged per item from 0.5 to 2.9 percent. Ceiling effects were found to be highest in the role limitation-physical (76.7% and role limitation-emotional (76.5% scales. All correlations between items and their hypothesised scales exceeded the suggested standard of 0.40 for satisfactory item-consistency. Across all scales, the Cronbach's alpha coefficient of reliability was found to be higher than the suggested value of 0.70. Consistent across all cancer groups, the physical health related scale scores correlated strongly with the Physical Component Summary (PCS scale scores and weakly with the Mental Component Summary (MCS scale scores. Also, the mental health and role limitation-emotional scales correlated strongly with the MCS scale score and weakly with the PCS scale score. Moderate to strong correlations with both summary scores were found for the general health perception, energy/vitality, and social functioning

Association Between History of Multiple Concussions and Health Outcomes Among Former College Football Players: 15-Year Follow-up From the NCAA Concussion Study (1999-2001).

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Kerr, Zachary Y; Thomas, Leah C; Simon, Janet E; McCrea, Michael; Guskiewicz, Kevin M

2018-06-01

Previous research has examined associations between concussion history and adverse health outcomes among former professional football players. Less is known about the potential effects of concussion among former college football players without additional exposure at the professional level. To examine the association between concussion and adverse health outcomes in a cohort of former college football players without exposure to professional football, 15 years after their playing careers ended. Cross-sectional study; Level of evidence, 3. A sample of 204 former collegiate football players (23.4% of eligible athletes with available contact information)-all of whom played at least 1 season of football from 1999 to 2001 in the National Collegiate Athletic Association (NCAA) and had no professional football exposure-completed a general health survey that assessed lifetime concussion history and included the following: the Veterans RAND 36 Item Health Survey, containing a physical composite score (PCS) and mental composite score (MCS); the depression module of the Patient Health Questionnaire; and the 4-item CAGE alcohol dependence questionnaire (for "cutting down, annoyance by criticism, guilty feeling, and eye-openers"). Multivariable binomial regression models estimated adjusted prevalence ratios (PRs) with 95% CIs while controlling for demographics and playing history covariates through forward selection model building. Most participants reported a concussion history (84.3%). Overall, 22.1% and 39.2% of participants reported a PCS and an MCS history of multiple concussions and adverse health outcomes were found among former collegiate football players without professional football exposure but were limited to those reporting ≥3 prior concussions. Because only 23.4% of eligible athletes responded to the survey, the possibility of ascertainment bias exists, and our findings should thus be interpreted with some caution. Continued examination within nonprofessional

A validated model for the 22-item Sino-Nasal Outcome Test subdomain structure in chronic rhinosinusitis.

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Feng, Allen L; Wesely, Nicholas C; Hoehle, Lloyd P; Phillips, Katie M; Yamasaki, Alisa; Campbell, Adam P; Gregorio, Luciano L; Killeen, Thomas E; Caradonna, David S; Meier, Josh C; Gray, Stacey T; Sedaghat, Ahmad R

2017-12-01

Previous studies have identified subdomains of the 22-item Sino-Nasal Outcome Test (SNOT-22), reflecting distinct and largely independent categories of chronic rhinosinusitis (CRS) symptoms. However, no study has validated the subdomain structure of the SNOT-22. This study aims to validate the existence of underlying symptom subdomains of the SNOT-22 using confirmatory factor analysis (CFA) and to develop a subdomain model that practitioners and researchers can use to describe CRS symptomatology. A total of 800 patients with CRS were included into this cross-sectional study (400 CRS patients from Boston, MA, and 400 CRS patients from Reno, NV). Their SNOT-22 responses were analyzed using exploratory factor analysis (EFA) to determine the number of symptom subdomains. A CFA was performed to develop a validated measurement model for the underlying SNOT-22 subdomains along with various tests of validity and goodness of fit. EFA demonstrated 4 distinct factors reflecting: sleep, nasal, otologic/facial pain, and emotional symptoms (Cronbach's alpha, >0.7; Bartlett's test of sphericity, p Kaiser-Meyer-Olkin >0.90), independent of geographic locale. The corresponding CFA measurement model demonstrated excellent measures of fit (root mean square error of approximation, 0.95; Tucker-Lewis index, >0.95) and measures of construct validity (heterotrait-monotrait [HTMT] ratio, 0.7), again independent of geographic locale. The use of the 4-subdomain structure for SNOT-22 (reflecting sleep, nasal, otologic/facial pain, and emotional symptoms of CRS) was validated as the most appropriate to calculate SNOT-22 subdomain scores for patients from different geographic regions using CFA. © 2017 ARS-AAOA, LLC.

Evaluation of the Fecal Incontinence Quality of Life Scale (FIQL) using item response theory reveals limitations and suggests revisions.

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Peterson, Alexander C; Sutherland, Jason M; Liu, Guiping; Crump, R Trafford; Karimuddin, Ahmer A

2018-06-01

The Fecal Incontinence Quality of Life Scale (FIQL) is a commonly used patient-reported outcome measure for fecal incontinence, often used in clinical trials, yet has not been validated in English since its initial development. This study uses modern methods to thoroughly evaluate the psychometric characteristics of the FIQL and its potential for differential functioning by gender. This study analyzed prospectively collected patient-reported outcome data from a sample of patients prior to colorectal surgery. Patients were recruited from 14 general and colorectal surgeons in Vancouver Coastal Health hospitals in Vancouver, Canada. Confirmatory factor analysis was used to assess construct validity. Item response theory was used to evaluate test reliability, describe item-level characteristics, identify local item dependence, and test for differential functioning by gender. 236 patients were included for analysis, with mean age 58 and approximately half female. Factor analysis failed to identify the lifestyle, coping, depression, and embarrassment domains, suggesting lack of construct validity. Items demonstrated low difficulty, indicating that the test has the highest reliability among individuals who have low quality of life. Five items are suggested for removal or replacement. Differential test functioning was minimal. This study has identified specific improvements that can be made to each domain of the Fecal Incontinence Quality of Life Scale and to the instrument overall. Formatting, scoring, and instructions may be simplified, and items with higher difficulty developed. The lifestyle domain can be used as is. The embarrassment domain should be significantly revised before use.

Factors of influence upon the SF-36-based health related quality of life of patients following surgery for petroclival and lateral posterior surface of pyramid meningiomas.

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Pintea, B; Kandenwein, J A; Lorenzen, H; Boström, J P; Daher, F; Velazquez, V; Kristof, R A

2018-03-01

To describe the patient's self assessed health related quality of life (saHRQoL) based upon the medical outcome study 36-item short form health survey (SF-36) as well as the factors of influence upon the saHRQoL following surgery for petroclival (PCM) and lateral posterior surface of the pyramid (LPPM) meningiomas. In a series of 78 patients operated consecutively for PCM (n = 46) or LPPM (n = 32) the preoperative, intraoperative and postoperative data were collected retrospectively. The saHRQoL was obtained by mailing the SF-36 questionnaire to the patients. The SF-36 data of the whole patients group was compared with a healthy population. The SF-36 data of the PCM- and LPPM were compared to each other. The influence of pre-, intra- and postoperative findings upon the SF-36 was assessed by uni- and multifactorial analysis. 58 (69%) out of the 78 patients answered the SF-36 questionnaire at a median postoperative follow-up of 59 months. The patients, who answered the SF-36 questionnaire, had a significant lower perioperative complication rate than those who did not (46% vs. 75%, p = 0.019). The saHRQoL of the LPPM and PCM was reduced on several sub-scales, when compared to the German reference population. The outcome of PCM is, assessed by saHRQoL as well as by conventional neurosurgical grading scales, inferior to that of LPPM. The saHRQoL of LPPM correlated in the uni- and multivariate analysis with the early postoperative KPI on the sub-scales SF1 (physical functioning) and SF5 (vitality). Accordingly, the sub-scale SF2 (role-physical) of PCM correlated with the change of the KPI from preoperative to the last follow up. The saHRQoL of the evaluable patients was lower than that of the normal population. The saHRQoL score of PCM-patients was lower than that of LPPM-patients. For the future the saHRQol should be assessed routinely; It reflects the patients' perspective upon postoperative outcome and enables the comparison with other treatment modalities

Measuring the Effects of Self-Awareness: Construction of the Self-Awareness Outcomes Questionnaire

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Anna Sutton

2016-11-01

Full Text Available Dispositional self-awareness is conceptualized in several different ways, including insight, reflection, rumination and mindfulness, with the latter in particular attracting extensive attention in recent research. While self-awareness is generally associated with positive psychological well-being, these different conceptualizations are also each associated with a range of unique outcomes. This two part, mixed methods study aimed to advance understanding of dispositional self-awareness by developing a questionnaire to measure its outcomes. In Study 1, expert focus groups categorized and extended an initial pool of potential items from previous research. In Study 2, these items were reduced to a 38 item self-report questionnaire with four factors representing three beneficial outcomes (reflective self-development, acceptance and proactivity and one negative outcome (costs. Regression of these outcomes against self-awareness measures revealed that self-reflection and insight predicted beneficial outcomes, rumination predicted reduced benefits and increased costs, and mindfulness predicted both increased proactivity and costs. These studies help to refine the self-awareness concept by identifying the unique outcomes associated with the concepts of self-reflection, insight, reflection, rumination and mindfulness. It can be used in future studies to evaluate and develop awareness-raising techniques to maximize self-awareness benefits while minimizing related costs.

Development of six PROMIS pediatrics proxy-report item banks

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Irwin Debra E

2012-02-01

Full Text Available Abstract Background Pediatric self-report should be considered the standard for measuring patient reported outcomes (PRO among children. However, circumstances exist when the child is too young, cognitively impaired, or too ill to complete a PRO instrument and a proxy-report is needed. This paper describes the development process including the proxy cognitive interviews and large-field-test survey methods and sample characteristics employed to produce item parameters for the Patient Reported Outcomes Measurement Information System (PROMIS pediatric proxy-report item banks. Methods The PROMIS pediatric self-report items were converted into proxy-report items before undergoing cognitive interviews. These items covered six domains (physical function, emotional distress, social peer relationships, fatigue, pain interference, and asthma impact. Caregivers (n = 25 of children ages of 5 and 17 years provided qualitative feedback on proxy-report items to assess any major issues with these items. From May 2008 to March 2009, the large-scale survey enrolled children ages 8-17 years to complete the self-report version and caregivers to complete the proxy-report version of the survey (n = 1548 dyads. Caregivers of children ages 5 to 7 years completed the proxy report survey (n = 432. In addition, caregivers completed other proxy instruments, PedsQL™ 4.0 Generic Core Scales Parent Proxy-Report version, PedsQL™ Asthma Module Parent Proxy-Report version, and KIDSCREEN Parent-Proxy-52. Results Item content was well understood by proxies and did not require item revisions but some proxies clearly noted that determining an answer on behalf of their child was difficult for some items. Dyads and caregivers of children ages 5-17 years old were enrolled in the large-scale testing. The majority were female (85%, married (70%, Caucasian (64% and had at least a high school education (94%. Approximately 50% had children with a chronic health condition, primarily

Development of a questionnaire to assess patient satisfaction with allergen-specific immunotherapy in adults: item generation, item reduction, and preliminary validation

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Justícia JL

2011-05-01

Full Text Available Jose Luis Justícia1, Eva Baró2, Victoria Cardona3, Pedro Guardia4, Pedro Ojeda5, José Maria Olaguíbel6, José Maria Vega7, Carmen Vidal81Medical Department, Stallergenes Ibérica, Barcelona, Spain; 2Health Outcomes Research Department, 3D Health Research, Barcelona, Spain; 3Hospital Vall d'Hebron, Barcelona, Spain; 4Hospital Virgen Macarena, Sevilla, Spain; 5Clínica de Asma y Alergia Dres. Ojeda, Madrid, Spain; 6Complejo Hospitalario de Navarra, Pamplona, Spain; 7Hospital Regional Universitario Carlos Haya Málaga, Spain; 8Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, SpainBackground: Allergen-specific immunotherapy (SIT is a treatment capable of modifying the natural course of allergy, so ensuring good adherence to SIT is fundamental. Up until now there has not existed an instrument specifically developed to measure patient satisfaction with SIT, although its assessment could help us to comprehend better and improve treatment adherence and effectiveness. The aim of this study was to develop an instrument to measure adult patient satisfaction with SIT.Methods: Items were generated from a literature review, focus groups with allergic adult patients undergoing SIT, and a meeting with experts. Potential items were administered to allergic patients undergoing SIT in an observational, cross-sectional, multicenter study. Item reduction was based on quantitative and qualitative criteria. A preliminary assessment of feasibility, reliability, and validity of the retained items was performed.Results: An initial pool of 70 items was administered to 257 patients undergoing SIT. Fifty-four items were eliminated resulting in a provisional instrument with 16 items. Factor analysis yielded four factors that were identified as perceived efficacy, activities and environment, cost-benefit balance, and overall satisfaction, explaining 74.8% of variance. Ceiling and floor effects were negligible for overall score. Overall score was

Correlations Between the SF-36, the Oswestry-Disability Index and Rolland-Morris Disability Questionnaire in Patients Undergoing Lumbar Decompression According to Types of Spine Origin Pain.

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Ko, Sangbong; Chae, Seungbum

2017-07-01

Cross-sectional study. To determine the correlation between SF-36 (a measure for overall health status in patients) and Oswestry-Disability Index (ODI) or Rolland-Morris Disability Questionnaire (RMDQ) confined to spine according to the type of pain from the spine. Data showed moderate correlation between ODI and SF-36 Physical Component Score (PCS), Physical Functioning (PF) (r=-0.46), Physical Role Functioning (RP) (r=-0.284), Bodily Pain (BP) (r=-0.327), and Mental Component Score (MCS), Emotional Role Functioning (r=-0.250), Social Role Functioning (r=0.254), Vitality (r=0.296). Between January 1, 2008 and December 31, 2013, a total of 69 patients were enrolled in this study. They were diagnosed with lumbar spinal stenosis and underwent decompression surgery such as laminotomy in this hospital. The 3 standardized questionnaires (ODI, RMDQ, and SF-36) were given to these patients, at least 1 year after the surgery. ODI and SF-36 had a statistically significant (P=0.001) and moderate correlation. Small correlations were also seen between Physical Functioning (r=-0.46), Physical Role Functioning (r=-0.284), and Bodily Pain (r=-0.327) of SF-36 PCS and ODI, and between Emotional Role Functioning (r=-0.250), Social Role Functioning (r=-0.254), and Vitality (r=-0.296) of SF-36 Mental Component Score and ODI. Items in ODI for the level of pain while standing and traveling were mostly related to axial back pain, while item of lifting was related to referred buttock pain. Sleeping disturbance section in the ODI was mainly caused by radiated leg pain. In addition, RMDQ was also associated to the 3 types of pain. Moderate correlation was found between ODI or RMDQ as a condition-specific outcome and the SF-36, indicating overall health status. ODI was found to be a more adequate measure to evaluate axial back pain rather than referred pain or radiating pain. RMDQ was adequate to measure the health status and to evaluate the 3 types of spine pain. These 3 instruments could

Long-Term Social Reintegration Outcomes for Burn Survivors With and Without Peer Support Attendance: A Life Impact Burn Recovery Evaluation (LIBRE) Study.

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Grieve, Brian; Shapiro, Gabriel D; Wibbenmeyer, Lucy; Acton, Amy; Lee, Austin; Marino, Molly; Jette, Alan; Schneider, Jeffrey C; Kazis, Lewis E; Ryan, Colleen M

2017-10-31

To examine differences in long-term social reintegration outcomes for burn survivors with and without peer support attendance. Cross-sectional survey. Community-dwelling burn survivors. Burn survivors (N=601) aged ≥18 years with injuries to ≥5% total body surface area (TBSA) or burns to critical areas (hands, feet, face, or genitals). Not applicable. The Life Impact Burn Recovery Evaluation Profile was used to examine the following previously validated 6 scale scores of social participation: Family and Friends, Social Interactions, Social Activities, Work and Employment, Romantic Relationships, and Sexual Relationships. Burn support group attendance was reported by 330 (55%) of 596 respondents who responded to this item. Attendees had larger burn size (43.4%±23.6% vs 36.8%±23.4% TBSA burned, P10 years from injury (50% vs 42.5%, Preintegration in burn survivors. This cross-sectional study prompts further exploration into the potential benefits of peer support groups on burn recovery with future intervention studies. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Study protocol: The Intensive Care Outcome Network ('ICON' study

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Barber Vicki S

2008-06-01

Full Text Available Abstract Background Extended follow-up of survivors of ICU treatment has shown many patients suffer long-term physical and psychological consequences that affect their health-related quality of life. The current lack of rigorous longitudinal studies means that the true prevalence of these physical and psychological problems remains undetermined. Methods/Design The ICON (Intensive Care Outcome Network study is a multi-centre, longitudinal study of survivors of critical illness. Patients will be recruited prior to hospital discharge from 20–30 ICUs in the UK and will be assessed at 3, 6, and 12 months following ICU discharge for health-related quality of life as measured by the Short Form-36 (SF-36 and the EuroQoL (EQ-5D; anxiety and depression as measured by the Hospital Anxiety and Depression Scale (HADS; and post traumatic stress disorder (PTSD symptoms as measured by the PTSD Civilian Checklist (PCL-C. Postal questionnaires will be used. Discussion The ICON study will create a valuable UK database detailing the prevalence of physical and psychological morbidity experienced by patients as they recover from critical illness. Knowledge of the prevalence of physical and psychological morbidity in ICU survivors is important because research to generate models of causality, prognosis and treatment effects is dependent on accurate determination of prevalence. The results will also inform economic modelling of the long-term burden of critical illness. Trial Registration ISRCTN69112866

The Role of Item Models in Automatic Item Generation

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Gierl, Mark J.; Lai, Hollis

2012-01-01

Automatic item generation represents a relatively new but rapidly evolving research area where cognitive and psychometric theories are used to produce tests that include items generated using computer technology. Automatic item generation requires two steps. First, test development specialists create item models, which are comparable to templates…

Patient-reported outcome after fast-track hip arthroplasty: a prospective cohort study

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Hansen Torben B

2010-11-01

Full Text Available Abstract Background A fast-track intervention with a short preoperative optimization period and short postoperative hospitalization has a potential for reduced convalescence and thereby a reduced need for postoperative rehabilitation. The purpose of this study was to describe patient-related outcomes, the need for additional rehabilitation after a fast-track total hip arthroplasty (THA, and the association between generic and disease specific outcomes. Methods The study consisted of 196 consecutive patients of which none received additional rehabilitation beyond an instructional exercise plan at discharge, which was adjusted at one in-patient visit. The patients filled in 3 questionnaires to measure health-related quality-of-life (HRQOL and hip specific function (EQ-5 D, SF36, and Harris Hip Score (HHS at 2 time points pre- and 2 time points postoperatively. The observed results were compared to normative population data for EQ-5 D, SF36, and HHS. Results 3-months postoperatively patients had reached a HRQOL level of 0.84 (SD, 0.14, which was similar to the population norm (P = 0.33, whereas they exceeded the population norm at 12 months postoperatively (P P P = 0.35. For HHS, patients never reached the population norm within 12 months postoperatively. Generic and disease specific outcomes were strongly associated. Conclusions If HRQOL is considered the primary outcome after THA, the need for additional postoperative rehabilitation for all THA patients following a fast-track intervention is questionable. However, a pre- or early postoperative physical intervention seems relevant if the PF of the population norm should be reached at 3 months. If disease specific outcome is considered the primary outcome after fast-track THA, clear goals for the rehabilitation must be established before patient selection, intervention type and timing of intervention can be made.

Smallest detectable change and test-retest reliability of a self-reported outcome measure: Results of the Center for Epidemiologic Studies Depression Scale, General Self-Efficacy Scale, and 12-item General Health Questionnaire.

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Ohno, Shotaro; Takahashi, Kana; Inoue, Aimi; Takada, Koki; Ishihara, Yoshiaki; Tanigawa, Masaru; Hirao, Kazuki

2017-12-01

This study aims to examine the smallest detectable change (SDC) and test-retest reliability of the Center for Epidemiologic Studies Depression Scale (CES-D), General Self-Efficacy Scale (GSES), and 12-item General Health Questionnaire (GHQ-12). We tested 154 young adults at baseline and 2 weeks later. We calculated the intra-class correlation coefficients (ICCs) for test-retest reliability with a two-way random effects model for agreement. We then calculated the standard error of measurement (SEM) for agreement using the ICC formula. The SEM for agreement was used to calculate SDC values at the individual level (SDC ind ) and group level (SDC group ). The study participants included 137 young adults. The ICCs for all self-reported outcome measurement scales exceeded 0.70. The SEM of CES-D was 3.64, leading to an SDC ind of 10.10 points and SDC group of 0.86 points. The SEM of GSES was 1.56, leading to an SDC ind of 4.33 points and SDC group of 0.37 points. The SEM of GHQ-12 with bimodal scoring was 1.47, leading to an SDC ind of 4.06 points and SDC group of 0.35 points. The SEM of GHQ-12 with Likert scoring was 2.44, leading to an SDC ind of 6.76 points and SDC group of 0.58 points. To confirm that the change was not a result of measurement error, a score of self-reported outcome measurement scales would need to change by an amount greater than these SDC values. This has important implications for clinicians and epidemiologists when assessing outcomes. © 2017 John Wiley & Sons, Ltd.

Modeling the World Health Organization Disability Assessment Schedule II using non-parametric item response models.

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Galindo-Garre, Francisca; Hidalgo, María Dolores; Guilera, Georgina; Pino, Oscar; Rojo, J Emilio; Gómez-Benito, Juana

2015-03-01

The World Health Organization Disability Assessment Schedule II (WHO-DAS II) is a multidimensional instrument developed for measuring disability. It comprises six domains (getting around, self-care, getting along with others, life activities and participation in society). The main purpose of this paper is the evaluation of the psychometric properties for each domain of the WHO-DAS II with parametric and non-parametric Item Response Theory (IRT) models. A secondary objective is to assess whether the WHO-DAS II items within each domain form a hierarchy of invariantly ordered severity indicators of disability. A sample of 352 patients with a schizophrenia spectrum disorder is used in this study. The 36 items WHO-DAS II was administered during the consultation. Partial Credit and Mokken scale models are used to study the psychometric properties of the questionnaire. The psychometric properties of the WHO-DAS II scale are satisfactory for all the domains. However, we identify a few items that do not discriminate satisfactorily between different levels of disability and cannot be invariantly ordered in the scale. In conclusion the WHO-DAS II can be used to assess overall disability in patients with schizophrenia, but some domains are too general to assess functionality in these patients because they contain items that are not applicable to this pathology. Copyright © 2014 John Wiley & Sons, Ltd.

Problems with the factor analysis of items: Solutions based on item response theory and item parcelling

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Gideon P. De Bruin

2004-10-01

Full Text Available The factor analysis of items often produces spurious results in the sense that unidimensional scales appear multidimensional. This may be ascribed to failure in meeting the assumptions of linearity and normality on which factor analysis is based. Item response theory is explicitly designed for the modelling of the non-linear relations between ordinal variables and provides a strong alternative to the factor analysis of items. Items may also be combined in parcels that are more likely to satisfy the assumptions of factor analysis than do the items. The use of the Rasch rating scale model and the factor analysis of parcels is illustrated with data obtained with the Locus of Control Inventory. The results of these analyses are compared with the results obtained through the factor analysis of items. It is shown that the Rasch rating scale model and the factoring of parcels produce superior results to the factor analysis of items. Recommendations for the analysis of scales are made. Opsomming Die faktorontleding van items lewer dikwels misleidende resultate op, veral in die opsig dat eendimensionele skale as meerdimensioneel voorkom. Hierdie resultate kan dikwels daaraan toegeskryf word dat daar nie aan die aannames van lineariteit en normaliteit waarop faktorontleding berus, voldoen word nie. Itemresponsteorie, wat eksplisiet vir die modellering van die nie-liniêre verbande tussen ordinale items ontwerp is, bied ’n aantreklike alternatief vir die faktorontleding van items. Items kan ook in pakkies gegroepeer word wat meer waarskynlik aan die aannames van faktorontleding voldoen as individuele items. Die gebruik van die Rasch beoordelingskaalmodel en die faktorontleding van pakkies word aan die hand van data wat met die Lokus van Beheervraelys verkry is, gedemonstreer. Die resultate van hierdie ontledings word vergelyk met die resultate wat deur ‘n faktorontleding van die individuele items verkry is. Die resultate dui daarop dat die Rasch

Assessment of the psychometrics of a PROMIS item bank: self-efficacy for managing daily activities.

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Hong, Ickpyo; Velozo, Craig A; Li, Chih-Ying; Romero, Sergio; Gruber-Baldini, Ann L; Shulman, Lisa M

2016-09-01

The aim of this study is to investigate the psychometrics of the Patient-Reported Outcomes Measurement Information System self-efficacy for managing daily activities item bank. The item pool was field tested on a sample of 1087 participants via internet (n = 250) and in-clinic (n = 837) surveys. All participants reported having at least one chronic health condition. The 35 item pool was investigated for dimensionality (confirmatory factor analyses, CFA and exploratory factor analysis, EFA), item-total correlations, local independence, precision, and differential item functioning (DIF) across gender, race, ethnicity, age groups, data collection modes, and neurological chronic conditions (McFadden Pseudo R (2) less than 10 %). The item pool met two of the four CFA fit criteria (CFI = 0.952 and SRMR = 0.07). EFA analysis found a dominant first factor (eigenvalue = 24.34) and the ratio of first to second eigenvalue was 12.4. The item pool demonstrated good item-total correlations (0.59-0.85) and acceptable internal consistency (Cronbach's alpha = 0.97). The item pool maintained its precision (reliability over 0.90) across a wide range of theta (3.70), and there was no significant DIF. The findings indicated the item pool has sound psychometric properties and the test items are eligible for development of computerized adaptive testing and short forms.

Comparative responsiveness of measures of pain and function after total hip replacement

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Nilsdotter, A K; Roos, Ewa M.; Westerlund, J P

2001-01-01

To compare the responsiveness of the Functional Assessment System (FAS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Medical Outcomes Study 36-item Short Form (SF-36) in patients with osteoarthritis (OA) scheduled for total hip replacement....

The Iranian version of 12-item Short Form Health Survey (SF-12): factor structure, internal consistency and construct validity.

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Montazeri, Ali; Vahdaninia, Mariam; Mousavi, Sayed Javad; Omidvari, Speideh

2009-09-16

The 12-item Short Form Health Survey (SF-12) as a shorter alternative of the SF-36 is largely used in health outcomes surveys. The aim of this study was to validate the SF-12 in Iran. A random sample of the general population aged 15 years and over living in Tehran, Iran completed the SF-12. Reliability was estimated using internal consistency and validity was assessed using known groups comparison and convergent validity. In addition, the factor structure of the questionnaire was extracted by performing both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). In all, 5587 individuals were studied (2721 male and 2866 female). The mean age and formal education of the respondents were 35.1 (SD = 15.4) and 10.2 (SD = 4.4) years respectively. The results showed satisfactory internal consistency for both summary measures, that are the Physical Component Summary (PCS) and the Mental Component Summary (MCS); Cronbach's alpha for PCS-12 and MCS-12 was 0.73 and 0.72, respectively. Known-groups comparison showed that the SF-12 discriminated well between men and women and those who differed in age and educational status (P < 0.001). In addition, correlations between the SF-12 scales and single items showed that the physical functioning, role physical, bodily pain and general health subscales correlated higher with the PCS-12 score, while the vitality, social functioning, role emotional and mental health subscales more correlated with the MCS-12 score lending support to its good convergent validity. Finally the principal component analysis indicated a two-factor structure (physical and mental health) that jointly accounted for 57.8% of the variance. The confirmatory factory analysis also indicated a good fit to the data for the two-latent structure (physical and mental health). In general the findings suggest that the SF-12 is a reliable and valid measure of health related quality of life among Iranian population. However, further studies are needed to

Varying the item format improved the range of measurement in patient-reported outcome measures assessing physical function

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Liegl, Gregor; Gandek, Barbara; Fischer, H. Felix

2017-01-01

precision between the short forms using different item formats. Results: Sufficient unidimensionality of all short-form items and the original PF item bank was supported. Compared to formats A and B, format C increased the range of reliable measurement by about 0.5 standard deviations on the positive side...

The reliability and validity of Chinese version of SF36 v2 in aging patients with chronic heart failure.

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Dong, Aishu; Chen, Sisi; Zhu, Lianlian; Shi, Lingmin; Cai, Yueli; Zeng, Jingni; Guo, Wenjian

2017-08-01

Chronic heart failure (CHF), a major public health problem worldwide, seriously limits health-related quality of life (HRQOL). How to evaluate HRQOL in older patients with CHF remains a problem. To evaluate the reliability and validity of the Chinese version of the Medical Outcomes Study Short Form version 2 (SF-36v2) in CHF patients. From September 2012 to June 2014, we assessed QOL using the SF-36v2 in 171 aging participants with CHF in four cardiology departments. Convergent and discriminant validity, factorial validity, sensitivity among different NYHA classes and between different age groups, and reliability were determined using standard measurement methods. A total of 150 participants completed a structured questionnaire including general information and the Chinese SF-36v2; 132 questionnaires were considered valid, while 21 patients refused to take part. 25 of the 50 participants invited to complete the 2-week test-retest questionnaires returned completed questionnaires. The internal consistency reliability (Cronbach's α) of the total SF-36v2 was 0.92 (range 0.74-0.93). All hypothesized item-subscale correlations showed satisfactory convergent and discriminant validity. Sensitivity was measured in different NYHA classes and age groups. Comparison of different NYHA classes showed statistical significance, but there was no significant difference between age groups. We confirmed the SF-36v2 as a valid instrument for evaluating HRQOL Chinese CHF patients. Both reliability and validity were strongly satisfactory, but there was divergence in understanding subscales such as "social functioning" because of differing cultural background. The reliability, validity, and sensitivity of SF-36v2 in aging patients with CHF were acceptable.

The Technical Quality of Test Items Generated Using a Systematic Approach to Item Writing.

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Siskind, Theresa G.; Anderson, Lorin W.

The study was designed to examine the similarity of response options generated by different item writers using a systematic approach to item writing. The similarity of response options to student responses for the same item stems presented in an open-ended format was also examined. A non-systematic (subject matter expertise) approach and a…

Determinants of quality of life in Brazilian patients with myasthenia gravis.

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Mourão, Aline Mansueto; Gomez, Rodrigo Santiago; Barbosa, Luiz Sergio Mageste; Freitas, Denise da Silva; Comini-Frota, Elizabeth Regina; Kummer, Arthur; Lemos, Stella Maris Aguiar; Teixeira, Antonio Lucio

2016-07-01

The aims of the current study were 1) to evaluate the reliability and validity of the Brazilian version of the 15-item Myasthenia Gravis Quality of Life Scale and 2) to investigate the quality of life of Brazilian patients with myasthenia gravis and its determinants. This cross-sectional study included 69 patients with myasthenia gravis who underwent neurological evaluation and completed questionnaires regarding quality of life (the 36-item Short Form of the Medical Outcomes Study and the 15-item Myasthenia Gravis Quality of Life Scale), anxiety and depressive symptoms. The Brazilian version of the 15-item Myasthenia Gravis Quality of Life Scale showed high internal consistency and good concurrent validity with the 36-item Short Form of the Medical Outcomes Study and its subscales. Determinants of quality of life in Brazilian patients with myasthenia gravis included the current status of myasthenia gravis as assessed by the Myasthenia Gravis Composite, the current prednisone dose and the levels of anxiety and depression. The Brazilian version of the 15-item Myasthenia Gravis Quality of Life Scale is a valid instrument. Symptom severity, prednisone dosage and anxiety and depression levels impact the quality of life of patients with myasthenia gravis.

Item information and discrimination functions for trinary PCM items

NARCIS (Netherlands)

Akkermans, Wies; Muraki, Eiji

1997-01-01

For trinary partial credit items the shape of the item information and the item discrimination function is examined in relation to the item parameters. In particular, it is shown that these functions are unimodal if δ2 – δ1 < 4 ln 2 and bimodal otherwise. The locations and values of the maxima are

Investigating Separate and Concurrent Approaches for Item Parameter Drift in 3PL Item Response Theory Equating

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Arce-Ferrer, Alvaro J.; Bulut, Okan

2017-01-01

This study examines separate and concurrent approaches to combine the detection of item parameter drift (IPD) and the estimation of scale transformation coefficients in the context of the common item nonequivalent groups design with the three-parameter item response theory equating. The study uses real and synthetic data sets to compare the two…

Validity and Reliability of the U.S. National Cancer Institute's Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE)

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Dueck, Amylou C.; Mendoza, Tito R.; Mitchell, Sandra A.; Reeve, Bryce B.; Castro, Kathleen M.; Rogak, Lauren J.; Atkinson, Thomas M.; Bennett, Antonia V.; Denicoff, Andrea M.; O'Mara, Ann M.; Li, Yuelin; Clauser, Steven B.; Bryant, Donna M.; Bearden, James D.; Gillis, Theresa A.; Harness, Jay K.; Siegel, Robert D.; Paul, Diane B.; Cleeland, Charles S.; Schrag, Deborah; Sloan, Jeff A.; Abernethy, Amy P.; Bruner, Deborah W.; Minasian, Lori M.; Basch, Ethan

2016-01-01

Importance Symptomatic adverse events (AEs) in cancer trials are currently reported by clinicians using the National Cancer Institute's (NCI) Common Terminology Criteria for Adverse Events (CTCAE). To integrate the patient perspective, the NCI developed a patient-reported outcomes version of the CTCAE (PRO-CTCAE) to capture symptomatic AEs directly from patients. Objective To assess the construct validity, test-retest reliability, and responsiveness of PRO-CTCAE items. Design Participants completed PRO-CTCAE items on tablet computers in clinic waiting rooms at two visits 1-6 weeks apart. A subset completed PRO-CTCAE items during an additional visit one business day after the first visit. Setting Nine U.S. cancer centers and community oncology practices. Participants 975 adult cancer patients undergoing outpatient chemotherapy and/or radiation enrolled between January 2011 and February 2012. Eligibility required participants to read English and be without clinically significant cognitive impairment. Main Outcome(s) and Measure(s) Primary comparators were clinician-reported Eastern Cooperative Oncology Group Performance Status (ECOG PS) and the European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire (QLQ-C30). Results 940/975 (96%) and 852/940 (91%) participants completed PRO-CTCAE items at each visit. 938/940 (99.8%) participants (53% female, median age 59, 32% high school education or less, 17% ECOG PS 2-4) reported having at least one symptom. All PRO-CTCAE items had at least one correlation in the expected direction with a QLQ-C30 scale (111/124 P<.05). Stronger correlations were seen between PRO-CTCAE items and conceptually-related QLQ-C30 domains. Scores for 94/124 PRO-CTCAE items were higher in the ECOG PS 2-4 versus 0-1 group (58/124 P<.05). Overall, 119/124 items met at least one construct validity criterion. Test-retest reliability was acceptable for 36/49 pre-specified items (median intra-class correlation coefficient

Emotional and behavioral problems in late preterm and early term births: outcomes at child age 36 months.

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Stene-Larsen, Kim; Lang, Astri M; Landolt, Markus A; Latal, Beatrice; Vollrath, Margarete E

2016-12-01

Recent findings has shown that late preterm births (gestational weeks 34-36) and early term births (gestational weeks 37-38) is associated with an increased risk of several psychological and developmental morbidities. In this article we investigate whether late preterm and early term births is associated with an increased risk of emotional and behavioral problems at 36 months of age and whether there are gender differences in risk of these outcomes. Forty-three thousand, two hundred ninety-seven children and their mothers participating in the Norwegian Mother and Child Cohort Study (MoBa). One thousand, eight hundred fifty-three (4.3%) of the children in the sample were born late preterm and 7,835 (18.1%) were born early term. Information on gestational age and on prenatal and postnatal risk factors was retrieved from the Medical Birth Registry of Norway. Information on emotional and behavioral problems was assessed by standardized questionnaires (CBCL/ITSEA) filled out by the mothers. Gender-stratified logistic regression analyses were used to explore the association between late preterm / early term and emotional and behavioral problems at 36 months of age. We found a gender-specific increased risk of emotional problems in girls born late preterm (OR 1.47 95%CI 1.11-1.95) and in girls born early term (OR 1.21 95%CI 1.04-1.42). We did not find an increased risk of emotional problems in boys born late preterm (OR 1.09 95%CI 0.82-1.45) or early term (OR 0.93 95%CI 0.79-1.10). Behavioral problems were not increased in children born late preterm or early term. Girls born late preterm and early term show an increased risk of emotional problems at 36 months of age. This finding suggests that gender should be taken into account when evaluating children born at these gestational ages.

Exploring problem solving strategies on multiple-choice science items: Comparing native Spanish-speaking English Language Learners and mainstream monolinguals

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Kachchaf, Rachel Rae

The purpose of this study was to compare how English language learners (ELLs) and monolingual English speakers solved multiple-choice items administered with and without a new form of testing accommodation---vignette illustration (VI). By incorporating theories from second language acquisition, bilingualism, and sociolinguistics, this study was able to gain more accurate and comprehensive input into the ways students interacted with items. This mixed methods study used verbal protocols to elicit the thinking processes of thirty-six native Spanish-speaking English language learners (ELLs), and 36 native-English speaking non-ELLs when solving multiple-choice science items. Results from both qualitative and quantitative analyses show that ELLs used a wider variety of actions oriented to making sense of the items than non-ELLs. In contrast, non-ELLs used more problem solving strategies than ELLs. There were no statistically significant differences in student performance based on the interaction of presence of illustration and linguistic status or the main effect of presence of illustration. However, there were significant differences based on the main effect of linguistic status. An interaction between the characteristics of the students, the items, and the illustrations indicates considerable heterogeneity in the ways in which students from both linguistic groups think about and respond to science test items. The results of this study speak to the need for more research involving ELLs in the process of test development to create test items that do not require ELLs to carry out significantly more actions to make sense of the item than monolingual students.

The Iranian version of 12-item Short Form Health Survey (SF-12: factor structure, internal consistency and construct validity

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Mousavi Sayed

2009-09-01

Full Text Available Abstract Background The 12-item Short Form Health Survey (SF-12 as a shorter alternative of the SF-36 is largely used in health outcomes surveys. The aim of this study was to validate the SF-12 in Iran. Methods A random sample of the general population aged 15 years and over living in Tehran, Iran completed the SF-12. Reliability was estimated using internal consistency and validity was assessed using known groups comparison and convergent validity. In addition, the factor structure of the questionnaire was extracted by performing both exploratory factor analysis (EFA and confirmatory factor analysis (CFA. Results: In all, 5587 individuals were studied (2721 male and 2866 female. The mean age and formal education of the respondents were 35.1 (SD = 15.4 and 10.2 (SD = 4.4 years respectively. The results showed satisfactory internal consistency for both summary measures, that are the Physical Component Summary (PCS and the Mental Component Summary (MCS; Cronbach's α for PCS-12 and MCS-12 was 0.73 and 0.72, respectively. Known-groups comparison showed that the SF-12 discriminated well between men and women and those who differed in age and educational status (P Conclusion In general the findings suggest that the SF-12 is a reliable and valid measure of health related quality of life among Iranian population. However, further studies are needed to establish stronger psychometric properties for this alternative form of the SF-36 Health Survey in Iran.

Complement or Contamination: A Study of the Validity of Multiple-Choice Items when Assessing Reasoning Skills in Physics

OpenAIRE

Anders Jönsson; David Rosenlund; Fredrik Alvén

2017-01-01

The purpose of this study is to investigate the validity of using multiple-choice (MC) items as a complement to constructed-response (CR) items when making decisions about student performance on reasoning tasks. CR items from a national test in physics have been reformulated into MC items and students’ reasoning skills have been analyzed in two substudies. In the first study, 12 students answered the MC items and were asked to explain their answers orally. In the second study, 102 students fr...

The natural progression of health-related quality of life: results of a five-year prospective study of SF-36 scores in a normative population.

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Hopman, Wilma M; Berger, Claudie; Joseph, Lawrence; Towheed, Tanveer; VandenKerkhof, Elizabeth; Anastassiades, Tassos; Adachi, Jonathan D; Ioannidis, George; Brown, Jacques P; Hanley, David A; Papadimitropoulos, Emmanuel A

2006-04-01

Limited information exists regarding the natural progression of health-related quality of life (HRQOL) in the general population, as most research has been cross-sectional or has followed populations with specific medical conditions. Such norms are important to establish, because the effect of any intervention may be confounded by changes due to the natural progression of HRQOL over time. Participants were randomly selected from 9 Canadian cities and surrounding rural areas. Changes in the eight domains and 2 summary component scores of the Medical Outcomes Study 36-item short form (SF-36) were examined over a 5 year period (1996/1997-2001/2002). Mean changes were calculated for men and women within 10 year age categories. Multiple imputation was used to adjust for potential selection bias due to missing data. The baseline sample included 6539 women and 2884 men. Loss to follow-up was 17% for women and 23% for men. Mean changes tended to be small, but there was an overall trend towards decreasing HRQOL over time. Changes were more pronounced in the older age groups and in the physically oriented domains. Younger age groups tended towards small mean improvements, particularly in the mentally oriented domains. Large standard errors suggest that on an individual level, large improvements in some participants are balanced by large declines in others. In general, the HRQOL of Canadians appears relatively stable over a 5 year period. However, care should be taken when assessing HRQOL longitudinally in certain age or gender groups, as changes associated with an intervention can potentially be confounded by the natural progression of HRQOL.

Do Patient-Reported Outcome Measures describe functioning in patients with low back pain, using the Brief International Classification of Functioning, Disability and Health Core Set as a reference?

DEFF Research Database (Denmark)

Ibsen, Charlotte; Schiøttz-Christensen, Berit; Melchiorsen, Hanne

2016-01-01

OBJECTIVE: To link the items in the Patient-Reported Outcome Measures (PROMs): Roland Morris Disability Questionnaire, Short Form 36 (SF-36) and pain scores, to the Brief International Classification of Functioning, Disability and Health (ICF) Core Set for low back pain, and to examine the extent...... Set (34%). A weak correlation was found between the patients' responses and the clinician's assessment. CONCLUSION: The selected PROMs do not cover the prototypical spectrum of problems encountered in patients with low back pain as defined by the Brief ICF Core Set. The clinical assessment of patients...

Sleep quality, the neglected outcome variable in clinical studies focusing on locomotor system; a construct validation study

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Röder Christoph

2010-09-01

Full Text Available Abstract Background In addition to general health and pain, sleep is highly relevant to judging the well-being of an individual. Of these three important outcome variables, however, sleep is neglected in most outcome studies. Sleep is a very important resource for recovery from daily stresses and strains, and any alteration of sleep will likely affect mental and physical health, especially during disease. Sleep assessment therefore should be standard in all population-based or clinical studies focusing on the locomotor system. Yet current sleep assessment tools are either too long or too specific for general use. Methods Based on a literature review and subsequent patient-based rating of items, an expert panel designed a four-item questionnaire about sleep. Construct validation of the questionnaire in a random sample of the German-speaking Swiss population was performed in 2003. Reliability, correlation, and tests for internal consistency and validity were analyzed. Results Overall, 16,634 (70% out of 23,763 eligible individuals participated in the study. Test-retest reliability coefficients ranged from 0.72 to 0.87, and a Cronbach's alpha of 0.83 indicates good internal consistency. Results show a moderate to good correlation between sleep disturbances and health perception, and between sleep disturbances and overall pain. Conclusions The Sleep Standard Evaluation Questionnaire (SEQ-Sleep is a reliable and short tool with confirmed construct validity for sleep assessment in population-based observational studies. It is easy to administer and therefore suitable for postal surveys of the general population. Criterion validity remains to be determined.

Item level diagnostics and model - data fit in item response theory ...

African Journals Online (AJOL)

Item response theory (IRT) is a framework for modeling and analyzing item response data. Item-level modeling gives IRT advantages over classical test theory. The fit of an item score pattern to an item response theory (IRT) models is a necessary condition that must be assessed for further use of item and models that best fit ...

Item Analysis of Multiple Choice Questions at the Department of Paediatrics, Arabian Gulf University, Manama, Bahrain

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Deena Kheyami

2018-04-01

Full Text Available Objectives: The current study aimed to carry out a post-validation item analysis of multiple choice questions (MCQs in medical examinations in order to evaluate correlations between item difficulty, item discrimination and distraction effectiveness so as to determine whether questions should be included, modified or discarded. In addition, the optimal number of options per MCQ was analysed. Methods: This cross-sectional study was performed in the Department of Paediatrics, Arabian Gulf University, Manama, Bahrain. A total of 800 MCQs and 4,000 distractors were analysed between November 2013 and June 2016. Results: The mean difficulty index ranged from 36.70–73.14%. The mean discrimination index ranged from 0.20–0.34. The mean distractor efficiency ranged from 66.50–90.00%. Of the items, 48.4%, 35.3%, 11.4%, 3.9% and 1.1% had zero, one, two, three and four nonfunctional distractors (NFDs, respectively. Using three or four rather than five options in each MCQ resulted in 95% or 83.6% of items having zero NFDs, respectively. The distractor efficiency was 91.87%, 85.83% and 64.13% for difficult, acceptable and easy items, respectively (P <0.005. Distractor efficiency was 83.33%, 83.24% and 77.56% for items with excellent, acceptable and poor discrimination, respectively (P <0.005. The average Kuder-Richardson formula 20 reliability coefficient was 0.76. Conclusion: A considerable number of the MCQ items were within acceptable ranges. However, some items needed to be discarded or revised. Using three or four rather than five options in MCQs is recommended to reduce the number of NFDs and improve the overall quality of the examination.

Development and validation of the impact of dry eye on everyday life (IDEEL) questionnaire, a patient-reported outcomes (PRO) measure for the assessment of the burden of dry eye on patients.

Science.gov (United States)

Abetz, Linda; Rajagopalan, Krithika; Mertzanis, Polyxane; Begley, Carolyn; Barnes, Rod; Chalmers, Robin

2011-12-08

To develop and validate a comprehensive patient-reported outcomes instrument focusing on the impact of dry eye on everyday life (IDEEL). Development and validation of the IDEEL occurred in four phases: 1) focus groups with 45 dry eye patients to develop a draft instrument, 2) item generation, 3) pilot study to assess content validity in 16 patients and 4) psychometric validation in 210 subjects: 130 with non-Sjögren's keratoconjunctivitis sicca, 32 with Sjögren's syndrome and 48 controls, and subsequent item reduction. Focus groups identified symptoms and the associated bother, the impact of dry eye on daily life and the patients' satisfaction with their treatment as the central concepts in patients' experience of dry eye. Qualitative analysis indicated that saturation was achieved for these concepts and yielded an initial 112-item draft instrument. Patients understood the questionnaire and found the items to be relevant indicating content validity. Patient input, item descriptive statistics and factor analysis identified 55 items that could be deleted. The final 57-item IDEEL assesses dry eye impact constituting 3 modules: dry eye symptom-bother, dry eye impact on daily life comprising impact on daily activities, emotional impact, impact on work, and dry eye treatment satisfaction comprising satisfaction with treatment effectiveness and treatment-related bother/inconvenience. The psychometric analysis results indicated that the IDEEL met the criteria for item discriminant validity, internal consistency reliability, test-retest reliability and floor/ceiling effects. As expected, the correlations between IDEEL and the Dry Eye Questionnaire (a habitual symptom questionnaire) were higher than between IDEEL and Short-Form-36 and EuroQoL-5D, indicating concurrent validity. The IDEEL is a reliable, valid and comprehensive questionnaire relevant to issues that are specific to dry eye patients, and meets current FDA patient-reported outcomes guidelines. The use of this

Lawton IADL scale in dementia: can item response theory make it more informative?

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McGrory, Sarah; Shenkin, Susan D; Austin, Elizabeth J; Starr, John M

2014-07-01

impairment of functional abilities represents a crucial component of dementia diagnosis. Current functional measures rely on the traditional aggregate method of summing raw scores. While this summary score provides a quick representation of a person's ability, it disregards useful information on the item level. to use item response theory (IRT) methods to increase the interpretive power of the Lawton Instrumental Activities of Daily Living (IADL) scale by establishing a hierarchy of item 'difficulty' and 'discrimination'. this cross-sectional study applied IRT methods to the analysis of IADL outcomes. Participants were 202 members of the Scottish Dementia Research Interest Register (mean age = 76.39, range = 56-93, SD = 7.89 years) with complete itemised data available. a Mokken scale with good reliability (Molenaar Sijtsama statistic 0.79) was obtained, satisfying the IRT assumption that the items comprise a single unidimensional scale. The eight items in the scale could be placed on a hierarchy of 'difficulty' (H coefficient = 0.55), with 'Shopping' being the most 'difficult' item and 'Telephone use' being the least 'difficult' item. 'Shopping' was the most discriminatory item differentiating well between patients of different levels of ability. IRT methods are capable of providing more information about functional impairment than a summed score. 'Shopping' and 'Telephone use' were identified as items that reveal key information about a patient's level of ability, and could be useful screening questions for clinicians. © The Author 2013. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@ oup.com.

Dissociating the neural correlates of intra-item and inter-item working-memory binding.

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Carinne Piekema

Full Text Available BACKGROUND: Integration of information streams into a unitary representation is an important task of our cognitive system. Within working memory, the medial temporal lobe (MTL has been conceptually linked to the maintenance of bound representations. In a previous fMRI study, we have shown that the MTL is indeed more active during working-memory maintenance of spatial associations as compared to non-spatial associations or single items. There are two explanations for this result, the mere presence of the spatial component activates the MTL, or the MTL is recruited to bind associations between neurally non-overlapping representations. METHODOLOGY/PRINCIPAL FINDINGS: The current fMRI study investigates this issue further by directly comparing intrinsic intra-item binding (object/colour, extrinsic intra-item binding (object/location, and inter-item binding (object/object. The three binding conditions resulted in differential activation of brain regions. Specifically, we show that the MTL is important for establishing extrinsic intra-item associations and inter-item associations, in line with the notion that binding of information processed in different brain regions depends on the MTL. CONCLUSIONS/SIGNIFICANCE: Our findings indicate that different forms of working-memory binding rely on specific neural structures. In addition, these results extend previous reports indicating that the MTL is implicated in working-memory maintenance, challenging the classic distinction between short-term and long-term memory systems.

A signal detection-item response theory model for evaluating neuropsychological measures.

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Thomas, Michael L; Brown, Gregory G; Gur, Ruben C; Moore, Tyler M; Patt, Virginie M; Risbrough, Victoria B; Baker, Dewleen G

2018-02-05

Models from signal detection theory are commonly used to score neuropsychological test data, especially tests of recognition memory. Here we show that certain item response theory models can be formulated as signal detection theory models, thus linking two complementary but distinct methodologies. We then use the approach to evaluate the validity (construct representation) of commonly used research measures, demonstrate the impact of conditional error on neuropsychological outcomes, and evaluate measurement bias. Signal detection-item response theory (SD-IRT) models were fitted to recognition memory data for words, faces, and objects. The sample consisted of U.S. Infantry Marines and Navy Corpsmen participating in the Marine Resiliency Study. Data comprised item responses to the Penn Face Memory Test (PFMT; N = 1,338), Penn Word Memory Test (PWMT; N = 1,331), and Visual Object Learning Test (VOLT; N = 1,249), and self-report of past head injury with loss of consciousness. SD-IRT models adequately fitted recognition memory item data across all modalities. Error varied systematically with ability estimates, and distributions of residuals from the regression of memory discrimination onto self-report of past head injury were positively skewed towards regions of larger measurement error. Analyses of differential item functioning revealed little evidence of systematic bias by level of education. SD-IRT models benefit from the measurement rigor of item response theory-which permits the modeling of item difficulty and examinee ability-and from signal detection theory-which provides an interpretive framework encompassing the experimentally validated constructs of memory discrimination and response bias. We used this approach to validate the construct representation of commonly used research measures and to demonstrate how nonoptimized item parameters can lead to erroneous conclusions when interpreting neuropsychological test data. Future work might include the

Cross-cultural validation of a disease-specific patient-reported outcome measure for lupus in Philippines.

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Navarra, S V; Tanangunan, R M D V; Mikolaitis-Preuss, R A; Kosinski, M; Block, J A; Jolly, M

2013-03-01

LupusPRO is a disease-targeted patient-reported outcome measure that was developed and validated among US patients with systemic lupus erythematosus (SLE). We report the cross-cultural validation results of the LupusPRO English-language version among Filipino SLE patients. The 43-item LupusPRO was pretested in 15 SLE individuals, then administered to 106 SLE patients, along with short-form SF36 and the EQ5D visual analogue scale. A mail/drop-back LupusPRO and change in health status item survey were returned within two to three days. Demographics, clinical and serological characteristics, disease activity and damage measured by PGA, SELENA-SLEDAI, LFA Flare, and SLICC-ACR SLE damage index (SDI) were collected. Internal consistency reliability (ICR), test-retest reliability (TRT), convergent validity (corresponding SF36 domains) and criterion validity (against general health and disease activity measures) were tested. Reported p values are two tailed. A total of 121 Filipino SLE subjects (95% women, median age 31.0 ± 16 years) with at least a high school level of English instruction participated. Median (IQR) PGA, SLEDAI and SDI were 0.0 (1.0), 2.0 (10) and 0 (1), respectively. ICR exceeded 0.7 for all domains except the lupus symptoms domain. TRT was greater than 0.85 for all LupusPRO domains. Convergent and criterion validity were observed against corresponding SF36 domains and disease activity measures. The tool was well received by patients. Confirmatory factor analysis showed good fit. English LupusPRO has fair psychometric properties among SLE patients in the Philippines, and is now available for inclusion in clinical trials and longitudinal studies to test responsiveness to change.

Development of an item bank for computerized adaptive test (CAT) measurement of pain

DEFF Research Database (Denmark)

Petersen, Morten Aa.; Aaronson, Neil K; Chie, Wei-Chu

2016-01-01

PURPOSE: Patient-reported outcomes should ideally be adapted to the individual patient while maintaining comparability of scores across patients. This is achievable using computerized adaptive testing (CAT). The aim here was to develop an item bank for CAT measurement of the pain domain as measured...... were obtained from 1103 cancer patients from five countries. Psychometric evaluations showed that 16 items could be retained in a unidimensional item bank. Evaluations indicated that use of the CAT measure may reduce sample size requirements with 15-25 % compared to using the QLQ-C30 pain scale....... CONCLUSIONS: We have established an item bank of 16 items suitable for CAT measurement of pain. While being backward compatible with the QLQ-C30, the new item bank will significantly improve measurement precision of pain. We recommend initiating CAT measurement by screening for pain using the two original QLQ...

Item response theory scoring and the detection of curvilinear relationships.

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Carter, Nathan T; Dalal, Dev K; Guan, Li; LoPilato, Alexander C; Withrow, Scott A

2017-03-01

Psychologists are increasingly positing theories of behavior that suggest psychological constructs are curvilinearly related to outcomes. However, results from empirical tests for such curvilinear relations have been mixed. We propose that correctly identifying the response process underlying responses to measures is important for the accuracy of these tests. Indeed, past research has indicated that item responses to many self-report measures follow an ideal point response process-wherein respondents agree only to items that reflect their own standing on the measured variable-as opposed to a dominance process, wherein stronger agreement, regardless of item content, is always indicative of higher standing on the construct. We test whether item response theory (IRT) scoring appropriate for the underlying response process to self-report measures results in more accurate tests for curvilinearity. In 2 simulation studies, we show that, regardless of the underlying response process used to generate the data, using the traditional sum-score generally results in high Type 1 error rates or low power for detecting curvilinearity, depending on the distribution of item locations. With few exceptions, appropriate power and Type 1 error rates are achieved when dominance-based and ideal point-based IRT scoring are correctly used to score dominance and ideal point response data, respectively. We conclude that (a) researchers should be theory-guided when hypothesizing and testing for curvilinear relations; (b) correctly identifying whether responses follow an ideal point versus dominance process, particularly when items are not extreme is critical; and (c) IRT model-based scoring is crucial for accurate tests of curvilinearity. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The Italian version of the 92-item Prodromal Questionnaire: Concurrent validity with the SIPS and factor analysis in a sample of 258 outpatients aged 11-36years.

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Kotzalidis, Georgios D; Solfanelli, Andrea; Piacentino, Daria; Savoja, Valeria; Fiori Nastro, Paolo; Curto, Martina; Lindau, Juliana Fortes; Masillo, Alice; Brandizzi, Martina; Fagioli, Francesca; Raballo, Andrea; Gebhardt, Eva; Preti, Antonio; D'Alema, Marco; Fucci, Maria Rosa; Miletto, Roberto; Andropoli, Daniela; Leccisi, Donato; Girardi, Paolo; Loewy, Rachel L; Schultze-Lutter, Frauke

2017-11-01

Current early screeners for psychosis-risk states have still to prove ability in identifying at-risk individuals. Among screeners, the 92-item Prodromal Questionnaire (PQ-92) is often used. We aimed to assess the validity of its Italian translation in a large Italian adolescent and young adult help-seeking sample. We included all individuals aged 12-36years seeking help at psychiatric mental health services in a large semirural Roman area (534,600 population) who accepted to participate. Participants completed the Italian version of the PQ-92 and were subsequently assessed with the Structured Interview of Prodromal/Psychosis-Risk Syndromes (SIPS). We examined diagnostic accuracy (sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios) and content, concurrent, and convergent validity between PQ-92 and SIPS using Cronbach's alpha, Cohen's kappa, and Spearman's rho, respectively. We tested the validity of adopted cut-offs through Receiver Operating Characteristic (ROC) curves plotted against SIPS diagnoses and the instrument's factor-structure through Principal Component Analysis. PQ-92 showed high internal consistency, acceptable diagnostic accuracy and concurrent validity, and excellent convergent validity. ROC analyses pointed to scores of 18 on the Positive subscale and 36 on the total PQ-92 as best cut-offs. The Scree-test identified a four-factor solution as fitting best. Psychometric properties of Italian PQ-92 were satisfactory. Optimal cut-offs were confirmed at ≥18 on the positive subscale, but at ≥36 on the total scale was able to identify more SIPS-positive cases. Copyright © 2017 Elsevier B.V. All rights reserved.

Patient-reported outcome measures in arthroplasty registries

DEFF Research Database (Denmark)

Rolfson, Ola; Bohm, Eric; Franklin, Patricia

2016-01-01

The International Society of Arthroplasty Registries (ISAR) Patient-Reported Outcome Measures (PROMs) Working Group have evaluated and recommended best practices in the selection, administration, and interpretation of PROMs for hip and knee arthroplasty registries. The 2 generic PROMs in common use...... are the Short Form health surveys (SF-36 or SF-12) and EuroQol 5-dimension (EQ-5D). The Working Group recommends that registries should choose specific PROMs that have been appropriately developed with good measurement properties for arthroplasty patients. The Working Group recommend the use of a 1-item pain...... should consider the absolute level of pain, function, and general health status as well as improvement, missing data, approaches to analysis and case-mix adjustment, minimal clinically important difference, and minimal detectable change. The Working Group recommends data collection immediately before...

Measuring treatment outcomes in gambling disorders: a systematic review.

Science.gov (United States)

Pickering, Dylan; Keen, Brittany; Entwistle, Gavin; Blaszczynski, Alex

2018-03-01

Considerable variation of outcome variables used to measure recovery in the gambling treatment literature has precluded effective cross-study evaluations and hindered the development of best-practice treatment methodologies. The aim of this systematic review was to describe current diffuse concepts of recovery in the gambling field by mapping the range of outcomes and measurement strategies used to evaluate treatments, and to identify more commonly accepted indices of recovery. A systematic search of six academic databases for studies evaluating treatments (psychological and pharmacological) for gambling disorders with a minimum 6-month follow-up. Data from eligible studies were tabulated and analysis conducted using a narrative approach. Guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were adhered to. Thirty-four studies were reviewed systematically (RCTs = 17, comparative designs = 17). Sixty-three different outcome measures were identified: 25 (39.7%) assessed gambling-specific constructs, 36 (57.1%) assessed non-gambling specific constructs, and two instruments were used across both categories (3.2%). Self-report instruments ranged from psychometrically validated to ad-hoc author-designed questionnaires. Units of measurement were inconsistent, particularly in the assessment of gambling behaviour. All studies assessed indices of gambling behaviour and/or symptoms of gambling disorder. Almost all studies (n = 30; 88.2%) included secondary measures relating to psychiatric comorbidities, psychological processes linked to treatment approach, or global functioning and wellbeing. In research on gambling disorders, the incorporation of broader outcome domains that extend beyond disorder-specific symptoms and behaviours suggests a multi-dimensional conceptualization of recovery. Development of a single comprehensive scale to measure all aspects of gambling recovery could help to facilitate uniform reporting practices

The Effects of Test Length and Sample Size on Item Parameters in Item Response Theory

Science.gov (United States)

Sahin, Alper; Anil, Duygu

2017-01-01

This study investigates the effects of sample size and test length on item-parameter estimation in test development utilizing three unidimensional dichotomous models of item response theory (IRT). For this purpose, a real language test comprised of 50 items was administered to 6,288 students. Data from this test was used to obtain data sets of…

The medial tibial stress syndrome score: Item generation for a new ...

African Journals Online (AJOL)

The medial tibial stress syndrome score: Item generation for a new patient reported outcome measure. ... instrument that evaluates injury severity and treatment effects for medial tibial stress syndrome (MTSS) patients. ... from 32 Countries:.

Can Orthopedic Oncologists Predict Functional Outcome in Patients with Sarcoma after Limb Salvage Surgery in the Lower Limb? A Nationwide Study

Directory of Open Access Journals (Sweden)

Sjoerd Kolk

2014-01-01

Full Text Available Accurate predictions of functional outcome after limb salvage surgery (LSS in the lower limb are important for several reasons, including informing the patient preoperatively and, in some cases, deciding between amputation and LSS. This study aimed to elucidate the correlation between surgeon-predicted and patient-reported functional outcome of LSS in the Netherlands. Twenty-three patients (between six months and ten years after surgery and five independent orthopedic oncologists completed the Toronto Extremity Salvage Score (TESS and the RAND-36 physical functioning subscale (RAND-36 PFS. The orthopedic oncologists made their predictions based on case descriptions (including MRI scans that reflected the preoperative status. The correlation between patient-reported and surgeon-predicted functional outcome was “very poor” to “poor” on both scores (r2 values ranged from 0.014 to 0.354. Patient-reported functional outcome was generally underestimated, by 8.7% on the TESS and 8.3% on the RAND-36 PFS. The most difficult and least difficult tasks on the RAND-36 PFS were also the most difficult and least difficult to predict, respectively. Most questions had a “poor” intersurgeon agreement. It was difficult to accurately predict the patient-reported functional outcome of LSS. Surgeons’ ability to predict functional scores can be improved the most by focusing on accurately predicting more demanding tasks.

Comparative Studies of Vertebrate Platelet Glycoprotein 4 (CD36

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Roger S. Holmes

2012-09-01

Full Text Available Platelet glycoprotein 4 (CD36 (or fatty acyl translocase [FAT], or scavenger receptor class B, member 3 [SCARB3] is an essential cell surface and skeletal muscle outer mitochondrial membrane glycoprotein involved in multiple functions in the body. CD36 serves as a ligand receptor of thrombospondin, long chain fatty acids, oxidized low density lipoproteins (LDLs and malaria-infected erythrocytes. CD36 also influences various diseases, including angiogenesis, thrombosis, atherosclerosis, malaria, diabetes, steatosis, dementia and obesity. Genetic deficiency of this protein results in significant changes in fatty acid and oxidized lipid uptake. Comparative CD36 amino acid sequences and structures and CD36 gene locations were examined using data from several vertebrate genome projects. Vertebrate CD36 sequences shared 53–100% identity as compared with 29–32% sequence identities with other CD36-like superfamily members, SCARB1 and SCARB2. At least eight vertebrate CD36 N-glycosylation sites were conserved which are required for membrane integration. Sequence alignments, key amino acid residues and predicted secondary structures were also studied. Three CD36 domains were identified including cytoplasmic, transmembrane and exoplasmic sequences. Conserved sequences included N- and C-terminal transmembrane glycines; and exoplasmic cysteine disulphide residues; TSP-1 and PE binding sites, Thr92 and His242, respectively; 17 conserved proline and 14 glycine residues, which may participate in forming CD36 ‘short loops’; and basic amino acid residues, and may contribute to fatty acid and thrombospondin binding. Vertebrate CD36 genes usually contained 12 coding exons. The human CD36 gene contained transcription factor binding sites (including PPARG and PPARA contributing to a high gene expression level (6.6 times average. Phylogenetic analyses examined the relationships and potential evolutionary origins of the vertebrate CD36 gene with vertebrate

Validation of the MOS Social Support Survey 6-item (MOS-SSS-6) measure with two large population-based samples of Australian women.

Science.gov (United States)

Holden, Libby; Lee, Christina; Hockey, Richard; Ware, Robert S; Dobson, Annette J

2014-12-01

This study aimed to validate a 6-item 1-factor global measure of social support developed from the Medical Outcomes Study Social Support Survey (MOS-SSS) for use in large epidemiological studies. Data were obtained from two large population-based samples of participants in the Australian Longitudinal Study on Women's Health. The two cohorts were aged 53-58 and 28-33 years at data collection (N = 10,616 and 8,977, respectively). Items selected for the 6-item 1-factor measure were derived from the factor structure obtained from unpublished work using an earlier wave of data from one of these cohorts. Descriptive statistics, including polychoric correlations, were used to describe the abbreviated scale. Cronbach's alpha was used to assess internal consistency and confirmatory factor analysis to assess scale validity. Concurrent validity was assessed using correlations between the new 6-item version and established 19-item version, and other concurrent variables. In both cohorts, the new 6-item 1-factor measure showed strong internal consistency and scale reliability. It had excellent goodness-of-fit indices, similar to those of the established 19-item measure. Both versions correlated similarly with concurrent measures. The 6-item 1-factor MOS-SSS measures global functional social support with fewer items than the established 19-item measure.

Geriatric Anxiety Scale: item response theory analysis, differential item functioning, and creation of a ten-item short form (GAS-10).

Science.gov (United States)

Mueller, Anne E; Segal, Daniel L; Gavett, Brandon; Marty, Meghan A; Yochim, Brian; June, Andrea; Coolidge, Frederick L

2015-07-01

The Geriatric Anxiety Scale (GAS; Segal et al. (Segal, D. L., June, A., Payne, M., Coolidge, F. L. and Yochim, B. (2010). Journal of Anxiety Disorders, 24, 709-714. doi:10.1016/j.janxdis.2010.05.002) is a self-report measure of anxiety that was designed to address unique issues associated with anxiety assessment in older adults. This study is the first to use item response theory (IRT) to examine the psychometric properties of a measure of anxiety in older adults. A large sample of older adults (n = 581; mean age = 72.32 years, SD = 7.64 years, range = 60 to 96 years; 64% women; 88% European American) completed the GAS. IRT properties were examined. The presence of differential item functioning (DIF) or measurement bias by age and sex was assessed, and a ten-item short form of the GAS (called the GAS-10) was created. All GAS items had discrimination parameters of 1.07 or greater. Items from the somatic subscale tended to have lower discrimination parameters than items on the cognitive or affective subscales. Two items were flagged for DIF, but the impact of the DIF was negligible. Women scored significantly higher than men on the GAS and its subscales. Participants in the young-old group (60 to 79 years old) scored significantly higher on the cognitive subscale than participants in the old-old group (80 years old and older). Results from the IRT analyses indicated that the GAS and GAS-10 have strong psychometric properties among older adults. We conclude by discussing implications and future research directions.

Validation of the Spanish versions of the long (26 items) and short (12 items) forms of the Self-Compassion Scale (SCS).

Science.gov (United States)

Garcia-Campayo, Javier; Navarro-Gil, Mayte; Andrés, Eva; Montero-Marin, Jesús; López-Artal, Lorena; Demarzo, Marcelo Marcos Piva

2014-01-10

Self-compassion is a key psychological construct for assessing clinical outcomes in mindfulness-based interventions. The aim of this study was to validate the Spanish versions of the long (26 item) and short (12 item) forms of the Self-Compassion Scale (SCS). The translated Spanish versions of both subscales were administered to two independent samples: Sample 1 was comprised of university students (n = 268) who were recruited to validate the long form, and Sample 2 was comprised of Aragon Health Service workers (n = 271) who were recruited to validate the short form. In addition to SCS, the Mindful Attention Awareness Scale (MAAS), the State-Trait Anxiety Inventory-Trait (STAI-T), the Beck Depression Inventory (BDI) and the Perceived Stress Questionnaire (PSQ) were administered. Construct validity, internal consistency, test-retest reliability and convergent validity were tested. The Confirmatory Factor Analysis (CFA) of the long and short forms of the SCS confirmed the original six-factor model in both scales, showing goodness of fit. Cronbach's α for the 26 item SCS was 0.87 (95% CI = 0.85-0.90) and ranged between 0.72 and 0.79 for the 6 subscales. Cronbach's α for the 12-item SCS was 0.85 (95% CI = 0.81-0.88) and ranged between 0.71 and 0.77 for the 6 subscales. The long (26-item) form of the SCS showed a test-retest coefficient of 0.92 (95% CI = 0.89-0.94). The Intraclass Correlation (ICC) for the 6 subscales ranged from 0.84 to 0.93. The short (12-item) form of the SCS showed a test-retest coefficient of 0.89 (95% CI: 0.87-0.93). The ICC for the 6 subscales ranged from 0.79 to 0.91. The long and short forms of the SCS exhibited a significant negative correlation with the BDI, the STAI and the PSQ, and a significant positive correlation with the MAAS. The correlation between the total score of the long and short SCS form was r = 0.92. The Spanish versions of the long (26-item) and short (12-item) forms of the SCS are valid and

The 12-item World Health Organization Disability Assessment Schedule II (WHO-DAS II: a nonparametric item response analysis

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Fernandez Ana

2010-05-01

Full Text Available Abstract Background Previous studies have analyzed the psychometric properties of the World Health Organization Disability Assessment Schedule II (WHO-DAS II using classical omnibus measures of scale quality. These analyses are sample dependent and do not model item responses as a function of the underlying trait level. The main objective of this study was to examine the effectiveness of the WHO-DAS II items and their options in discriminating between changes in the underlying disability level by means of item response analyses. We also explored differential item functioning (DIF in men and women. Methods The participants were 3615 adult general practice patients from 17 regions of Spain, with a first diagnosed major depressive episode. The 12-item WHO-DAS II was administered by the general practitioners during the consultation. We used a non-parametric item response method (Kernel-Smoothing implemented with the TestGraf software to examine the effectiveness of each item (item characteristic curves and their options (option characteristic curves in discriminating between changes in the underliying disability level. We examined composite DIF to know whether women had a higher probability than men of endorsing each item. Results Item response analyses indicated that the twelve items forming the WHO-DAS II perform very well. All items were determined to provide good discrimination across varying standardized levels of the trait. The items also had option characteristic curves that showed good discrimination, given that each increasing option became more likely than the previous as a function of increasing trait level. No gender-related DIF was found on any of the items. Conclusions All WHO-DAS II items were very good at assessing overall disability. Our results supported the appropriateness of the weights assigned to response option categories and showed an absence of gender differences in item functioning.

Development of the Oxford Participation and Activities Questionnaire: constructing an item pool

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Kelly L

2015-05-01

Full Text Available Laura Kelly, Crispin Jenkinson, Sarah Dummett, Jill Dawson, Ray Fitzpatrick, David Morley Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK Purpose: The Oxford Participation and Activities Questionnaire is a patient-reported outcome measure in development that is grounded on the World Health Organization International Classification of Functioning, Disability, and Health (ICF. The study reported here aimed to inform and generate an item pool for the new measure, which is specifically designed for the assessment of participation and activity in patients experiencing a range of health conditions. Methods: Items were informed through in-depth interviews conducted with 37 participants spanning a range of conditions. Interviews aimed to identify how their condition impacted their ability to participate in meaningful activities. Conditions included arthritis, cancer, chronic back pain, diabetes, motor neuron disease, multiple sclerosis, Parkinson's disease, and spinal cord injury. Transcripts were analyzed using the framework method. Statements relating to ICF themes were recast as questionnaire items and shown for review to an expert panel. Cognitive debrief interviews (n=13 were used to assess items for face and content validity. Results: ICF themes relevant to activities and participation in everyday life were explored, and a total of 222 items formed the initial item pool. This item pool was refined by the research team and 28 generic items were mapped onto all nine chapters of the ICF construct, detailing activity and participation. Cognitive interviewing confirmed the questionnaire instructions, items, and response options were acceptable to participants. Conclusion: Using a clear conceptual basis to inform item generation, 28 items have been identified as suitable to undergo further psychometric testing. A large-scale postal survey will follow in order to refine the instrument further and

Gender-Based Differential Item Performance in Mathematics Achievement Items.

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Doolittle, Allen E.; Cleary, T. Anne

1987-01-01

Eight randomly equivalent samples of high school seniors were each given a unique form of the ACT Assessment Mathematics Usage Test (ACTM). Signed measures of differential item performance (DIP) were obtained for each item in the eight ACTM forms. DIP estimates were analyzed and a significant item category effect was found. (Author/LMO)

American Orthopaedic Foot and Ankle Society ankle-hindfoot scale: A cross-cultural adaptation and validation study from Iran.

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Vosoughi, Amir Reza; Roustaei, Narges; Mahdaviazad, Hamideh

2017-02-17

The use of valid and reliable outcome rating scales is essential for evaluating the result of different treatments and interventions. The purposes of this study were to translate and culturally adapt the American Orthopaedic Foot and Ankle Society ankle-hindfoot scale (AOFAS-AHFS) into Persian languages and evaluate its psychometric properties. Forward-backward translation and cultural adaptation method were used to develop Persian version of AOFAS-AHFS. From March to July 2016, one hundred consecutive patients with ankle and hindfoot injuries were included. Internal consistency and reproducibility were evaluated using Cronbach's alpha, Spearman's rank correlation coefficient and Intraclass correlation coefficient (ICC) respectively. Construct validity reported which compare the outcome rating scale measurements with Short Form-36 (SF-36), also convergent and discriminant validity evaluated using Spearman's rank correlation coefficient. Mean age (SD) of the patients was 41.95±13.45years. Cronbach's α coefficient, Spearman's rho and ICC values were 0.71, 0.89 and 0.90 respectively. Total score of AOFAS-AHFS and SF-36 domains has a correlation ranged between 0.17-0.55. Spearman's rank correlation coefficient of 0.4 was exceeded by all items with the exception of stability. The Spearman's rank correlation between each item in functional subscales with its own subscales was higher than the correlation between these items and other subscales. Persian version of AOFAS-AHFS provides additional reliable and valid instrument which can be used to assess broad range of patients with foot and ankle disorders that speaking in Persian. However, it seems that the original version of AOFAS-AHFS needs some revisions. Copyright © 2017 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Item response theory analysis of Working Alliance Inventory, revised response format, and new Brief Alliance Inventory.

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Mallinckrodt, Brent; Tekie, Yacob T

2016-11-01

The Working Alliance Inventory (WAI) has made great contributions to psychotherapy research. However, studies suggest the 7-point response format and 3-factor structure of the client version may have psychometric problems. This study used Rasch item response theory (IRT) to (a) improve WAI response format, (b) compare two brief 12-item versions (WAI-sr; WAI-s), and (c) develop a new 16-item Brief Alliance Inventory (BAI). Archival data from 1786 counseling center and community clients were analyzed. IRT findings suggested problems with crossed category thresholds. A rescoring scheme that combines neighboring responses to create 5- and 4-point scales sharply reduced these problems. Although subscale variance was reduced by 11-26%, rescoring yielded improved reliability and generally higher correlations with therapy process (session depth and smoothness) and outcome measures (residual gain symptom improvement). The 16-item BAI was designed to maximize "bandwidth" of item difficulty and preserve a broader range of WAI sensitivity than WAI-s or WAI-sr. Comparisons suggest the BAI performed better in several respects than the WAI-s or WAI-sr and equivalent to the full WAI on several performance indicators.

The influence of mothers' and fathers' sensitivity in the first year of life on children's cognitive outcomes at 18 and 36 months.

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Malmberg, L-E; Lewis, S; West, A; Murray, E; Sylva, K; Stein, A

2016-01-01

There has been increasing interest in the relative effects of mothers' and fathers' interactions with their infants on later development. However to date there has been little work on children's cognitive outcomes. We examined the relative influence of fathers' and mothers' sensitivity during interactions with their children at the end of the child's first year (10-12 months, n = 97), on child general cognitive development at 18 months and language at 36 months. Both parents' sensitivity was associated with cognitive and language outcomes in univariate analyses. Mothers' sensitivity, however, appeared to be associated with family socio-demographic factors to a greater extent that fathers' sensitivity. Using path modelling the effect of paternal sensitivity on general cognitive development at 18 months and language at 36 months was significantly greater than the effect of maternal sensitivity, when controlling for socio-demographic background. In relation to language at 36 months, there was some evidence that sensitivity of one parent buffered the effect of lower sensitivity of the other parent. These findings suggest that parental sensitivity can play an important role in children's cognitive and language development, and that higher sensitivity of one parent can compensate for the lower sensitivity of the other parent. Replication of these findings, however, is required in larger samples. © 2015 John Wiley & Sons Ltd.

Psychological factors related to physical, social, and mental dimensions of the SF-36: a population-based study of middle-aged women and men

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Evalill Nilsson

2010-10-01

Full Text Available Evalill Nilsson1, Margareta Kristenson21Department of Social and Welfare Studies, Linköping University, Linköping, Sweden; 2Department of Medicine and Health, Division of Community Medicine/Social Medicine and Public Health Sciences, Linköping University, Linköping, SwedenBackground: Measures of health-related quality of life (HRQoL are increasingly used as patient-reported outcome measures in routine health care. Research on determinants and correlates of HRQoL has, therefore, grown in importance. Earlier studies have generally been patient-based and few of them have examined differences between women and men. The aim of this study was to explore the relationship between psychological factors and physical, social, and mental dimensions of HRQoL, as measured by the Medical Outcome Study Short Form-36 Health Survey (SF-36, in a normal population and to see if observed relations were the same for women and men.Methods: Relations between scale scores for the eight scales of SF-36 and scale scores for Self-esteem, Sense of Coherence, Perceived Control, Depressed Mood (CES-D, and Cynicism were assessed through partial correlation and multiple linear regression analyses on a sample of 505 women and 502 men (aged 45–69 years, stratified for sex and adjusted for effects of age, presence of disease, back pain, lifestyle, and social support.Results: All psychological factors tested, except Cynicism, were significantly correlated to all scales of the SF-36 for women and men (Pearson product-moment partial correlation coefficient, |r| = 0.11–0.63 and |r| = 0.11–0.60, respectively. The addition of psychological factors into regression models resulted in significant total explained variance (R2 changes in all scales of the SF-36 for both sexes. Any discrepancies between women and men pertained more to the strength of relationships rather than the significance of different psychological factors.Conclusion: In this population-based study

Predicting functional outcomes of posterior circulation acute ischemic stroke in first 36 h of stroke onset.

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Lin, Sheng-Feng; Chen, Chin-I; Hu, Han-Hwa; Bai, Chyi-Huey

2018-04-01

Posterior circulation acute ischemic stroke constitutes one-fourth of all ischemic strokes and can be efficiently quantified using the posterior circulation Alberta stroke program early computed tomography score (PC-ASPECTS) through diffusion-weighted imaging. We investigated whether the PC-ASPECTS and National Institutes of Health Stroke Scale (NIHSS) facilitate functional outcome prediction among Chinese patients with posterior circulation acute ischemic stroke. Participants were selected from our prospective stroke registry from January 1, 2015, to December 31, 2016. The baseline NIHSS score was assessed on the first day of admission, and brain magnetic resonance imaging was performed within 36 h after stroke onset. Simple and multiple logistic regressions were conducted to determine stroke risk factors and the PC-ASPECTS. Receiver operating characteristics (ROC) curve analysis was performed to compare the NIHSS and PC-ASPECTS. Of 549 patients from our prospective stroke admission registry database, 125 (22.8%) had a diagnosis of posterior circulation acute ischemic stroke. The optimal cutoff for the PC-ASPECTS in predicting outcomes was 7. The odds ratios of the PC-ASPECTS (≤ 7 vs > 7) in predicting outcomes were 6.33 (p = 0.0002) and 8.49 (p = 0.0060) in the univariate and multivariate models, respectively, and 7.52 (p = 0.0041) in the aging group. On ROC curve analysis, the PC-ASPECTS demonstrated more reliability than the baseline NIHSS for predicting functional outcomes of minor posterior circulation stroke. In conclusion, both the PC-ASPECTS and NIHSS help clinicians predict functional outcomes. PC-ASPECTS > 7 is a helpful discriminator for achieving favorable functional outcome prediction in posterior circulation acute ischemic stroke.

The Australian Racism, Acceptance, and Cultural-Ethnocentrism Scale (RACES): item response theory findings.

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Grigg, Kaine; Manderson, Lenore

2016-03-17

Racism and associated discrimination are pervasive and persistent challenges with multiple cumulative deleterious effects contributing to inequities in various health outcomes. Globally, research over the past decade has shown consistent associations between racism and negative health concerns. Such research confirms that race endures as one of the strongest predictors of poor health. Due to the lack of validated Australian measures of racist attitudes, RACES (Racism, Acceptance, and Cultural-Ethnocentrism Scale) was developed. Here, we examine RACES' psychometric properties, including the latent structure, utilising Item Response Theory (IRT). Unidimensional and Multidimensional Rating Scale Model (RSM) Rasch analyses were utilised with 296 Victorian primary school students and 182 adolescents and 220 adults from the Australian community. RACES was demonstrated to be a robust 24-item three-dimensional scale of Accepting Attitudes (12 items), Racist Attitudes (8 items), and Ethnocentric Attitudes (4 items). RSM Rasch analyses provide strong support for the instrument as a robust measure of racist attitudes in the Australian context, and for the overall factorial and construct validity of RACES across primary school children, adolescents, and adults. RACES provides a reliable and valid measure that can be utilised across the lifespan to evaluate attitudes towards all racial, ethnic, cultural, and religious groups. A core function of RACES is to assess the effectiveness of interventions to reduce community levels of racism and in turn inequities in health outcomes within Australia.

Item reduction and psychometric validation of the Oily Skin Self Assessment Scale (OSSAS) and the Oily Skin Impact Scale (OSIS).

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Arbuckle, Robert; Clark, Marci; Harness, Jane; Bonner, Nicola; Scott, Jane; Draelos, Zoe; Rizer, Ronald; Yeh, Yating; Copley-Merriman, Kati

2009-01-01

Developed using focus groups, the Oily Skin Self Assessment Scale (OSSAS) and Oily Skin Impact Scale (OSIS) are patient-reported outcome measures of oily facial skin. The aim of this study was to finalize the item-scale structure of the instruments and perform psychometric validation in adults with self-reported oily facial skin. The OSSAS and OSIS were administered to 202 adult subjects with oily facial skin in the United States. A subgroup of 152 subjects returned, 4 to 10 days later, for test–retest reliability evaluation. Of the 202 participants, 72.8% were female; 64.4% had self-reported nonsevere acne. Item reduction resulted in a 14-item OSSAS with Sensation (five items), Tactile (four items) and Visual (four items) domains, a single blotting item, and an overall oiliness item. The OSIS was reduced to two three-item domains assessing Annoyance and Self-Image. Confirmatory factor analysis supported the construct validity of the final item-scale structures. The OSSAS and OSIS scales had acceptable item convergent validity (item-scale correlations >0.40) and floor and ceiling effects (skin severity (P skin (P skin), as assessments of self-reported oily facial skin severity and its emotional impact, respectively.

P2-19: The Effect of item Repetition on Item-Context Association Depends on the Prior Exposure of Items

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Hongmi Lee

2012-10-01

Full Text Available Previous studies have reported conflicting findings on whether item repetition has beneficial or detrimental effects on source memory. To reconcile such contradictions, we investigated whether the degree of pre-exposure of items can be a potential modulating factor. The experimental procedures spanned two consecutive days. On Day 1, participants were exposed to a set of unfamiliar faces. On Day 2, the same faces presented on the previous day were used again in half of the participants, whereas novel faces were used for the other half. Day 2 procedures consisted of three successive phases: item repetition, source association, and source memory test. In the item repetition phase, half of the face stimuli were repeatedly presented while participants were making male/female judgments. During the source association phase, both the repeated and the unrepeated faces appeared in one of the four locations on the screen. Finally, participants were tested on the location in which a given face was presented during the previous phase and reported the confidence of their memory. Source memory accuracy was measured as the percentage of correct non-guess trials. As results, we found a significant interaction between prior exposure and repetition. Repetition impaired source memory when the items had been pre-exposed on Day 1, while it led to greater accuracy in novel ones. These results show that pre-experimental exposure can modulate the effects of repetition on associative binding between an item and its contextual information, suggesting that pre-existing representation and novelty signal interact to form new episodic memory.

Human Adenovirus 36 Infection Increased the Risk of Obesity: A Meta-Analysis Update.

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Xu, Mei-Yan; Cao, Bing; Wang, Dong-Fang; Guo, Jing-Hui; Chen, Kai-Li; Shi, Mai; Yin, Jian; Lu, Qing-Bin

2015-12-01

Human adenovirus 36 (HAdV-36), as the key pathogen, was supposed and discussed to be associated with obesity. We searched the references on the association between HAdV-36 infection and obesity with the different epidemiological methods, to explore the relationship with a larger sample size by meta-analysis and compare the differences of epidemiological methods and population subsets by the subgroup analyses.We conducted literature search on the association between HAdV-36 infections and obesity in English or Chinese published up to July 1, 2015. The primary outcome was the HAdV-36 infection rate in the obese and lean groups; the secondary outcomes were the BMI level and BMI z-score in the HAdV-36 positive and negative groups. The pooled odds ratio (OR) was calculated for the primary outcome; the standardized mean differences (SMDs) were calculated for the secondary and third outcomes. Prediction interval (PI) was graphically presented in the forest plot of the random effect meta-analyses. Metaregression analysis and subgroup analysis were performed.Finally 24 references with 10,191 study subjects were included in the meta-analysis. The obesity subjects were more likely to be infected with HAdV-36 compared to the lean controls (OR = 2.00; 95%CI: 1.46, 2.74; PI: 0.59, 6.76; P infection for obesity were 1.77 (95%CI: 1.19, 2.63; PI: 0.44, 7.03; P = 0.005) and 2.26 (95%CI: 1.67, 3.07; PI: 1.45, 3.54; P SMD of BMI was 0.28 (95% CI: 0.08, 0.47; PI: -0.53, 1.08; P = 0.006) in the HAdV-36 positive subjects with a high heterogeneity (I = 86.5%; P infection was higher than those without HAdV-36 infection (SMD = 0.19; 95%CI: -0.31, 0.70; PI: -2.10, 2.49), which had no significantly statistical difference (P = 0.453).HAdV-36 infection increased the risk of obesity. HAdV-36 also increased the risk of weight gain in adults, which was not observed in children.

Poor Employment Conditions Adversely Affect Mental Health Outcomes Among Surgical Trainees.

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Kevric, Jasmina; Papa, Nathan; Perera, Marlon; Rashid, Prem; Toshniwal, Sumeet

Poor mental health in junior clinicians is prevalent and may lead to poor productivity and significant medical errors. We aimed to provide contemporary data on the mental health of surgical trainees and identify risk factors relating to poorer mental health outcomes. A detailed questionnaire was developed comprising questions based on the 36-item short-form health survey (SF-36) and Physical Activity Questionnaire. Each of the questionnaires has proven validity and reliability in the clinical context. Ethics approval was obtained from the Royal Australasian College of Surgeons. The questionnaire was aimed at surgical registrars. We used Physical Activity Questionnaire, SF-36 scores and linear regression to evaluate the effect of putative predictors on mental health. A total of 83 responses were collected during the study period, of which 49 (59%) were from men and 34 (41%) were from women. The mean Mental Component Summary (MCS) score for both sexes was significantly lower than the population mean at ages 25-34 (p work culture and a feeling of a lack of support at work were extremely strong predictors of a lower MCS score (p Hours of overtime worked, particularly unpaid overtime, were also strong predictors of a poorer score. Australian surgical trainees reported lower MCS scores from the SF-36 questionnaire compared to the general population. Increasing working hours, unpaid overtime, poor job security, and job satisfaction were associated with poorer scores among trainees. Interventions providing improved working conditions need to be considered by professional training bodies and employers. Copyright © 2018 Association of Program Directors in Surgery. All rights reserved.

Teoria da Resposta ao Item Teoria de la respuesta al item Item response theory

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Eutalia Aparecida Candido de Araujo

2009-12-01

Full Text Available A preocupação com medidas de traços psicológicos é antiga, sendo que muitos estudos e propostas de métodos foram desenvolvidos no sentido de alcançar este objetivo. Entre os trabalhos propostos, destaca-se a Teoria da Resposta ao Item (TRI que, a princípio, veio completar limitações da Teoria Clássica de Medidas, empregada em larga escala até hoje na medida de traços psicológicos. O ponto principal da TRI é que ela leva em consideração o item particularmente, sem relevar os escores totais; portanto, as conclusões não dependem apenas do teste ou questionário, mas de cada item que o compõe. Este artigo propõe-se a apresentar esta Teoria que revolucionou a teoria de medidas.La preocupación con las medidas de los rasgos psicológicos es antigua y muchos estudios y propuestas de métodos fueron desarrollados para lograr este objetivo. Entre estas propuestas de trabajo se incluye la Teoría de la Respuesta al Ítem (TRI que, en principio, vino a completar las limitaciones de la Teoría Clásica de los Tests, ampliamente utilizada hasta hoy en la medida de los rasgos psicológicos. El punto principal de la TRI es que se tiene en cuenta el punto concreto, sin relevar las puntuaciones totales; por lo tanto, los resultados no sólo dependen de la prueba o cuestionario, sino que de cada ítem que lo compone. En este artículo se propone presentar la Teoría que revolucionó la teoría de medidas.The concern with measures of psychological traits is old and many studies and proposals of methods were developed to achieve this goal. Among these proposed methods highlights the Item Response Theory (IRT that, in principle, came to complete limitations of the Classical Test Theory, which is widely used until nowadays in the measurement of psychological traits. The main point of IRT is that it takes into account the item in particular, not relieving the total scores; therefore, the findings do not only depend on the test or questionnaire

The association of targeted temperature management at 33 and 36 °C with outcome in patients with moderate shock on admission after out-of-hospital cardiac arrest

DEFF Research Database (Denmark)

Annborn, Martin; Bro-Jeppesen, John; Nielsen, Niklas

2014-01-01

of supportive measures to maintain a blood pressure ≥90 mmHg and/or clinical signs of end-organ hypoperfusion. In this post hoc analysis reported here, we further analyzed the 139 patients with shock at admission; all had been randomized to receive intervention at 33 °C (TTM33; n = 71) or 36 °C (TTM36; n = 68......). Primary outcome was 180-day mortality. Secondary outcomes were intensive care unit (ICU) and 30-day mortality, severity of circulatory shock assessed by mean arterial pressure, serum lactate, fluid balance and the extended Sequential Organ Failure assessment (SOFA) score. RESULTS......: There was no significance difference between targeted temperature management at 33 °C or 36 °C on 180-day mortality [log-rank test, p = 0.17, hazard ratio 1.33, 95 % confidence interval (CI) 0.88-1.98] or ICU mortality (61 vs. 44 %, p = 0.06; relative risk 1.37, 95 % CI 0.99-1.91). Serum lactate and the extended...

Impact of the mode of delivery on maternal and neonatal outcome in spontaneous-onset breech labor at 32+0-36+6 weeks of gestation: A retrospective cohort study.

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Toivonen, Elli; Palomäki, Outi; Korhonen, Päivi; Huhtala, Heini; Uotila, Jukka

2018-03-30

To compare neonatal and maternal outcomes in spontaneously onset preterm breech deliveries after trial of labor (BTOL) and intended cesarean section (BCS), and between BTOL and vertex control deliveries, in singleton fetuses at 32 +0 -36 +6  weeks of gestation. Retrospective single center cohort study in a Finnish University Hospital including all spontaneous-onset preterm breech deliveries with 32 completed gestational weeks in 2003-2015. The study population comprised a total of 176 preterm breech and 103 vertex control deliveries, matched by gestational age and whether the mother had given birth vaginally before or not. Infants with severe malformations and antepartum fetal distress were excluded. Subgroup analyses were made in two cohorts according to gestational age. Main outcome measures were maternal and neonatal mortality and morbidity, low cord pH and Apgar score. No mortality was observed, and severe morbidity was rare. No difference in incidence of low cord pH or five-minute Apgar score was observed between the groups. Apgar scores at the age of one minute were comparable in the breech groups but more often low in the BTOL group compared to the vertex control group. 16.5% of neonates in the BTOL group, 23.3% in the BCS group and 7.8% in the vertex group needed intensive care. In logistic regression analysis, lower gestational age and being small for gestational age were associated with the need for neonatal intensive care. Being allowed a trial of labor was not associated with the need for neonatal intensive care. Maternal morbidity was similar across the groups, but median blood loss was more pronounced in the BCS group compared to the BTOL group. In breech deliveries at 32 +0 -36 +6 gestational weeks, trial of labor did not increase neonatal morbidity compared to intended cesarean delivery. Infants born after a trial of labor in breech presentation display low one-minute Apgar score and need intensive care more often compared to vertex controls

Using Patient Health Questionnaire-9 item parameters of a common metric resulted in similar depression scores compared to independent item response theory model reestimation.

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Liegl, Gregor; Wahl, Inka; Berghöfer, Anne; Nolte, Sandra; Pieh, Christoph; Rose, Matthias; Fischer, Felix

2016-03-01

To investigate the validity of a common depression metric in independent samples. We applied a common metrics approach based on item-response theory for measuring depression to four German-speaking samples that completed the Patient Health Questionnaire (PHQ-9). We compared the PHQ item parameters reported for this common metric to reestimated item parameters that derived from fitting a generalized partial credit model solely to the PHQ-9 items. We calibrated the new model on the same scale as the common metric using two approaches (estimation with shifted prior and Stocking-Lord linking). By fitting a mixed-effects model and using Bland-Altman plots, we investigated the agreement between latent depression scores resulting from the different estimation models. We found different item parameters across samples and estimation methods. Although differences in latent depression scores between different estimation methods were statistically significant, these were clinically irrelevant. Our findings provide evidence that it is possible to estimate latent depression scores by using the item parameters from a common metric instead of reestimating and linking a model. The use of common metric parameters is simple, for example, using a Web application (http://www.common-metrics.org) and offers a long-term perspective to improve the comparability of patient-reported outcome measures. Copyright © 2016 Elsevier Inc. All rights reserved.

Ethical imperatives against item restriction in the Supplemental Nutrition Assistance Program.

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Chrisinger, Benjamin W

2017-07-01

The Supplemental Nutrition Assistance Program (SNAP, formerly known as food stamps) is the federal government's largest form of food assistance, and a frequent focus of political and scholarly debate. Previous discourse in the public health community and recent proposals in state legislatures have suggested limiting the use of SNAP benefits on unhealthy food items, such as sugar-sweetened beverages (SSBs). This paper identifies two possible underlying motivations for item restriction, health and morals, and analyzes the level of empirical support for claims about the current state of the program, as well as expectations about how item restriction would change participant outcomes. It also assesses how item restriction would reduce individual agency of low-income individuals, and identifies mechanisms by which this may adversely affect program participants. Finally, this paper offers alternative policies to promote healthier purchasing and eating among SNAP participants that can be pursued without reducing individual agency. Health advocates and officials must more fully weigh the attendant risks of implementing SNAP item restrictions, including the reduction of individual agency of a vulnerable population. Copyright © 2017 Elsevier Inc. All rights reserved.

Teachers' Teaching Experience and Students' Learning Outcomes ...

African Journals Online (AJOL)

cce

Items 1 - 6 ... Keywords: teaching experience, students' learning outcomes, teacher incentives ... revealed that experienced teachers' perception of their teaching objectives were ... African Journal of Educational Studies in Mathematics and Sciences Vol. .... Years. English language. Mathematics Physics. Chemistry. Biology. %.

Quality of life in infants and children with atopic dermatitis: Addressing issues of differential item functioning across countries in multinational clinical trials

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Tennant Alan

2007-07-01

Full Text Available Abstract Background A previous study had identified 45 items assessing the impact of atopic dermatitis (AD on the whole family. From these it was intended to develop two separate scales, one assessing impact on carers and the other determining the effect on the child. Methods The 45 items were included in three clinical trials designed to test the efficacy of a new topical treatment (pimecrolimus, Elidel cream 1% in the treatment of AD in infants and children and in validation studies in the UK, US, Germany, France and the Netherlands. Rasch analyses were undertaken to determine whether an internationally valid, unidimensional scale could be developed that would inform on the direct impact of AD on the child. Results Rasch analyses applied to the data from the trials indicated that the draft measure consisted of two scales, one assessing the QoL of the carer and the other (consisting of 12 items measuring the impact of AD on the child. Three of the 12 potential items failed to fit the measurement model in Europe and five in the US. In addition, four items exhibiting differential item functioning (DIF by country were identified. After removing the misfitting items and controlling for DIF it was possible to derive a scale; The Childhood Impact of Atopic Dermatitis (CIAD with good item fit for each trial analysis. Analysis of the validation data from each of the different countries confirmed that the CIAD had adequate internal consistency, reproducibility and construct validity. The CIAD demonstrated the benefits of treatment with Elidel over placebo in the European trial. A similar (non-significant trend was found for the US trials. Conclusion The study represents a novel method of dealing with the problem of DIF associated with different cultures. Such problems are likely to arise in any multinational study involving patient-reported outcome measures, as items in the scales are likely to be valued differently in different cultures. However, where

Translation and cross-cultural adaptation of the Detailed Assessment of Speed of Handwriting 17+ to Brazilian Portuguese: conceptual, item and semantic equivalence.

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Cardoso, Monique Herrera; Capellini, Simone Aparecida

2018-02-19

Perform a cross-cultural adaptation of the Detailed Assessment of Speed of Handwriting 17+ (DASH 17+) for Brazilians. Evaluation of (1) conceptual, item and (2) semantic equivalence, with assistance of four translators and application of a pilot study to 36 students. (1) The concepts and items are equivalent in the British and Brazilian cultures. (2) Adaptations were made concerning the English language pangram used in copying tasks and selection of the lower-case, cursive handwriting in the alphabet-writing task. Application of the pilot study verified acceptability and understanding of the proposed tasks by the students. The Brazilian Portuguese version of the DASH 17+ was presented after finalization of the conceptual, item and semantic equivalence of the instrument. Further studies on psychometric properties should be conducted with the purpose of measuring the speed of handwriting in youngsters and adults with greater reliability and validity to the procedure.

Memory for Items and Relationships among Items Embedded in Realistic Scenes: Disproportionate Relational Memory Impairments in Amnesia

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Hannula, Deborah E.; Tranel, Daniel; Allen, John S.; Kirchhoff, Brenda A.; Nickel, Allison E.; Cohen, Neal J.

2014-01-01

Objective The objective of this study was to examine the dependence of item memory and relational memory on medial temporal lobe (MTL) structures. Patients with amnesia, who either had extensive MTL damage or damage that was relatively restricted to the hippocampus, were tested, as was a matched comparison group. Disproportionate relational memory impairments were predicted for both patient groups, and those with extensive MTL damage were also expected to have impaired item memory. Method Participants studied scenes, and were tested with interleaved two-alternative forced-choice probe trials. Probe trials were either presented immediately after the corresponding study trial (lag 1), five trials later (lag 5), or nine trials later (lag 9) and consisted of the studied scene along with a manipulated version of that scene in which one item was replaced with a different exemplar (item memory test) or was moved to a new location (relational memory test). Participants were to identify the exact match of the studied scene. Results As predicted, patients were disproportionately impaired on the test of relational memory. Item memory performance was marginally poorer among patients with extensive MTL damage, but both groups were impaired relative to matched comparison participants. Impaired performance was evident at all lags, including the shortest possible lag (lag 1). Conclusions The results are consistent with the proposed role of the hippocampus in relational memory binding and representation, even at short delays, and suggest that the hippocampus may also contribute to successful item memory when items are embedded in complex scenes. PMID:25068665

Development and application of course-embedded assessment system for program outcome evaluation in the Korean nursing education: A pilot study.

Science.gov (United States)

Park, Jee Won; Seo, Eun Ji; You, Mi-Ae; Song, Ju-Eun

2016-03-01

Program outcome evaluation is important because it is an indicator for good quality of education. Course-embedded assessment is one of the program outcome evaluation methods. However, it is rarely used in Korean nursing education. The study purpose was to develop and apply preliminarily a course-embedded assessment system to evaluate one program outcome and to share our experiences. This was a methodological study to develop and apply the course-embedded assessment system based on the theoretical framework in one nursing program in South Korea. Scores for 77 students generated from the three practicum courses were used. The course-embedded assessment system was developed following the six steps suggested by Han's model as follows. 1) One program outcome in the undergraduate program, "nursing process application ability", was selected and 2) the three clinical practicum courses related to the selected program outcome were identified. 3) Evaluation tools including rubric and items were selected for outcome measurement and 4) performance criterion, the educational goal level for the program, was established. 5) Program outcome was actually evaluated using the rubric and evaluation items in the three practicum courses and 6) the obtained scores were analyzed to identify the achievement rate, which was compared with the performance criterion. Achievement rates for the selected program outcome in adult, maternity, and pediatric nursing practicum were 98.7%, 100%, and 66.2% in the case report and 100% for all three in the clinical practice, and 100%, 100%, and 87% respectively for the conference. These are considered as satisfactory levels when compared with the performance criterion of "at least 60% or more". Course-embedded assessment can be used as an effective and economic method to evaluate the program outcome without running an integrative course additionally. Further studies to develop course-embedded assessment systems for other program outcomes in nursing

A new Integrated Negative Symptom structure of the Positive and Negative Syndrome Scale (PANSS) in schizophrenia using item response analysis.

Science.gov (United States)

Khan, Anzalee; Lindenmayer, Jean-Pierre; Opler, Mark; Yavorsky, Christian; Rothman, Brian; Lucic, Luka

2013-10-01

Debate persists with regard to how best to categorize the syndromal dimension of negative symptoms in schizophrenia. The aim was to first review published Principle Components Analysis (PCA) of the PANSS, and extract items most frequently included in the negative domain, and secondly, to examine the quality of items using Item Response Theory (IRT) to select items that best represent a measurable dimension (or dimensions) of negative symptoms. First, 22 factor analyses and PCA met were included. Second, using a large dataset (n=7187) of participants in clinical trials with chronic schizophrenia, we extracted items loading on one or more PCA. Third, items not loading with a value of ≥ 0.5, or loading on more than one component with values of ≥ 0.5 were discarded. Fourth, resulting items were included in a non-parametric IRT and retained based on Option Characteristic Curves (OCCs) and Item Characteristic Curves (ICCs). 15 items loaded on a negative domain in at least one study, with Emotional Withdrawal loading on all studies. Non-parametric IRT retained nine items as an Integrated Negative Factor: Emotional Withdrawal, Blunted Affect, Passive/Apathetic Social Withdrawal, Poor Rapport, Lack of Spontaneity/Conversation Flow, Active Social Avoidance, Disturbance of Volition, Stereotyped Thinking and Difficulty in Abstract Thinking. This is the first study to use a psychometric IRT process to arrive at a set of negative symptom items. Future steps will include further examination of these nine items in terms of their stability, sensitivity to change, and correlations with functional and cognitive outcomes. © 2013 Elsevier B.V. All rights reserved.

Epidemiology and Outcomes of Vertebral Artery Injury in 16 582 Cervical Spine Surgery Patients: An AOSpine North America Multicenter Study.

Science.gov (United States)

Hsu, Wellington K; Kannan, Abhishek; Mai, Harry T; Fehlings, Michael G; Smith, Zachary A; Traynelis, Vincent C; Gokaslan, Ziya L; Hilibrand, Alan S; Nassr, Ahmad; Arnold, Paul M; Mroz, Thomas E; Bydon, Mohamad; Massicotte, Eric M; Ray, Wilson Z; Steinmetz, Michael P; Smith, Gabriel A; Pace, Jonathan; Corriveau, Mark; Lee, Sungho; Isaacs, Robert E; Wang, Jeffrey C; Lord, Elizabeth L; Buser, Zorica; Riew, K Daniel

2017-04-01

A multicenter retrospective case series was compiled involving 21 medical institutions. Inclusion criteria included patients who underwent cervical spine surgery between 2005 and 2011 and who sustained a vertebral artery injury (VAI). To report the frequency, risk factors, outcomes, and management goals of VAI in patients who have undergone cervical spine surgery. Patients were evaluated on the basis of condition-specific functional status using the Neck Disability Index (NDI), modified Japanese Orthopaedic Association (mJOA) score, the Nurick scale, and the 36-Item Short-Form Health Survey (SF-36). VAIs were identified in a total of 14 of 16 582 patients screened (8.4 per 10 000). The mean age of patients with VAI was 59 years (±10) with a female predominance (78.6%). Patient diagnoses included myelopathy, radiculopathy, cervical instability, and metastatic disease. VAI was associated with substantial blood loss (770 mL), although only 3 cases required transfusion. Of the 14 cases, 7 occurred with an anterior-only approach, 3 cases with posterior-only approach, and 4 during circumferential approach. Fifty percent of cases of VAI with available preoperative imaging revealed anomalous vessel anatomy during postoperative review. Average length of hospital stay was 10 days (±8). Notably, 13 of the 14 (92.86%) cases resolved without residual deficits. Compared to preoperative baseline NDI, Nurick, mJOA, and SF-36 scores for these patients, there were no observed changes after surgery ( P = .20-.94). Vertebral artery injuries are potentially catastrophic complications that can be sustained from anterior or posterior cervical spine approaches. The data from this study suggest that with proper steps to ensure hemostasis, patients recover function at a high rate and do not exhibit residual deficits.

The Alberta Pregnancy Outcomes and Nutrition (APrON) cohort study: rationale and methods.

Science.gov (United States)

Kaplan, Bonnie J; Giesbrecht, Gerald F; Leung, Brenda M Y; Field, Catherine J; Dewey, Deborah; Bell, Rhonda C; Manca, Donna P; O'Beirne, Maeve; Johnston, David W; Pop, Victor J; Singhal, Nalini; Gagnon, Lisa; Bernier, Francois P; Eliasziw, Misha; McCargar, Linda J; Kooistra, Libbe; Farmer, Anna; Cantell, Marja; Goonewardene, Laki; Casey, Linda M; Letourneau, Nicole; Martin, Jonathan W

2014-01-01

The Alberta Pregnancy Outcomes and Nutrition (APrON) study is an ongoing prospective cohort study that recruits pregnant women early in pregnancy and, as of 2012, is following up their infants to 3 years of age. It has currently enrolled approximately 5000 Canadians (2000 pregnant women, their offspring and many of their partners). The primary aims of the APrON study were to determine the relationships between maternal nutrient intake and status, before, during and after gestation, and (1) maternal mood; (2) birth and obstetric outcomes; and (3) infant neurodevelopment. We have collected comprehensive maternal nutrition, anthropometric, biological and mental health data at multiple points in the pregnancy and the post-partum period, as well as obstetrical, birth, health and neurodevelopmental outcomes of these pregnancies. The study continues to follow the infants through to 36 months of age. The current report describes the study design and methods, and findings of some pilot work. The APrON study is a significant resource with opportunities for collaboration. © 2012 John Wiley & Sons Ltd.

Changes in the Oswestry Disability Index that predict improvement after lumbar fusion.

Science.gov (United States)

Djurasovic, Mladen; Glassman, Steven D; Dimar, John R; Crawford, Charles H; Bratcher, Kelly R; Carreon, Leah Y

2012-11-01

Clinical studies use both disease-specific and generic health outcomes measures. Disease-specific measures focus on health domains most relevant to the clinical population, while generic measures assess overall health-related quality of life. There is little information about which domains of the Oswestry Disability Index (ODI) are most important in determining improvement in overall health-related quality of life, as measured by the 36-Item Short Form Health Survey (SF-36), after lumbar spinal fusion. The objective of the study is to determine which clinical elements assessed by the ODI most influence improvement of overall health-related quality of life. A single tertiary spine center database was used to identify patients undergoing lumbar fusion for standard degenerative indications. Patients with complete preoperative and 2-year outcomes measures were included. Pearson correlation was used to assess the relationship between improvement in each item of the ODI with improvement in the SF-36 physical component summary (PCS) score, as well as achievement of the SF-36 PCS minimum clinically important difference (MCID). Multivariate regression modeling was used to examine which items of the ODI best predicted achievement for the SF-36 PCS MCID. The effect size and standardized response mean were calculated for each of the items of the ODI. A total of 1104 patients met inclusion criteria (674 female and 430 male patients). The mean age at surgery was 57 years. All items of the ODI showed significant correlations with the change in SF-36 PCS score and achievement of MCID for the SF-36 PCS, but only pain intensity, walking, and social life had r values > 0.4 reflecting moderate correlation. These 3 variables were also the dimensions that were independent predictors of the SF-36 PCS, and they were the only dimensions that had effect sizes and standardized response means that were moderate to large. Of the health dimensions measured by the ODI, pain intensity, walking

The Cervical Dystonia Impact Profile (CDIP-58: Can a Rasch developed patient reported outcome measure satisfy traditional psychometric criteria?

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Bhatia Kailash P

2008-08-01

Full Text Available Abstract Background The United States Food and Drug Administration (FDA are currently producing guidelines for the scientific adequacy of patient reported outcome measures (PROMs in clinical trials, which will have implications for the selection of scales used in future clinical trials. In this study, we examine how the Cervical Dystonia Impact Profile (CDIP-58, a rigorous Rasch measurement developed neurologic PROM, stands up to traditional psychometric criteria for three reasons: 1 provide traditional psychometric evidence for the CDIP-58 in line with proposed FDA guidelines; 2 enable researchers and clinicians to compare it with existing dystonia PROMs; and 3 help researchers and clinicians bridge the knowledge gap between old and new methods of reliability and validity testing. Methods We evaluated traditional psychometric properties of data quality, scaling assumptions, targeting, reliability and validity in a group of 391 people with CD. The main outcome measures used were the CDIP-58, Medical Outcome Study Short Form-36, the 28-item General Health Questionnaire, and Hospital and Anxiety and Depression Scale. Results A total of 391 people returned completed questionnaires (corrected response rate 87%. Analyses showed: 1 data quality was high (low missing data ≤ 4%, subscale scores could be computed for > 96% of the sample; 2 item groupings passed tests for scaling assumptions; 3 good targeting (except for the Sleep subscale, ceiling effect = 27%; 4 good reliability (Cronbach's alpha ≥ 0.92, test-retest intraclass correlations ≥ 0.83; and 5 validity was supported. Conclusion This study has shown that new psychometric methods can produce a PROM that stands up to traditional criteria and supports the clinical advantages of Rasch analysis.

Identifying potential misfit items in cognitive process of learning engineering mathematics based on Rasch model

International Nuclear Information System (INIS)

Ataei, Sh; Mahmud, Z; Khalid, M N

2014-01-01

The students learning outcomes clarify what students should know and be able to demonstrate after completing their course. So, one of the issues on the process of teaching and learning is how to assess students' learning. This paper describes an application of the dichotomous Rasch measurement model in measuring the cognitive process of engineering students' learning of mathematics. This study provides insights into the perspective of 54 engineering students' cognitive ability in learning Calculus III based on Bloom's Taxonomy on 31 items. The results denote that some of the examination questions are either too difficult or too easy for the majority of the students. This analysis yields FIT statistics which are able to identify if there is data departure from the Rasch theoretical model. The study has identified some potential misfit items based on the measurement of ZSTD where the removal misfit item was accomplished based on the MNSQ outfit of above 1.3 or less than 0.7 logit. Therefore, it is recommended that these items be reviewed or revised to better match the range of students' ability in the respective course.

Establishing utility values for the 22-item Sino-Nasal Outcome Test (SNOT-22) using a crosswalk to the EuroQol-five-dimensional questionnaire-three-level version (EQ-5D-3L).

Science.gov (United States)

Crump, R Trafford; Lai, Ernest; Liu, Guiping; Janjua, Arif; Sutherland, Jason M

2017-05-01

Chronic rhinosinusitis (CRS) is a common condition for which there are numerous medical and surgical treatments. The 22-item Sino-Nasal Outcome Test (SNOT-22) is a patient-reported outcome measure often used with patients diagnosed with CRS. However, there are no utility values associated with the SNOT-22, limiting its use in comparative effectiveness research. The purpose of this study was to establish utilities for the SNOT-22 by mapping responses to utility values associated with the EuroQol-5-dimensional questionnaire-3-level version (EQ-5D-3L). This study used data collected from patients diagnosed with CRS awaiting bilateral endoscopic sinus surgery in Vancouver, Canada. Study participants completed both the SNOT-22 and the EQ-5D-3L. Ordinary least squares was used for 3 models that estimated the EQ-5D-3L utility values as a function of the SNOT-22 items. A total of 232 participants completed both the SNOT-22 and the EQ-5D-3L. As expected, there was a negative relationship between the SNOT-22 global scores and EQ-5D-3L utility values. Adjusted R 2 for the 3 models ranged from 0.28 to 0.33, and root mean squared errors between 0.23 and 0.24. A nonparametric bootstrap analysis demonstrated robustness of the findings. This study successfully developed a mapping model to associate utility values with responses to the SNOT-22. This model could be used to conduct comparative effectiveness research in CRS to evaluate the various interventions available for treating this condition. © 2017 ARS-AAOA, LLC.

An emotional functioning item bank of 24 items for computerized adaptive testing (CAT) was established

DEFF Research Database (Denmark)

Petersen, Morten Aa.; Gamper, Eva-Maria; Costantini, Anna

2016-01-01

of the widely used EORTC Quality of Life questionnaire (QLQ-C30). STUDY DESIGN AND SETTING: On the basis of literature search and evaluations by international samples of experts and cancer patients, 38 candidate items were developed. The psychometric properties of the items were evaluated in a large...... international sample of cancer patients. This included evaluations of dimensionality, item response theory (IRT) model fit, differential item functioning (DIF), and of measurement precision/statistical power. RESULTS: Responses were obtained from 1,023 cancer patients from four countries. The evaluations showed...... that 24 items could be included in a unidimensional IRT model. DIF did not seem to have any significant impact on the estimation of EF. Evaluations indicated that the CAT measure may reduce sample size requirements by up to 50% compared to the QLQ-C30 EF scale without reducing power. CONCLUSION...

Measuring outcomes in allergic rhinitis: psychometric characteristics of a Spanish version of the congestion quantifier seven-item test (CQ7

Directory of Open Access Journals (Sweden)

Mullol Joaquim

2011-03-01

Full Text Available Abstract Background No control tools for nasal congestion (NC are currently available in Spanish. This study aimed to adapt and validate the Congestion Quantifier Seven Item Test (CQ7 for Spain. Methods CQ7 was adapted from English following international guidelines. The instrument was validated in an observational, prospective study in allergic rhinitis patients with NC (N = 166 and a control group without NC (N = 35. Participants completed the CQ7, MOS sleep questionnaire, and a measure of psychological well-being (PGWBI. Clinical data included NC severity rating, acoustic rhinometry, and total symptom score (TSS. Internal consistency was assessed using Cronbach's alpha and test-retest reliability using the intraclass correlation coefficient (ICC. Construct validity was tested by examining correlations with other outcome measures and ability to discriminate between groups classified by NC severity. Sensitivity and specificity were assessed using Area under the Receiver Operating Curve (AUC and responsiveness over time using effect sizes (ES. Results Cronbach's alpha for the CQ7 was 0.92, and the ICC was 0.81, indicating good reliability. CQ7 correlated most strongly with the TSS (r = 0.60, p Conclusions The Spanish version of the CQ7 is appropriate for detecting, measuring, and monitoring NC in allergic rhinitis patients.

Psychological Distress in Acute Low Back Pain

DEFF Research Database (Denmark)

Shaw, William S; Hartvigsen, Jan; Woiszwillo, Mary J

2016-01-01

INFO, PubMed, Web of Science, AMED, and Academic Search Premier) for the period from January 1, 1966, to April 30, 2015, in English, Danish, Norwegian, and Swedish languages. STUDY SELECTION: Cross-sectional, case-control, cohort, or randomized controlled trials assessing psychological distress......-Depression Scale, and the Medical Outcomes Study 12-Item Short-Form Health Survey and Medical Outcomes Study 36-Item Short-Form Health Survey. Pooled results for these scales showed consistent elevations in depression, but not anxiety, and reduced mental health status in comparison with the general population...

Cross-cultural validity of the thyroid-specific quality-of-life patient-reported outcome measure, ThyPRO

DEFF Research Database (Denmark)

Watt, Torquil; Barbesino, Giuseppe; Bjørner, Jakob

2015-01-01

BACKGROUND AND PURPOSE: Thyroid diseases are common and often affect quality of life (QoL). No cross-culturally validated patient-reported outcome measuring thyroid-related QoL is available. The purpose of the present study was to test the cross-cultural validity of the newly developed thyroid......-related patient-reported outcome ThyPRO, using tests for differential item functioning (DIF) according to language version. METHODS: The ThyPRO consists of 85 items summarized in 13 multi-item scales and one single item. Scales cover physical and mental symptoms, well-being and function as well as social...... scale scores, most of which could be explained by sample differences not controlled for. CONCLUSION: The ThyPRO has good cross-cultural validity with only minor cross-cultural invariance and is recommended for use in international multicenter studies....

Reliability and norms for the 10-item self-motivation inventory: The TIGER Study

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The Self-Motivation Inventory (SMI) has been shown to be a predictor of exercise dropout. The original SMI of 40 items has been shortened to 10 items and the psychometric qualities of the 10-item SMI are not known. To estimate the reliability of a 10-item SMI and develop norms for an ethnically dive...

Magnitude and meaningfulness of change in SF-36 scores in four types of orthopedic surgery

DEFF Research Database (Denmark)

Busija, Lucy; Osborne, Richard H; Nilsdotter, Anna

2008-01-01

BACKGROUND: The Medical Outcomes General Health Survey (SF-36) is a widely used health status measure; however, limited evidence is available for its performance in orthopedic settings. The aim of this study was to examine the magnitude and meaningfulness of change and sensitivity of SF-36...

Measurement Equivalence of the Patient Reported Outcomes Measurement Information System® (PROMIS®) Pain Interference Short Form Items: Application to Ethnically Diverse Cancer and Palliative Care Populations.

Science.gov (United States)

Teresi, Jeanne A; Ocepek-Welikson, Katja; Cook, Karon F; Kleinman, Marjorie; Ramirez, Mildred; Reid, M Carrington; Siu, Albert

2016-01-01

Reducing the response burden of standardized pain measures is desirable, particularly for individuals who are frail or live with chronic illness, e.g., those suffering from cancer and those in palliative care. The Patient Reported Outcome Measurement Information System ® (PROMIS ® ) project addressed this issue with the provision of computerized adaptive tests (CAT) and short form measures that can be used clinically and in research. Although there has been substantial evaluation of PROMIS item banks, little is known about the performance of PROMIS short forms, particularly in ethnically diverse groups. Reviewed in this article are findings related to the differential item functioning (DIF) and reliability of the PROMIS pain interference short forms across diverse sociodemographic groups. DIF hypotheses were generated for the PROMIS short form pain interference items. Initial analyses tested item response theory (IRT) model assumptions of unidimensionality and local independence. Dimensionality was evaluated using factor analytic methods; local dependence (LD) was tested using IRT-based LD indices. Wald tests were used to examine group differences in IRT parameters, and to test DIF hypotheses. A second DIF-detection method used in sensitivity analyses was based on ordinal logistic regression with a latent IRT-derived conditioning variable. Magnitude and impact of DIF were investigated, and reliability and item and scale information statistics were estimated. The reliability of the short form item set was excellent. However, there were a few items with high local dependency, which affected the estimation of the final discrimination parameters. As a result, the item, "How much did pain interfere with enjoyment of social activities?" was excluded in the DIF analyses for all subgroup comparisons. No items were hypothesized to show DIF for race and ethnicity; however, five items showed DIF after adjustment for multiple comparisons in both primary and sensitivity

Measurement Equivalence of the Patient Reported Outcomes Measurement Information System® (PROMIS®) Pain Interference Short Form Items: Application to Ethnically Diverse Cancer and Palliative Care Populations

Science.gov (United States)

Teresi, Jeanne A.; Ocepek-Welikson, Katja; Cook, Karon F.; Kleinman, Marjorie; Ramirez, Mildred; Reid, M. Carrington; Siu, Albert

2017-01-01

Reducing the response burden of standardized pain measures is desirable, particularly for individuals who are frail or live with chronic illness, e.g., those suffering from cancer and those in palliative care. The Patient Reported Outcome Measurement Information System® (PROMIS®) project addressed this issue with the provision of computerized adaptive tests (CAT) and short form measures that can be used clinically and in research. Although there has been substantial evaluation of PROMIS item banks, little is known about the performance of PROMIS short forms, particularly in ethnically diverse groups. Reviewed in this article are findings related to the differential item functioning (DIF) and reliability of the PROMIS pain interference short forms across diverse sociodemographic groups. Methods DIF hypotheses were generated for the PROMIS short form pain interference items. Initial analyses tested item response theory (IRT) model assumptions of unidimensionality and local independence. Dimensionality was evaluated using factor analytic methods; local dependence (LD) was tested using IRT-based LD indices. Wald tests were used to examine group differences in IRT parameters, and to test DIF hypotheses. A second DIF-detection method used in sensitivity analyses was based on ordinal logistic regression with a latent IRT-derived conditioning variable. Magnitude and impact of DIF were investigated, and reliability and item and scale information statistics were estimated. Results The reliability of the short form item set was excellent. However, there were a few items with high local dependency, which affected the estimation of the final discrimination parameters. As a result, the item, “How much did pain interfere with enjoyment of social activities?” was excluded in the DIF analyses for all subgroup comparisons. No items were hypothesized to show DIF for race and ethnicity; however, five items showed DIF after adjustment for multiple comparisons in both primary and

A Multicenter Study of the Presentation, Treatment, and Outcomes of Cervical Dural Tears.

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O'Neill, Kevin R; Fehlings, Michael G; Mroz, Thomas E; Smith, Zachary A; Hsu, Wellington K; Kanter, Adam S; Steinmetz, Michael P; Arnold, Paul M; Mummaneni, Praveen V; Chou, Dean; Nassr, Ahmad; Qureshi, Sheeraz A; Cho, Samuel K; Baird, Evan O; Smith, Justin S; Shaffrey, Christopher; Tannoury, Chadi A; Tannoury, Tony; Gokaslan, Ziya L; Gum, Jeffrey L; Hart, Robert A; Isaacs, Robert E; Sasso, Rick C; Bumpass, David B; Bydon, Mohamad; Corriveau, Mark; De Giacomo, Anthony F; Derakhshan, Adeeb; Jobse, Bruce C; Lubelski, Daniel; Lee, Sungho; Massicotte, Eric M; Pace, Jonathan R; Smith, Gabriel A; Than, Khoi D; Riew, K Daniel

2017-04-01

Retrospective multicenter case series study. Because cervical dural tears are rare, most surgeons have limited experience with this complication. A multicenter study was performed to better understand the presentation, treatment, and outcomes following cervical dural tears. Multiple surgeons from 23 institutions retrospectively identified 21 rare complications that occurred between 2005 and 2011, including unintentional cervical dural tears. Demographic data and surgical history were obtained. Clinical outcomes following surgery were assessed, and any reoperations were recorded. Neck Disability Index (NDI), modified Japanese Orthopaedic Association (mJOA), Nurick classification (NuC), and Short-Form 36 (SF36) scores were recorded at baseline and final follow-up at certain centers. All data were collected, collated, and analyzed by a private research organization. There were 109 cases of cervical dural tears among 18 463 surgeries performed. In 101 cases (93%) there was no clinical sequelae following successful dural tear repair. There were statistical improvements ( P < .05) in mJOA and NuC scores, but not NDI or SF36 scores. No specific baseline or operative factors were found to be associated with the occurrence of dural tears. In most cases, no further postoperative treatments of the dural tear were required, while there were 13 patients (12%) that required subsequent treatment of cerebrospinal fluid drainage. Analysis of those requiring further treatments did not identify an optimum treatment strategy for cervical dural tears. In this multicenter study, we report our findings on the largest reported series (n = 109) of cervical dural tears. In a vast majority of cases, no subsequent interventions were required and no clinical sequelae were observed.

Maternal mental health and childrearing context in the development of children at 6, 18 and 36 months: a Taiwan birth cohort pilot study.

Science.gov (United States)

Lung, F-W; Shu, B-C; Chiang, T-L; Lin, S-J

2011-03-01

This study investigated a possible pathway of the childrearing context and maternal mental health at 6 months, and how these factors influence children's development at 6, 18 and 36 months. Using random sampling, 2048 children and mothers were selected. The mother's health status was evaluated using the Taiwanese version of the 36-Item Short Form Health Survey (SF-36), and infant development was assessed using the high reliable Taiwan birth cohort study instrument. All data were collected using parental self-report, and were analysed using multiple linear regression analysis and further pathway using structural equation modelling. This study showed that 12 factors effected children's development at 6 months, and some dissipated with growth. Of these, maternal education had an enduring effect on different domains of child development, and this effect intensified as the child grew older. Children who grew up in a family with more siblings would show a delay in language development at 6 months; they have a delay in motor and social development at 18 and 36 months. Additionally, maternal mental health effected the children's fine motor development at 6 months. However, this effect disappeared at 18 months, and influenced children's social development at 36 months. This study demonstrated that the development of children at as young as 6 months is affected by various factors. These factors may dissipate, continue to influence child development up to 3 years of age, turn from being disadvantageous to beneficial, or affect different domains of child development. Also, parental self-report instrument might be has its limitation and could be contributed by several confounding factors. Thus, continuous longitudinal follow-up on changes in maternal conditions, family factors, and environmental factors is vital to understand how these early infantile factors affect each other and influence the developmental trajectories of children into early childhood. © 2010 Blackwell

The Dutch-Flemish PROMIS Physical Function item bank exhibited strong psychometric properties in patients with chronic pain.

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Crins, Martine H P; Terwee, Caroline B; Klausch, Thomas; Smits, Niels; de Vet, Henrica C W; Westhovens, Rene; Cella, David; Cook, Karon F; Revicki, Dennis A; van Leeuwen, Jaap; Boers, Maarten; Dekker, Joost; Roorda, Leo D

2017-07-01

The objective of this study was to assess the psychometric properties of the Dutch-Flemish Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function item bank in Dutch patients with chronic pain. A bank of 121 items was administered to 1,247 Dutch patients with chronic pain. Unidimensionality was assessed by fitting a one-factor confirmatory factor analysis and evaluating resulting fit statistics. Items were calibrated with the graded response model and its fit was evaluated. Cross-cultural validity was assessed by testing items for differential item functioning (DIF) based on language (Dutch vs. English). Construct validity was evaluated by calculation correlations between scores on the Dutch-Flemish PROMIS Physical Function measure and scores on generic and disease-specific measures. Results supported the Dutch-Flemish PROMIS Physical Function item bank's unidimensionality (Comparative Fit Index = 0.976, Tucker Lewis Index = 0.976) and model fit. Item thresholds targeted a wide range of physical function construct (threshold-parameters range: -4.2 to 5.6). Cross-cultural validity was good as four items only showed DIF for language and their impact on item scores was minimal. Physical Function scores were strongly associated with scores on all other measures (all correlations ≤ -0.60 as expected). The Dutch-Flemish PROMIS Physical Function item bank exhibited good psychometric properties. Development of a computer adaptive test based on the large bank is warranted. Copyright © 2017 Elsevier Inc. All rights reserved.

Positivity effect in source attributions of arousal-matched emotional and non-emotional words during item-based directed forgetting.

Science.gov (United States)

Gallant, Sara N; Yang, Lixia

2014-01-01

Consistent with their emphasis on emotional goals, older adults often exhibit a positivity bias in attention and memory relative to their young counterparts (i.e., a positivity effect). The current study sought to determine how this age-related positivity effect would impact intentional forgetting of emotional words, a process critical to efficient operation of memory. Using an item-based directed forgetting task, 36 young and 36 older adults studied a series of arousal-equivalent words that varied in valence (i.e., positive, negative, and neutral). Each word was followed by a cue to either remember or forget the word. A subsequent "tagging" recognition task required classification of items as to-be-remembered (TBR), to-be-forgotten (TBF), or new as a measure of directed forgetting and source attribution in participants' memory. Neither young nor older adults' intentional forgetting was affected by the valence of words. A goal-consistent valence effect did, however, emerge in older adults' source attribution performance. Specifically, older adults assigned more TBR-cues to positive words and more TBF-cues to negative words. Results are discussed in light of existing literature on emotion and directed forgetting as well as the socioemotional selectivity theory underlying the age-related positivity effect.

Positivity effect in source attributions of arousal-matched emotional and non-emotional words during item-based directed forgetting

Directory of Open Access Journals (Sweden)

Sara N. Gallant

2014-11-01

Full Text Available Consistent with their emphasis on emotional goals, older adults often exhibit a positivity bias in attention and memory relative to their young counterparts (i.e., a positivity effect. The current study sought to determine how this age-related positivity effect would impact intentional forgetting of emotional words, a process critical to efficient operation of memory. Using an item-based directed forgetting task, 36 young and 36 older adults studied a series of arousal-equivalent words that varied in valence (i.e., positive, negative, and neutral. Each word was followed by a cue to either remember or forget the word. A subsequent tagging recognition task required classification of items as to-be-remembered (TBR, to-be-forgotten (TBF, or new as a measure of directed forgetting and source attribution in participants’ memory. Valence did not affect intentional forgetting in both young and older age groups. A goal-consistent valence effect did, however, emerge in older adults’ source attribution performance. Specifically, older adults assigned more TBR-cues to positive words and more TBF-cues to negative words. Results are discussed in light of existing literature on emotion and directed forgetting as well as the socioemotional selectivity theory underlying the age-related positivity effect.

Maternal thyroid function and the outcome of external cephalic version: a prospective cohort study

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van der Donk Riet W

2011-01-01

Full Text Available Abstract Background To investigate the relation between maternal thyroid function and the outcome of external cephalic version (ECV in breech presentation. Methods Prospective cohort study in 141 women (≥ 35 weeks gestation with a singleton fetus in breech. Blood samples for assessing thyroid function were taken prior to ECV. Main outcome measure was the relation between maternal thyroid function and ECV outcome indicated by post ECV ultrasound. Results ECV success rate was 77/141 (55%, 41/48 (85% in multipara and 36/93 (39% in primipara. Women with a failed ECV attempt had significantly higher TSH concentrations than women with a successful ECV (p Conclusions Higher TSH levels increase the risk of ECV failure. Trial registration number ClinicalTrials.gov: NCT00516555

Factoring handedness data: I. Item analysis.

Science.gov (United States)

Messinger, H B; Messinger, M I

1995-12-01

Recently in this journal Peters and Murphy challenged the validity of factor analyses done on bimodal handedness data, suggesting instead that right- and left-handers be studied separately. But bimodality may be avoidable if attention is paid to Oldfield's questionnaire format and instructions for the subjects. Two characteristics appear crucial: a two-column LEFT-RIGHT format for the body of the instrument and what we call Oldfield's Admonition: not to indicate strong preference for handedness item, such as write, unless "... the preference is so strong that you would never try to use the other hand unless absolutely forced to...". Attaining unimodality of an item distribution would seem to overcome the objections of Peters and Murphy. In a 1984 survey in Boston we used Oldfield's ten-item questionnaire exactly as published. This produced unimodal item distributions. With reflection of the five-point item scale and a logarithmic transformation, we achieved a degree of normalization for the items. Two surveys elsewhere based on Oldfield's 20-item list but with changes in the questionnaire format and the instructions, yielded markedly different item distributions with peaks at each extreme and sometimes in the middle as well.

Rasch-family models are more valuable than score-based approaches for analysing longitudinal patient-reported outcomes with missing data.

Science.gov (United States)

de Bock, Élodie; Hardouin, Jean-Benoit; Blanchin, Myriam; Le Neel, Tanguy; Kubis, Gildas; Bonnaud-Antignac, Angélique; Dantan, Étienne; Sébille, Véronique

2016-10-01

The objective was to compare classical test theory and Rasch-family models derived from item response theory for the analysis of longitudinal patient-reported outcomes data with possibly informative intermittent missing items. A simulation study was performed in order to assess and compare the performance of classical test theory and Rasch model in terms of bias, control of the type I error and power of the test of time effect. The type I error was controlled for classical test theory and Rasch model whether data were complete or some items were missing. Both methods were unbiased and displayed similar power with complete data. When items were missing, Rasch model remained unbiased and displayed higher power than classical test theory. Rasch model performed better than the classical test theory approach regarding the analysis of longitudinal patient-reported outcomes with possibly informative intermittent missing items mainly for power. This study highlights the interest of Rasch-based models in clinical research and epidemiology for the analysis of incomplete patient-reported outcomes data. © The Author(s) 2013.

Objective assessment of gender roles: Gender Roles Test (GRT-36).

Science.gov (United States)

Fernández, Juan; Quiroga, M Angeles; del Olmo, Isabel; Aróztegui, Javier; Martín, Arantxa

2011-11-01

This study was designed to develop a computerized test to assess gender roles. This test is presented as a decision-making task to mask its purpose. Each item displays a picture representing an activity and a brief sentence that describes it. Participants have to choose the most suitable sex to perform each activity: man or woman. The test (Gender Roles Test, GRT-36) consists of 36 items/activities. The program registers both the choices made and their response times (RTs). Responses are considered as stereotyped when the chosen sex fits stereotyped roles and non-stereotyped when the chosen sex does not fit stereotyped roles. Individual means (RTs) were computed for stereotyped and non-stereotyped responses, differentiating between domestic and work spheres. A "D" score, reflecting the strength of association between activities and sex, was calculated for each sphere and sex. The study incorporated 78 participants (69% women and 31% men) ranging from 19 to 59 years old. The results show that: (a) reading speed does not explain the variability in the RTs; (b) RTs show good internal consistency; (c) RTs are shorter for stereotyped than for neutral stimuli; (d) RTs are shorter for stereotyped than for non-stereotyped responses. Intended goals are supported by obtained results. Scores provided by the task facilitate both group and individual detailed analysis of gender role, differentiating the gender role assigned to men from that assigned to women, at the domestic and work spheres. Obtained data fall within the scope of the genderology and their implications are discussed.

Paradoxical effects of alcohol information on alcohol outcome expectancies.

Science.gov (United States)

Krank, Marvin D; Ames, Susan L; Grenard, Jerry L; Schoenfeld, Tara; Stacy, Alan W

2010-07-01

Cognitive associations with alcohol predict both current and future use in youth and young adults. Much cognitive and social cognitive research suggests that exposure to information may have unconscious influences on thinking and behavior. The present study assessed the impact of information statements on the accessibility of alcohol outcome expectancies. The 2 studies reported here investigated the effects of exposure to alcohol statements typical of informational approaches to prevention on the accessibility of alcohol outcome expectancies. High school and university students were presented with information statements about the effects of alcohol and other commercial products. The alcohol statements were taken from expectancy questionnaires. Some of these statements were presented as facts and others as myths. The retention of detailed information about these statements was manipulated by (i) divided attention versus focused attention or (ii) immediate versus delayed testing. Accessibility of personal alcohol outcome expectancies was subsequently measured using an open-ended question about the expected effects of alcohol. Participants reported more alcohol outcomes seen during the information task as personal expectations about the effects of alcohol use than similar unseen items. Paradoxically, myth statements were also more likely to be reported as expectancies than unseen items in all conditions. Additionally, myth statements were generated less often than fact statements only under the condition of immediate testing with strong content processing instructions. These observations are consistent with findings from cognitive research where familiarity in the absence of explicit memory can have an unconscious influence on performance. In particular, the exposure to these items in an informational format increases accessibility of the seen items even when the participants were told that they were myths. The findings have implications for the development of

Ion beam studies of archaeological gold jewellery items

International Nuclear Information System (INIS)

Demortier, G.

1996-01-01

Analytical work on material of archaeological interest performed at LARN mainly concerns gold jewellery, with an emphasis to solders on the artefacts and to gold plating or copper depletion gilding. PIXE, RBS but also PIGE and NRA have been applied to a large variety of items. On the basis of elemental analysis, we have identified typical workmanship of ancient goldsmiths in various regions of the world: finely decorated Mesopotamian items, Hellenistic and Byzantine craftsmanship, cloisonne of the Merovingian period, depletion gilding on Pre-Colombian tumbaga. This paper is some shortening of the work performed at LARN during the last ten years. Criteria to properly use PIXE for quantitative analysis of non-homogeneous ancient artefacts presented at the 12th IBA conference in 1995 are also shortly discussed. (orig.)

Ion beam studies of archaeological gold jewellery items

Energy Technology Data Exchange (ETDEWEB)

Demortier, G [Facultes Universitaires Notre-Dame de la Paix, Namur (Belgium). Lab. d` Analyses par Reactions Nucleaires

1996-06-01

Analytical work on material of archaeological interest performed at LARN mainly concerns gold jewellery, with an emphasis to solders on the artefacts and to gold plating or copper depletion gilding. PIXE, RBS but also PIGE and NRA have been applied to a large variety of items. On the basis of elemental analysis, we have identified typical workmanship of ancient goldsmiths in various regions of the world: finely decorated Mesopotamian items, Hellenistic and Byzantine craftsmanship, cloisonne of the Merovingian period, depletion gilding on Pre-Colombian tumbaga. This paper is some shortening of the work performed at LARN during the last ten years. Criteria to properly use PIXE for quantitative analysis of non-homogeneous ancient artefacts presented at the 12th IBA conference in 1995 are also shortly discussed. (orig.).

Study of Subjective Life Quality in Young People with Disabilities

Directory of Open Access Journals (Sweden)

Kurtanova Yu.E.,

2014-08-01

Full Text Available We present a study of subjective life quality in young people with disabilities compared with their healthy peers. The study sample comprised 62 women aged 14 to 18 years. The experimental study group consisted of 30 students of grades VIII-XI of Secondary School of home-based learning № 1673 "Support". The control group included 32 student of grades VIII-XI of School № 1222 with in-depth study of the German language. The methods used were: Medical Outcomes Study 36 Item Short Form Health Survey (SF-36, M. Kuhn test "Who am I" (M. Kuhn, T. McPartland; modification by T.V. Rumjantseva, Method and diagnosis of health, activity and mood, projective technique "Picture of the actual self" and "Picture of the desired self" with questions. We formulated conclusions about the features of the subjective assessment of the quality of life in young people with disabilities compared with their healthy peers.

Psychometric Evaluation of the Lower Extremity Computerized Adaptive Test, the Modified Harris Hip Score, and the Hip Outcome Score.

Science.gov (United States)

Hung, Man; Hon, Shirley D; Cheng, Christine; Franklin, Jeremy D; Aoki, Stephen K; Anderson, Mike B; Kapron, Ashley L; Peters, Christopher L; Pelt, Christopher E

2014-12-01

The applicability and validity of many patient-reported outcome measures in the high-functioning population are not well understood. To compare the psychometric properties of the modified Harris Hip Score (mHHS), the Hip Outcome Score activities of daily living subscale (HOS-ADL) and sports (HOS-sports), and the Lower Extremity Computerized Adaptive Test (LE CAT). The hypotheses was that all instruments would perform well but that the LE CAT would show superiority psychometrically because a combination of CAT and a large item bank allows for a high degree of measurement precision. Cohort study (diagnosis); Level of evidence, 2. Data were collected from 472 advanced-age, active participants from the Huntsman World Senior Games in 2012. Validity evidences were examined through item fit, dimensionality, monotonicity, local independence, differential item functioning, person raw score to measure correlation, and instrument coverage (ie, ceiling and floor effects), and reliability evidences were examined through Cronbach alpha and person separation index. All instruments demonstrated good item fit, unidimensionality, monotonicity, local independence, and person raw score to measure correlations. The HOS-ADL had high ceiling effects of 36.02%, and the mHHS had ceiling effects of 27.54%. The LE CAT had ceiling effects of 8.47%, and the HOS-sports had no ceiling effects. None of the instruments had any floor effects. The mHHS had a very low Cronbach alpha of 0.41 and an extremely low person separation index of 0.08. Reliabilities for the LE CAT were excellent and for the HOS-ADL and HOS-sports were good. The LE CAT showed better psychometric properties overall than the HOS-ADL, HOS-sports, and mHHS for the senior population. The mHHS demonstrated pronounced ceiling effects and poor reliabilities that should be of concern. The high ceiling effects for the HOS-ADL were also of concern. The LE CAT was superior in all psychometric aspects examined in this study. Future

Patient-reported outcomes assessment in chronic hepatitis C treated with sofosbuvir and ribavirin: the VALENCE study

NARCIS (Netherlands)

Younossi, Zobair M.; Stepanova, Maria; Zeuzem, Stefan; Dusheiko, Geoffrey; Esteban, Rafael; Hezode, Christophe; Reesink, Hendrik W.; Weiland, Ola; Nader, Fatema; Hunt, Sharon L.

2014-01-01

Interferon (IFN) negatively impacts patients' well-being and patient-reported outcomes (PROs). Our aim was to assess PROs during treatment with an IFN-free regimen [sofosbuvir (SOF)+ribavirin (RBV)]. Four PRO questionnaires [Short Form-36 (SF-36), Chronic Liver Disease Questionnaire-HCV (CLDQ-HCV),

An economic production model for deteriorating items and time dependent demand with rework and multiple production setups

Science.gov (United States)

Uthayakumar, R.; Tharani, S.

2017-12-01

Recently, much emphasis has given to study the control and maintenance of production inventories of the deteriorating items. Rework is one of the main issues in reverse logistic and green supply chain, since it can reduce production cost and the environmental problem. Many researchers have focused on developing rework model, but few of them have developed model for deteriorating items. Due to this fact, we take up productivity and rework with deterioration as the major concern in this paper. In this paper, a production-inventory model with deteriorative items in which one cycle has n production setups and one rework setup (n, 1) policy is considered for deteriorating items with stock-dependent demand in case 1 and exponential demand in case 2. An effective iterative solution procedure is developed to achieve optimal time, so that the total cost of the system is minimized. Numerical and sensitivity analyses are discussed to examine the outcome of the proposed solution procedure presented in this research.

Non-ignorable missingness item response theory models for choice effects in examinee-selected items.

Science.gov (United States)

Liu, Chen-Wei; Wang, Wen-Chung

2017-11-01

Examinee-selected item (ESI) design, in which examinees are required to respond to a fixed number of items in a given set, always yields incomplete data (i.e., when only the selected items are answered, data are missing for the others) that are likely non-ignorable in likelihood inference. Standard item response theory (IRT) models become infeasible when ESI data are missing not at random (MNAR). To solve this problem, the authors propose a two-dimensional IRT model that posits one unidimensional IRT model for observed data and another for nominal selection patterns. The two latent variables are assumed to follow a bivariate normal distribution. In this study, the mirt freeware package was adopted to estimate parameters. The authors conduct an experiment to demonstrate that ESI data are often non-ignorable and to determine how to apply the new model to the data collected. Two follow-up simulation studies are conducted to assess the parameter recovery of the new model and the consequences for parameter estimation of ignoring MNAR data. The results of the two simulation studies indicate good parameter recovery of the new model and poor parameter recovery when non-ignorable missing data were mistakenly treated as ignorable. © 2017 The British Psychological Society.

The medial tibial stress syndrome score: item generation for a new ...

African Journals Online (AJOL)

new patient-reported outcome measure for patients with MTSS. Methods: The ... aforementioned domains while evaluating treatment effects in patients with ... from the local medical ethics committees of the provinces of Utrecht. (12-542/C) .... The second expert suggested including items on the current content of sporting ...

Changes in Transformational Leadership and Empirical Quality Outcomes in a Finnish Hospital over a Two-Year Period: A Longitudinal Study

Science.gov (United States)

Mäntynen, Raija; Vehviläinen-Julkunen, Katri; Partanen, Pirjo; Turunen, Hannele; Miettinen, Merja; Kvist, Tarja

2014-01-01

This paper describes the changes in transformational leadership and quality outcomes that occurred between 2008 and 2011 in a Finnish university hospital that is aiming to meet the Magnet standards. Measurements were conducted in 2008-2009 and subsequently in 2010-2011 by surveying nursing staff and patients. Nursing staff were surveyed using web-based surveys to collect data on transformational leadership (n 1 = 499, n 2 = 498) and patient safety culture (n 1 = 234, n 2 = 512) and using both postal and web-based surveys to gather information on job satisfaction (n 1 = 1176, n 2 = 779). Questionnaires were used to collect data on care satisfaction from patients (n 1 = 678, n 2 = 867). Transformational leadership was measured using the 54-item TLS, job satisfaction with the 37-item KUHJSS, patient safety culture with the 42-item HSPSC, and patient satisfaction using the 42-item RHCS questionnaire. Transformational leadership, which was the weakest area, was at the same level between the two measurement occasions. Job satisfaction scores increased between 2008 and 2010, although they were generally excellent in 2008. The scores for nonpunitive responses to errors and events reported were also higher in the 2010-2011 surveys. The highest empirical outcome scores related to patient satisfaction. The project and the development initiatives undertaken since 2008 seem to have had positive effects on empirical quality outcomes. PMID:25009744

A review of the effects on IRT item parameter estimates with a focus on misbehaving common items in test equating

Directory of Open Access Journals (Sweden)

Michalis P Michaelides

2010-10-01

Full Text Available Many studies have investigated the topic of change or drift in item parameter estimates in the context of Item Response Theory. Content effects, such as instructional variation and curricular emphasis, as well as context effects, such as the wording, position, or exposure of an item have been found to impact item parameter estimates. The issue becomes more critical when items with estimates exhibiting differential behavior across test administrations are used as common for deriving equating transformations. This paper reviews the types of effects on IRT item parameter estimates and focuses on the impact of misbehaving or aberrant common items on equating transformations. Implications relating to test validity and the judgmental nature of the decision to keep or discard aberrant common items are discussed, with recommendations for future research into more informed and formal ways of dealing with misbehaving common items.

A Review of the Effects on IRT Item Parameter Estimates with a Focus on Misbehaving Common Items in Test Equating.

Science.gov (United States)

Michaelides, Michalis P

2010-01-01

Many studies have investigated the topic of change or drift in item parameter estimates in the context of item response theory (IRT). Content effects, such as instructional variation and curricular emphasis, as well as context effects, such as the wording, position, or exposure of an item have been found to impact item parameter estimates. The issue becomes more critical when items with estimates exhibiting differential behavior across test administrations are used as common for deriving equating transformations. This paper reviews the types of effects on IRT item parameter estimates and focuses on the impact of misbehaving or aberrant common items on equating transformations. Implications relating to test validity and the judgmental nature of the decision to keep or discard aberrant common items are discussed, with recommendations for future research into more informed and formal ways of dealing with misbehaving common items.

Delaying ACL reconstruction and treating with exercise therapy alone may alter prognostic factors for 5-year outcome

DEFF Research Database (Denmark)

Filbay, Stephanie R; Roos, Ewa M; Frobell, Richard B

2017-01-01

, body mass index, preinjury activity level, education and smoking. RESULTS: For all participants (n=118), graft/contralateral ACL rupture, non-ACL surgery and worse baseline 36-item Short-Form Mental Component Scores were associated with worse outcomes. Treatment with exercise therapy alone......AIM: Identify injury-related, patient-reported and treatment-related prognostic factors for 5-year outcomes in acutely ACL-ruptured individuals managed with early reconstruction plus exercise therapy, exercise therapy plus delayed reconstruction or exercise therapy alone. METHODS: Exploratory...... was a prognostic factor for less knee symptoms compared with early reconstruction plus exercise therapy (regression coefficient 10.1, 95% CI 2.3 to 17.9). Baseline meniscus lesion was associated with worse sport/recreation function (-14.4, 95% CI -27.6 to -1.3) and osteochondral lesions were associated with worse...

Predictors of visual outcome in patients operated for craniopharyngioma - a Danish national study

DEFF Research Database (Denmark)

Jacobsen, Mads Forslund; Thomsen, Ann Sofia Skou; Bach-Holm, Daniella

2018-01-01

Purpose Craniopharyngioma often causes visual loss due to the close relation to the anterior visual pathways. This study investigates the incidence and predictors of visual outcomes in patients with craniopharyngioma. Methods Data from sixty-six patients who underwent surgery for craniopharyngioma...... from 2009 to 2013 in Denmark were reviewed. Primary outcomes were visual acuity (VA) and visual field (VF) defects from pre-and postoperative visits. Secondary outcomes were optic nerve atrophy (OA) and papilledema. Results Fifty-eight patients were included. The VA of the patients 1-year after surgery...... = 0.011 and p = 0.011, respectively). Patients undergoing surgery within a week or less after their first ophthalmological examination had a significant improvement in VA (−0.36; 95%CI: −0.62 to −0.09; p = 0.0099). Patients undergoing surgery using a subfrontal approach also showed improvement in VA...

The medial temporal lobes distinguish between within-item and item-context relations during autobiographical memory retrieval.

Science.gov (United States)

Sheldon, Signy; Levine, Brian

2015-12-01

During autobiographical memory retrieval, the medial temporal lobes (MTL) relate together multiple event elements, including object (within-item relations) and context (item-context relations) information, to create a cohesive memory. There is consistent support for a functional specialization within the MTL according to these relational processes, much of which comes from recognition memory experiments. In this study, we compared brain activation patterns associated with retrieving within-item relations (i.e., associating conceptual and sensory-perceptual object features) and item-context relations (i.e., spatial relations among objects) with respect to naturalistic autobiographical retrieval. We developed a novel paradigm that cued participants to retrieve information about past autobiographical events, non-episodic within-item relations, and non-episodic item-context relations with the perceptuomotor aspects of retrieval equated across these conditions. We used multivariate analysis techniques to extract common and distinct patterns of activity among these conditions within the MTL and across the whole brain, both in terms of spatial and temporal patterns of activity. The anterior MTL (perirhinal cortex and anterior hippocampus) was preferentially recruited for generating within-item relations later in retrieval whereas the posterior MTL (posterior parahippocampal cortex and posterior hippocampus) was preferentially recruited for generating item-context relations across the retrieval phase. These findings provide novel evidence for functional specialization within the MTL with respect to naturalistic memory retrieval. © 2015 Wiley Periodicals, Inc.

Immunoglobulin for necrotising soft tissue infections (INSTINCT)

DEFF Research Database (Denmark)

Madsen, Martin Bruun; Lange, Theis; Hjortrup, Peter Buhl

2016-01-01

with concealed allocation of patients with NSTI 1:1 to IVIG or an equal volume of 0.9% saline. Patients are recruited at Rigshospitalet, Denmark. The primary outcome is the physical component summary score of the Medical Outcomes Study 36-Item Short-Form Health Survey as assessed six months after randomisation...

Applying Hierarchical Model Calibration to Automatically Generated Items.

Science.gov (United States)

Williamson, David M.; Johnson, Matthew S.; Sinharay, Sandip; Bejar, Isaac I.

This study explored the application of hierarchical model calibration as a means of reducing, if not eliminating, the need for pretesting of automatically generated items from a common item model prior to operational use. Ultimately the successful development of automatic item generation (AIG) systems capable of producing items with highly similar…

Science Library of Test Items. Volume Eighteen. A Collection of Multiple Choice Test Items Relating Mainly to Chemistry.

Science.gov (United States)

New South Wales Dept. of Education, Sydney (Australia).

As one in a series of test item collections developed by the Assessment and Evaluation Unit of the Directorate of Studies, items are made available to teachers for the construction of unit tests or term examinations or as a basis for class discussion. Each collection was reviewed for content validity and reliability. The test items meet syllabus…

Science Library of Test Items. Volume Seventeen. A Collection of Multiple Choice Test Items Relating Mainly to Biology.

Science.gov (United States)

New South Wales Dept. of Education, Sydney (Australia).

As one in a series of test item collections developed by the Assessment and Evaluation Unit of the Directorate of Studies, items are made available to teachers for the construction of unit tests or term examinations or as a basis for class discussion. Each collection was reviewed for content validity and reliability. The test items meet syllabus…

Science Library of Test Items. Volume Nineteen. A Collection of Multiple Choice Test Items Relating Mainly to Geology.

Science.gov (United States)

New South Wales Dept. of Education, Sydney (Australia).

As one in a series of test item collections developed by the Assessment and Evaluation Unit of the Directorate of Studies, items are made available to teachers for the construction of unit tests or term examinations or as a basis for class discussion. Each collection was reviewed for content validity and reliability. The test items meet syllabus…

Modeling Local Item Dependence in Cloze and Reading Comprehension Test Items Using Testlet Response Theory

Science.gov (United States)

Baghaei, Purya; Ravand, Hamdollah

2016-01-01

In this study the magnitudes of local dependence generated by cloze test items and reading comprehension items were compared and their impact on parameter estimates and test precision was investigated. An advanced English as a foreign language reading comprehension test containing three reading passages and a cloze test was analyzed with a…

Study of sample preparation in the measurement of 36Ar(n, p)36Cl reaction cross section

International Nuclear Information System (INIS)

Jiang Songsheng; Hemick, T.K.

1992-01-01

The preparation of enriched 36 Ar gas samples and 36 Cl samples for the use in the AMS measurement of 36 Ar(n, p) 36 Cl reaction cross section was described. The 36 Ar samples prepared had the volumes of about 0.4 ml and the weights of about 0.5 mg. The uncertainty in atomic numbers of 36 Ar was (0.3∼0.4)%. The reaction product, 36 Cl, in the 36 Ar was collected and the AgCl samples were prepared

Maternal Dietary Patterns and Pregnancy Outcome

Science.gov (United States)

Chen, Xuyang; Zhao, Diqi; Mao, Xun; Xia, Yinyin; Baker, Philip N.; Zhang, Hua

2016-01-01

Maternal nutritional status during pregnancy will affect the outcomes for the mother and the baby. Many analyses of the relationship between diet and outcome are often based on a single or a few food items or nutrients. However, foods are not consumed in isolation and dietary patterns can be used to assess the whole diet consumed. The use of dietary pattern analysis to understand nutritional intake and pregnancy outcome is becoming more and more popular. Many published studies have showed the association between maternal dietary patterns and pregnancy outcome. This review examined articles about the relationship between maternal dietary patterns and pregnancy outcome. As a modifiable factor, dietary patterns may be more applicable to clinical and pregnant health interventions. PMID:27338455

Dignity Impact as a Primary Outcome Measure for Dignity Therapy.

Science.gov (United States)

Scarton, Lisa; Oh, Sungho; Sylvera, Ashley; Lamonge, Ralph; Yao, Yingwei; Chochinov, Harvey; Fitchett, George; Handzo, George; Emanuel, Linda; Wilkie, Diana

2018-01-01

Feasibility of dignity therapy (DT) is well established in palliative care. Evidence of its efficacy, however, has been inconsistent and may stem from DT's primary effects differing from the outcomes measured in previous studies. We proposed that DT effects were in the spiritual domain and created a new outcome measure, Dignity Impact Scale (DIS), from items previously used in a large randomized controlled trial (RCT). The purpose of this secondary analysis study was to examine properties of a new measure of dignity impact. Using the DIS, we conducted reanalysis of posttest data from a large 3-arm, multi-site RCT study. Participants were receiving hospice/palliative care (n = 326, 50.6% female, mean age = 65.1 years, 89.3% white, all with a terminal illness with 6 months or less life expectancy). They had been randomized to standard palliative care (n = 111), client-centered care (n = 107), or DT (n = 108). The 7-item DIS was derived from selected items in a posttest DT Patient Feedback Questionnaire. The DIS had strong internal consistency (α = 0.85). The DT group mean DIS score (21.4 ± 5.0) was significantly higher than the usual care group mean score (17.7 ± 5.5; t = 5.2, df = 216, P death, and life completion tasks. We propose that the DIS be used as the primary outcome measure in evaluating the effects of DT.

Montessori Preschool Elevates and Equalizes Child Outcomes: A Longitudinal Study.

Science.gov (United States)

Lillard, Angeline S; Heise, Megan J; Richey, Eve M; Tong, Xin; Hart, Alyssa; Bray, Paige M

2017-01-01

Quality preschool programs that develop the whole child through age-appropriate socioemotional and cognitive skill-building hold promise for significantly improving child outcomes. However, preschool programs tend to either be teacher-led and didactic, or else to lack academic content. One preschool model that involves both child-directed, freely chosen activity and academic content is Montessori. Here we report a longitudinal study that took advantage of randomized lottery-based admission to two public Montessori magnet schools in a high-poverty American city. The final sample included 141 children, 70 in Montessori and 71 in other schools, most of whom were tested 4 times over 3 years, from the first semester to the end of preschool (ages 3-6), on a variety of cognitive and socio-emotional measures. Montessori preschool elevated children's outcomes in several ways. Although not different at the first test point, over time the Montessori children fared better on measures of academic achievement, social understanding, and mastery orientation, and they also reported relatively more liking of scholastic tasks. They also scored higher on executive function when they were 4. In addition to elevating overall performance on these measures, Montessori preschool also equalized outcomes among subgroups that typically have unequal outcomes. First, the difference in academic achievement between lower income Montessori and higher income conventionally schooled children was smaller at each time point, and was not (statistically speaking) significantly different at the end of the study. Second, defying the typical finding that executive function predicts academic achievement, in Montessori classrooms children with lower executive function scored as well on academic achievement as those with higher executive function. This suggests that Montessori preschool has potential to elevate and equalize important outcomes, and a larger study of public Montessori preschools is warranted.

Predictors of long-term treatment outcome in combat and peacekeeping veterans with military-related PTSD.

Science.gov (United States)

Richardson, J Don; Contractor, Ateka A; Armour, Cherie; St Cyr, Kate; Elhai, Jon D; Sareen, Jitender

2014-11-01

Posttraumatic stress disorder (PTSD) is a significant psychiatric condition that may result from exposure to combat; it has been associated with severe psychosocial dysfunction. This study examined the predictors of long-term treatment outcomes in a group of veterans with military-related PTSD. The study consisted of a retrospective chart review of 151 consecutive veterans treated at an outpatient clinic for veterans with psychiatric disorders resulting from their military operations between January 2002 and May 2012. The diagnosis of PTSD was made using the Clinician-Administered PTSD Scale. As part of treatment as usual, all patients completed the PTSD Checklist-Military version and Beck Depression Inventory (BDI-II) at intake and at each follow-up appointment, the Short-Form Health Survey (SF-36) at intake, and either the SF-36 or the 12-item Short-Form Health Survey at follow-up. All patients received psychoeducation about PTSD and combined pharmacotherapy and psychotherapy. Analyses demonstrated a significant and progressive improvement in PTSD severity over the 2-year period ([n = 117] Yuan-Bentler χ²40 = 221.25, P loss of probable PTSD diagnosis, is possible in an outpatient setting for veterans with chronic military-related PTSD. © Copyright 2014 Physicians Postgraduate Press, Inc.

Meta-analysis of studies comparing oncologic outcomes of radical prostatectomy and brachytherapy for localized prostate cancer.

Science.gov (United States)

Cozzi, Gabriele; Musi, Gennaro; Bianchi, Roberto; Bottero, Danilo; Brescia, Antonio; Cioffi, Antonio; Cordima, Giovanni; Delor, Maurizio; Di Trapani, Ettore; Ferro, Matteo; Matei, Deliu Victor; Russo, Andrea; Mistretta, Francesco Alessandro; De Cobelli, Ottavio

2017-11-01

The aim of this study was to compare oncologic outcomes of radical prostatectomy (RP) with brachytherapy (BT). A literature review was conducted according to the 'Preferred reporting items for systematic reviews and meta-analyses' (PRISMA) statement. We included studies reporting comparative oncologic outcomes of RP versus BT for localized prostate cancer (PCa). From each comparative study, we extracted the study design, the number and features of the included patients, and the oncologic outcomes expressed as all-cause mortality (ACM), PCa-specific mortality (PCSM) or, when the former were unavailable, as biochemical recurrence (BCR). All of the data retrieved from the selected studies were recorded in an electronic database. Cumulative analysis was conducted using the Review Manager version 5.3 software, designed for composing Cochrane Reviews (Cochrane Collaboration, Oxford, UK). Statistical heterogeneity was tested using the Chi-square test. Our cumulative analysis did not show any significant difference in terms of BCR, ACM or PCSM rates between the RP and BT cohorts. Only three studies reported risk-stratified outcomes of intermediate- and high-risk patients, which are the most prone to treatment failure. our analysis suggested that RP and BT may have similar oncologic outcomes. However, the analysis included a limited number of studies, and most of them were retrospective, making it impossible to derive any definitive conclusion, especially for intermediate- and high-risk patients. In this scenario, appropriate urologic counseling remains of utmost importance.

The relationship between unhealthy snacking at school and academic outcomes: a population study in Chilean schoolchildren.

Science.gov (United States)

Correa-Burrows, Paulina; Burrows, Raquel; Orellana, Yasna; Ivanovic, Daniza

2015-08-01

We examined the association between unhealthy snacking at school and academic outcomes in students from the Santiago Metropolitan Region (Chile). Cross-sectional population-based study. We measured the nutritional quality of snacks at school using an FFQ, and accounting for the amounts of saturated fat, fibre, sugar and salt in the foods, and academic outcomes using national standardized test scores in Language and Mathematics. Multivariate regression analyses modelled the relationship between unhealthy snacking at school (exposure), potential confounders and performance in Mathematics and Language (outcomes). Random sample of 1073 students (13.1 (SD 2.3) years old) attending public, partially subsidized and private schools. Fifty-six per cent of students ate items at snack time that were high in fat, sugar, salt and energy, and thus were considered to have unhealthy snaking. Thirty-six per cent and 8% were considered to have poor-to-fair and healthy snacking, respectively. Unhealthy snacking significantly lowered the odds of good academic performance in both domains. Students having unhealthy snacks were 56% less likely to pass in Language (fully adjusted OR = 0.44; 95% CI 0.23, 0.85) and 66% less likely to pass in Mathematics (fully adjusted OR = 0.34; 95% CI 0.19, 0.64) compared with students having healthy snack items. Schoolchildren eating unhealthy foods at snack time had worse academic performance in Language and Mathematics, as measured by a standardized test. Although association does not imply causation, these findings support the notion that academic and health-related behaviours are linked. More research is needed on the effect of school health programmes on educational outcomes.

Development and validation of a primary sclerosing cholangitis-specific patient-reported outcomes instrument: The PSC PRO.

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Younossi, Zobair M; Afendy, Arian; Stepanova, Maria; Racila, Andrei; Nader, Fatema; Gomel, Rachel; Safer, Ricky; Lenderking, William R; Skalicky, Anne; Kleinman, Leah; Myers, Robert P; Subramanian, G Mani; McHutchison, John G; Levy, Cynthia; Bowlus, Christopher L; Kowdley, Kris; Muir, Andrew J

2017-11-20

Primary sclerosing cholangitis (PSC) is a chronic liver disease associated with inflammation and biliary fibrosis that leads to cholangitis, cirrhosis, and impaired quality of life. Our objective was to develop and validate a PSC-specific patient-reported outcome (PRO) instrument. We developed a 42-item PSC PRO instrument that contains two modules (Symptoms and Impact of Symptoms) and conducted an external validation. Reliability and validity were evaluated using clinical data and a battery of other validated instruments. Test-retest reliability was assessed in a subgroup of patients who repeated the PSC PRO after the first administration. One hundred two PSC subjects (44 ± 13 years; 32% male, 74% employed, 39% with cirrhosis, 14% with a history of decompensated cirrhosis, 38% history of depression, and 68% with inflammatory bowel disease [IBD]) completed PSC PRO and other PRO instruments (Short Form 36 V2 [SF-36], Chronic Liver Disease Questionnaire [CLDQ], Primary Biliary Cholangitis - 40 [PBC-40], and five dimensions [5-D Itch]). PSC PRO demonstrated excellent internal consistency (Cronbach alphas, 0.84-0.94) and discriminant validity (41 of 42 items had the highest correlations with their own domains). There were good correlations between PSC PRO domains and relevant domains of SF-36, CLDQ, and PBC-40 (R = 0.69-0.90; all P 0.05). Test-retest reliability was assessed in 53 subjects who repeated PSC PRO within a median (interquartile range) of 37 (27-47) days. There was excellent reliability for most domains with intraclass correlations (0.71-0.88; all P < 0.001). PSC PRO is a self-administered disease-specific instrument developed according to U.S. Food and Drug Administration guidelines. This preliminary validation study suggests good psychometric properties. Further validation of the instrument in a larger and more diverse sample of PSC patients is needed. (Hepatology 2017). © 2017 by the American Association for the Study of Liver Diseases.

Within-item strategy switching in arithmetic: a comparative study in children

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Ardiale, Eléonore; Lemaire, Patrick

2013-01-01

The present study aimed at determining whether (1) children were able to interrupt a strategy execution to switch and choose another better strategy, and (2) their ability to switch strategy within-item improved with age. Third, fifth, and seventh graders performed a computational estimation task in which they had to provide the better estimates to two-digit addition problems (e.g., 32 + 54) while using the rounding-down (e.g., 30 + 50) or the rounding-up strategy (e.g., 40 + 60). After having executing the cued strategy (e.g., 30 + 50) during 1,000 ms, participants were given the opportunity to switch to another better strategy (e.g., 40 + 60) or to repeat the same strategy (e.g., 30 + 50). The results showed that children switched strategies within items, and were able to switch more often when the addition problems were cued with the poorer strategy (e.g., 40 + 60 for 32 + 54) than when cued with the better strategy (e.g., 30 + 50). As they grew up, children based their decisions to switch strategies more often on whether the 1,000-ms strategy execution concerned the better strategy or strategy difficulty (i.e., the rounding-up strategy). These findings have important implications to further understand mechanisms underlying within-item strategy switching as well as strategic variations in children. PMID:24368906

Does remembering emotional items impair recall of same-emotion items?

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Sison, Jo Ann G; Mather, Mara

2007-04-01

In the part-set cuing effect, cuing a subset of previously studied items impairs recall of the remaining noncued items. This experiment reveals that cuing participants with previously-studied emotional pictures (e.g., fear-evoking pictures of people) can impair recall of pictures involving the same emotion but different content (e.g., fear-evoking pictures of animals). This indicates that new events can be organized in memory using emotion as a grouping function to create associations. However, whether new information is organized in memory along emotional or nonemotional lines appears to be a flexible process that depends on people's current focus. Mentioning in the instructions that the pictures were either amusement- or fear-related led to memory impairment for pictures with the same emotion as cued pictures, whereas mentioning that the pictures depicted either animals or people led to memory impairment for pictures with the same type of actor.

More is not Always Better: The Relation between Item Response and Item Response Time in Raven’s Matrices

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Frank Goldhammer

2015-03-01

Full Text Available The role of response time in completing an item can have very different interpretations. Responding more slowly could be positively related to success as the item is answered more carefully. However, the association may be negative if working faster indicates higher ability. The objective of this study was to clarify the validity of each assumption for reasoning items considering the mode of processing. A total of 230 persons completed a computerized version of Raven’s Advanced Progressive Matrices test. Results revealed that response time overall had a negative effect. However, this effect was moderated by items and persons. For easy items and able persons the effect was strongly negative, for difficult items and less able persons it was less negative or even positive. The number of rules involved in a matrix problem proved to explain item difficulty significantly. Most importantly, a positive interaction effect between the number of rules and item response time indicated that the response time effect became less negative with an increasing number of rules. Moreover, exploratory analyses suggested that the error type influenced the response time effect.

The e-MSWS-12: improving the multiple sclerosis walking scale using item response theory.

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Engelhard, Matthew M; Schmidt, Karen M; Engel, Casey E; Brenton, J Nicholas; Patek, Stephen D; Goldman, Myla D

2016-12-01

The Multiple Sclerosis Walking Scale (MSWS-12) is the predominant patient-reported measure of multiple sclerosis (MS) -elated walking ability, yet it had not been analyzed using item response theory (IRT), the emerging standard for patient-reported outcome (PRO) validation. This study aims to reduce MSWS-12 measurement error and facilitate computerized adaptive testing by creating an IRT model of the MSWS-12 and distributing it online. MSWS-12 responses from 284 subjects with MS were collected by mail and used to fit and compare several IRT models. Following model selection and assessment, subpopulations based on age and sex were tested for differential item functioning (DIF). Model comparison favored a one-dimensional graded response model (GRM). This model met fit criteria and explained 87 % of response variance. The performance of each MSWS-12 item was characterized using category response curves (CRCs) and item information. IRT-based MSWS-12 scores correlated with traditional MSWS-12 scores (r = 0.99) and timed 25-foot walk (T25FW) speed (r =  -0.70). Item 2 showed DIF based on age (χ 2  = 19.02, df = 5, p Item 11 showed DIF based on sex (χ 2  = 13.76, df = 5, p = 0.02). MSWS-12 measurement error depends on walking ability, but could be lowered by improving or replacing items with low information or DIF. The e-MSWS-12 includes IRT-based scoring, error checking, and an estimated T25FW derived from MSWS-12 responses. It is available at https://ms-irt.shinyapps.io/e-MSWS-12 .

Differential item functioning magnitude and impact measures from item response theory models.

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Kleinman, Marjorie; Teresi, Jeanne A

2016-01-01

Measures of magnitude and impact of differential item functioning (DIF) at the item and scale level, respectively are presented and reviewed in this paper. Most measures are based on item response theory models. Magnitude refers to item level effect sizes, whereas impact refers to differences between groups at the scale score level. Reviewed are magnitude measures based on group differences in the expected item scores and impact measures based on differences in the expected scale scores. The similarities among these indices are demonstrated. Various software packages are described that provide magnitude and impact measures, and new software presented that computes all of the available statistics conveniently in one program with explanations of their relationships to one another.

ITEM LEVEL DIAGNOSTICS AND MODEL - DATA FIT IN ITEM ...

African Journals Online (AJOL)

Global Journal

Item response theory (IRT) is a framework for modeling and analyzing item response ... data. Though, there is an argument that the evaluation of fit in IRT modeling has been ... National Council on Measurement in Education ... model data fit should be based on three types of ... prediction should be assessed through the.

Work ability as prognostic risk marker of disability pension : Single-item work ability score versus multi-item work ability index

NARCIS (Netherlands)

Roelen, C.A.M.; Rhenen, van W.; Groothoff, J.W.; Klink, van der J.J.L.; Twisk, W.R.; Heymans, M.W.

2014-01-01

Work ability predicts future disability pension (DP). A single-item work ability score (WAS) is emerging as a measure for work ability. This study compared single-item WAS with the multi-item work ability index (WAI) in its ability to identify workers at risk of DP.

An ascending multi-item auction with financially constrained bidders

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Gerard van der Laan

2016-12-01

Full Text Available Several heterogeneous items are to be sold to a group of potentially budget- constrained bidders. Every bidder has private knowledge of his own valuation of the items and his own budget. Due to budget constraints, bidders may not be able to pay up to their values and typically no Walrasian equilibrium exists. To deal with such markets, we propose the notion of 'equilibrium under allotment' and develop an ascending auction mechanism that always finds such an equilibrium assignment and a corresponding system of prices in finite time. The auction can be viewed as a novel generalization of the ascending auction of Demange et al. (1986 from settings without financial constraints to settings with financial constraints. We examine various strategic and efficiency properties of the auction and its outcome.

Direct repair surgery with screw fixation for young patients with lumbar spondylolysis: patient-reported outcomes and fusion rate in a prospective interventional study.

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Lee, Gun Woo; Lee, Sun-Mi; Suh, Bo-Gun

2015-02-15

Prospective interventional study. To thoroughly investigate the therapeutic outcomes of direct repair (DR) for young patients with lumbar spondylolysis. DR surgery with screw fixation for a pars defect of lumbar spondylolysis is considered a notable surgical option. However, prior studies do not provide clear information on the significance of DR and its outcomes in young patients with lumbar spondylolysis because most previous studies in this area were conducted with spondylolysis patients of all ages and with low-quality study designs that were retrospective in design and had a small sample size and short follow-up time. A total of 47 young patients with lumbar spine spondylolysis who were surgically treated with DR surgery and followed up for 1 year after surgery were enrolled in this study. The primary outcome was degree of pain assessed by visual analogue scale, which separately recorded pain intensity and pain frequency. Secondary outcomes included (1) patient satisfaction, (2) clinical outcomes based on Oswestry Disability Index score and a 12-item short form health survey, (3) fusion rate of pars defect based on computed tomographic scans, and (4) surgery-related complications. The degree of lower back pain (intensity and frequency) significantly improved at final follow-up compared with preoperative level. However, 6 patients (13%) had no significant improvement, and pain frequency tended to worsen 6 months after the operation. Only 25 patients (53%) were satisfied with DR surgery. One-year postoperative clinical outcomes (Oswestry Disability Index and 12-item short form health survey) significantly improved compared with preoperative levels, but the 2 scores also tended to decrease after 6 months. The union rate of the pars defect was 55% (26/47). There was no significant difference in clinical outcomes between fusion group and nonunion group of the pars defect at the final follow-up. Two patients (4%) experienced surgery-related complications. The

Examination of the PROMIS upper extremity item bank.

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Hung, Man; Voss, Maren W; Bounsanga, Jerry; Crum, Anthony B; Tyser, Andrew R

Clinical measurement. The psychometric properties of the PROMIS v1.2 UE item bank were tested on various samples prior to its release, but have not been fully evaluated among the orthopaedic population. This study assesses the performance of the UE item bank within the UE orthopaedic patient population. The UE item bank was administered to 1197 adult patients presenting to a tertiary orthopaedic clinic specializing in hand and UE conditions and was examined using traditional statistics and Rasch analysis. The UE item bank fits a unidimensional model (outfit MNSQ range from 0.64 to 1.70) and has adequate reliabilities (person = 0.84; item = 0.82) and local independence (item residual correlations range from -0.37 to 0.34). Only one item exhibits gender differential item functioning. Most items target low levels of function. The UE item bank is a useful clinical assessment tool. Additional items covering higher functions are needed to enhance validity. Supplemental testing is recommended for patients at higher levels of function until more high function UE items are developed. 2c. Copyright © 2016 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Re-evaluating a vision-related quality of life questionnaire with item response theory (IRT and differential item functioning (DIF analyses

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Knol Dirk L

2011-09-01

Full Text Available Abstract Background For the Low Vision Quality Of Life questionnaire (LVQOL it is unknown whether the psychometric properties are satisfactory when an item response theory (IRT perspective is considered. This study evaluates some essential psychometric properties of the LVQOL questionnaire in an IRT model, and investigates differential item functioning (DIF. Methods Cross-sectional data were used from an observational study among visually-impaired patients (n = 296. Calibration was performed for every dimension of the LVQOL in the graded response model. Item goodness-of-fit was assessed with the S-X2-test. DIF was assessed on relevant background variables (i.e. age, gender, visual acuity, eye condition, rehabilitation type and administration type with likelihood-ratio tests for DIF. The magnitude of DIF was interpreted by assessing the largest difference in expected scores between subgroups. Measurement precision was assessed by presenting test information curves; reliability with the index of subject separation. Results All items of the LVQOL dimensions fitted the model. There was significant DIF on several items. For two items the maximum difference between expected scores exceeded one point, and DIF was found on multiple relevant background variables. Item 1 'Vision in general' from the "Adjustment" dimension and item 24 'Using tools' from the "Reading and fine work" dimension were removed. Test information was highest for the "Reading and fine work" dimension. Indices for subject separation ranged from 0.83 to 0.94. Conclusions The items of the LVQOL showed satisfactory item fit to the graded response model; however, two items were removed because of DIF. The adapted LVQOL with 21 items is DIF-free and therefore seems highly appropriate for use in heterogeneous populations of visually impaired patients.

Syndesmotic fixation in supination-external rotation ankle fractures: a prospective randomized study.

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Pakarinen, Harri J; Flinkkilä, Tapio E; Ohtonen, Pasi P; Hyvönen, Pekka H; Lakovaara, Martti T; Leppilahti, Juhana I; Ristiniemi, Jukka Y

2011-12-01

This study was designed to assess whether transfixion of an unstable syndesmosis is necessary in supination-external rotation (Lauge-Hansen SE/Weber B)-type ankle fractures. A prospective study of 140 patients with unilateral Lauge-Hansen supination-external rotation type 4 ankle fractures was done. After bony fixation, the 7.5-Nm standardized external rotation (ER) stress test for both ankles was performed under fluoroscopy. A positive stress examination was defined as a difference of more than 2 mm side-to-side in the tibiotalar or tibiofibular clear spaces on mortise radiographs. If the stress test was positive, the patient was randomized to either syndesmotic transfixion with 3.5-mm tricortical screws or no syndesmotic fixation. Clinical outcome was assessed using the Olerud-Molander scoring system, RAND 36-Item Health Survey, and Visual Analogue Scale (VAS) to measure pain and function after a minimum 1-year of followup. Twenty four (17%) of 140 patients had positive standardized 7.5-Nm ER stress tests after malleolar fixation. The stress view was positive three times on tibiotalar clear space, seven on tibiofibular clear space, and 14 times on both tibiotalar and tibiofibular clear spaces. There was no significant difference between the two randomization groups with regards to Olerud-Molander functional score, VAS scale measuring pain and function, or RAND 36-Item Health Survey pain or physical function at 1 year. Relevant syndesmotic injuries are rare in supination-external rotation ankle fractures, and syndesmotic transfixion with a screw did not influence the functional outcome or pain after the 1-year followup compared with no fixation.

Science Library of Test Items. Volume Twenty-Two. A Collection of Multiple Choice Test Items Relating Mainly to Skills.

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New South Wales Dept. of Education, Sydney (Australia).

As one in a series of test item collections developed by the Assessment and Evaluation Unit of the Directorate of Studies, items are made available to teachers for the construction of unit tests or term examinations or as a basis for class discussion. Each collection was reviewed for content validity and reliability. The test items meet syllabus…

Science Library of Test Items. Volume Twenty. A Collection of Multiple Choice Test Items Relating Mainly to Physics, 1.

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New South Wales Dept. of Education, Sydney (Australia).

As one in a series of test item collections developed by the Assessment and Evaluation Unit of the Directorate of Studies, items are made available to teachers for the construction of unit tests or term examinations or as a basis for class discussion. Each collection was reviewed for content validity and reliability. The test items meet syllabus…

Does surgical stabilization improve outcomes in patients with isolated multiple distracted and painful non-flail rib fractures?

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Girsowicz, Elie; Falcoz, Pierre-Emmanuel; Santelmo, Nicola; Massard, Gilbert

2012-03-01

A best evidence topic was constructed according to a structured protocol. The question addressed was whether surgical stabilization is effective in improving the outcomes of patients with isolated multiple distracted and painful non-flail rib fractures. Of the 356 papers found using a report search, nine presented the best evidence to answer the clinical question. The authors, journal, date and country of publication, study type, group studied, relevant outcomes and results of these papers are given. We conclude that, on the whole, the nine retrieved studies clearly support the use of surgical stabilization in the management of isolated multiple non-flail and painful rib fractures for improving patient outcomes. The interest and benefit was shown not only in terms of pain (McGill pain questionnaire) and respiratory function (forced vital capacity, forced expiratory volume in 1 s and carbon monoxide diffusing capacity), but also in improved quality of life (RAND 36-Item Health Survey) and reduced socio-professional disability. Indeed, most of the authors justified surgical management based on the fact that the results of surgical stabilization showed improvement in short- and long-term patient outcomes, with fast reduction in pain and disability, as well as lower average wait before recommencing normal activities. Hence, the current evidence shows surgical stabilization to be safe and effective in alleviating post-operative pain and in improving patient recovery, thus enhancing the outcome after isolated multiple rib fractures. However, given the little published evidence, prospective trials are necessary to confirm these encouraging results.

Dynamic interaction between fetal adversity and a genetic score reflecting dopamine function on developmental outcomes at 36 months.

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Adrianne R Bischoff

Full Text Available Fetal adversity, evidenced by poor fetal growth for instance, is associated with increased risk for several diseases later in life. Classical cut-offs to characterize small (SGA and large for gestational age (LGA newborns are used to define long term vulnerability. We aimed at exploring the possible dynamism of different birth weight cut-offs in defining vulnerability in developmental outcomes (through the Bayley Scales of Infant and Toddler Development, using the example of a gene vs. fetal adversity interaction considering gene choices based on functional relevance to the studied outcome.36-month-old children from an established prospective birth cohort (Maternal Adversity, Vulnerability, and Neurodevelopment were classified according to birth weight ratio (BWR (SGA ≤0.85, LGA >1.15, exploring a wide range of other cut-offs and genotyped for polymorphisms associated with dopamine signaling (TaqIA-A1 allele, DRD2-141C Ins/Ins, DRD4 7-repeat, DAT1-10- repeat, Met/Met-COMT, composing a score based on the described function, in which hypofunctional variants received lower scores.There were 251 children (123 girls and 128 boys. Using the classic cut-offs (0.85 and 1.15, there were no statistically significant interactions between the neonatal groups and the dopamine genetic score. However, when changing the cut-offs, it is possible to see ranges of BWR that could be associated with vulnerability to poorer development according to the variation in the dopamine function.The classic birth weight cut-offs to define SGA and LGA newborns should be seen with caution, as depending on the outcome in question, the protocols for long-term follow up could be either too inclusive-therefore most costly, or unable to screen true vulnerabilities-and therefore ineffective to establish early interventions and primary prevention.

Negative effects of item repetition on source memory.

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Kim, Kyungmi; Yi, Do-Joon; Raye, Carol L; Johnson, Marcia K

2012-08-01

In the present study, we explored how item repetition affects source memory for new item-feature associations (picture-location or picture-color). We presented line drawings varying numbers of times in Phase 1. In Phase 2, each drawing was presented once with a critical new feature. In Phase 3, we tested memory for the new source feature of each item from Phase 2. Experiments 1 and 2 demonstrated and replicated the negative effects of item repetition on incidental source memory. Prior item repetition also had a negative effect on source memory when different source dimensions were used in Phases 1 and 2 (Experiment 3) and when participants were explicitly instructed to learn source information in Phase 2 (Experiments 4 and 5). Importantly, when the order between Phases 1 and 2 was reversed, such that item repetition occurred after the encoding of critical item-source combinations, item repetition no longer affected source memory (Experiment 6). Overall, our findings did not support predictions based on item predifferentiation, within-dimension source interference, or general interference from multiple traces of an item. Rather, the findings were consistent with the idea that prior item repetition reduces attention to subsequent presentations of the item, decreasing the likelihood that critical item-source associations will be encoded.

The Domain-Specific Risk Taking Scale for Adult Populations: Item Selection and Preliminary Psychometric Properties

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2009-12-01

result, and mostly based on content and face validity considerations, we deleted 8 items (e.g., “Cheating on an exam,” “ Plagiarizing a term paper,” etc...contributions of Ward Edwards. Norwell, MA: Kluwer Academic Press. [36] Weber, E.U., Ames, D., & Blais, A.-R. (2005). How do I choose thee? Let me count

Development of a mobbing short scale in the Gutenberg Health Study.

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Garthus-Niegel, Susan; Nübling, Matthias; Letzel, Stephan; Hegewald, Janice; Wagner, Mandy; Wild, Philipp S; Blettner, Maria; Zwiener, Isabella; Latza, Ute; Jankowiak, Sylvia; Liebers, Falk; Seidler, Andreas

2016-01-01

Despite its highly detrimental potential, most standard questionnaires assessing psychosocial stress at work do not include mobbing as a risk factor. In the German standard version of COPSOQ, mobbing is assessed with a single item. In the Gutenberg Health Study, this version was used together with a newly developed short scale based on the Leymann Inventory of Psychological Terror. The purpose of the present study was to evaluate the psychometric properties of these two measures, to compare them and to test their differential impact on relevant outcome parameters. This analysis is based on a population-based sample of 1441 employees participating in the Gutenberg Health Study. Exploratory and confirmatory factor analyses and reliability analyses were used to assess the mobbing scale. To determine their predictive validities, multiple linear regression analyses with six outcome parameters and log-binomial regression models for two of the outcome aspects were run. Factor analyses of the five-item scale confirmed a one-factor solution, reliability was α = 0.65. Both the single-item and the five-item scales were associated with all six outcome scales. Effect sizes were similar for both mobbing measures. Mobbing is an important risk factor for health-related outcomes. For the purpose of psychosocial risk assessment in the workplace, both the single-item and the five-item constructs were psychometrically appropriate. Associations with outcomes were about equivalent. However, the single item has the advantage of parsimony, whereas the five-item construct depicts several distinct forms of mobbing.

Work ability as prognostic risk marker of disability pension: single-item work ability score versus multi-item work ability index

NARCIS (Netherlands)

Roelen, C.A.M.; van Rhenen, W.; Groothoff, J.W.; van der Klink, J.J.L.; Twisk, J.W.R.; Heymans, M.W.

2014-01-01

Objectives Work ability predicts future disability pension (DP). A single-item work ability score (WAS) is emerging as a measure for work ability. This study compared single-item WAS with the multi-item work ability index (WAI) in its ability to identify workers at risk of DP. Methods This

Work ability as prognostic risk marker of disability pension : single-item work ability score versus multi-item work ability index

NARCIS (Netherlands)

Roelen, Corne A. M.; van Rhenen, Willem; Groothoff, Johan W.; van der Klink, Jac J. L.; Twisk, Jos W. R.; Heymans, Martijn W.

Objectives Work ability predicts future disability pension (DP). A single-item work ability score (WAS) is emerging as a measure for work ability. This study compared single-item WAS with the multi-item work ability index (WAI) in its ability to identify workers at risk of DP. Methods This

A physiotherapy-directed occupational health programme for Austrian school teachers: a cluster randomised pilot study.

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Figl-Hertlein, A; Horsak, B; Dean, E; Schöny, W; Stamm, T

2014-03-01

Although physiotherapists have long advocated workplace health, school teachers have not traditionally been a focus of study by these professionals. However, classroom teaching contributes to a range of occupational health issues related to general health as well as ergonomics that can be prevented or addressed by physiotherapists. To undertake a pilot study to explore the potential effects of a physiotherapy-directed occupational health programme individualised for school teachers, develop study methodology and gather preliminary data to establish a 'proof of concept' to inform future studies. Cluster randomised pilot study using a convenience sample. Eight Austrian regional secondary schools. Schools and their teachers were recruited and allocated to an intervention group (IG, n=26 teachers) or a control group (CG, n=43 teachers). Teachers were eligible to participate if they reported no health issues that compromised their classroom responsibilities. The IG participated in an individualised physiotherapy-directed occupational health programme (six 30-minute sessions) related to ergonomics and stress management conducted over a 5-month semester. The CG had a pseudo-intervention of one oral education session. Primary outcomes included scores from the physical and mental components and health transition item of the Short-Form-36 Health Survey questionnaire (SF-36), and emotional well-being and resistance to stress items from the work-related behaviour and experience patterns questionnaire. Data were collected before and after one semester. The primary outcome measure, the SF-36 physical component score, showed a reduction in the CG and no change in the IG, meaning that the CG deteriorated over the study semester while the IG did not show any change. A physiotherapy-directed occupational health programme may prevent deterioration of physical health of school teachers in one semester (proof of concept). This pilot study provided valuable information to inform the

Incidence of and risk factors for severe maternal complications associated with hypertensive disorders after 36 weeks' gestation in uncomplicated twin pregnancies: A prospective cohort study.

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Yamamoto, Ryo; Ishii, Keisuke; Muto, Haruka; Ota, Shiyo; Kawaguchi, Haruna; Hayashi, Shusaku; Mitsuda, Nobuaki

2018-04-19

To elucidate the incidence of and risk factors for severe hypertensive disorders (HD) and related maternal complications in uncomplicated twin pregnancies that reached 36 weeks' gestation. We conducted a prospective cohort study of twin pregnancies delivered after 36 weeks' gestation. Cases of twin-twin transfusion syndrome, twin anemia-polycythemia sequence, malformed fetuses, monoamniotic twins, selective reduction, fetal therapy and HD or fetal death before 35 weeks' gestation were excluded. The study's primary outcome was the incidence of severe maternal complications, including severe HD, eclampsia, placental abruption, HELLP (hemolysis, elevated liver enzyme and low platelet) syndrome, pulmonary edema and cerebrovascular disease. Perinatal factors associated with the primary outcome were identified using a multivariate logistic regression model. In 330 enrolled women, the number of cases with the primary outcome was 28 (8.5%; 95% confidence interval 5.9-12.0), including 25 cases of severe HD and each one case of placental abruption, HELLP syndrome and eclampsia. The rate of severe maternal complications significantly increased with gestational age, demonstrating 1.2% at 36 weeks, 3.9% at 37 weeks and 6.4% at 38 weeks. Only gestational proteinuria was identified as the independent risk factor for severe maternal complications (adjusted odds ratio 17.1 [95% confidence interval 6.71-45.4]). Severe maternal HD and related complications increased from late preterm to early term; particularly, patients with gestational proteinuria were at high risk. © 2018 Japan Society of Obstetrics and Gynecology.

Preoperative KOOS and SF-36 Scores Are Associated With the Development of Symptomatic Knee Osteoarthritis at 7 Years After Anterior Cruciate Ligament Reconstruction.

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Ware, J Kristopher; Owens, Brett D; Akelman, Matthew R; Karamchedu, Naga Padmini; Fadale, Paul D; Hulstyn, Michael J; Shalvoy, Robert M; Badger, Gary J; Fleming, Braden C

2018-03-01

Anterior cruciate ligament (ACL) tears are associated with the development of knee osteoarthritis despite ACL reconstruction surgery. However, little evidence is available to determine which patients will develop symptomatic knee osteoarthritis. To determine if preoperative outcome measures-KOOS (Knee injury and Osteoarthritis Outcome Score) and SF-36 (36-item Short Form Health Survey)-were associated with the development of a symptomatic knee 7 years after ACL reconstruction. A secondary goal was to examine the relationship between imaging evidence of knee osteoarthritis and development of knee pain. Case-control study; Level of evidence, 3. Prospectively collected data from 72 patients were reviewed with 7-year follow-up after unilateral ACL reconstruction. Patients were divided into symptomatic and asymptomatic groups based on the previously defined KOOS pain ≤72. Demographic variables and preoperative KOOS and SF-36 scores were compared between groups. Radiographic and magnetic resonance imaging data were used to evaluate differences in joint space width, Osteoarthritis Research Society International radiographic score, and the Whole-Organ Magnetic Resonance Imaging Score between groups. Univariate and multivariate analyses were performed to identify potential predictors of pain at 7-year follow-up. Wilcoxon sum rank and t tests were used to compare imaging findings between the symptomatic and asymptomatic patients at 7 years. According to KOOS pain, 7 of the 72 patients available at 7-year follow-up formed the symptomatic group. No differences were found between groups in regard to demographic variables or intraoperative findings. In multivariate analysis, lower preoperative scores for KOOS sports/recreation ( P = .005) and SF-36 mental health ( P = .025) were associated with a painful knee at 7 years, with increased odds of 82% and 68% per 10-unit decrease, respectively. The Whole-Organ Magnetic Resonance Imaging Score at 7 years showed evidence of

Improved utilization of ADAS-cog assessment data through item response theory based pharmacometric modeling.

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Ueckert, Sebastian; Plan, Elodie L; Ito, Kaori; Karlsson, Mats O; Corrigan, Brian; Hooker, Andrew C

2014-08-01

This work investigates improved utilization of ADAS-cog data (the primary outcome in Alzheimer's disease (AD) trials of mild and moderate AD) by combining pharmacometric modeling and item response theory (IRT). A baseline IRT model characterizing the ADAS-cog was built based on data from 2,744 individuals. Pharmacometric methods were used to extend the baseline IRT model to describe longitudinal ADAS-cog scores from an 18-month clinical study with 322 patients. Sensitivity of the ADAS-cog items in different patient populations as well as the power to detect a drug effect in relation to total score based methods were assessed with the IRT based model. IRT analysis was able to describe both total and item level baseline ADAS-cog data. Longitudinal data were also well described. Differences in the information content of the item level components could be quantitatively characterized and ranked for mild cognitively impairment and mild AD populations. Based on clinical trial simulations with a theoretical drug effect, the IRT method demonstrated a significantly higher power to detect drug effect compared to the traditional method of analysis. A combined framework of IRT and pharmacometric modeling permits a more effective and precise analysis than total score based methods and therefore increases the value of ADAS-cog data.

Development of a Short Version of the Thyroid-Related Patient-Reported Outcome ThyPRO

DEFF Research Database (Denmark)

Watt, Torquil; Bjorner, Jakob Bue; Groenvold, Mogens

2015-01-01

BACKGROUND: Thyroid diseases affect quality of life (QoL). The Thyroid-Related Patient-Reported Outcome (ThyPRO) is an international comprehensive well-validated patient-reported outcome, measuring thyroid-related QoL. The current version is rather long-85 items. The purpose of the present study...... was to develop an abbreviated version of the ThyPRO, with conserved good measurement properties. METHODS: A cross-sectional (N = 907) and a longitudinal sample (N = 435) of thyroid patients were analyzed. A graded item response theory (IRT) model was fitted to the cross-sectional data. Short-form scales.......89-0.98), and the mean scale levels were similar. CONCLUSIONS: A 39-item version of the ThyPRO, with good measurement properties, was developed and is recommended for clinical use....

Reference values for generic instruments used in routine outcome monitoring: the leiden routine outcome monitoring study

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Schulte-van Maaren Yvonne WM

2012-11-01

Full Text Available Abstract Introduction The Brief Symptom Inventory (BSI, Mood & Anxiety Symptom Questionnaire −30 (MASQ-D30, Short Form Health Survey 36 (SF-36, and Dimensional Assessment of Personality Pathology-Short Form (DAPP-SF are generic instruments that can be used in Routine Outcome Monitoring (ROM of patients with common mental disorders. We aimed to generate reference values usually encountered in 'healthy' and ‘psychiatrically ill’ populations to facilitate correct interpretation of ROM results. Methods We included the following specific reference populations: 1294 subjects from the general population (ROM reference group recruited through general practitioners, and 5269 psychiatric outpatients diagnosed with mood, anxiety, or somatoform (MAS disorders (ROM patient group. The outermost 5% of observations were used to define limits for one-sided reference intervals (95th percentiles for BSI, MASQ-D30 and DAPP-SF, and 5th percentiles for SF-36 subscales. Internal consistency and Receiver Operating Characteristics (ROC analyses were performed. Results Mean age for the ROM reference group was 40.3 years (SD=12.6 and 37.7 years (SD=12.0 for the ROM patient group. The proportion of females was 62.8% and 64.6%, respectively. The mean for cut-off values of healthy individuals was 0.82 for the BSI subscales, 23 for the three MASQ-D30 subscales, 45 for the SF-36 subscales, and 3.1 for the DAPP-SF subscales. Discriminative power of the BSI, MASQ-D30 and SF-36 was good, but it was poor for the DAPP-SF. For all instruments, the internal consistency of the subscales ranged from adequate to excellent. Discussion and conclusion Reference values for the clinical interpretation were provided for the BSI, MASQ-D30, SF-36, and DAPP-SF. Clinical information aided by ROM data may represent the best means to appraise the clinical state of psychiatric outpatients.

Mixed-methods development of a new patient-reported outcome instrument for chronic low back pain: part 1-the Patient Assessment for Low Back Pain - Symptoms (PAL-S).

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Martin, Mona L; Blum, Steven I; Liedgens, Hiltrud; Bushnell, Donald M; McCarrier, Kelly P; Hatley, Noël V; Ramasamy, Abhilasha; Freynhagen, Rainer; Wallace, Mark; Argoff, Charles; Eerdekens, Mariёlle; Kok, Maurits; Patrick, Donald L

2018-06-01

We describe the mixed-methods (qualitative and quantitative) development and preliminary validation of the Patient Assessment for Low Back Pain-Symptoms (PAL-S), a patient-reported outcome measure for use in chronic low back pain (cLBP) clinical trials. Qualitative methods (concept elicitation and cognitive interviews) were used to identify and refine symptom concepts and quantitative methods (classical test theory and Rasch measurement theory) were used to evaluate item- and scale-level performance of the measure using an iterative approach. Patients with cLBP participated in concept elicitation interviews (N = 43), cognitive interviews (N = 38), and interview-based assessment of paper-to-electronic mode equivalence (N = 8). A web-based sample of patients with self-reported cLBP participated in quantitative studies to evaluate preliminary (N = 598) and revised (n = 401) drafts and a physician-diagnosed cohort of patients with cLBP (N = 45) participated in preliminary validation of the measure. The PAL-S contained 14 items describing symptoms (overall pain, sharp, prickling, sensitive, tender, radiating, shocking, shooting, burning, squeezing, muscle spasms, throbbing, aching, and stiffness). Item-level performance, scale structure, and scoring seemed to be appropriate. One-week test-retest reproducibility was acceptable (intraclass correlation coefficient 0.81 [95% confidence interval, 0.61-0.91]). Convergent validity was demonstrated with total score and MOS-36 Bodily Pain (Pearson correlation -0.79), Neuropathic Pain Symptom Inventory (0.73), Roland-Morris Disability Questionnaire (0.67), and MOS-36 Physical Functioning (-0.65). Individual item scores and total score discriminated between numeric rating scale tertile groups and painDETECT categories. Respondent interpretation of paper and electronic administration modes was equivalent. The PAL-S has demonstrated content validity and is potentially useful to assess treatment benefit in cLBP clinical trials.

Using Linear Equating to Map PROMIS(®) Global Health Items and the PROMIS-29 V2.0 Profile Measure to the Health Utilities Index Mark 3.

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Hays, Ron D; Revicki, Dennis A; Feeny, David; Fayers, Peter; Spritzer, Karen L; Cella, David

2016-10-01

Preference-based health-related quality of life (HR-QOL) scores are useful as outcome measures in clinical studies, for monitoring the health of populations, and for estimating quality-adjusted life-years. This was a secondary analysis of data collected in an internet survey as part of the Patient-Reported Outcomes Measurement Information System (PROMIS(®)) project. To estimate Health Utilities Index Mark 3 (HUI-3) preference scores, we used the ten PROMIS(®) global health items, the PROMIS-29 V2.0 single pain intensity item and seven multi-item scales (physical functioning, fatigue, pain interference, depressive symptoms, anxiety, ability to participate in social roles and activities, sleep disturbance), and the PROMIS-29 V2.0 items. Linear regression analyses were used to identify significant predictors, followed by simple linear equating to avoid regression to the mean. The regression models explained 48 % (global health items), 61 % (PROMIS-29 V2.0 scales), and 64 % (PROMIS-29 V2.0 items) of the variance in the HUI-3 preference score. Linear equated scores were similar to observed scores, although differences tended to be larger for older study participants. HUI-3 preference scores can be estimated from the PROMIS(®) global health items or PROMIS-29 V2.0. The estimated HUI-3 scores from the PROMIS(®) health measures can be used for economic applications and as a measure of overall HR-QOL in research.

Evolution of a Test Item

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Spaan, Mary

2007-01-01

This article follows the development of test items (see "Language Assessment Quarterly", Volume 3 Issue 1, pp. 71-79 for the article "Test and Item Specifications Development"), beginning with a review of test and item specifications, then proceeding to writing and editing of items, pretesting and analysis, and finally selection of an item for a…

Comparison of the Sensitivity to Change of the 36-Item Short Form Health Survey and the Lupus Quality of Life Measure Using Various Definitions of Minimum Clinically Important Differences in Patients With Active Systemic Lupus Erythematosus.

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Nantes, Stephanie G; Strand, Vibeke; Su, Jiandong; Touma, Zahi

2018-01-01

The Medical Outcomes Study Short Form 36 (SF-36) and Lupus Quality of Life (LupusQoL) are health-related quality of life questionnaires used in systemic lupus erythematosus (SLE). We first determined the hypothesis-testing construct validity of the SF-36 and LupusQoL against disease activity in patients with active SLE and then compared the sensitivity to change of SF-36 and LupusQoL domains according to different definitions of minimum clinically important differences (MCIDs) for improvement and worsening in the current cohort. Seventy-eight clinically active SLE patients concurrently completed both questionnaires at their baseline and followup visits. Questionnaire domain scores were correlated with the SLE Disease Activity Index 2000 (SLEDAI-2K) and evaluated for floor/ceiling effects. The sensitivity to change of domains in each questionnaire was analyzed first, according to the various MCID definitions and, second, by clinically meaningful changes in disease activity. The magnitudes of change in each domain score between the baseline and followup visit were evaluated using standardized response means. In the 78 patients, the mean ± SD SLEDAI-2K scores were 9.7 ± 4.8 at baseline and 8.8 ± 5.1 at followup. SF-36/LupusQoL domain scores did not correlate with disease activity. The SF-36 showed floor effects, and ceiling effects were evident in both questionnaires. All domains of both questionnaires showed sensitivity to change over time. Specific domains that reflected worsening or improvement differed according to differing MCID definitions. In SLE patients with active disease, both the SF-36 and LupusQoL are sensitive to change, reflecting both improvement and worsening. More importantly, the LupusQoL SLE-specific domains (planning, burden to others, body image, and intimate relationships) were largely responsive to change. © 2017, American College of Rheumatology.

Qualitative Evaluation of Pediatric Pain Behavior, Quality, and Intensity Item Candidates and the PROMIS Pain Domain Framework in Children With Chronic Pain.

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Jacobson, C Jeffrey; Kashikar-Zuck, Susmita; Farrell, Jennifer; Barnett, Kimberly; Goldschneider, Ken; Dampier, Carlton; Cunningham, Natoshia; Crosby, Lori; DeWitt, Esi Morgan

2015-12-01

As initial steps in a broader effort to develop and test pediatric pain behavior and pain quality item banks for the Patient-Reported Outcomes Measurement Information System (PROMIS), we used qualitative interview and item review methods to 1) evaluate the overall conceptual scope and content validity of the PROMIS pain domain framework among children with chronic/recurrent pain conditions, and 2) develop item candidates for further psychometric testing. To elicit the experiential and conceptual scope of pain outcomes across a variety of pediatric recurrent/chronic pain conditions, we conducted 32 semi-structured individual and 2 focus-group interviews with children and adolescents (8-17 years), and 32 individual and 2 focus-group interviews with parents of children with pain. Interviews with pain experts (10) explored the operational limits of pain measurement in children. For item bank development, we identified existing items from measures in the literature, grouped them by concept, removed redundancies, and modified the remaining items to match PROMIS formatting. New items were written as needed and cognitive debriefing was completed with the children and their parents, resulting in 98 pain behavior (47 self, 51 proxy), 54 quality, and 4 intensity items for further testing. Qualitative content analyses suggest that reportable pain outcomes that matter to children with pain are captured within and consistent with the pain domain framework in PROMIS. PROMIS pediatric pain behavior, quality, and intensity items were developed based on a theoretical framework of pain that was evaluated by multiple stakeholders in the measurement of pediatric pain, including researchers, clinicians, and children with pain and their parents, and the appropriateness of the framework was verified. Copyright © 2015 American Pain Society. Published by Elsevier Inc. All rights reserved.

Psychometric evaluation of the Patient-Reported Outcomes Measurement Information System (PROMIS) Nicotine Dependence Item Bank for use with electronic cigarettes.

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Morean, Meghan; Krishnan-Sarin, Suchitra; Sussman, Steve; Foulds, Jonathan; Fishbein, Howard; Grana, Rachel; O'Malley, Stephanie S

2018-01-02

Psychometrically sound measures of e-cigarette dependence are lacking. We modified the PROMIS Nicotine Dependence Item Banks for use with e-cigarettes and evaluated the psychometrics of the 22-, 8- and 4-item adapted versions. 1009 adults who reported using e-cigarettes at least weekly completed an anonymous survey in Summer 2016 (50.2% male, 77.1% White, mean age 35.81 [10.71], 66.4% daily e-cigarette users, 72.6% current cigarette smokers). Psychometric analyses included confirmatory factor analysis, internal consistency, measurement invariance, examination of mean-level differences, convergent validity, and test-criterion relationships with e-cigarette use outcomes. All PROMIS-E versions had confirmable, internally consistent latent structures that were scalar invariant by sex, race, e-cigarette use (non-daily/daily), e-liquid nicotine content (no/yes), and current cigarette smoking status (no/yes). Daily e-cigarette users, nicotine e-liquid users, and cigarette smokers reported being more dependent on e-cigarettes than their counterparts. All PROMIS-E versions correlated strongly with one another, evidenced convergent validity with the Penn State E-cigarette Dependence Index and time to first e-cigarette use in the morning, and evidenced test-criterion relationships with vaping frequency, e-liquid nicotine concentration, and e-cigarette quit attempts. Similar results were observed when analyses were conducted within subsamples of exclusive e-cigarette users and duals-users of cigarettes and e-cigarettes. Each PROMIS-E version evidenced strong psychometric properties for assessing e-cigarette dependence in adults who either use e-cigarette exclusively or who are dual-users of cigarettes and e-cigarettes. However, results indicated little benefit of the longer versions over the 4-item PROMIS-E, which provides an efficient assessment of e-cigarette dependence. The availability of the novel, psychometrically sound PROMIS-E can further research on a wide range of

Negative decision outcomes are more common among people with lower decision-making competence: An item-level analysis of the Decision Outcome Inventory (DOI

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Andrew M Parker

2015-04-01

Full Text Available Most behavioral decision research takes place in carefully controlled laboratory settings, and examination of relationships between performance and specific real-world decision outcomes is rare. One prior study shows that people who perform better on hypothetical decision tasks, assessed using the Adult Decision-Making Competence (A-DMC measure, also tend to experience better real-world decision outcomes, as reported on the Decision Outcomes Inventory (DOI. The DOI score reflects avoidance of outcomes that could result from poor decisions, ranging from serious (e.g., bankruptcy to minor (e.g., blisters from sunburn. The present analyses go beyond the initial work, which focused on the overall DOI score, by analyzing the relationships between specific decision outcomes and A-DMC performance. Most outcomes are significantly more likely among people with lower A-DMC scores, even after taking into account two variables expected to produce worse real-world decision outcomes: younger age and lower socio-economic status. We discuss the usefulness of DOI as a measure of successful real-world decision making.

Development of a patient-reported outcome

DEFF Research Database (Denmark)

Juul, Tina; Søgaard, Karen; Roos, Ewa M.

2015-01-01

removed from the original 69. A multidimensional questionnaire, divided into five subscales, was developed from the remaining 34 items: mobility; symptoms; sleep disturbance; everyday activity and pain; and participation in everyday life. Exploratory factor analysis supported a 5-subscale structure......OBJECTIVE: To develop a patient-reported outcome evaluating the impact of neck pain. The results of item generation and reduction and subscale structure in support of the content and construct validity of the measure are reported. METHODS: Items were generated from the literature and through focus...

Why Students Answer TIMSS Science Test Items the Way They Do

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Harlow, Ann; Jones, Alister

2004-04-01

The purpose of this study was to explore how Year 8 students answered Third International Mathematics and Science Study (TIMSS) questions and whether the test questions represented the scientific understanding of these students. One hundred and seventy-seven students were tested using written test questions taken from the science test used in the Third International Mathematics and Science Study. The degree to which a sample of 38 children represented their understanding of the topics in a written test compared to the level of understanding that could be elicited by an interview is presented in this paper. In exploring student responses in the interview situation this study hoped to gain some insight into the science knowledge that students held and whether or not the test items had been able to elicit this knowledge successfully. We question the usefulness and quality of data from large-scale summative assessments on their own to represent student scientific understanding and conclude that large scale written test items, such as TIMSS, on their own are not a valid way of exploring students'' understanding of scientific concepts. Considerable caution is therefore needed in exploiting the outcomes of international achievement testing when considering educational policy changes or using TIMSS data on their own to represent student understanding.

A Study on the Countermeasures to the Revision of Nuclear Controlled Items

International Nuclear Information System (INIS)

Choi, Sun Do; Lim, Dong Hyuk

2011-01-01

NSG(Nuclear Suppliers Group) was formed to prevent proliferation in 1977 with nuclear test in India in 1974. INFCIRC/254/Part1 (Trigger List) as guidelines for controlling the nuclear material, reactor and related equipment, reactor nuclear material, reprocessing, enrichment, conversion, molding, heavy water production plant/equipment, technical was released in 1978, and the Export Control guidelines (INFCIRC/ 254/Part2) about Dual-use item which can be used for nuclear development was established in 1992. The two Export Control guidelines are agreements between NSG Participating Governments (PGs), so all PGs have an obligation about implementation of the agreement. In addition, NSG guidelines can be the export base of control law of the member nations including our country which joined in 1995 or matched with it. Recently, NSG is in the progress of the fundamental review of NSG guidelines established in 1978 and 1992. The terms of agreement will be reflected to the domestic legislation through the fundamental review, and it will entail the changes of classification and export license standard of export items. Thus, it was studied about export controlled items review and revise plan for establishing the clear export control guidelines by review of NSG guidelines as follows

Item response theory analysis of the life orientation test-revised: age and gender differential item functioning analyses.

Science.gov (United States)

Steca, Patrizia; Monzani, Dario; Greco, Andrea; Chiesi, Francesca; Primi, Caterina

2015-06-01

This study is aimed at testing the measurement properties of the Life Orientation Test-Revised (LOT-R) for the assessment of dispositional optimism by employing item response theory (IRT) analyses. The LOT-R was administered to a large sample of 2,862 Italian adults. First, confirmatory factor analyses demonstrated the theoretical conceptualization of the construct measured by the LOT-R as a single bipolar dimension. Subsequently, IRT analyses for polytomous, ordered response category data were applied to investigate the items' properties. The equivalence of the items across gender and age was assessed by analyzing differential item functioning. Discrimination and severity parameters indicated that all items were able to distinguish people with different levels of optimism and adequately covered the spectrum of the latent trait. Additionally, the LOT-R appears to be gender invariant and, with minor exceptions, age invariant. Results provided evidence that the LOT-R is a reliable and valid measure of dispositional optimism. © The Author(s) 2014.

How physicians identify with predetermined personalities and links to perceived performance and wellness outcomes: a cross-sectional study.

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Lemaire, Jane B; Wallace, Jean E

2014-11-29

Certain personalities are ascribed to physicians. This research aims to measure the extent to which physicians identify with three predetermined personalities (workaholic, Type A and control freak) and to explore links to perceptions of professional performance, and wellness outcomes. This is a cross-sectional study using a mail-out questionnaire sent to all practicing physicians (2957 eligible, 1178 responses, 40% response rate) in a geographical health region within a western Canadian province. Survey items were used to assess the extent to which participants felt they are somewhat of a workaholic, Type A and/or control freak, and if they believed that having these personalities makes one a better doctor. Participants' wellness outcomes were also measured. Zero-order correlations were used to determine the relationships between physicians identifying with a personality and feeling it makes one a better doctor. T-tests were used to compare measures of physician wellness for those who identified with the personality versus those who did not. 53% of participants identified with the workaholic personality, 62% with the Type A, and 36% with the control freak. Identifying with any one of the personalities was correlated with feeling it makes one a better physician. There were statistically significant differences in several wellness outcomes comparing participants who identified with the personalities versus those who did not. These included higher levels of emotional exhaustion (workaholic, Type A and control freak), higher levels of anxiety (Type A and control freak) and higher levels of depression, poorer mental health and lower levels of job satisfaction (control freak). Participants who identified with the workaholic personality versus those who did not reported higher levels of job satisfaction, rewarding patient experiences and career commitment. Most participants identified with at least one of the three personalities. The beliefs of some participants that

Effect of Differential Item Functioning on Test Equating

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Kabasakal, Kübra Atalay; Kelecioglu, Hülya

2015-01-01

This study examines the effect of differential item functioning (DIF) items on test equating through multilevel item response models (MIRMs) and traditional IRMs. The performances of three different equating models were investigated under 24 different simulation conditions, and the variables whose effects were examined included sample size, test…

Identifying Country-Specific Cultures of Physics Education: A differential item functioning approach

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Mesic, Vanes

2012-11-01

In international large-scale assessments of educational outcomes, student achievement is often represented by unidimensional constructs. This approach allows for drawing general conclusions about country rankings with respect to the given achievement measure, but it typically does not provide specific diagnostic information which is necessary for systematic comparisons and improvements of educational systems. Useful information could be obtained by exploring the differences in national profiles of student achievement between low-achieving and high-achieving countries. In this study, we aimed to identify the relative weaknesses and strengths of eighth graders' physics achievement in Bosnia and Herzegovina in comparison to the achievement of their peers from Slovenia. For this purpose, we ran a secondary analysis of Trends in International Mathematics and Science Study (TIMSS) 2007 data. The student sample consisted of 4,220 students from Bosnia and Herzegovina and 4,043 students from Slovenia. After analysing the cognitive demands of TIMSS 2007 physics items, the correspondent differential item functioning (DIF)/differential group functioning contrasts were estimated. Approximately 40% of items exhibited large DIF contrasts, indicating significant differences between cultures of physics education in Bosnia and Herzegovina and Slovenia. The relative strength of students from Bosnia and Herzegovina showed to be mainly associated with the topic area 'Electricity and magnetism'. Classes of items which required the knowledge of experimental method, counterintuitive thinking, proportional reasoning and/or the use of complex knowledge structures proved to be differentially easier for students from Slovenia. In the light of the presented results, the common practice of ranking countries with respect to universally established cognitive categories seems to be potentially misleading.

Theoretical framework and methodological development of common subjective health outcome measures in osteoarthritis: a critical review

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Johnston Marie

2007-03-01

Full Text Available Abstract Subjective measures involving clinician ratings or patient self-assessments have become recognised as an important tool for the assessment of health outcome. The value of a health outcome measure is usually assessed by a psychometric evaluation of its reliability, validity and responsiveness. However, psychometric testing involves an accumulation of evidence and has recognised limitations. It has been suggested that an evaluation of how well a measure has been developed would be a useful additional criteria in assessing the value of a measure. This paper explored the theoretical background and methodological development of subjective health status measures commonly used in osteoarthritis research. Fourteen subjective health outcome measures commonly used in osteoarthritis research were examined. Each measure was explored on the basis of their i theoretical framework (was there a definition of what was being assessed and was it part of a theoretical model? and ii methodological development (what was the scaling strategy, how were the items generated and reduced, what was the response format and what was the scoring method?. Only the AIMS, SF-36 and WHOQOL defined what they were assessing (i.e. the construct of interest and no measure assessed was part of a theoretical model. None of the clinician report measures appeared to have implemented a scaling procedure or described the rationale for the items selected or scoring system. Of the patient self-report measures, the AIMS, MPQ, OXFORD, SF-36, WHOQOL and WOMAC appeared to follow a standard psychometric scaling method. The DRP and EuroQol used alternative scaling methods. The review highlighted the general lack of theoretical framework for both clinician report and patient self-report measures. This review also drew attention to the wide variation in the methodological development of commonly used measures in OA. While, in general the patient self-report measures had good methodological

Osteogenic differentiation in dedifferentiated liposarcoma: a study of 36 cases in comparison to the cases without ossification.

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Yamashita, Kyoko; Kohashi, Kenichi; Yamada, Yuichi; Ishii, Takeaki; Nishida, Yoshihiro; Urakawa, Hiroshi; Ito, Ichiro; Takahashi, Mitsuru; Inoue, Takeshi; Ito, Masafumi; Ohara, Yuuki; Oda, Yoshinao; Toyokuni, Shinya

2018-04-01

Ossification is found occasionally in dedifferentiated liposarcoma (DDLPS). The aims of this study were to elucidate whether the formed bone tissue is usually produced by tumour cells or by reactive non-neoplastic cells, and to reveal the clinicopathological characteristics of DDLPS with ossification. We examined 36 cases of ossified DDLPS by comparing them to 31 cases of non-ossified DDLPS. MDM2 amplification was confirmed in osteocytes and/or osteoblastic cells in all but one ossified DDLPS cases (27 of 28) using fluorescence in-situ hybridisation, although the morphological impression of ossification appeared to be mainly metaplastic (27 of 36) or high-grade osteosarcoma-like (six of 36). The bone tissue was often formed predominantly at the periphery of the DDLPS area near the well-differentiated liposarcoma component (18 of 36), and an organised structure such as bone marrow-like differentiation was not uncommon (12 of 36). According to a modified French Fédération Nationale des Centers de Lutte Contre le Cancer (FNCLCC) grading system, ossified DDLPS tended to be lower grade than non-ossified DDLPS (mean grade: 1.88 and 2.15, respectively). Ossification in DDLPS was associated significantly with shorter local recurrence-free survival by multivariate analysis (P = 0.02347), but metaplastic-appearing ossification tended to be associated with longer overall survival (P = 0.1400). The bone tissue formed in DDLPS was mainly neoplastic regardless of its morphology and maturity, which highlighted the osteogenic differentiation of the tumour cells. DDLPS patients with osteogenic differentiation tended to suffer from earlier local recurrences, which did not necessarily lead to poor life outcomes. © 2017 John Wiley & Sons Ltd.

Science Library of Test Items. Volume Twenty-One. A Collection of Multiple Choice Test Items Relating Mainly to Physics, 2.

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New South Wales Dept. of Education, Sydney (Australia).

As one in a series of test item collections developed by the Assessment and Evaluation Unit of the Directorate of Studies, items are made available to teachers for the construction of unit tests or term examinations or as a basis for class discussion. Each collection was reviewed for content validity and reliability. The test items meet syllabus…

A study of the face validity of the 40 item version of the Defense Style Questionnaire (DSQ-40).

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Chabrol, Henri; Rousseau, Amélie; Rodgers, Rachel; Callahan, Stacey; Pirlot, Gérard; Sztulman, Henri

2005-11-01

There are few studies examining the face validity of the 40-item version of the Defense Style Questionnaire (DSQ-40). Moreover, the existing studies have provided conflicting results. The present study provides an in-depth examination of the face validity of the DSQ-40. Eight clinicians independently attributed each item of the DSQ-40 to a defense mechanism. The defense mechanisms listed in the DSM-IV Defensive Functioning Scale and their definitions were provided as a guide, along with the definition of those defense mechanisms investigated by the DSQ that are not included. It was further specified that the raters could attribute the items to defense mechanisms other than those listed or coping mechanisms. Twelve items out of 40 (30%) were attributed to the defense mechanisms they were supposed to investigate by fewer than four out of the eight raters. This result suggests that a substantial part of the DSQ-40 is lacking in face validity.

Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies: The PRISMA-DTA Statement.

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McInnes, Matthew D F; Moher, David; Thombs, Brett D; McGrath, Trevor A; Bossuyt, Patrick M; Clifford, Tammy; Cohen, Jérémie F; Deeks, Jonathan J; Gatsonis, Constantine; Hooft, Lotty; Hunt, Harriet A; Hyde, Christopher J; Korevaar, Daniël A; Leeflang, Mariska M G; Macaskill, Petra; Reitsma, Johannes B; Rodin, Rachel; Rutjes, Anne W S; Salameh, Jean-Paul; Stevens, Adrienne; Takwoingi, Yemisi; Tonelli, Marcello; Weeks, Laura; Whiting, Penny; Willis, Brian H

2018-01-23

Systematic reviews of diagnostic test accuracy synthesize data from primary diagnostic studies that have evaluated the accuracy of 1 or more index tests against a reference standard, provide estimates of test performance, allow comparisons of the accuracy of different tests, and facilitate the identification of sources of variability in test accuracy. To develop the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) diagnostic test accuracy guideline as a stand-alone extension of the PRISMA statement. Modifications to the PRISMA statement reflect the specific requirements for reporting of systematic reviews and meta-analyses of diagnostic test accuracy studies and the abstracts for these reviews. Established standards from the Enhancing the Quality and Transparency of Health Research (EQUATOR) Network were followed for the development of the guideline. The original PRISMA statement was used as a framework on which to modify and add items. A group of 24 multidisciplinary experts used a systematic review of articles on existing reporting guidelines and methods, a 3-round Delphi process, a consensus meeting, pilot testing, and iterative refinement to develop the PRISMA diagnostic test accuracy guideline. The final version of the PRISMA diagnostic test accuracy guideline checklist was approved by the group. The systematic review (produced 64 items) and the Delphi process (provided feedback on 7 proposed items; 1 item was later split into 2 items) identified 71 potentially relevant items for consideration. The Delphi process reduced these to 60 items that were discussed at the consensus meeting. Following the meeting, pilot testing and iterative feedback were used to generate the 27-item PRISMA diagnostic test accuracy checklist. To reflect specific or optimal contemporary systematic review methods for diagnostic test accuracy, 8 of the 27 original PRISMA items were left unchanged, 17 were modified, 2 were added, and 2 were omitted. The 27-item

Conditioning factors of test-taking engagement in PIAAC: an exploratory IRT modelling approach considering person and item characteristics

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Frank Goldhammer

2017-11-01

Full Text Available Abstract Background A potential problem of low-stakes large-scale assessments such as the Programme for the International Assessment of Adult Competencies (PIAAC is low test-taking engagement. The present study pursued two goals in order to better understand conditioning factors of test-taking disengagement: First, a model-based approach was used to investigate whether item indicators of disengagement constitute a continuous latent person variable by domain. Second, the effects of person and item characteristics were jointly tested using explanatory item response models. Methods Analyses were based on the Canadian sample of Round 1 of the PIAAC, with N = 26,683 participants completing test items in the domains of literacy, numeracy, and problem solving. Binary item disengagement indicators were created by means of item response time thresholds. Results The results showed that disengagement indicators define a latent dimension by domain. Disengagement increased with lower educational attainment, lower cognitive skills, and when the test language was not the participant’s native language. Gender did not exert any effect on disengagement, while age had a positive effect for problem solving only. An item’s location in the second of two assessment modules was positively related to disengagement, as was item difficulty. The latter effect was negatively moderated by cognitive skill, suggesting that poor test-takers are especially likely to disengage with more difficult items. Conclusions The negative effect of cognitive skill, the positive effect of item difficulty, and their negative interaction effect support the assumption that disengagement is the outcome of individual expectations about success (informed disengagement.

Is Cesarean Delivery Preferable in Twin Pregnancies at >=36 Weeks Gestation?

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Dong, Yu; Luo, Zhong-Cheng; Yang, Zu-Jing; Chen, Lu; Guo, Yu-Na; Branch, Ware; Zhang, Jun; Huang, Hong

2016-01-01

Background The optimal mode of delivery in twin pregnancies remains controversial. A recent randomized trial did not find any benefit of planned cesarean vs. vaginal delivery at 32–38 weeks gestation, but the trial was not powered to detect a moderate effect. We aimed to evaluate the impact of cesarean delivery on perinatal mortality and severe neonatal morbidity in twin pregnancies at ≥32 weeks through a large database exploration approach with the power to detect moderate risk differences. Methods In a retrospective birth cohort study using the U.S. matched multiple births, 1995–2000 (the available largest multiple birth dataset), we compared perinatal outcomes in twins (n = 181,810 pregnancies) delivered at 32–41 weeks gestation without congenital anomalies. The primary outcome was a composite of perinatal death and severe neonatal morbidity. Cox regression was used to estimate the adjusted hazard ratio (aHR) controlling for the propensity to cesarean delivery, fetal characteristics (sex, birth weight, birth weight discordance, same-sex twin or not) and twin-cluster level dependence. Prospective risks were calculated using the fetuses-at-risk denominators. Results The overall rates of the primary outcome were slightly lower in intended cesarean (6.20%) vs. vaginal (6.45%) deliveries. The aHRs of the primary outcome were in favor of vaginal delivery at 32 (aHR = 1.06, p = 0.03) or 33 (aHR = 1.22, pcesarean delivery at 36 (aHR = 0.94, p = 0.004), 37, 38 and 39+ weeks (aHR: 0.72 to 0.78, all pcesarean vs. vaginal deliveries at 36+ weeks of gestation remained when the analyses were restricted to different-sex (dichorionic) twins (aHR = 0.84, 95% CI 0.80–0.88). Conclusion Cesarean delivery may be beneficial for perinatal outcomes overall in twin pregnancies at ≥36 weeks gestation. PMID:27227678

Instructional Topics in Educational Measurement (ITEMS) Module: Using Automated Processes to Generate Test Items

Science.gov (United States)

Gierl, Mark J.; Lai, Hollis

2013-01-01

Changes to the design and development of our educational assessments are resulting in the unprecedented demand for a large and continuous supply of content-specific test items. One way to address this growing demand is with automatic item generation (AIG). AIG is the process of using item models to generate test items with the aid of computer…

A 67-Item Stress Resilience item bank showing high content validity was developed in a psychosomatic sample.

Science.gov (United States)

Obbarius, Nina; Fischer, Felix; Obbarius, Alexander; Nolte, Sandra; Liegl, Gregor; Rose, Matthias

2018-04-10

To develop the first item bank to measure Stress Resilience (SR) in clinical populations. Qualitative item development resulted in an initial pool of 131 items covering a broad theoretical SR concept. These items were tested in n=521 patients at a psychosomatic outpatient clinic. Exploratory and Confirmatory Factor Analysis (CFA), as well as other state-of-the-art item analyses and IRT were used for item evaluation and calibration of the final item bank. Out of the initial item pool of 131 items, we excluded 64 items (54 factor loading .3, 2 non-discriminative Item Response Curves, 4 Differential Item Functioning). The final set of 67 items indicated sufficient model fit in CFA and IRT analyses. Additionally, a 10-item short form with high measurement precision (SE≤.32 in a theta range between -1.8 and +1.5) was derived. Both the SR item bank and the SR short form were highly correlated with an existing static legacy tool (Connor-Davidson Resilience Scale). The final SR item bank and 10-item short form showed good psychometric properties. When further validated, they will be ready to be used within a framework of Computer-Adaptive Tests for a comprehensive assessment of the Stress-Construct. Copyright © 2018. Published by Elsevier Inc.