Translation and Adaptation of the Genetic Counselling Outcome Scale (GCOS-24) for Use in Denmark.

Outcome measurement in clinical genetics is challenging. Robust outcome measures are needed to provide evidence to support service development within genetic counseling. The Genetic Counselling Outcome Scale (GCOS-24), a Patient Reported Outcome Measure (PROM), was developed in English and validated with clinical genetics patients in the British NHS. This study reports the translation and adaptation of the GCOS-24 for use in Denmark. GCOS-24 was translated and back translated, supervised by an expert committee. Feedback on the first version was collected from genetic counseling patients in qualitative interviews focusing on instructions for use, response options and specific items considered semantically difficult. After further adjustment the adapted and translated version was administered to a second sample of patients, with responses analyzed using descriptive statistics. Eighteen interviews were conducted, and led to adjustment of item wording. Sixty-one patients completed the final version GCOS-24dk. Internal consistency is good (Cronbach's α =0.79), with an acceptable number of missing responses and no floor or ceiling effect observed. GCOS-24 has been successfully translated and adapted for use in a Danish setting. The study confirms the feasibility of local adaptation of patient reported outcome measures and stresses the importance of adaptation, even across quite similar populations and health care systems.

From experimental design to uncertainty estimation for the European Pharmacopoeia HPLC analysis of human insulin.

In this paper the process from experimental design (e.g. ruggedness test) to uncertainty estimation is described. The uncertainty estimate was calculated for the peak area of insulin plus A21 desamido insulin resulting from an HPLC analysis of a sample of an injectable human insulin preparation, Actrapid HM 100 IU ml(-1) (Novo Nordisk A/S). The analytical method used was the European Pharmacopoeia assay. (4) An expanded uncertainty (1) of 1.8% (of the area from the HPLC analysis) at an approximately 95% confidence level was found and confirmed by a validation study. This uncertainty refers to the peak area of the analyte from a single injection of the sample. The input parameters to the uncertainty estimate were found from a factorial experimental design (e.g. ruggedness test) consisting of 9 factors applied to the HPLC analysis. The input parameters were chosen to cover the probable contributors to the variability of the measured area of the HPLC analysis, including the sample preparation, but excluding uncertainty deriving from the reference material(s).