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We aimed to perform cross-cultural adaptation of the Interprofessional Collaboration Scale (IPC-BR) and to evaluate evidence of its validity for the Brazilian hospital context. The research consisted of six steps: translation of the instrument into the new language, synthesis of the translated versions, back-translation, synthesis of the versions in the original language, evaluation of the syntheses by an expert committee, and pilot testing or pretesting and validation of the internal structure of the items of the instrument. The pilot testing involved 4 translators, 14 judges, and 30 healthcare professionals; the validation of the internal structure involved 686 professionals including nurses, physicians and physiotherapists. Translation and cross-cultural adaptation revealed no significant changes or discrepancies in meaning from the original model. Exploratory, confirmatory, and parallel factor analyses confirmed that the Brazilian scale is unidimensional. We found unidimensional characteristics and satisfactory factor loadings, with good levels of reliability, which makes the instrument provide consistent and reliable internal evidence for measuring the construct. Thus, the possibility of using it to assess interprofessional collaboration among different target groups in the Brazilian scenario was confirmed.
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BACKGROUND: The manufacturing processes of plasma products include steps that can remove prions. The efficacy of these steps is measured in validation studies using animal brain-derived prion materials called spikes. Because the nature of the prion agent in blood is not known, the relevance of these spikes, particularly with steps that are based on retention mechanisms such as nanofiltration, is important to investigate. STUDY DESIGN AND METHODS: The aggregation and sizes of PrPres assemblies of microsomal fractions (MFs) extracted from 263K-infected hamster brains were analyzed using velocity gradients. The separated gradient fractions were either inoculated to Tg7 mice expressing hamster-PrPc to measure infectivity or used in Protein Misfolding Cyclic Amplification for measuring seeding activity. The collected data allowed for reanalyzing results from previous nanofiltration validation studies. RESULTS: A significant portion of MFs was found to be composed of small PrPres assemblies, estimated to have a size ≤24 mers (~22-528 kDa), and to contain a minimum of 20% of total prion infectivity. With this data we could calculate reductions of 4.10 log (15 N), 2.53 log (35 N), and 1.77 log (35 N) from validation studies specifically for these small PrPres objects. CONCLUSION: Our gradient data provided evidence that nanofilters can remove the majority of the smallest PrPres entities within microsomes spikes, estimated to be in a size below 24 mers, giving insight about the fact that, in our conditions, size exclusion may not be the only mechanism for retention nanofiltration.
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Microssomos , Animais , Camundongos , Cricetinae , Microssomos/metabolismo , Filtração , Príons/metabolismo , Encéfalo/metabolismo , Camundongos Transgênicos , NanotecnologiaRESUMO
Background: Predicting fall injuries can mitigate the sequelae of falls and potentially utilize medical resources effectively. This study aimed to externally validate the accuracy of the Saga Fall Injury Risk Model (SFIRM), consisting of six factors including age, sex, emergency transport, medical referral letter, Bedriddenness Rank, and history of falls, assessed upon admission. Methods: This was a two-center, prospective, observational study. We included inpatients aged 20 years or older in two hospitals, an acute and a chronic care hospital, from October 2018 to September 2019. The predictive performance of the model was evaluated by calculating the area under the curve (AUC), 95% confidence interval (CI), and shrinkage coefficient of the entire study population. The minimum sample size of this study was 2,235 cases. Results: A total of 3,549 patients, with a median age of 78 years, were included in the analysis, and men accounted for 47.9% of all the patients. Among these, 35 (0.99%) had fall injuries. The performance of the SFIRM, as measured by the AUC, was 0.721 (95% CI: 0.662-0.781). The observed fall incidence closely aligned with the predicted incidence calculated using the SFIRM, with a shrinkage coefficient of 0.867. Conclusions: The external validation of the SFIRM in this two-center, prospective study showed good discrimination and calibration. This model can be easily applied upon admission and is valuable for fall injury prediction.
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Acidentes por Quedas , Humanos , Acidentes por Quedas/estatística & dados numéricos , Masculino , Feminino , Idoso , Estudos Prospectivos , Pessoa de Meia-Idade , Medição de Risco/estatística & dados numéricos , Medição de Risco/métodos , Idoso de 80 Anos ou mais , Adulto , Fatores de Risco , Ferimentos e Lesões/epidemiologia , Incidência , Adulto JovemRESUMO
BACKGROUND AND OBJECTIVE: Motherhood is considered to be a joyous occasion cross-culturally but can bring forth an array of issues including depression. In Asia, Pakistan is dangerously high on the prevalence of postpartum depression (PPD) with sporadic results ranging from 28 to 63%, which could be due to the use of non-indigenous tools. METHODS: An exploratory study-mixed method design was implied. During phase I mothers in the postpartum phase (up to 12 months) and experts were interviewed, items were generated, and pilot study was conducted. In second phase exploratory and confirmatory factor analysis was conducted to establish construct validity, convergent and divergent validity was also established. RESULTS: A pool of 46 items was generated related to postpartum depression, which was reduced to 35 items as per the factor loading of 0.5 in exploratory factor analysis. Psychometric properties of the scale revealed good reliability (Cronbach α = 0.92) and factor structure of the scale. As per exploratory factor analysis five factors were revealed, explaining 58.07% variance, and the model was confirmed by confirmatory factor analysis. The scale showed significant positive correlation with Edinburgh' postpartum depression scale, depression anxiety and stress scale; establishing convergent validity and significant negative correlation with satisfaction with life scale; establishing divergent validity of the scale. CONCLUSION AND IMPLICATIONS FOR TRANSLATION: Questionnaire of postpartum depression scale is a reliable and valid tool that can be used to measure postpartum depression in Asian mothers and provide targeted interventions.
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Depressão Pós-Parto , Feminino , Humanos , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/epidemiologia , Projetos Piloto , Reprodutibilidade dos Testes , Período Pós-Parto , PaquistãoRESUMO
BACKGROUND: Several instruments have been designed to assess the childbirth experience. The Childbirth Experience Questionnaire (CEQ) is one of the most widely used tools. There is an improved version of this instrument, the Childbirth Experience Questionnaire (CEQ 2.0), which has not been adapted or validated for use in Spain. The aim of present study is to adapt the CEQ 2.0 to the Spanish context and evaluate its psychometric properties. METHODS: This research was carried out in 2 stages. In the first stage, a methodological study was carried out in which the instrument was translated and back-translated, content validity was assessed by 10 experts (by calculating Aiken's V coefficient) and face validity was assessed in a sample of 30 postpartum women. In the second stage, a cross-sectional study was carried out to evaluate construct validity by using confirmatory factor analysis, reliability evaluation (internal consistency and temporal stability) and validation by known groups. RESULTS: In Stage 1, a Spanish version of the CEQ 2.0 (CEQ-E 2.0) was obtained with adequate face and content validity, with Aiken V scores greater than 0.70 for all items. A final sample of 500 women participated in Stage 2 of the study. The fit values for the obtained four-domain model were RMSEA = 0.038 [95% CI: 0.038-0.042], CFI = 0.989 [95% CI: 0.984-0.991], and GFI = 0.990 [95% CI: 0.982-0.991]. The overall Omega and Cronbach's Alpha coefficients were 0.872 [95% CI: 0.850-0.891] and 0.870 [95% CI: 0.849-0.890] respectively. A coefficient of intraclass correlation of 0.824 [95% CI: 0.314-0.936] (p ≤ 0.001) and a concordance coefficient of 0.694 [95% CI: 0.523-0.811] were obtained. CONCLUSIONS: The Spanish version of CEQ 2.0 (CEQ-E 2.0), has adequate psychometric properties and is a valid, useful, and reliable instrument for assessing the childbirth experience in Spanish women.
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Parto , Gravidez , Feminino , Humanos , Psicometria , Reprodutibilidade dos Testes , Estudos Transversais , Inquéritos e QuestionáriosRESUMO
PURPOSE: To translate and culturally adapt the Core Outcome Measures Index for the back (COMI-back) into Thai and to evaluate its psychometric properties in Thai-speaking patients with low back pain (LBP). METHODS: The translation process followed a standardized forward-backward method with two independent translators, followed by synthesis and back-translation. An expert committee reviewed the translations for cultural and conceptual equivalence. Pre-testing was done with Thai patients to refine the questionnaire. The validation study included 131 patients with LBP, who completed the Thai COMI-Back along with other validated questionnaires like the Oswestry Disability Index (ODI), and EQ-5D-5L. Reliability was assessed using Cronbach's alpha and intraclass correlation coefficients (ICC). Construct validity was determined by correlating COMI scores with those of reference scales. RESULTS: The Thai COMI-Back exhibited strong reliability, with Cronbach's alpha values from 0.89 to 0.93 and ICC values over 0.80 for all domains. Construct validity was supported by significant correlations with reference scales, with Spearman's rho values ranging from 0.47 to 0.84. Floor and ceiling effects were acceptable for most items, with notable exceptions for symptom-specific well-being and work disability. CONCLUSION: The Thai COMI-Back shows strong psychometric properties, making it suitable for clinical and research use in Thailand.
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BACKGROUND: The healthcare system is currently facing challenges in transitioning to a more integrated, patient-centered care. China has implemented various practical exploration and pilot programs in developing an integrated healthcare service system. However, there remains an absence of appropriate instrument to assess integrated care from the patient's perspective, particularly one that aligns with China's national conditions. METHODS: Using a literature review, Delphi methods, a pilot study involving 171 chronic patients in Guangdong Province, and the analytic hierarchy process, we developed and validated the Chinese Patient-Centered Integrated Care (CPCIC) with a weighting system. RESULTS: The results of exploratory factor analysis indicated CPCIC scale had robust structural validity. The overall Cronbach's α coefficient was 0.868, signifying excellent internal consistency. The final scale included four first-level indicators (dimensions): services responsiveness, services convenience, services continuity and services coordination and 14 s-level indicators (items). The assigned weights of these dimensions were 0.1070, 0.2926, 0.4155 and 0.1849, respectively. CONCLUSIONS: The four-dimension, 14-item CPCIC scale with a weighting system was successfully developed and validated. The scale provides a reliable and valid instrument for evaluating the degree of integrated care from the patient's perspective, and has potential applications in informing the reform of China's healthcare system to enhance patient-centered care.
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Prestação Integrada de Cuidados de Saúde , Técnica Delphi , Assistência Centrada no Paciente , Psicometria , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , China , Prestação Integrada de Cuidados de Saúde/organização & administração , Análise Fatorial , Assistência Centrada no Paciente/organização & administração , Projetos Piloto , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Frozen Shoulder (FS) is a painful condition characterized by severe pain and progressive restriction of shoulder movement, leading to functional impairment and reduced quality of life. While different Patient Reported Outcome Measurements (PROMs) tools exist for assessing shoulder diseases, few specific PROMs are validated for FS patients. PURPOSE: This study aims to assess the psychometric properties of the Disability of Arm, Shoulder, and Hand (DASH) questionnaire in FS patients. METHODS: One hundred and twenty-four subjects (mean ± SD age = 55.4 ± 7.9 years; 55.6% female) diagnosed with FS were included and completed the DASH questionnaire, the Numerical Pain Rating Scale (NPRS), the Shoulder Pain and Disability Index (SPADI), and the Short-Form Health Survey 36 (SF-36). Floor or ceiling effects were investigated. Structural validity was analysed through a unidimensional Confirmatory Factor Analysis (CFA), internal consistency through Cronbach's alpha, test-retest reliability through the Intraclass Correlation coefficient (ICC), measurement error through the Standard Error of Measurement (SEM), and the Minimum Detectable Change (MDC), and construct validity through the hypothesis testing with the correlation with the other outcome measures used. RESULTS: No floor or ceiling effects were observed. CFA confirmed a one-factor structure after addressing local item dependency (Root Mean Square Error of Approximation = 0.055; Standardized Root Mean Square Residual = 0.077; Comparative Fit Index = 0.970; Tucker-Lewis Index = 0.968). Cronbach's alpha was high (= 0.951), and test-retest reliability was excellent (ICC = 0.999; 95% CI: 0.998-1.000). SEM was equal to 0.5 points, and MDC to 1.5 points. Construct validity was considered satisfactory as 80% of the a-priori hypotheses were met. CONCLUSION: The DASH questionnaire demonstrated good psychometric properties in FS patients, supporting its use as a valuable tool for assessing the impact of FS in clinical and research settings.
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Bursite , Ombro , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Braço , Psicometria , Reprodutibilidade dos Testes , Qualidade de Vida , Dor de Ombro/diagnóstico , Inquéritos e Questionários , Bursite/diagnóstico , Avaliação da DeficiênciaRESUMO
PURPOSE: Management reasoning is a distinct subset of clinical reasoning. We sought to explore features to be considered when designing assessments of management reasoning. METHODS: This is a hybrid empirical research study, narrative review, and expert perspective. In 2021, we reviewed and discussed 10 videos of simulated (staged) physician-patient encounters, actively seeking actions that offered insights into assessment of management reasoning. We analyzed our own observations in conjunction with literature on clinical reasoning assessment, using a constant comparative qualitative approach. RESULTS: Distinguishing features of management reasoning that will influence its assessment include management scripts, shared decision-making, process knowledge, illness-specific knowledge, and tailoring of the encounter and management plan. Performance domains that merit special consideration include communication, integration of patient preferences, adherence to the management script, and prognostication. Additional facets of encounter variation include the clinical problem, clinical and nonclinical patient characteristics (including preferences, values, and resources), team/system characteristics, and encounter features. We cataloged several relevant assessment approaches including written/computer-based, simulation-based, and workplace-based modalities, and a variety of novel response formats. CONCLUSIONS: Assessment of management reasoning could be improved with attention to the performance domains, facets of variation, and variety of approaches herein identified.
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AIMS: To test the clinical validity of clinical indicators and causal relationships of aetiological factors of the new nursing diagnosis of inadequate health self-efficacy in people with hypertension. BACKGROUND: The diagnosis of inadequate health self-efficacy has both theoretical and content validity. However, a clinical validation study is needed to establish an appropriate framework for distinguishing individuals who manifest this unique human response. DESIGN: The study adopts a cross-sectional clinical validation approach, adhering strictly to the STROBE guidelines throughout its design and implementation. METHODS: Naturalistic sampling was used to identify 302 adults diagnosed with hypertension. Their data were subjected to latent class analysis, which facilitated the identification of a comprehensive set of clinical indicators that demonstrated better diagnostic accuracy and established posterior probabilities to guide the inference of inadequate health self-efficacy. In addition, logistic regression analysis was used to assess the magnitude of the impact of aetiological factors. RESULTS: The prevalence of inadequate health self-efficacy was 76.61%. Among the 13 indicators examined, seven demonstrated notable sensitivity: 'risk-prone health behaviour', 'failure to take action that prevents health problems', 'inadequate self-control', 'avoidance behaviours', 'negative health self-perception', 'inadequate health-related quality of life' and 'difficulty feeling good about adopting a healthy lifestyle'. Additionally, two indicators showed high specificity: 'difficulty feeling good about adopting a healthy lifestyle' and 'inadequate adherence to treatment regimen'. Notably, 15 aetiological factors were identified as significantly associated with an increased risk of inadequate health self-efficacy. CONCLUSIONS: A clinical framework consisting of eight clinical indicators and 15 aetiological factors was developed to characterise inadequate health self-efficacy in individuals with hypertension. RELEVANCE TO PRACTICE: Clinical validation provides insight into the precision of clinical indicators and the magnitude of the effect of putative causal elements, thereby facilitating identification and tailored intervention for individuals with hypertension and inadequate health self-efficacy.
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Orthorexia Nervosa (ON) is characterized by an excessive preoccupation with healthy foods accompanied by the avoidance of self-declared unhealthy options, yet it remains unrecognized in major diagnostic guidelines. The Düsseldorf Orthorexia Scale (DOS), a 10-item self-report questionnaire using a four-point Likert scale, assesses the obsession with healthy eating. This study evaluates the reliability and validity of the TR-DOS in the Turkish context and estimates the prevalence of ON among university students. Several studies have shown that translating the DOS into various linguistic groups may exhibit different models of DOS scores. However, the psychometric properties and model fit of the DOS have not yet been investigated in Turkish-speaking populations; to address this gap, we assessed the psychometric properties of a Turkish translation of DOS (TR-DOS) in a sample of 425 university students in Türkiye. The TR-DOS revealed a 7.3% ON prevalence and a 9.0% risk of development. Weak positive associations were observed between TR-DOS total scores and BMI (r = 0.152, p = .002). Exploratory Factor Analysis confirmed the validity of TR-DOS (KMO = 0.867) with satisfactory reliability (Cronbach's alpha = 0.854). Confirmatory Factor Analysis indicated an acceptable fit for the TR-DOS model (χ2/df = 3.127, RMSEA = 0.071, SRMR = 0.046, IFI = 0.955, CFI = 0.955, GFI = 0.956, TLI = 0.932). Moderate positive correlations were found between TR-DOS and eating disorder measures (EAT-26: r = 0.428, p < .001; EDE-Q-13: r = 0.430, p < .001). The findings demonstrated that the TR-DOS is both culturally appropriate and psychometrically adequate for Turkish university students. It is a reliable and valid instrument for assessing obsessive healthy eating behaviors in this population.
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OBJECTIVE: To analyze the relevance of a set of clinical elements to represent the content domain of the nursing diagnosis Ineffective Protection. DESIGN AND METHODS: This study employed content validation, using expert judgment to assess the appropriateness of clinical indicators, etiological factors, and conceptual and operational definitions, integrating the collective wisdom framework, the theory of predictive diversity, and the determination of rater skill level. RESULTS: From the middle range theory, 28 clinical indicators and 17 etiological factors were identified, which were rated by 34 raters. The analysis showed that the clinical indicators restlessness and insomnia and the etiological factors ambient temperature and humidity were not considered relevant for the nursing diagnosis of Ineffective Protection, because the median content validity index was lower than 0.9. CONCLUSIONS: Content validation verified that most of the components of the nursing diagnosis of Ineffective Protection were considered relevant by judges. PRACTICAL IMPLICATIONS: It is believed that the data obtained can help nurses to more easily evaluate the related factors and clinical indicators of Ineffective Protection presented by adolescents with cancer, which favors the process of diagnostic inference.
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Neoplasias , Diagnóstico de Enfermagem , Humanos , Neoplasias/enfermagem , Adolescente , Feminino , MasculinoRESUMO
OBJECTIVE: This study aimed to develop the Turkish version of the Orofacial Esthetic Scale (OES-Tr) and to evaluate its psychometric properties. MATERIALS AND METHODS: The OES-Tr questionnaire was obtained from the English version of OES by translation and back-translation. The current version's psychometric properties were evaluated in a cohort of 221 participants (81 dental students, 70 dentists with 1-10 years of clinical experience, and 70 dentists with 11-20 years of clinical experience). To assess the test-retest reliability, the OES was administered twice to all participants, with a time interval of 2-4 weeks. The reliability and validity of the questionnaire were assessed. Also, in validity studies, OES total scores were correlated with Oral Health Impact Profile-Turkish Version (OHIP-Tr) total scores. RESULTS: The Cronbach's alpha value obtained from seven items was 0.866 in the examination performed on all individuals. Reliability results show that all questionnaire items are consistent within the test. Bartlett's test of sphericity was statistically significant (p < 0.05) and Kaiser-Meyer-Olkin test was 0.794. The results of the exploratory factor analysis indicated the creation of a single-factor structure. The examinations conducted on all participants revealed a statistically significant weak negative correlation between OES and OHIP scores (r = -0.144). CONCLUSIONS: OES-Tr can be utilized as a reliable tool to evaluate an individual's perception of their orofacial appearance. With its excellent psychometric properties, it serves as a valuable instrument for assessing self-perceived orofacial esthetics. CLINICAL SIGNIFICANCE: OES-Tr is a valuable instrument for assessing the appearance of the orofacial region, with good psychometric properties.
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Estética Dentária , Psicometria , Humanos , Turquia , Inquéritos e Questionários , Feminino , Masculino , Reprodutibilidade dos Testes , AdultoRESUMO
BACKGROUND: The purpose of this study was to examine the reliability and validity of the Turkish version of the Nursing Activities Score. METHODS: To validate the Turkish version of the Nursing Activities Score, a sample comprising 30 adult intensive care patients and 30 nurses was employed. After a pilot study, the internal consistency, Cronbach's alpha coefficient, was found to be p = 0.718. Following the significant internal consistency obtained in the pilot study, the correlation between Nursing Activities Score internal consistency and Critical Nursing Situation Index scores was examined in 150 adult intensive care patients and 150 nurses. RESULTS: The assessment of inter-rater reliability showed a high level of agreement (99%) and an average Kappa index of 0.598 (p < 0.001). Concurrent validity was demonstrated through a statistically significant correlation between Nursing Activities Score and the Critical Nursing Situation Index (r = 0.71, p < 0.001) and multivariate regression analysis (R2 = 83%, p < 0.001). The validity is supported by the statistically significant relationship between Nursing Activities Score and Critical Nursing Situation Index. CONCLUSION: These results demonstrate that Nursing Activities Score is a valid and reliable tool for measuring nursing workload in Turkish intensive care units. TRIAL REGISTRATION: Samsun University Samsun Training and Research Hospital, following ethics committee approval (Samsun University clinical research ethics committee (KAEK) 202312/2) and Clinical Trials (NCT04928040) registration.
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BACKGROUND: The assessment of plaque indices may be time-consuming and error-prone. Simplification of these indices may increase their utility without compromising their validity. The aim of this study was to evaluate the validity of two simplified versions of the Marginal Plaque Index (MPI). METHODS: Two simplified versions of the MPI as well as the Plaque Control Record (PCR) were derived from full-scale MPI assessments in two studies with four age groups (N = 42 10-year-olds; N = 24 15 year-olds; N = 53 university students (18y-33y); N = 66 parents (32y-57y). Correlations with the Turesky modification of the Quigley-Hein Index (TQHI) and the Papillary Bleeding Index (PBI) were calculated. RESULTS: The indices derived from the MPI showed high convergence with each other (all r ≥ 0.94) and with the TQHI (r ≥ 0.80). The concurrent validity of the MPI with the PBI was equal to that of the TQHI in all age groups. The simplified versions of the MPI and the PCR show a lower convergent validity with the PBI than the MPI within parents (p < 0.05). In the other age groups, their convergent validity was equal to that of the MPI. DISCUSSION: Simplification of the MPI does not affect its convergent validity with other plaque indices but may reduce its concurrent validity with the PBI in middle-aged adults.
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Índice de Placa Dentária , Humanos , Adulto , Criança , Masculino , Adulto Jovem , Feminino , Adolescente , Pessoa de Meia-Idade , Placa Dentária , Reprodutibilidade dos Testes , Fatores Etários , PaisRESUMO
Background and Objectives: The Walking Impairment Questionnaire (WIQ) is a short and simple tool to measure walking impairment for patients with peripheral arterial disease requiring no special equipment or trained staff. The aim of this study was to assess the validity and reliability of the culturally adapted Lithuanian WIQ version in patients with intermittent claudication. Materials and Methods: In total, 40 patients with intermittent claudication and ankle-brachial index < 0.90 participated in this study. Reliability and internal consistency of the questionnaire were assessed by the intra-class correlation coefficient (ICC) and Cronbach's alpha (α), respectively. Validity was determined by correlations between the WIQ scores and a subjective test (Quality of Life 5 Dimension Questionnaire 3 Level Version (EQ-5D-3L)) and objective tests (6 min walk test (6MWT), treadmill test, and ankle-brachial index). Results: The test-retest reliability was assessed as excellent with an intraclass correlation coefficient of 0.90. The values of Cronbach's alpha were 0.957 (I time) and 0.948 (II time) and indicated an excellent internal consistency. Statistically significant Spearman correlations were detected between the WIQ and walking distances on the 6MWT (rho 0.514, p < 0.001) and treadmill test (rho 0.515, p < 0.001). Higher WIQ scores were associated with longer walking distances and duration. Moderate negative and low negative correlations were found between the WIQ and EQ-5D-3L scores. Conclusions: The Lithuanian version of culturally adapted WIQ demonstrates reliability and validity for patients with intermittent claudication, supported by two different walking tests showing statistically significant moderate Spearman correlations.
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Claudicação Intermitente , Doença Arterial Periférica , Humanos , Claudicação Intermitente/diagnóstico , Lituânia , Qualidade de Vida , Reprodutibilidade dos Testes , Doença Arterial Periférica/complicações , Doença Arterial Periférica/diagnóstico , CaminhadaRESUMO
Regression calibration is a popular approach for correcting biases in estimated regression parameters when exposure variables are measured with error. This approach involves building a calibration equation to estimate the value of the unknown true exposure given the error-prone measurement and other covariates. The estimated, or calibrated, exposure is then substituted for the unknown true exposure in the health outcome regression model. When used properly, regression calibration can greatly reduce the bias induced by exposure measurement error. Here, we first provide an overview of the statistical framework for regression calibration, specifically discussing how a special type of error, called Berkson error, arises in the estimated exposure. We then present practical issues to consider when applying regression calibration, including: 1) how to develop the calibration equation and which covariates to include; 2) valid ways to calculate standard errors of estimated regression coefficients; and 3) problems arising if one of the covariates in the calibration model is a mediator of the relationship between the exposure and outcome. Throughout, we provide illustrative examples using data from the Hispanic Community Health Study/Study of Latinos (United States, 2008-2011) and simulations. We conclude with recommendations for how to perform regression calibration.
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Saúde Pública , Humanos , Calibragem , Análise de Regressão , ViésRESUMO
The Critical Success Index (CSI) and Gilbert Skill score (GS) are verification measures that are commonly used to check the accuracy of weather forecasting. In this article, we propose that they can also be used to simplify the joint interpretation of positive predictive value (PPV) and sensitivity estimates across diagnostic accuracy studies of epilepsy data. This is because CSI and GS each provide a single measure that takes the weather forecasting equivalent of PPV and sensitivity into account. We have re-analysed data from our recent systematic review of diagnostic accuracy studies of administrative epilepsy data using CSI and GS. We summarise the results and benefits of this approach.
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Epilepsia , Humanos , Valor Preditivo dos Testes , Epilepsia/diagnóstico , Previsões , Tempo (Meteorologia) , Sensibilidade e EspecificidadeRESUMO
INTRODUCTION: The Memory Complaint Scale (MCS-15) is a 15-item instrument to explore frequent forgetfulness in daily life in people with possible cognitive impairment. However, knowledge about its psychometric performance is limited. OBJECTIVE: The objective of this study was to know the dimensionality and internal consistency of the MCS-15 in Colombian older adults. METHODS: A probabilistic sample of 1,957 older adults from the general Colombian population was taken, aged between 60 and 98 years (mean = 71.0 ± 7.9), and 62.2% were women. Internal consistency (Cronbach's alpha and McDonald's omega) and dimensionality (exploratory and confirmatory factor analysis) were calculated for the original and ten-item versions. RESULTS: The 15-item version showed Cronbach's alpha and McDonald's omega of 0.91, and one dimension accounted for 45.3% of the variance. A version of ten items showed Cronbach's alpha and McDonald's omega of 0.89 and a single factor that explained 50.9% of the variance with better indicators in the confirmatory factor analysis. Convergence with the shortened Mini-Mental State Examination was rs = 0.43 (p < 0.001), and the Montreal Cognitive Assessment test was rs = 0.38 (p < 0.001). The nomological validity with the geriatric depression scale was rs = 0.44 (p < 0.001), and women scored higher than men (p < 0.001). CONCLUSIONS: The MCS-15 shows high internal consistency with poor dimensionality. However, a ten-item version shows high internal consistency and a clear one-dimensional structure. More research is needed: testing the performance against a structured interview for major cognitive impairment.
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Disfunção Cognitiva , Masculino , Humanos , Feminino , Idoso , Idoso de 80 Anos ou mais , Psicometria , Colômbia , Reprodutibilidade dos Testes , Análise Fatorial , Disfunção Cognitiva/diagnóstico , Inquéritos e QuestionáriosRESUMO
The SeqStudio™ for human identification (HID) is a new benchtop capillary electrophoresis (CE) platform recently developed by Applied Biosystems for genotyping and sequencing short tandem repeat (STR) fragments. Compared to the previous series of CE systems developed by this maker, it is more compact and easier to use. Moreover, by allowing the detection of 4 to 8 fluorescent dyes, it seems to be fully compatible with the different kits of autosomal and gonosomal STR markers usually used in forensic genetics, which are available in trade and supplied by various manufacturers. However, being a new CE model, before its routine use in forensic genetics applications, it should undergo appropriate analytical validation studies in its own laboratories to understand its potential and limitations. A series of experiments on DNA samples coming from cell line controls, using the GlobalFiler™ IQC Amplification Kit, were carried out to meet this purpose. The SeqStudio™ Genetic Analyzer for HID's findings on genotyping reproducibility (precision and accuracy of sizing), sensitivity, signal variability between dyes (intra- and inter-color channel balance), and stutter ratios are reported. These findings confirm the validity of this new CE system and its capability to generate reliable results.