Readability of patient-reported outcome questionnaires for use with persons with tinnitus.

OBJECTIVES: The readability of 15 tinnitus-focused, patient-reported outcome (PRO) questionnaires was analyzed. DESIGN: Reading grade levels were analyzed using the Flesch Reading Ease, FOG, and FORCAST formulas as computed by a readability calculations software package. RESULTS: The results of this study demonstrate that the majority of questionnaires exceeded the fifth- to sixth-grade reading levels recommended by health literacy experts regardless of the formula applied. CONCLUSIONS: In the demand for standardization of tinnitus assessment tools, developers and clinicians should consider readability as another testable construct, as poor readability may affect both validity and reliability.

Criterion groups validation of the Seashore Rhythm Test and Speech Sounds Perception Test for the detection of malingering in traumatic brain injury.

A criterion-groups validation was used to determine the classification accuracy of the Seashore Rhythm Test (SRT) and Speech Sounds Perception Test (SSPT) in detecting malingered neurocognitive dysfunction (MND) in traumatic brain injury (TBI). TBI patients were classified into the following groups: (1) Mild TBI Not-MND (n = 24); (2) Mild TBI MND (n = 27); and (3) Moderate/Severe TBI Not-MND (n = 23). A sample of 90 general clinical patients was utilized for comparison. Results showed that both SRT correct and SSPT errors differentiated malingerers from non-malingerers in the Mild TBI sample. At 96% specificity, sensitivities were 37% for SRT correct and 59% for SSPT errors. Joint classification accuracy showed that the best accuracy was achieved when using a cut-off associated with a 4% false positive error rate in the Mild TBI sample. Specificity was considerably lower in the Moderate/Severe TBI and General Clinical groups. The clinical application of these findings is discussed.

The relationship between the modified somatic perception questionnaire and dynamic platform posturography.

OBJECTIVE: To analyze if patients whose vestibular symptoms are associated with nonorganic sway patterns show more evidence of somatization and/or malingering than patients whose vestibular symptoms are associated with normal or physiologically abnormal sway patterns observed in people with documented vestibular pathologic findings. PATIENTS: One hundred fifteen patients with complaints of vestibular dysfunction and hearing impairment. INTERVENTIONS: Computerized dynamic posturography (CDP) and completion of the Modified Somatic Perception Questionnaire (MSPQ)--a validated test for the detection of malingering. MAIN OUTCOME MEASURES: Computerized dynamic posturography results classified into 4 categories (normal, physiologic abnormal, borderline-aphysiologic, and aphysiologic) were correlated with the results of the MSPQ. RESULTS: A significant CDP group effect on the MSPQ, with the aphysiologic patients scoring significantly higher than the other groups. Moreover, a significantly higher proportion of aphysiologic patients scored more than the MSPQ cutoffs for malingering. CONCLUSION: Results indicate that patients who have aphysiologic CDP sway patterns are more likely to have higher MSPQ scores. Both aphysiologic CDP results and high MSPQ scores have been associated with intentional exaggeration. These results indicate that patients with both aphysiologic CDP findings and high MSPQ scores are more likely to be intentionally exaggerating their balance-related complaints and deficits.