Test of Practical Judgment (TOP-J): Construct, Criterion, and Incremental Validity in a Community Sample of Older Adults.

OBJECTIVE: The Test of Practical Judgment (TOP-J) is a stand-alone judgment measure that is considered to tap into aspects of executive functioning (EF) and inform clinical predictions of daily functioning in older adults. Past validation research is variable and has some limitations. The present study sought to examine the reliability and construct, criterion, and incremental validities of scores on TOP-J 9-item version (TOP-J/9). METHOD: Participants were 95 community-dwelling older adults aged 60 to 85. Participants completed TOP-J/9, measures of EF and global cognition, and three different modalities of instrumental activities of daily living (IADLs) (self-report, performance-based tasks conducted in the laboratory, and performance-based tasks completed at home over 3 weeks). RESULTS: TOP-J/9 scores showed adequate internal consistency (α = 0.73) after correcting for the low number of items. TOP-J/9 was correlated with global cognition and EF, although EF did not survive correction for lower-order processes. Finally, although TOP-J/9 scores were associated with home-based IADL tasks (but not with self-report and laboratory-based IADLs), providing some evidence of criterion validity, they did not incrementally contribute to home-based IADL performance beyond other cognitive measures. However, when two items pertaining to social/ethical judgment were removed, this modified version of TOP-J did relate to EF beyond lower-order processes and contributed uniquely to prediction of home-based IADLs beyond other measures. CONCLUSION: Results suggest that TOP-J/9 taps into global cognitive status (but not necessarily EF) and predicts "real-world" functioning (but not above and beyond other cognitive measures). TOP-J psychometrics may be improved by removing two social/ethical items.

Construindo escalas de autorrelato: o que fazer? / Developing self-report scales: what to do? / Construcción de escalas de autoinforme: ¿qué hacer?

Escalas de autorrelato são comuns no cotidiano de pesquisadores, porém detalhes, que às vezes parecem de pouca importância, acabam sendo desconsiderados. Autorrelato são caracterizados pela pessoa de interesse ser a própria fonte de informação do pesquisador, assim a forma em que as possibilidades de resposta são apresentadas é de suma importância. Os formatos de resposta mais comuns são tipo Likert e as escolhas forçadas que vem ganhando popularidade nos últimos anos. Neste artigo são apresentados os elementos necessários que devem ser observados quando se constrói ou se escolhe escalas que possuam esses dois formatos de resposta. São discutidos também a quantidade de itens ou blocos necessários, as opções de resposta, polaridade dos itens, sistema de correção, bem como ao final são indicadas boas práticas na construção de itens para ambos os formatos. Dessa forma, pretende-se contribuir para a Psicologia, em especial a área de construção de instrumentos de autorrelato.(AU)

Self-report scales are common in the daily lives of researchers, however, details, which sometimes seem of little importance, can end up being disregarded. Self-reports are characterized by the person of interest being the researcher's own source of information, therefore the way in which the response possibilities are presented is of paramount importance. The most common response formats are Likert type and forced choice, which have been gaining popularity in recent years. This article presents the elements that must be observed when developing or choosing scales that have these two response formats. Also discussed are the number of items or blocks needed, the answer options, item polarity, the correction system, and good practices in the construction of items for both formats. The intention is to contribute to Psychology, especially the area of construction of self-report instruments.(AU)

Las escalas de autoinforme son habituales en el día a día de los investigadores, pero los detalles, que a veces parecen de poca importancia, acaban siendo desestimados. Los autoinformes se caracterizan porque la persona de interés es la propia fuente de información del investigador, por lo que la forma en que se presentan las posibilidades de respuesta es de suma importancia. Los formatos de respuesta más comunes son tipo Likert y las elecciones forzadas, que han ido ganando popularidad en los últimos años. Este artículo presenta los elementos necesarios que se deben observar al momento de construir o elegir escalas que tengan estos dos formatos de respuesta. También se discute la cantidad de ítems o bloques necesarios, las opciones de respuesta, la polaridad de los ítems, el sistema de corrección, así como las buenas prácticas en la construcción de ítems para ambos formatos. De esta forma, se pretende contribuir a la Psicología, especialmente al área de construcción de instrumentos de autoinforme.(AU)

Validation of Identifying Cancer Diagnosis Based on Self-Reported Information in the Japan Nurses' Health Study.

BACKGROUND: The Japan Nurses' Health Study (JNHS) is a large-scale, nationwide prospective cohort study of female nurses. This study aimed to examine the validity of self-reported diagnosis of cancer among the JNHS cohort members (N=15,019). METHODS: For women who reported any diagnosis of five cancers (stomach, colorectal, liver, lung and thyroid) in the biennial follow-up surveys, an additional outcome survey, medical facility survey, and confirmation of death certificate (DC) were conducted. The JNHS Validation Study Committee (referred to as "the committee") made a final decision on the reported outcomes. To examine the validity of self-reported diagnosis of cancer, the positive predictive value (PPV) was calculated using the committee's decision as the gold standard. To examine the validity of the committee's decision based on self-reports and DCs, PPV was calculated using physician-reported information as the gold standard. RESULTS: The PPV of self-reported diagnosis in the biennial follow-up surveys was 77.8% for stomach, 66.2% for colorectal, 41.7% for liver, 60.2% for lung, and 64.6% for thyroid cancer. The corresponding PPVs in the additional outcome survey were 96.2%, 80.7%, 62.5%, 82.5%, and 96.9%, respectively. The PPV of the committee's decision was 100% for stomach, 87.5% for colorectal, 94.7% for lung, and 100% for thyroid cancer (data not available for liver cancer). The proportion of DC-only cases among committee-defined cases was below 10% for all cancers except liver cancer (28.6%). CONCLUSIONS: The validity of identifying cancer diagnosis based on self-reported information in the JNHS was favorable for stomach, colorectal, lung and thyroid cancer.

Reliability of patient self-report of cognition, awareness, and consciousness during seizures.

OBJECTIVE: Clinicians rely on patient self-report of impairment during seizures for decisions including driving eligibility. However, the reliability of patient reports on cognitive and behavioral functions during seizures remains unknown. METHODS: We administered a daily questionnaire to epilepsy patients undergoing continuous video-EEG monitoring, asking about responsiveness, speech, memory, awareness, and consciousness during seizures in the preceding 24 hours. We also administered a questionnaire upon admission about responsiveness, speech, and awareness during seizures. Subjective questionnaire answers were compared with objective behavioral ratings on video review. Criteria for agreement were Cohen's kappa >0.60 and proportions of positive and negative agreement both >0.75. RESULTS: We analyzed 86 epileptic seizures in 39 patients. Memory report on the daily questionnaire met criteria for agreement with video review (κ = 0.674 for early, 0.743 for late recall). Subjective report of awareness also met agreement criteria with video ratings of memory (κ = 0.673 early, 0.774 late). Concordance for speech was relatively good (κ = 0.679) but did not meet agreement criteria, nor did responsiveness or consciousness. On the admission questionnaire, agreement criteria were met for subjective report of awareness versus video ratings of memory (κ = 0.814 early, 0.806 late), but not for other comparisons. INTERPRETATION: Patient self-report of memory or awareness showed the best concordance with objective memory impairment during seizures. Self-report of impairment in other categories was less reliable. These findings suggest that patient reports about impaired memory during seizures may be most reliable, and otherwise determining functional impairments should be based on objective observations.

Mental health in the UK Biobank: A roadmap to self-report measures and neuroimaging correlates.

The UK Biobank (UKB) is a highly promising dataset for brain biomarker research into population mental health due to its unprecedented sample size and extensive phenotypic, imaging, and biological measurements. In this study, we aimed to provide a shared foundation for UKB neuroimaging research into mental health with a focus on anxiety and depression. We compared UKB self-report measures and revealed important timing effects between scan acquisition and separate online acquisition of some mental health measures. To overcome these timing effects, we introduced and validated the Recent Depressive Symptoms (RDS-4) score which we recommend for state-dependent and longitudinal research in the UKB. We furthermore tested univariate and multivariate associations between brain imaging-derived phenotypes (IDPs) and mental health. Our results showed a significant multivariate relationship between IDPs and mental health, which was replicable. Conversely, effect sizes for individual IDPs were small. Test-retest reliability of IDPs was stronger for measures of brain structure than for measures of brain function. Taken together, these results provide benchmarks and guidelines for future UKB research into brain biomarkers of mental health.

Repeatability of dyspnea measurements during exercise in women with obesity.

While the 0-10 Borg scale to rate perceived breathlessness (RPB) is widely used to assess dyspnea on exertion, the repeatability of RPB in women with obesity is unknown. We examined the repeatability of RPB in women with obesity during submaximal constant-load cycling following at least 10 weeks of normal daily life. Seventeen women (37 ± 7 yr; 34.6 ± 4.5 kg/m2) who rated their breathlessness as 3 on the Borg scale (i.e., "moderate") during 60 W submaximal cycling repeated the same test following 19 ± 9 weeks of normal living. Mean body weight (93.8 ± 16.1 vs. 93.6 ± 116.8 kg, p = 0.94) and RPB (3.0 ± 0.0 vs. 3.1 ± 1.4, p = 0.80) did not differ between pre- and post-normal living periods. We demonstrate that subjective ratings of breathlessness are repeatable for the majority of subjects and can be used to accurately assess DOE during submaximal constant-load cycling in women with obesity.

Examining the Item-Level Factor Structure of the Behavior Rating Inventory of Executive Function-Adult Version Within a Traumatic Brain Injury Sample.

OBJECTIVE: To conduct the first item-level exploration of scale and index structure of the self-report Behavior Rating Inventory of Executive Function-Adult version (BRIEF-A) in traumatic brain injury (TBI). DESIGN: This was an observational cross-sectional study design using secondary data. We conducted exploratory factor analyses (EFA) to explore the index structure and scale structure of the BRIEF-A. We conducted EFA with all 70 items of the BRIEF-A to examine the index structure. Based on the finding of index structure, we conducted EFA on the 30 items of the Behavioral Regulation Index (BRI) and the 40 items of the Metacognitive Index (MI). SETTING: Data were collected through 5 studies in outpatient and community settings in the southeast United States. PARTICIPANTS: Individuals (N=338) aged 18-89 years with a history of mild to severe TBI who were able to speak English fluently. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The BRIEF-A. RESULTS: The 2-factor structure aligned with the BRIEF-A manual at the index level. Scale structure for the MI (40 items) resulted in 1 factor, whereas the BRI (30 items) could be represented by either a 2- or 3-factor structure. The 2-factor structure of the BRI is more parsimonious and matched other factor analyses derived from the sum of scale items. CONCLUSIONS: We confirmed the manual designated index structure (BRI and MI) of the BRIEF-A but took precautions against using the 9 scales. Instead, we recommend using the 2 designated index scores and 2 newly identified composite scores representing Behavioral Control Trait and Emotional Control Trait.

A systematic review of self-report measures used in epidemiological studies to assess alcohol consumption among older adults.

BACKGROUND: There is a lack of standardization regarding how to assess and categorize alcohol intake in older adults. The aim of this study was to systematically review methods used in epidemiological studies to define drinking patterns and measure alcohol consumption among older adults. METHODS: A systematic search was conducted in the MEDLINE, PubMed, PsycINFO, EMBASE, and CINAHL databases for studies published from January 2009 to April 2021. Studies were included if they were observational studies with a quantitative design; the mean age of the participants was ≥ 65 years; questionnaires, screening tools, or diagnostic tools were used to define alcohol consumption; and alcohol consumption was self-reported. RESULTS: Of 492 studies considered, 105 were included. Among the 105 studies, we detected 19 different drinking patterns, and each drinking pattern had a wide range of definitions. The drinking patterns abstaining from alcohol, current drinking, and risk drinking had seven, 12 and 21 diverse definitions, respectively. The most used questionnaire and screening tools were the quantity-frequency questionnaire, with a recall period of 12 months, and the full and short versions of the Alcohol Use Disorders Identification Test, respectively. CONCLUSION: No consensus was found regarding methods used to assess, define, and measure alcohol consumption in older adults. Identical assessments and definitions must be developed to make valid comparisons of alcohol consumption in older adults. We recommend that alcohol surveys for older adults define the following drinking patterns: lifetime abstainers, former drinkers, current drinkers, risk drinking, and heavy episodic drinking. Standardized and valid definitions of risk drinking, and heavy episodic drinking should be developed. The expanded quantity-frequency questionnaire including three questions focused on drinking frequency, drinking volume, and heavy episodic drinking, with a recall period of 12 months, could be used.

Validación de los datos antropométricos declarados por padres de participantes en el proyecto SENDO / Validation of the anthropometric data reported by parents of participants in the SENDO project

Objetivo: analizar la validez de las medidas antropométricas declaradas por los padres de los participantes en el proyecto SENDO. Método: el proyecto SENDO (SEguimiento del Niño para un Desarrollo Óptimo) es una cohorte pediátrica abierta y prospectiva. Los participantes se reclutan cuando tienen entre 4 y 6 años, y se siguen anualmente mediante un cuestionario “online”. En una submuestra de 82 participantes, se comparó la información antropométrica declarada en el cuestionario basal con las mediciones directas recogidas por el personal investigador. Para ello, se calcularon el índice de correlación intraclase (ICC) y el coeficiente de mala clasificación de Bland-Altman. Resultados: el ICC fue de 0,96 (intervalo de confianza [IC] del 95 %: 0,94-0,98) para el peso; de 0,95 (IC 95 %: 0,92-0,96) para la altura; de 0,75 (IC 95 %: 0,64-0,86) para el perímetro de la cintura, y de 0,84 (IC 95 %: 0,76-0,89) para el perímetro de la cadera. En relación a los índices calculados a partir de esas mediciones, se encontró un ICC de 0,84 (IC 95 %: 0,77-0,90) para el índice de masa corporal; de 0,46 (IC 95 %: 0,27-0,62) para el cociente cintura-cadera, y de 0,59 (IC 95 %: 0,43-0,72) para el índice cintura-altura. El índice de mala clasificación de Bland-Altman osciló entre el 3,7 % para el peso y el 8,5 % para el índice de masa corporal. Conclusiones: se encontró una muy elevada concordancia para la información antropométrica declarada por los padres y la medida de forma directa. Los resultados indican que las medidas antropométricas referidas por los padres, especialmente aquellas con los que están más familiarizados, son válidas y pueden utilizarse en la investigación epidemiológica. (AU)

Objective: to analyze the validity of self-reported somatometry data through a self-reported online questionnaire. Method: the SENDO project (Follow-up of Children for Optimal Development) is a prospective, dynamic pediatric cohort. Participants are recruited when they are between 4 and 6 years old, and followed annually through an online questionnaire. In a subsample of 82 participants, we compared the anthropometric information reported in the baseline questionnaire with the direct measurements collected by the investigating staff. To do this, we calculated the intraclass correlation index (ICC) and the Bland-Altman coefficient. Results: the ICC was 0.96 (95 % confidence interval [CI]: 0.94-0.98 for weight; 0.95 (95 % CI: 0.92-0.96) for height; 0.75 (95 % CI: 0.64-0.86) for waist circumference; and 0.84 (95 % CI: 0.76-0.89) for hip circumference. In relation to the indices calculated from these measurements, we found an ICC of 0.84 (95 % CI: 0.77-0.90) for body mass index; 0.46 (95 % CI: 0.27-0.62) for waist-hip ratio; and 0.59 (95 % CI: 0.43-0.72) for waist-height index. The Bland-Altman index ranged from 3.7 % for weight to 8.5 % for body mass index. Conclusions: we found a high correlation and concordance between the data collected in the physical exam and those reported by the parents. Our results indicate that the anthropometric measures provided by parents, especially those with which they are most familiar, are valid and can be used in epidemiological research. (AU)

Association between self-esteem and efficacy and mental health in people with disabilities.

This study aimed to investigate the association among self-evaluations-such as self-esteem and self-efficacy-self report of depression, and perceived stress among Korean individuals with disabilities. Data from the second wave of the Panel Survey of Employment for the Disabled (collected from 2016-2018) were used. In 2016 and the follow-up in 2018, 4,033 participants were included. We estimated the annual change in both independent variables and the probability of self-report of depression and stress. Generalized estimating equation model and chi-square test were used. Compared with those whose self-esteem and self-efficacy scores were ≥30, those with scores ≤19 were, respectively, 5.825 (95% Confidence Interval [CI]: 4.235-8.011; p < .0001) and 1.494 times (95% CI: 1.233-1.810; p < .0001) more likely to have self-report of depression. The perceived stress of those with self-esteem scores ≤19 or ranging from 20-24 were, respectively, 2.036 (95% CI: 1.510-2.747; p < .0001) and 1.451 times higher (95% CI: 1.269-1.659; p < .0001) than those with self-esteem scores ≥30. There exists an inverse correlation between self-evaluations, such as self-efficacy and self-esteem, and mental health in people with disabilities. The results of this study can be used as a basis for developing interventional strategies and training and intervention programs for people with disabilities. Future research is needed to investigate potential mediating factors among Korean individuals.

[Validation of the anthropometric data reported by parents of participants in the SENDO project]. / Validación de los datos antropométricos declarados por padres de participantes en el proyecto SENDO.

INTRODUCTION: Objective: to analyze the validity of self-reported somatometry data through a self-reported online questionnaire. Method: the SENDO project (Follow-up of Children for Optimal Development) is a prospective, dynamic pediatric cohort. Participants are recruited when they are between 4 and 6 years old, and followed annually through an online questionnaire. In a subsample of 82 participants, we compared the anthropometric information reported in the baseline questionnaire with the direct measurements collected by the investigating staff. To do this, we calculated the intraclass correlation index (ICC) and the Bland-Altman coefficient. Results: the ICC was 0.96 (95 % confidence interval [CI]: 0.94-0.98 for weight; 0.95 (95 % CI: 0.92-0.96) for height; 0.75 (95 % CI: 0.64-0.86) for waist circumference; and 0.84 (95 % CI: 0.76-0.89) for hip circumference. In relation to the indices calculated from these measurements, we found an ICC of 0.84 (95 % CI: 0.77-0.90) for body mass index; 0.46 (95 % CI: 0.27-0.62) for waist-hip ratio; and 0.59 (95 % CI: 0.43-0.72) for waist-height index. The Bland-Altman index ranged from 3.7 % for weight to 8.5 % for body mass index. Conclusions: we found a high correlation and concordance between the data collected in the physical exam and those reported by the parents. Our results indicate that the anthropometric measures provided by parents, especially those with which they are most familiar, are valid and can be used in epidemiological research.

INTRODUCCIÓN: Objetivo: analizar la validez de las medidas antropométricas declaradas por los padres de los participantes en el proyecto SENDO. Método: el proyecto SENDO (Seguimiento del Niño para un Desarrollo Óptimo) es una cohorte pediátrica abierta y prospectiva. Los participantes se reclutan cuando tienen entre 4 y 6 años, y se siguen anualmente mediante un cuestionario "online". En una submuestra de 82 participantes, se comparó la información antropométrica declarada en el cuestionario basal con las mediciones directas recogidas por el personal investigador. Para ello, se calcularon el índice de correlación intraclase (ICC) y el coeficiente de mala clasificación de Bland-Altman. Resultados: el ICC fue de 0,96 (intervalo de confianza [IC] del 95 %: 0,94-0,98) para el peso; de 0,95 (IC 95 %: 0,92-0,96) para la altura; de 0,75 (IC 95 %: 0,64-0,86) para el perímetro de la cintura, y de 0,84 (IC 95 %: 0,76-0,89) para el perímetro de la cadera. En relación a los índices calculados a partir de esas mediciones, se encontró un ICC de 0,84 (IC 95 %: 0,77-0,90) para el índice de masa corporal; de 0,46 (IC 95 %: 0,27-0,62) para el cociente cintura-cadera, y de 0,59 (IC 95 %: 0,43-0,72) para el índice cintura-altura. El índice de mala clasificación de Bland-Altman osciló entre el 3,7 % para el peso y el 8,5 % para el índice de masa corporal. Conclusiones: se encontró una muy elevada concordancia para la información antropométrica declarada por los padres y la medida de forma directa. Los resultados indican que las medidas antropométricas referidas por los padres, especialmente aquellas con los que están más familiarizados, son válidas y pueden utilizarse en la investigación epidemiológica.

Self-report instruments for assessing adherence to warfarin therapy: a systematic review.

BACKGROUND: The assessment of adherence to warfarin therapy is useful in clinical practice due to its wide variability in dose-response and risks of complications. The aim of this study was to investigate validated instruments used to assess adherence to warfarin therapy. METHODS: Information was collected from the MEDLINE (PubMed), LILACS, EMBASE, and Cochrane Library databases. Search strategies were applied for each database, with no time limit or language restriction. Inclusion criteria consisted of study participants of ≥ 18 years of age, from both sexes, on chronic anticoagulation with warfarin for any indication and the use of validated instruments to assess adherence to warfarin therapy. Exclusion criteria consisted of duplicate articles, narrative or systematic reviews, and meta-analyses, as well as case reports/series and experimental studies involving animals. Two independent reviewers performed the following steps: evaluation of titles/abstracts, selection of studies after full reading, data extraction, and evaluation of potential bias. Discrepancies were resolved by a third reviewer. RESULTS: Overall, 19 articles were selected for this systematic review, including 17 cross-sectional studies, one cohort study, and one quasi-experimental study, published from 2009 to 2019. The validated instruments identified in this review were Morisky Medication Adherence Scale (MMAS), the eight-item Morisky Medication Adherence Scale (MMAS-8), Measurement of Treatment Adherence (MTA), and Brief Medication Questionnaire (BMQ). Only MMAS-8 was tested for reliability, using the internal consistency assessment, with Cronbach's α range 0.56-0.71. CONCLUSIONS: This review highlighted a gap in knowledge regarding the scarcity of validated instruments to assess adherence to warfarin therapy. Limitations were found in instruments that comprised the assessment of the isolated use of medication and the lack of analysis of other relevant therapeutic aspects. Future studies are needed to develop and validate more comprehensive instruments in an attempt to assess adherence to warfarin therapy. PROSPERO: Registration number CRD42019128324.

Reweighting a Swedish health questionnaire survey using extensive population register and self-reported data for assessing and improving the validity of longitudinal associations.

BACKGROUND: In cohorts with voluntary participation, participants may not be representative of the underlying population, leading to distorted estimates. If the relevant sources of selective participation are observed, it is however possible to restore the representativeness by reweighting the sample to resemble the target population. So far, few studies in epidemiology have applied reweighting based on extensive register data on socio-demographics and disease history, or with self-reported data on health and health-related behaviors. METHODS: We examined selective participation at baseline and the first two follow-ups of the Scania Public Health Cohort (SPHC), a survey conducted in Southern Sweden in 1999/2000 (baseline survey; n = 13,581 participants, 58% participation rate), 2005 (first follow-up, n = 10,471), and 2010 (second follow-up; n = 9,026). Survey participants were reweighted to resemble the underlying population with respect to a broad range of socio-demographic, disease, and health-related characteristics, and we assessed how selective participation impacted the validity of associations between self-reported overall health and dimensions of socio-demographics and health. RESULTS: Participants in the baseline and follow-up surveys were healthier and more likely to be female, born in Sweden, middle-aged, and have higher socioeconomic status. However, the differences were not very large. In turn, reweighting the samples to match the target population had generally small or moderate impacts on associations. Most examined regression coefficients changed by less than 20%, with virtually no changes in the directions of the effects. CONCLUSION: Overall, selective participation with respect to the observed factors was not strong enough to substantially alter the associations with self-assessed health. These results are consistent with an interpretation that SPHC has high validity, perhaps reflective of a relatively high participation rate. Since validity must be determined on a case-by-case basis, however, researchers should apply the same method to other health cohorts to assess and potentially improve the validity.

International perspectives on suboptimal patient-reported outcome trial design and reporting in cancer clinical trials: A qualitative study.

PURPOSE: Evidence suggests that the patient-reported outcome (PRO) content of cancer trial protocols is frequently inadequate and non-reporting of PRO findings is widespread. This qualitative study examined the factors influencing suboptimal PRO protocol content, implementation, and reporting, and use of PRO data during clinical interactions. METHODS: Semi-structured interviews were conducted with four stakeholder groups: (1) trialists and chief investigators; (2) people with lived experience of cancer; (3) international experts in PRO cancer trial design; (4) journal editors, funding panelists, and regulatory agencies. Data were analyzed using directed thematic analysis with an iterative coding frame. RESULTS: Forty-four interviews were undertaken. Several factors were identified that could influenced effective integration of PROs into trials and subsequent findings. Participants described (1) late inclusion of PROs in trial design; (2) PROs being considered a lower priority outcome compared to survival; (3) trialists' reluctance to collect or report PROs due to participant burden, missing data, and perceived reticence of journals to publish; (4) lack of staff training. Strategies to address these included training research personnel and improved communication with site staff and patients regarding the value of PROs. Examples of good practice were identified. CONCLUSION: Misconceptions relating to PRO methodology and its use may undermine their planning, collection, and reporting. There is a role for funding, regulatory, methodological, and journalistic institutions to address perceptions around the value of PROs, their position within the trial outcomes hierarchy, that PRO training and guidance is available, signposted, and readily accessible, with accompanying measures to ensure compliance with international best practice guidelines.

The Michigan Hand Outcomes Questionnaire (MHQ-Swe) in patients with distal radius fractures-cross-cultural adaptation to Swedish, validation and reliability.

BACKGROUND: The Michigan Hand Outcomes Questionnaire-MHQ-is a well-known self-assessment questionnaire, where patients' own perception in terms of recovery, pain and the ability to return to activities of daily living is assessed. The purpose of the study was to translate and culturally adapt the Michigan Hand Outcomes Questionnaire to Swedish and to test the validity and reliability in patients with surgically treated distal radius fractures. METHODS: The cross-cultural adaptation and the translation process were conducted according to predefined guidelines. Seventy-eight patients with surgically treated distal radius fractures completed the translated version of the questionnaire on their six-week follow-up visit. RESULTS: The translation and cross-cultural adaptation process revealed no major linguistic or cultural issues. The internal consistency of the MHQ-Swe ranged from 0.77 to 0.94 at test 1 and from 0.81 to 0.96 at test 2 for all subscales, which indicates good internal consistency in the subscales. The hand function subscale revealed the lowest results and work performance the highest. The ICCs showed excellent test-retest reliability, ranging from 0.77 to 0.90 on all MHQ subscales and 0.92 on total score. The highest results for the ICC were seen in the satisfaction subscale (ICC = 0.90), while the lowest were seen in the aesthetic subscale (ICC = 0.77). The correlation analysis between the MHQ-Swe, PRWE and VAS showed a generally moderate to high correlation for all the subscales. CONCLUSIONS: The Swedish version of the MHQ, the MHQ-Swe, showed good validity and reliability and it is therefore an appropriate and relevant questionnaire for use in patients with surgically treated distal radius fractures. TRIAL REGISTRATION: FoU i VGR, Projectnumber: 208491 , registered December 9, 2015.

Fruit and Vegetable Intake Assessed by Repeat 24 h Recalls, but Not by A Dietary Screener, Is Associated with Skin Carotenoid Measurements in Children.

Accurate measurement of fruit and vegetable (FV) intake is important for nutrition surveillance and evaluation of dietary interventions. We compared two tools for reporting FV intake to objective measurement of skin carotenoids among children. FV cups/day was assessed by repeated 24 h dietary recalls (24H FV) and the National Cancer Institute's All-Day Fruit and Vegetable Screener (NCI FV). Skin carotenoids were measured by repeated resonance Raman spectroscopy (RRS) of the palm. FV cups were regressed on RRS scores in unadjusted, field-based, and research-setting models with covariates feasible in each scenario. Data were baseline values from children aged 2-12 years in low-income households enrolled in a healthy eating randomized trial in four U.S. states (n = 177). Twenty-four-hour FV cups were associated with skin carotenoids in all models (p < 0.001) but NCI FV cups were not. Predicted RRS scores for discrete 24H FV cups provide a guide to interpretation of RRS in children (2 cups FV intake ~36,000 RRS units), with the research-setting scenario generally providing the narrowest prediction range (+/-1924). When self-reported data are required, 24 h recalls are more accurate than NCI FV screener data; and, when limited time, resources, or literacy must be considered, RRS scores can be quickly obtained and easily interpreted.

Recovery from chronic fatigue syndrome: a systematic review-heterogeneity of definition limits study comparison.

BACKGROUND: Paediatric chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME) is a common illness with a major impact on quality of life. Recovery is poorly understood. Our aim was to describe definitions of recovery in paediatric CFS/ME, the rate of recovery and the time to recovery. METHODS: This systematic review included a detailed search of MEDLINE, EMBASE, PsycInfo and Cochrane Library between 1994 and July 2018. Inclusion criteria were (1) clinical trials and observational studies, (2) participants aged <19 years with CFS/ME, (3) conducted in Western Healthcare systems and (4) studies including a measure of recovery and time taken to recover. RESULTS: Twelve papers (10 studies) were identified, involving 826 patients (range 23-135). Recovery rates were highly varied, ranging between 4.5% and 83%.Eleven distinct definitions of recovery were used; six were composite outcomes while five used unidimensional outcomes. Outcome measures used to define recovery were highly heterogeneous. School attendance (n=8), fatigue (n=6) and physical functioning (n=4) were the most common outcomes included in definition of recovery. Only five definitions included a personal measure of recovery. IMPLICATIONS: Definitions of recovery are highly variable, likely secondary to differences in study design, outcomes used, follow-up and study populations. Heterogeneous definitions of recovery limit meaningful comparison between studies, highlighting the need for a consensus definition going forward. Recovery is probably best defined from the child's own perspective with a single self-reported measure. If composite measures are used for research, there should be agreement on the core outcome set used.

Health-related quality of life in Iranian adolescents: a psychometric evaluation of the self-report form of the PedsQL 4.0 and an investigation of gender and age differences.

BACKGROUND: Research on the psychometric properties of the Persian self-report form of the Pediatric Quality of Life Inventory Version 4.0 (PedsQL 4.0) in adolescents has several gaps (e.g., convergent validity) that limit its clinical application and therefore the cross-cultural impact of this measure. This study aimed at investigating the psychometric properties of the PedsQL 4.0 and the effects of gender and age on quality of life in Iranian adolescents. METHOD: The PedsQL 4.0 was administered to 326 adolescents (12-17 years). A subsample of 115 adolescents completed the scale two weeks after the first assessment. Confirmatory Factor Analysis (CFA), correlation of the PedsQL 4.0 with the Weiss Functional Impairment Rating Scale-Self-report (WFIRS-S), and Item Response Theory (IRT) analysis were conducted to examine validity. Cronbach's alpha, McDonald's Omega, and Intra class correlation (ICC) were calculated as well to examine reliability. Gender and age effects were also evaluated. RESULTS: Internal consistency and test-retest reliability of the total PedsQL 4.0 scale was .92 and .87, respectively. The PedsQL 4.0 scores showed negative moderate to strong correlations with the WFIRS-S total scale. The four-factor model of the PedsQL 4.0 was not fully supported by the CFA-the root mean square error of approximation and the comparative fit index showed a mediocre and poor fit, respectively. IRT analysis indicated that all items of the PedsQL 4.0 fit with the scale and most of them showed good discrimination. The items and total scale provided more information in the lower levels of the latent trait. Males showed significantly higher scores than females in physical and emotional functioning, psychosocial health, and total scale. Adolescents with lower ages showed better quality of life than those with higher ages in all scores of the PedsQL 4.0. CONCLUSION: The PedsQL 4.0 showed good psychometric properties with regard to internal consistency, test-retest reliability, and convergent validity in Iranian adolescents, which supports its use in clinical settings among Persian-speaking adolescents. However, factor structure according to our CFA indicates that future work should address how to improve fit. In addition, studies that include PedsQL 4.0 should consider gender and age effects were reported.

An exploratory study of discrepancies between objective and subjective measurement of the physical activity level in female patients with chronic fatigue syndrome.

OBJECTIVE: To explore the ability of a self-report activity diary to measure the physical activity level (PAL) in female patients with chronic fatigue syndrome (CFS) and whether illness-related complaints, health-related quality of life domains (HRQOL) or demographic factors are associated with discrepancies between self-reported and objectively measured PAL. METHODS: Sixty-six patients with CFS, recruited from the chronic fatigue clinic of a university hospital, and twenty matched healthy controls wore an accelerometer (Actical) for six consecutive days and registered their activities in an activity diary in the same period. Participants' demographic data was collected and all subjects completed the CFS Symptom List (illness-related complaints) daily and Short-Form-36 (HRQOL domains) during the first and second appointment. RESULTS: A significant, but weak association between the activity diary and Actical was present in patients with CFS (rs = 0.376 and rs = 0.352; p < 0.001) and a moderately strong association in healthy controls (rs = 0.605; and rs = 0.644; p < 0.001) between week and weekend days, respectively. A linear mixed model identified a negative association between age and the discrepancy between the self-reported and objective measure of PA in both patients with CFS and healthy controls. CONCLUSION: The activity diary showed limited ability to register the PAL in female patients with CFS. The discrepancy between measures was not explained by illness-related complaints, HRQOL domains or demographic factors. The activity diary cannot replace objective activity monitoring measured with an accelerometer, but may provide additional information about the perceived activity.