Validity of the modified Rankin Scale in patients with aneurysmal subarachnoid hemorrhage: a randomized study.

PURPOSE: The modified Rankin Scale (mRS), a clinician-reported outcome measure of global disability, has never been validated in patients with aneurysmal subarachnoid hemorrhage (aSAH). The aims of this study are to assess: (1) convergent validity of the mRS; (2) responsiveness of the mRS; and (3) the distribution of mRS scores across patient-reported outcome measures (PROMs). METHODS: This is a prospective randomized multicenter study. The mRS was scored by a physician for all patients, and subsequently by structured interview for half of the patients and by self-assessment for the other half. All patients completed EuroQoL 5D-5L, RAND-36, Stroke Specific Quality of Life scale (SS-QoL) and Global Perceived Effect (GPE) questionnaires. Convergent validity and responsiveness were assessed by testing hypotheses. RESULTS: In total, 149 patients with aSAH were included for analysis. The correlation of the mRS with EQ-5D-5L was r = - 0.546, while with RAND-36 physical and mental component scores the correlation was r = - 0.439and r = - 0.574 respectively, and with SS-QoL it was r = - 0.671. Three out of four hypotheses for convergent validity were met. The mRS assessed through structured interviews was more highly correlated with the mental component score than with the physical component score of RAND-36. Improvement in terms of GPE was indicated by 83% of patients; the mean change score of these patients on the mRS was - 0.08 (SD 0.915). None of the hypotheses for responsiveness were met. CONCLUSION: The results show that the mRS generally correlates with other instruments, as expected, but it lacks responsiveness. A structured interview of the mRS is best for detecting disabling neuropsychological complaints. REGISTRATION: URL: https://trialsearch.who.int ; Unique identifier: NL7859, Date of first administration: 08-07-2019.

Comparison of patient-reported outcomes measurement information system (PROMIS®)-29 and PROMIS global physical and mental health scores.

PURPOSE: The Patient-Reported Outcomes Measurement and Information System (PROMIS®): includes the PROMIS-29 physical and mental health summary and the PROMIS global physical and mental health scores. It is unknown how these scores coincide with one another. This study examines whether the scores yield similar or different information. METHODS: The PROMIS-29 and the PROMIS global health items were administered to 5804 adults from Amazon's Mechanical Turk (MTurk) in 2021-2022 and to 4060 adults in the Ipsos KnowledgePanel (KP) in 2022. RESULTS: The median age of those in MTurk (KP) was 36 (54) and 53% (50%) were male. Mean T-scores on the PROMIS-29 and PROMIS global physical health scales were similar, but PROMIS global mental health was 3-4 points lower than the PROMIS-29 mental health summary score. Product-moment correlations ranged from 0.69 to 0.81 between the PROMIS-29 physical health and PROMIS global physical health scales and 0.56-0.69 between the mental health scales. Multi-trait multimethod analyses indicated that only a small proportion of the correlations between the two methods of measuring mental health were significantly more highly correlated with one another than correlations between physical and mental health. CONCLUSIONS: PROMIS-29 and PROMIS global mental health scales provide different information and, therefore, study conclusions may vary depending on which measure is used. Interpretation of results needs to consider that the PROMIS-29 mental health scale is a weighted combination of specific domains while the PROMIS global mental health scale is based on general mental health perceptions. Further comparisons of methods of assessing mental health are needed.

Psychometric properties of the Interpersonal Emotion Regulation Questionnaire in a community sample of the Portuguese population.

BACKGROUND: Intrapersonal aspects of emotion regulation have been at the forefront of research, while interpersonal aspects have received less attention. The Interpersonal Emotion Regulation Questionnaire (IERQ) was developed to address this issue. However, this scale was neither adapted nor validated for European Portuguese. AIMS: The present study aims to adapt the IERQ to European Portuguese and explore the preliminary psychometric properties of the IERQ in a community sample, through confirmatory factor analysis (CFA). Construct validity was further supported by examining convergent validity with ERQ subscales. METHOD: Using a cross-sectional design, individuals were recruited online. Self-report questionnaires were used, namely the IERQ and the Emotion Regulation Questionnaire (ERQ). RESULTS: The four-factor structure was confirmed through CFA. IERQ subscales correlated positively with the dimensions of the ERQ of cognitive reappraisal and correlated negatively with experiential suppression. CONCLUSIONS: This preliminary study showed that the IERQ has adequate psychometric properties in a Portuguese sample and supports that this instrument can be used to assess interpersonal emotion regulation strategies in non-clinical samples.

Convergent validity between the school-age versions of the Sensory Processing Measure 2 (SPM2) and the Sensory Profile 2 (SP2): A pilot study.

INTRODUCTION: The Sensory Processing Measure 2 (SPM2) and the Sensory Profile 2 (SP2) are two sensory processing scales often used by occupational therapists. The SPM2 and SP2 both claim to assess aspects of children's sensory processing. This cross-sectional study examined the convergent validity of the SPM2-Home Form (SPM2-HF) and Child SP2 for school-aged neurotypical children. METHODS: Thirty parents/caregivers of neurotypical children aged 7 to 12 completed the SPM2-HF and the Child SP2 about their child. Spearman rho's correlation coefficient with bootstrapping was used to investigate the correlations among the sensory, behavioural, and quadrant scores of the Child SP2 and SPM2-HF subscale scores. CONSUMER AND COMMUNITY INVOLVEMENT: Given the topic, consumers and community members were not involved in the design, execution, or write up of the study results. RESULTS: Several statistically significant correlations were found between the sensory and quadrant subscales of the Child SP2 with the SPM-HF. Strong to moderate correlations were established between the sensory subscales of the Child SP2 and the SPM2-HF, ranging from 0.40 to 0.74 (p < 0.05). Additionally, correlations between the quadrant subscales of the Child SP2 and the subscales of the SPM2-HF ranged from weak (0.38) to strong (0.77) correlations (p < 0.05). CONCLUSION: These results provide evidence of convergent validity between the SPM2-HF and Child SP2 for neurotypical school-aged children. Further research on the psychometric properties of the SPM2-HF and Child SP2 is recommended.

Validating the Hebrew Version of the Modified Dementia Worry Scale (H-MDWS).

The body of knowledge regarding dementia worry - people's sense of threat about developing dementia - is still limited. Additional studies are essential to better understand levels of dementia worry and its correlates, especially in cross-cultural contexts. To reach this goal, it is critical to use structured and valid measures to assess dementia worry and to verify these measures in different languages. Therefore, the aim of the current study was to evaluate the psychometric properties of the Hebrew version of the Modified Dementia Worry Scale (the H-MDWS). A cross-sectional study using an online survey was conducted with 368 Israeli laypeople who were 18 years of age or older (53% women, 76% Jewish, mean age = 40, average years of education = 14). In addition to the H-MDWS, participants were asked to report their fear of Alzheimer's disease (using a dichotomous single item), stigma, health anxiety, and demographic characteristics. Reliability analyses showed that the Cronbach's alpha for the H-MDWS was excellent (α = 0.95). The results of the factor analysis demonstrated that the scale has a unidimensional structure, explaining over 66% of the variance. In addition, we found significant correlations between fear of developing Alzheimer's disease, stigma, and health anxiety, on the one hand, and the H-MDWS on the other. The H-MDWS is a reliable and valid tool for assessing dementia worry. The validation of the tool not only allows expanding the body of knowledge related to dementia worry, but will also allow professionals and caregivers to identify people who are at risk of reporting dementia worry and develop interventions accordingly.

Convergent validity of two adult self-report sensory scales: Comparing the Adolescent/Adult Sensory Profile and the Sensory Processing Measure 2-Adult Form.

INTRODUCTION: Occupational therapists use standardised scales and measures to assess an individual's sensory processing factors. To date, few studies have investigated the correlations between the Adolescent/Adult Sensory Profile (A/ASP) and the Sensory Processing Measure 2-Adult Form (SPM-2-Adult). The aim of the project is to investigate the association between the sensory processing factors measured by the A/ASP and SPM-2-Adult when completed by the same group of adult participants, with an additional research question investigating whether any significant differences existed between sensory processing scores based on participants' self-reported gender identity. METHODS: Forty-two adults aged 18-30 completed the A/ASP and the SPM-2-Adult. Associations between the A/ASP quadrant and the SPM-2-Adult subscales were examined using Spearman's rho correlation coefficients, and differences between participants based on their self-reported gender identity were investigated using Mann-Whitney U tests. RESULTS: Statistically significant correlations were obtained between the A/ASP Low Registration, Sensory Sensitivity, and Sensation Avoiding quadrant subscales and all nine of the SPM-2-Adult subscales ranging from weak (rho = 0.342, p < 0.027) to strong (rho = 0.790, p < 0.001) correlations. The A/ASP Sensation Seeking quadrant subscale was only significantly correlated with the SPM-2-Adult Social Participation subscale (rho = -0.416, p = 0.006). Three subscales had statistically significant differences based on gender identity: SPM-2-Adult Vision (p = 0.007), SPM-2-Adult Sensory Total (p = 0.048), and A/ASP Sensory Sensitivity (p = 0.043). CONSUMER AND COMMUNITY INVOLVEMENT: Consumers and community members were not involved in the design, execution, or write-up of the study results. CONCLUSION: The A/ASP and the SPM-2-Adult had several subscales that were significantly correlated with one another. Of note, significant associations were achieved between the A/ASP Low Registration, Sensory Sensitivity, and Sensation Avoiding quadrant subscales and all nine of the SPM-2-Adult subscales. These findings make a significant preliminary contribution to the psychometric body of evidence related to the sensory processing assessment of adults.

Validating the PROMIS cognitive function short form in cancer survivors.

PURPOSE: The Patient-Reported Outcome Measurement Information System Cognitive Function Short Form 8a  (PROMIS Cog) could provide a shorter, useful alternative to the often used Functional Assessment of Cancer Therapy - Cognition (FACT-Cog) in research and clinical care. This study aimed to determine the convergent validity and internal reliability of the PROMIS Cog in 3 separate samples of breast cancer survivors and to explore clinical cut points. METHODS: Data from three samples of breast cancer survivors were used for this secondary analysis. Convergent validity was determined by evaluating correlation strength among the derived PROMIS Cog and measures of depression, anxiety, stress, fatigue, sleep, loneliness, the FACT-Cog . Clinical cut-points for the PROMIS Cog were determined by plotting the receiver operating characteristic curves. RESULTS: 3 samples of breast cancer survivors (N = 471, N = 132, N = 90) were included. Absolute values of correlations demonstrating convergent validity ranged from 0.21 to 0.82, p's < 0.001, and were comparable to correlations with the full FACT-Cog 18 item perceived cognitive impairments (PCI) scale. ROC curve plots indicated a clinical cut off < 34 for the combined sample. CONCLUSION: The 8-item PROMIS Cog demonstrated good convergent validity and internal reliability in breast cancer survivors, comparable to the 18-item FACT-Cog PCI. The PROMIS Cog 8a is a brief self-report measure that can be easily incorporated into cancer-related cognitive impairment research designs or used in clinical settings.

Responsiveness and construct validity of EPIC-26, AQoL-6D and SF-6D following treatment in prostate cancer.

PURPOSE: To assess construct validity and responsiveness of the Expanded Prostate Cancer Index Composite Instrument (EPIC-26) relative to the Short-Form Six-Dimension (SF-6D) and Assessment of Quality of Life 6-Dimension (AQoL-6D) in patients following treatment for prostate cancer. METHODS: Retrospective prostate cancer registry data were used. The SF-6D, AQoL-6D, and EPIC-26 were collected at baseline and one year post treatment. Analyses were based on Spearman's correlation coefficient, Bland-Altman plots and intra-class correlation coefficient, Kruskal Wallis, and Effect Size and the Standardised Response Mean for responsiveness. RESULTS: The study sample was comprised of 1915 patients. Complete case analysis of 3,697 observations showed moderate evidence of convergent validity between EPIC-26 vitality/hormonal domain and AQoL-6D (r = 0.45 and 0.54) and SF-6D (r = 0.52 and 0.56) at both timepoints. Vitality/hormonal domain also showed moderate convergent validity with coping domain of AQoL-6D (r = 0.45 and 0.54) and with role (r = 0.41 and 0.49) and social function (r = 0.47 and 0.50) domains of SF-6D at both timepoints, and with independent living (r = 0.40) and mental health (r = 0.43) of AQoL-6D at one year. EPIC-26 sexual domain had moderate convergent validity with relationship domain (r = 0.42 and 0.41) of AQoL-6D at both timepoints. Both AQoL-6D and SF-6D did not discriminate between age groups and tumour stage at both timepoints but AQoL-6D discriminated between outcomes for different treatments at one year. All EPIC-26 domains discriminated between age groups and treatment at both timepoints. The EPIC-26 was more responsive than AQoL-6D and SF-6D between baseline and one year following treatment. CONCLUSIONS: AQoL-6D can be used in combination with EPIC-26 in place of SF-12. Although EPIC-26 is not utility based, its popularity amongst clinicians and ability to discriminate between disease-specific characteristics and post-treatment outcomes in clinical trials makes it a candidate for use within cost-effectiveness analyses. The generic measure provides a holistic assessment of quality of life and is suitable for generating quality adjusted life years (QALYs).

The Fear of Asthma Symptoms Scale and the Asthma Behavior Checklist: preliminary validity of two novel patient reported outcome measures.

Objective: The aim of this study was to investigate the preliminary validity of two novel scales, the Fear of Asthma Symptoms scale (FAS) and the Asthma Behavior Checklist (ABC). Methods: Using cross-sectional design, data was collected online from 188 adult participants (Age 18-71 years) with a diagnosis of asthma and self-reported anxiety related to asthma, recruited through social media. Confirmatory factor analysis, internal consistency and test-retest reliability were ascertained to address validity.Results: The confirmatory factor analysis demonstrated convergent validity for both the FAS (average variance extracted; AVE=.57) and the item-reduced ABC-8 (AVE=.61) as well as divergent validity for both scales. Both scales demonstrated high internal consistency (FAS: α = 0.94; ABC-8: α = 0.92). Test-retest reliability assessed after 1 week was good (FAS: r=.85; ABC-8: r=.88).Conclusions: We observed promising psychometric properties of the FAS and the ABC-8. The two novel scales could be useful to identify excessive fear and avoidance in patients with asthma and to investigate putative mechanisms in clinical research on anxiety related to asthma. Further evaluation of psychometric properties in independent samples are needed.

Validation of the Center for Epidemiologic Studies Depression Scale (CES-D) in a Moroccan sample with substance use disorder.

BACKGROUND: Transcultural validation studies of depression scales are rare in Morocco. The Center for Epidemiologic Studies Depression Scale (CES-D) is commonly one of the most common and frequently used screening instruments for depressive symptoms, but the scale has not, up to date, been validated in dialect of Arabic in Moroccan contexts. Given the importance of assessing and preventing depressive symptoms in our Moroccan context, this study aims to validate the CES-D, translated, and adapted to the dialect of Arabic and Moroccan culture, in a sample with substance use disorder. METHODS: The data were analyzed in two successive phases. First, exploratory factor analysis (EFA) was used to assess the factor structure in the pilot sample (N = 140). Then, this structure was confirmed in the validation sample (N = 205) using confirmatory factor analysis (CFA). RESULTS: Exploratory factor analysis extracted three factors different from the four factors in the original version. Confirmatory factor analysis confirmed the structure of three factors. The fit indices level showed acceptable to good performance of the measurement model. The instrument showed sufficient reliability and convergent validity, as demonstrated by acceptable values of composite reliability (CR = 0.89-0.93) and average variance extracted (AVE = 0.64-0.66), respectively. The square roots of AVE were higher than factor-factor pairs correlations, and the Heterotrait-Monotrait ratio (HTMT) of correlations values was less than 0.85, indicating acceptable discriminant validity. CONCLUSIONS: Overall reliability and both convergent and discriminant validity tests indicated that the Moroccan dialectal Arabic version of the CES-D had a good performance and may serve as a valid tool for measuring the severity of depression in people with substance use disorder.

Validity and reliability of the Persian version of self-administered foot evaluation questionnaire (SAFE-Q) in people with foot orthopedic problems.

INTRODUCTION: Foot problems are one of the main causes of seeing a doctor. According to the World Health Organization's definition of health, the healthcare system must consider patients' quality of life as an important entity. In this regard, many tools have been developed to evaluate patients' opinions about their health status. The purpose of the present study is to evaluate the validity and reliability of the Persian version of the Foot Self-Assessment Questionnaire (SAFE-Q) in patients with foot orthopedic problems. METHOD: 215 people aged 17-60 years with orthopedic foot problems were included in this cross-sectional study. The Spearman correlation coefficient of SAFE-Q questionnaires versus Foot Function Index (FFI) questionnaire was evaluated for the convergent validity. Forty-three people randomly completed SAFE-Q again one week later. Intraclass correlation coefficient (ICC) and Cronbach's alpha was calculated to evaluate the test-retest reliability and internal consistency of the SAFE-Q, respectively. RESULTS: A strong relationship was found between the SAFE-Q total score and other scales with FFI questionnaire (r = 0.52 to 0.87). ICC test-retest reliability and Cronbach's alpha were 0.981 and 0.98 for SAFE-Q, respectively. CONCLUSION: The results indicate that the Persian version of the SAFE-Q questionnaire has acceptable validity and reliability and can be used to assess the health status and quality of life of Persian speakers with orthopedic foot problems.

Convergent Validity of Myheartsmap: A Pediatric Psychosocial Health Screening Tool.

Recognition of pediatric mental health concerns often depends on assessment by parents, educators, and primary care professionals. Therefore, a psychosocial screening instrument suitable for routine use in schools and primary care is needed. The Pediatric Quality of Life (PedsQL) and the Strengths and Difficulties Questionnaire (SDQ) are widely used for screening but lack adolescent-specific mental health measures. MyHEARTSMAP is an instrument assessing aspects of youth psychosocial health via four domains: Psychiatry, Function, Social, and Youth Health. We evaluated MyHEARTSMAP convergent validity with PedsQL and SDQ among 122 child-parent dyads participating in a larger concussion study. Convergent validity was assessed via correlations: MyHEARTSMAP Psychiatry and Function domains correlated strongly (r ≥ 0.44) and Social domain correlated weakly (r ≤ 0.25) to corresponding PedsQL and SDQ subscales, while Youth Health domain correlated moderately (r ≥ 0.31) to the tools' total scales. In conclusion, MyHEARTSMAP converges with PedsQL and SDQ, and benefits from the inclusion of adolescent-specific psychosocial measures.

The Oxford Utilitarianism Scale: Psychometric properties of a French adaptation (OUS-Fr).

It is well established that one's sense of morality may be readily influenced by one's culture, education, and life situation. Very few psychometric tools are currently available to measure facets of human morality in different cultures. Therefore, the purpose of the present study was to develop a French adaptation of the Oxford Utilitarianism Scale (OUS-Fr) and formally evaluate its validity. The OUS-Fr was developed through a process of back-translation and administered to a sample of 552 participants. Results from exploratory factor analyses revealed a bidimensional structure with satisfactory loadings that was then also supported in the confirmatory factor analysis check. The OUS-Fr scale demonstrated good psychometric properties, with acceptable internal consistency and coherent results in the convergent validity analyses. These findings contribute to morality measurement literature by providing evidence for the reliability and validity of the French adaptation of the OUS. The OUS-Fr can be viewed as a valuable tool for researchers and practitioners for assessing utilitarian tendencies within the French-speaking population, which could pave the way for cross-cultural understandings that are important for fully understanding the intricacies of human morality.

Specific form of ageism in dental care: Convergent validity of the Ageism Scale for Dental Students and its implications for education.

INTRODUCTION: The World Health Organisation considers ageism as an important barrier to age-appropriate care for older adults. An Ageism Scale for Dental Students (ASDS) has been validated in the United States, Brazil, Greece, Romania and in France. At present, the convergent validity of ASDS has never been evaluated. Moreover, a specialised and disciplinary tool as the ASDS may not overlap with more general ageism assessment which may highlight the need for specific courses during the education of the future health professionals. MATERIALS AND METHODS: The survey was administered from December 2020 to January 2021. All the undergraduate students of the last 3 years of study at the dental school of Clermont-Ferrand were invited to complete both scales. Two hundred sixteen students were randomly divided into two equal groups. The first group answered first Aging Semantic Differential- ASD then ASDS, the second in reverse order. The convergent validity between ASDS and ASD was assessed by computing a Pearson correlation coefficient and discriminant analysis between each component of the two scales. RESULTS: The response rate was of 53.7%. The correlation analysis conducted on the total scores of the ASDS and of the ASD shows a significant, yet weak relationship. The discriminant analysis indicates that only the first component of the ASDS is significantly associated with each dimension of the ASD, whereas the second component is totally independent from the ASD and the third component almost independent from the ASD, except for the integrity dimension. CONCLUSIONS: This specialised questionnaire may assess a form of ageism that is not captured at all in more general scales. Such a scale may help to identify the different dimensions of ageism among dental students which is required to reduce ageism in medical care. This reduction should pass by adapted courses in gerodontology.

Improving the assessment of functional impairment in tinnitus sufferers: validation of the German version of the Tinnitus Functional Index using a confirmatory factor analysis.

OBJECTIVES: Chronic tinnitus negatively impacts daily functioning. To specifically assess this impairment, the Tinnitus Functional Index (TFI) was developed. The current study investigated the hierarchical, eight-factorial structure for the German TFI and examined its psychometric properties. DESIGN: In an online assessment, the TFI and other validated health-related measurements were completed. Confirmatory factor analysis (CFA) was conducted to investigate the factorial structure by testing two competing models: (1) a general factor model, and (2) a hierarchical second-order factor model. STUDY SAMPLE: 316 research volunteers (59.8% female) with low to moderate tinnitus distress were included. RESULTS: CFA revealed an insufficient fit of the data to the general factor model. For the hierarchical second-order factor model, an acceptable model fit was shown (χ2/df ratio = 2.74, RMSEA = 0.07, SRMR = 0.05, CFI = 0.95, TLI = 0.95). Correlational analyses between the TFI and measures assessing tinnitus distress, depression, sleeping difficulties, subjective well-being, and personality dimensions indicated high convergent and moderate discriminant validity. Internal consistency reliability was excellent. CONCLUSIONS: The results confirm the hierarchical, eight-factorial structure of the German TFI. The TFI is a promising inventory that should be used on a regular basis.HighlightsThe results of our study confirm the hierarchical eight-factorial structure of the German TFI.Confirmatory factor analysis revealed an acceptable model fit of the data.Convergent validity of the German TFI was high.Discriminant validity of the German TFI was moderate.The German TFI is a reliable questionnaire to assess tinnitus functional impairment.

Validation of the Tilburg Pregnancy Distress Scale among pregnant women in Capricorn District, South Africa.

BACKGROUND: The Tilburg Pregnancy Distress Scale (TPDS) was developed to measure pregnancy-specific psychological distress among pregnant women. METHOD: The present study evaluated the psychometric properties of the TPDS in a South African location. Analysis was conducted using data obtained from a sample of 205 participants (average age = 27.69 years [SD = 5.977], average gestation weeks = 25.37 weeks [SD = 8.448]; domicile = 63% rural) attending their antenatal check-ups at various medical health facilities in the Capricorn District, Limpopo Province. The analysis involved structural and convergent validation. RESULTS: Fit indices showed that the three-factor, second-order solution fitted the data better. The reliability estimates of the main TPDS factors, partner involvement (PI) and negative affect (NA), were good, and were obviously not influenced by gravidity. The associations of the TPDS factors with the Patient Health Questionnaire (PHQ-4) Depression and Anxiety, the Edinburgh Postnatal Depression Scale (EPDS), and the Pregnancy-Related Anxiety Scale (PRAS) were not generally good. CONCLUSION: The results suggest that in spite of the TPDS having potential to be used in South Africa, further validation studies are required.

Structural and Construct Validity of the Foot and Ankle Ability Measure (FAAM) With an Emphasis on Pain and Functionality After Foot Surgery: A Multicenter Study.

The Foot and Ankle Ability Measure (FAAM) is a patient-reported outcome measure that is available in several languages. We aim to assess the structural and construct validity of the FAAM with an emphasis on pain and functionality after foot surgery. The activities of daily living (ADL) and Sports subscales of the Finnish version of the FAAM were completed by 182 patients who underwent operative treatment for disorders of the foot. Convergent validity was assessed by principal component analysis using Spearman's correlation coefficient between the FAAM subscales and the principal components (Function-PC and Pain-PC) derived from validated patient-reported outcome measures. Subscales were studied for floor and ceiling effects, internal consistency and unidimensionality. Internal consistency was examined with Cronbach's alpha and the subscale structure with exploratory factor analysis. FAAM-ADL had high correlation with the Function-PC (r = 0.87, 95% confidence interval [CI] 0.81-0.91) and the Pain-PC (r = 0.75, 95% CI 0.65-0.83). FAAM-Sports had moderate correlation (r = 0.64, 95% CI 0.50-0.74) with the Function-PC and high correlation (r = 0.74, 95% CI 0.64-0.82) with the Pain-PC. No floor or ceiling effects were observed. Cronbach's alpha was 0.97 (95% CI 0.96-0.98) for the ADL and 0.93 (95% CI 0.91-0.95) for the Sports subscales. The results supported the unidimensionality of the FAAM-Sports. Within the ADL subscale, 3 factors were identified, suggesting a 3-factor model for the FAAM overall. Results highlighted the inter-relationship of pain and physical function. Further research on longitudinal validity is needed.

Responsiveness and convergent validity of QLU-C10D and EQ-5D-3L in assessing short-term quality of life following esophagectomy.

AIM: This study assessed the responsiveness and convergent validity of two preference-based measures; the newly developed cancer-specific EORTC Quality of Life Utility Measure-Core 10 dimensions (QLU-C10D) relative to the generic three-level version of the EuroQol 5 dimensions (EQ-5D-3L) in evaluating short-term health related quality of life (HRQoL) outcomes after esophagectomy. METHODS: Participants were enrolled in a multicentre randomised controlled trial to determine the impact of preoperative and postoperative immunonutrition versus standard nutrition in patients with esophageal cancer. HRQoL was assessed seven days before and 42 days after esophagectomy. Standardized Response Mean and Effect Size were calculated to assess responsiveness. Ceiling effects for each dimension were calculated as the proportion of the best level responses for that dimension at follow-up/post-operatively. Convergent validity was assessed using Spearman's correlation and the level of agreement was explored using Bland-Altman plots. RESULTS: Data from 164 respondents (mean age: 63 years, 81% male) were analysed. HRQoL significantly reduced on both measures with large effect sizes (> 0.80), and a greater mean difference (0.29 compared to 0.16) on QLU-C10D. Both measures had ceiling effects (> 15%) on all dimensions at baseline. Following esophagectomy, ceiling effects were observed with self-care (86%), mobility (67%), anxiety/depression (55%) and pain/discomfort (19%) dimensions on EQ-5D-3L. For QLU-C10D ceiling effects were observed with emotional function (53%), physical function (16%), nausea (35%), sleep (31%), bowel problems (21%) and pain (20%). A strong correlation (r = 0.71) was observed between EQ-5D-3L anxiety and QLU-C10D emotional function dimensions. Good agreement (3.7% observations outside the limits of agreement) was observed between the utility scores. CONCLUSION: The QLU-C10D is comparable to the more widely applied generic EQ-5D-3L, however, QLU-C10D was more sensitive to short-term utility changes following esophagectomy. Cognisant of requirements by policy makers to apply generic utility measures in cost effectiveness studies, the disease-specific QLU-C10D should be used alongside the generic measures like EQ-5D-3L. TRIAL REGISTRATION: The trial was registered with the Australian New Zealand Clinical Trial Registry (ACTRN12611000178943) on the 15th of February 2011.

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.

The Malay version of SF-36 health survey instrument: testing data quality, scaling assumptions, reliability and validity in post-coronary artery bypass grafting (CABG) surgery patients at the National Heart Institute (Institut Jantung Negara-IJN), Kuala Lumpur.

BACKGROUND: The Short Form 36 (SF-36) is a scoring system comprising of 36 items categorized into eight constructs corresponding to patients' health-related quality of life. It has been used extensively in various countries on different sub-populations and used to indicate the health status and help to ascertain the effect of clinical interventions on the particular population. OBJECTIVE: To examine the psychometric properties of the Malay version of SF-36 (Malay SF-36) summated rating scales and validate the scale among post-coronary artery bypass grafting surgery (CABG) patients at the National Heart Institute (IJN), Kuala Lumpur. METHODS: Five hundred and nine post-CABG patients at the IJN, Malaysia completed the questionnaires between 1 July and 31 December 2017. Psychometric tests endorsed by the "International Quality of Life Assessment Project" were utilised. RESULTS: The data quality was excellent with a high questionnaire completion rate (100%). As hypothesized, the ordering of item means within scales was clustered. In unison, scaling assumptions were satisfied. Good discriminant validity was shown between subsets of patients with various levels of health status. Notwithstanding, there were probably translation issues of the Physical Functioning scale which showed small ceiling effects. We clearly observed high ceiling and floor effects in both Role Physical and Role Emotional scale most probably attributed to the dichotomous style of their choice of responses. Cronbach alpha values of the eight scales ranged from 0.73 to 0.90, showing good internal consistency reliability. Confirmatory Factor Analysis (CFA) confirmed the 8-factor solution and Composite Reliability revealed internal consistency reliability except for Vitality and Social Functioning. Based on the Average Variance Extracted (AVE), convergent validity was adequate except for two domains. Discriminant Validity is good for the eight constructs as the √AVE are generally higher than the correlation coefficients between the latent constructs. CONCLUSION: The scoring for the Malay SF-36 based on the summated ratings method was proven to be valid to be applied in our local clinical population. The CFA, fitness estimates, reliability and validity assessments suggest that the Malay version of SF36 is a valid and reliable instrument. However, further work is warranted to further refine the convergent validity and reliability of some scales.