Psychometric and Machine Learning Approaches to Reduce the Length of Scales.

Brief measures are important in psychology research because they reduce participant burden. Researchers can select items from longer measures either to build a short-form or to administer items conditional on a participant's previous responses. Researchers who carry out these item selection strategies either focus on estimating a precise score on the measure (typically carried out in a psychometric approach) or on predicting the score on the measure (possibly taking a machine learning approach). However, it is unclear how scores from the psychometric and machine learning approaches compare to each other. In this paper, the following four statistical approaches to select items are reviewed and illustrated: item response theory to build static short-forms, computerized adaptive testing, the genetic algorithm, and regression trees. Theoretical strengths and weaknesses between these four statistical approaches are discussed, and the overlap between the areas of psychometrics and machine learning is considered.

Exploring Agreement between MB-CDI Short Forms for Evaluating the Language Skills of Italian Children Aged 18-24 Months.

INTRODUCTION: The short forms of MacArthur-Bates Communicative Development Inventories (MB-CDI) are widely used for assessing communicative and linguistic development in infants and toddlers. Italian norms for the Words and Gestures (WG) and Words and Sentences (WS) short forms overlap between 18 and 24 months. OBJECTIVE: To evaluate the agreement between these two forms. METHODS: Parents of 104 children aged 18-24 months filled in both questionnaires. RESULTS: The two questionnaires showed high agreement in measuring expressive vocabulary size and the percentile of lexical production and good agreement in identifying children at-risk for language delay (75% of the cases were accurately identified). Both short forms include a list of 100 words and a set of questions investigating potential risk factors for communication and language disorders. Ten children with an expressive vocabulary <10th percentile were compared to 10 with typical language development. Scores for children <10th percentile were significantly lower than their peers, in addition to scores of lexical comprehension, gesture-word, and 2-word combinations, and phonological accuracy, imitation of new words, and decontextualized use of language. CONCLUSIONS: Short forms of the Italian MB-CDI can be used interchangeably for evaluating lexical production, but each one offers different quantitative and qualitative information on the behaviours related to language acquisition.

A data-driven method for identifying shorter symptom criteria sets: the case for DSM-5 alcohol use disorder.

BACKGROUND: Although the DSM is a widely used diagnostic guide, lengthy criteria sets can be problematic and provide the primary motivation to identify short-forms. Using the 11 diagnostic criteria provided by the DSM-5 for alcohol use disorder (AUD), the present study develops a data-driven method to systematically identify subsets and associated cut-offs that yield diagnoses as similar as possible to use all 11 criteria. METHOD: Relying on data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III), our methodology identifies diagnostic short-forms for AUD by: (1) maximizing the association between the sum scores of all 11 criteria with newly constructed subscales from subsets of criteria; (2) optimizing the similarity of AUD prevalence between the current DSM-5 rule and newly constructed diagnostic short-forms; (3) maximizing sensitivity and specificity of the short-forms against the current DSM-5 rule; and (4) minimizing differences in the accuracy of the short-form across chosen covariates. Replication is shown using NESARC-Wave 2. RESULTS: More than 11 000 diagnostic short-forms for DSM-5 AUD can be created and our method narrows down the optimal choices to eight. Results found that 'Neglecting major roles' and 'Activities given up' could be dropped with practically no change in who is diagnosed (specificity = 100%, sensitivity ⩾ 99.6%) or the severity of those diagnosed (κ = 0.97). CONCLUSIONS: With a continuous improvement model adopted by the APA for DSM revisions, we offer a data-driven tool (a SAS Macro) that identifies diagnostic short-forms in a systematic and reproducible way to help advance potential improvements in future DSM revisions.

Measurement properties of PROMIS short forms for pain and function in orthopedic foot and ankle surgery patients.

PURPOSE: To examine the measurement properties of the German PROMIS short forms for pain intensity (PAIN), pain interference (PI) and physical function (PF) in orthopedic foot and ankle surgery patients. METHODS: Patient-rated outcomes were collected from consecutive patients of our foot and ankle registry before and 6 months after surgery. Measurement properties were tested according to the COnsensus-based Standards for the selection of health status Measurement Instruments (COSMIN). The German Foot Function Index (FFI-D) served as a legacy measure. RESULTS: 748 patients were included in our cross-sectional sample. Longitudinal and test-retest data were available for 202 and 65 patients, respectively. Construct validity of all short forms was good. All Cronbach's α and intraclass correlation coefficients were > 0.7. The smallest detectable change (SDC) was highest for PF (8.9) and lowest for PI (6.5). Minimal important change was 4 to 5 points and thus smaller than SDC for all instruments. We observed a baseline ceiling effect for PF. PI showed insufficiently correlated change scores with FFI-D disability change scores, and therefore failed the responsiveness testing. CONCLUSION: Our study showed some adequate psychometric properties, but also certain aspects regarding interpretability and responsiveness that researchers must be aware of when using PROMIS short forms of pain and function in foot and ankle surgery patients.

Short form development for oral health patient-reported outcome evaluation in children and adolescents.

PURPOSE: Children and adolescents are vulnerable to dental problems and oral diseases. This paper presents the development of two multi-item self-report scales for use in assessing oral health status of children and adolescents. METHODS: Following the Patient-Reported Outcome Measurement Information System framework, survey questions were designed using a newly developed conceptual model. These items were administered to 334 children and adolescents (8-17 years) along with concurrent dental exams. Exploratory and confirmatory factor analyses were conducted and the item response theory graded response model was used to estimate item parameters and oral health status scores and to identify short-form items. The items were selected by high level of information and wide coverage of different domains to assess Child Oral Health Status Index (COHSI) and treatment referral recommendations (RR). RESULTS: The long form consists of 28 items. The short-form includes 12 items (8 for COHSI and 7 for RR with 3 common items).The intra-class correlations between long form and short-form were 0.90 for COHSI and 0.87 for RR. CONCLUSION: The short-forms provide a possible solution for the longstanding challenge of oral health evaluation for large populations of children and adolescents. The calibrated long form provides the foundation for computer adaptive test administration. These oral health assessment toolkits can be used for oral health screening, surveillance program, policy planning, and research.

Assessing the validity of the RAND negative impact of asthma on quality of life short forms.

BACKGROUND: In response to recommendations from the 2010 National Institutes of Health Asthma Outcomes Workshop, we developed a system for measuring the negative impact of asthma on quality of life (QoL), which was referred to as the RAND Negative Impact of Asthma on Quality of Life (RAND-IAQL) item bank. The bank contains 65 items that focus on the patient's perception of the impact or bother of asthma on his or her life. OBJECTIVE: Evidence for the validity of 2 short forms, the RAND-IAQL 4-item and 12-item Short Forms, from the bank is presented. METHODS: Using a sample of 2032 adults with asthma, we validated our short forms against the Asthma Quality of Life Questionnaire-Marks (AQLQ-M), the Asthma Control Test, and generic measures of QoL developed by the Patient-reported Outcomes Measurement Information System (PROMIS). Discriminant validity was examined by comparing scores of respondents who differed according to multiple health indicators. RESULTS: Our sample ranged in age from 18 to 99 years (mean, 43 years), with 14% Hispanic, 11% Asian, 19% African American, and 56% non-Hispanic white race/ethnicity. Men had a significantly worse impact of asthma on QoL than women. The impact of asthma on QoL was greatest in African American and Hispanic subjects compared with that seen in non-Hispanic white subjects. Our measures correlated highly with the AQLQ-M and more strongly with the PROMIS global physical than mental scales. They differentiated between adults with asthma according to their perceived severity, level of control, presence or absence of exacerbations, and physical comorbidity. CONCLUSION: The RAND-IAQL item bank, measuring the impact of asthma on QoL, will complement other patient-reported outcomes, such as measures of asthma symptoms, functioning, and control.

Developing a machine learning-based short form of the positive and negative syndrome scale.

BACKGROUND AND HYPOTHESIS: The Positive and Negative Syndrome Scale (PANSS) consists of 30 items and takes up to 50 minutes to administer and score. Therefore, this study aimed to develop and validate a machine learning-based short form of the PANSS (PANSS-MLSF) that reproduces the PANSS scores. Moreover, the PANSS-MLSF estimated the removed-item scores. STUDY DESIGN: The PANSS-MLSF was developed using an artificial neural network, and the removed-item scores were estimated using the eXtreme Gradient Boosting classifier algorithm. The reliability of the PANSS-MLSF was examined using Cronbach's alpha. The concurrent validity was examined by the association (Pearson's r) between the PANSS-MLSF and the PANSS. The convergent validity was examined by the association (Pearson's r) between the PANSS-MLSF and the Clinical Global Impression-Severity, Mini-Mental State Examination, and Lawton Instrumental Activities of Daily Living Scale. The agreement of the estimated removed-item scores with their original scores was examined using Cohen's kappa. STUDY RESULTS: Our analysis included data from 573 patients with moderate severity. The two versions of the PANSS-MLSF comprised 15 items and 9 items were proposed. The PANSS-MLSF scores were similar to the PANSS scores (mean squared error=2.6-24.4 points). The reliability, concurrent validity, and convergent validity of the PANSS-MLSF were good. Moderate to good agreement between the estimated removed-item scores and the original item scores was found in 60% of the removed items. CONCLUSION: The PANSS-MLSF offers a viable way to reduce PANSS administration time, maintain score comparability, uphold reliability and validity, and even estimate scores for the removed items.

Developing an Accumulative Assessment System of Upper Extremity Motor Function in Patients With Stroke Using Deep Learning.

OBJECTIVE: The Fugl-Meyer assessment for upper extremity (FMA-UE) is a measure for assessing upper extremity motor function in patients with stroke. However, the considerable administration time of the assessment decreases its feasibility. This study aimed to develop an accumulative assessment system of upper extremity motor function (AAS-UE) based on the FMA-UE to improve administrative efficiency while retaining sufficient psychometric properties. METHODS: The study used secondary data from 3 previous studies having FMA-UE datasets, including 2 follow-up studies for subacute stroke individuals and 1 test-retest study for individuals with chronic stroke. The AAS-UE adopted deep learning algorithms to use patients' prior information (ie, the FMA-UE scores in previous assessments, time interval of adjacent assessments, and chronicity of stroke) to select a short and personalized item set for the following assessment items and reproduce their FMA-UE scores. RESULTS: Our data included a total of 682 patients after stroke. The AAS-UE administered 10 different items for each patient. The AAS-UE demonstrated good concurrent validity (r = 0.97-0.99 with the FMA-UE), high test-retest reliability (intra-class correlation coefficient = 0.96), low random measurement error (percentage of minimal detectable change = 15.6%), good group-level responsiveness (standardized response mean = 0.65-1.07), and good individual-level responsiveness (30.5%-53.2% of patients showed significant improvement). These psychometric properties were comparable to those of the FMA-UE. CONCLUSION: The AAS-UE uses an innovative assessment method, which makes good use of patients' prior information to achieve administrative efficiency with good psychometric properties. IMPACT: This study demonstrates a new assessment method to improve administrative efficiency while retaining psychometric properties, especially individual-level responsiveness and random measurement error, by making good use of patients' basic information and medical records.

Involvement of ObRb receptor, nitric oxide, and BKCa channel signaling pathways in leptin-induced relaxation of pregnant mouse uterus.

The purpose of this study was to determine the receptor subtype and the underlying mechanisms involved in the relaxant effect to leptin in mid- and late-pregnant mouse uterus. We determined the relative mRNA expression of receptor subtypes, eNOS, and BKCa channel by quantitative PCR and also the overall receptor expression by immunohistochemistry. Isometric tension studies were conducted to evaluate the effects of leptin and to delineate its mechanisms. A selective siRNA for the ObRb receptor was used to determine the participation of the receptor subtype in biochemical and molecular effects of leptin. The relaxant response to leptin was greater in mid-pregnancy compared to late pregnancy and was mediated by the activation of BKCa channels by eNOS-derived nitric oxide in an ObRb receptor-dependent manner. In comparison to mid-pregnancy, expression of short forms (mainly ObRa receptor) of the receptor was significantly increased in late pregnancy, whereas ObRb receptor expression was similar in both phases. The results of the study suggest that ObRb receptor mediates leptin-induced increase in eNOS expression and NO synthesis. Leptin-induced eNOS expression and activation cause cGMP-independent stimulation of BKCa channels causing uterine relaxation. Increased short forms of the receptors and reduced BKCa channels exert a negative effect on uterine relaxation in late pregnancy. Leptin may have a physiological role in maintaining uterine quiescence in mid-pregnancy and its reduced relaxant response in late gestation may facilitate labor. Further, ObRb receptor agonists may be useful in the management of preterm labor.

The Development of a Short Form of the Indonesian Version of the Wechsler Adult Intelligence Scale-Fourth Edition.

(1) Background: The Wechsler intelligence scales are very popular in clinical practice and for research purposes. However, they are time consuming to administer. Therefore, researchers and psychologists have explored the possibility of shorter test battery compositions. (2) Methods: In this study, we investigated 13 potential short forms of the Indonesian version of the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV-ID). An existing standardization data set of 1745 Indonesian participants collected for the validation of the WAIS-IV-ID was used to examine the short forms' validity. These ranged from 2-subtest versions to 7-subtest versions. Regression analyses with goodness-of-fit measures were performed, and regression equations were determined for each short form to estimate the Full Scale IQ (FSIQ) score. Discrepancies between the FSIQ and the estimated FSIQ (FSIQEst) scores were examined and classification accuracies were calculated for each short form (% agreement of intelligence classification between the FSIQEst and FSIQ). (3) Results: None of the 13 short form FSIQEst values significantly differed from the FSIQ scores based on the full WAIS-IV-ID, and strong correlations were observed between each of these values. The classification accuracies of the short forms were between 56.8% and 81.0%. The 4-subtest short form of the WAIS-IV-ID consisting of the subtests Matrix Reasoning, Information, Arithmetic, and Coding had the optimal balance between best classification values and a short administration duration. The validity of this short form was demonstrated in a second study in an independent sample (N = 20). (4) Conclusions: Based on the results presented here, the WAIS-IV-ID short forms are able to reliably estimate the FSIQ, with a significant shorter administration duration. The WAIS-IV-ID short form consisting of four subtests, Matrix Reasoning, Information, Arithmetic, and Coding, was the best version according to our criteria.

Computerized-adaptive testing versus short forms for pediatric inflammatory bowel disease patient-reported outcome assessment.

Introduction: Computerized-adaptive testing (CAT) may increase reliability or reduce respondent burden for assessing patient-reported outcomes compared with static short forms (SFs). We compared CAT versus SF administration of the Patient-Reported Outcomes Measurement Information System® (PROMIS®) Pediatric measures in pediatric inflammatory bowel disease (IBD). Methods: Participants completed 4-item CAT, 5- or 6-item CAT, and 4-item SF versions of the PROMIS Pediatric measures. We compared average T-scores, intra-class correlations (ICCs), floor and ceiling effects, and standard error of measurement (SEM) across forms, along with mean effect sizes between active versus quiescent IBD disease activity groups. Results: Average PROMIS T-scores across forms were <3 points (minimally important difference) of each other. All forms correlated highly with each other (ICCs ≥0.90) and had similar ceiling effects, but the CAT-5/6 had lower floor effects. The CAT-5/6 had lower SEM than the CAT-4 and SF-4, and the CAT-4 had a lower SEM than the SF-4. Mean effect sizes were similar across forms when contrasting disease activity groups. Conclusions: The CAT and SF forms produced similar score results, but the CAT had better precision and lower floor effects. Researchers should consider PROMIS pediatric CAT if they anticipate that their sample will skew toward symptom extremes.

Measurement properties of PROMIS short forms for pain and function in patients receiving knee arthroplasty.

BACKGROUND: While there are a few studies on measurement properties of PROMIS short forms for pain and function in patients with knee osteoarthritis, nothing is known about the measurement properties in patients with knee arthroplasty. Therefore, this study examined the measurement properties of the German Patient-Reported Outcomes Measurement Information System (PROMIS) short forms for pain intensity (PAIN), pain interference (PI) and physical function (PF) in knee arthroplasty patients. METHODS: Short forms were collected from consecutive patients of our clinic's knee arthroplasty registry before and 12 months post-surgery. Oxford Knee Score (OKS) was the reference measure. A subsample completed the short forms twice to test reliability. Construct validity and responsiveness were assessed using scale-specific hypothesis testing. For reliability, Cronbach's alpha, intraclass correlation coefficients, and agreement using standard error of measurement (SEMagr) were used. Agreement was used to determine standardised effect sizes and smallest detectable changes (SDC90). Individual-level minimal important change (MIC) was calculated using a method of adjusted prediction. RESULTS: Of 213 eligible patients, 155 received questionnaires, 143 returned baseline questionnaires and 119, 12-month questionnaires. Correlations of short forms with OKS were large (│r│ ≥ 0.7) with slightly lower values for PAIN, and specifically for men. Cronbach's alpha values were ≥ 0.84 and intraclass correlation coefficients ≥ 0.90. SEMagr were around 3.5 for PAIN and PI and 1.7 for PF. SDC90 were around 8 for PAIN and PI and 4 for PF. Follow-up showed a relevant ceiling effect for PF. Correlations with OKS change scores of around 0.5 to 0.6 were moderate. Adjusted MICs were 7.2 for PAIN, 3.5 for PI and 5.7 for PF. CONCLUSION: Our results partly support the use of the investigated short forms for knee arthroplasty patients. The ability of PF to differentiate between patients with high perceived recovery is limited. Therefore, the advantages and disadvantages should be strongly considered within the context of the intended use.

A brief young adult alcohol problems screening test: Short form development using combinatorics.

Objective: To develop a shortened form of the Young Adult Alcohol Problems Screening Test1 (YAAPST; original length = 27 items) using a novel combinatorial approach. Participants: 489 college freshmen, half of whom were above average risk for alcohol use disorder based upon family history, attending a large, Midwestern University followed prospectively for 16-17 years across 7 measurement occasions (waves). Methods: Using an exhaustive combinatorial approach, we evaluated all possible combinations of questions and questionnaire length. Each candidate short-form was evaluated using part-whole correlations, alpha coefficients, and polyserial correlations with DSM-III criteria. Results: The 12-item scale, the Brief-YAAPST, was chosen as the best candidate short-form as this scale had the fewest items while maintaining strong reliability and validity. Conclusions: Complete enumeration optimization effectively produced a 12-item short form with minimal loss of reliability and validity making the Brief-YAAPST a desirable assessment alternative when there are concerns about participant or client burden.

A validated WAIS-IV short-form to estimate intellectual functioning in myotonic dystrophy type 1.

Currently, no rapid and specific instrument is available to briefly estimate intelligence in patients with myotonic dystrophy type 1 (DM1), a multisystemic disease that involves the CNS and is associated with cognitive deficits and low intellectual functioning. This study aimed to develop a DM1-specific and valid short-form of the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) to estimate intellectual functioning in this population. Thirty non-congenital DM1 patients (10 female; mean age=46.77; SD= 9.76) were assessed with the WAIS-IV. Data were analyzed following two independent strategies: A) multiple linear regression with the aim of maintaining the scale's factorial structure; and B) correlational analyses between scores on all WAIS-IV subtests and Full-Scale IQ (FSIQ). Validity of the resulting short-forms was also analyzed. Three short-forms were developed: Proposal A from strategy A (Vocabulary, Block Design, Arithmetic and Symbol Search), Proposal B1 (Vocabulary, Block Design, Digit Span and Visual Puzzles) and Proposal B2 (Vocabulary and Block Design), from strategy B. All three short-forms showed a strong and significant correlation with the FSIQ and were considered psychometrically acceptable. Arguments in favor of Proposal B1 are discussed. Assessing FSIQ with these short-forms will be useful for avoiding long assessment procedures in a population characterized by high fatigability.

Comparing Boston naming test short forms in a rehabilitation sample.

The Boston Naming Test (BNT) has multiple short forms that do not include the noose item that have been primarily examined in dementia populations. This study compared BNT short forms with standard administration (BNT-S) in physical medicine and rehabilitation patients who underwent outpatient evaluation. The sample (N = 480) was 34% female and 91% white with average age of 46 years (SD = 15) and average education of 14 years (SD = 3). Five 15-item short forms were calculated: Consortium to Establish a Registry for Alzheimer's disease (CERAD-15); Lansing; and Mack 1, 2, and 4 (Mack-15.1, -15.2). Three 30-item short forms were calculated: Mack A, Saxon A, and BNT odd items. BNT-S and short forms were compared with Spearman correlations. Cronbach's alpha was calculated for all BNT forms. Impaired BNT scores were determined with norm-referenced scores (T < 36 and T < 40). Area under the curve (AUC) values were compared across short forms with impaired BNT as criterion. BNT-S showed strong correlations with 30-item (rho = 0.92-0.93) and 15-item short forms (rho = 0.80-0.87) except for CERAD-15 (rho = 0.69). Internal consistency was acceptable for all short forms (alpha = 0.72-0.86). BNT-S was impaired in 17% and 33% of participants at 35 T and 39 T cutoffs, respectively. BNT short forms showed excellent to outstanding classification accuracy predicting impairment using both cutoffs. BNT short forms warrant further study in rehabilitation settings.

Correlates of Social Cognition and Psychopathic Traits in a Community-Based Sample of Males.

Social cognition is the ability to identify, understand, and interpret mental states and emotions. Psychopathic traits are typically described in two ways; Primary: shallow affect, emotional detachment, and relationship difficulties, and Secondary Psychopathic Traits: antisocial traits, impulsiveness, and emotional dysregulation. People with high psychopathic traits tend to perform lower on measures of social cognition. This study investigated the relationship of social cognition (mentalising) to primary and secondary psychopathic traits in a non-clinical sample, and investigated the psychometric properties of the Reading the Mind in the Eyes Test (RMET) Short Forms (A and B). A community-based male sample (N = 1,000; age range 18-78) was recruited through an online platform. Psychopathic traits were measured using Levenson, Kiehl, and Fitzpatrick's Self-Report Psychopathy Scale, and stratified into Primary and Secondary Psychopathic traits. Secondary validation of the RMET Short Forms was completed investigating scale reliability, and validity. Findings suggest excellent psychometrics in a large community cohort for the RMET Short Forms (A and B), with significant negative correlations on social cognitive performance and high self-report psychopathy. The item valence within the social cognitive measure (positive, negative, and neutral affect stimuli) was also examined, and correlated significantly with both Primary and Secondary Psychopathic traits. This study provides further validation of the RMET Short Forms (A and B), and adds to the literature on the scale by investigating performance on short-form specific valence. This study further suggests that in a non-clinical community sample of males, that higher psychopathic traits correlated significantly, and negatively, with social cognitive performance.

Comparing Scores From Full Length, Short Form, and Adaptive Tests of the Social Interaction Anxiety and Social Phobia Scales.

The current study developed and examined the performance of a computerized adaptive version of the Social Interaction Anxiety and Social Phobia Scales (SIAS/SPS) and compared results with a previously developed static short form (SIAS-6/SPS-6) in terms of measurement precision, concordance with the full forms, and sensitivity to treatment. Among an online sample of Australian adults, there were relatively minor differences in the performance of the adaptive tests and static short forms when compared with the full scales. Moreover, both adaptive and static short forms generated similar effect sizes across treatment in a clinical sample. This provides further evidence for the use of static or adaptive short forms of the SIAS/SPS rather than the lengthier 20-item versions. However, at the individual level, the adaptive tests were able to maintain an acceptable level of precision, using few items as possible, across the severity continua in contrast to the static short forms.

Equivalent short forms of the Situational Feature Recognition Test 2: Psychometric properties and analysis of interform equivalence and test-retest reliability.

OBJECTIVE: To obtain two equivalent short forms of the "Situational Feature Recognition Test, Version 2," a social perception test, and their psychometric properties. METHODS: Patients with schizophrenia (n = 101) were assessed at two different times. Statistical analyses were performed as follows: (1) Cronbach's alpha was used to assess reliability; (2) Spearman correlations, Wilcoxon signed-rank test, and a 2 (form) × 2 (time) repeated measures multivariate analysis of variance were used to analyse interform equivalence; (3) Sensitivity to change was studied by a 2 (group) × 2 (time) repeated measures multivariate analysis of variance; (4) Spearman correlations were employed to assess test-retest reliability, convergent and discriminant validity, and relationship with functionality and symptoms. RESULTS: The short forms showed good internal consistency at both times. Significant and moderate correlation between forms was found along with no statistically significant form x time interaction. Hits and false positives of both forms were moderately correlated at both times. Group x time interaction was significant especially for hits when assessing sensitivity to change. Both forms were significantly correlated with other social cognition domains and with functionality. CONCLUSIONS: Results of this study support the use of short forms of the Situational Feature Recognition Test, Version 2 especially in clinical trials and longitudinal studies among patients with schizophrenia.

Assessment of Burden Among Family Caregivers of Schizophrenia: Psychometric Testing for Short-Form Zarit Burden Interviews.

Objective: Although various short forms of Zarit Burden Interview (ZBI) have been developed, there is a lack of standard psychometric testing and comparison among them. The study aims to examine the psychometric properties of ten short versions of the most frequently used ZBI among a sample of schizophrenia caregivers and to find the one with the best performance. Methods: Cross-sectional door-to-door survey of ZBI-22 and a series of validated instrument data from 327 family caregivers of schizophrenia patients in a Chinese rural community were conducted from October 2015 to January 2016. Reliability was assessed using McDonald's omega coefficient (ω). Validity including concurrent validity, known group's validity, and criterion validity were assessed by Spearman correlations and Mann-Whitney U tests. Overall discrimination ability was evaluated using the area under the receiver operating characteristic curve (AUC). Results: Reliability was generally good for all short forms (ω = 0.69-0.84), except for the Gort ZBI-4 (ω = 0.58), which is acceptable considering its small item numbers. Concurrent validity was good across all various ZBI forms with significant negative correlations with patient's function (r = -0.34 to -0.48, p < 0.01), as well as significant positive correlations with caregiver's depression (r = 0.49-0.65, p < 0.01), and anxiety symptoms (r = 0.45-0.58, p < 0.01). Known groups' validity (carers with disease vs. without disease; carers being parents vs. spouse vs. others) showed inconsistent results among various short forms. Criterion validity was generally good for all short forms with significant positive correlations with Family Burden Interview Schedule (r = 0.67-0.75, p < 0.01), except for the Higginson ZBI-1(r = 0.57, p < 0.01). Discriminative ability was also good for all short forms (AUC range: 0.85-0.99), with various cutpoints proposed. Among all ten short forms, the Ballesteros ZBI-12 and the Gort ZBI-7 outperformed others with almost equally good performance in comprehensive psychometric testing. Conclusions: This study provides support for the reliability, validity, and discriminative ability of the ten various short forms of ZBI for use among schizophrenia family caregivers, with the Ballesteros ZBI-12 and the Gort ZBI-7 endorsed as the best ones.

Accuracy of Short Forms of the Dutch Wechsler Preschool and Primary Scale of Intelligence: Third Edition.

This article investigated the accuracy of six short forms of the Dutch Wechsler Preschool and Primary Scale of Intelligence-Third edition (WPPSI-III-NL) in estimating intelligent quotient (IQ) scores in healthy children aged 4 to 7 years (N = 1,037). Overall, accuracy for each short form was studied, comparing IQ equivalences based on the short forms with the original WPPSI-III-NL Full Scale IQ (FSIQ) scores. Next, our sample was divided into three groups: children performing below average, average, or above average, based on the WPPSI-III-NL FSIQ estimates of the original long form, to study the accuracy of WPPSI-III-NL short forms at the tails of the FSIQ distribution. While studying the entire sample, all IQ estimates of the WPPSI-III-NL short forms correlated highly with the FSIQ estimates of the original long form (all rs ≥ .83). Correlations decreased significantly while studying only the tails of the IQ distribution (rs varied between .55 and .83). Furthermore, IQ estimates of the short forms deviated significantly from the FSIQ score of the original long form, when the IQ estimates were based on short forms containing only two subtests. In contrast, unlike the short forms that contained two to four subtests, the Wechsler Abbreviated Scale of Intelligence short form (containing the subtests Vocabulary, Similarities, Block Design, and Matrix Reasoning) and the General Ability Index short form (containing the subtests Vocabulary, Similarities, Comprehension, Block Design, Matrix Reasoning, and Picture Concepts) produced less variations when compared with the original FSIQ score.