Construct Validity, Test-Retest Reliability, and Inter-Rater Objectivity of the Swimming Competence Assessment Scale (SCAS)

The Global Assessment of Severity of Epilepsy (GASE) Scale is a single-item, 7-point global rating scale designed for neurologist-report of overall severity of epilepsy in children. Building on previous preliminary evidence of its validity and reliability for research and clinical use, this study evaluated the GASE Scale's construct validity, reliability, and responsiveness to changes in severity of epilepsy. Data used for the study arose from the Health-Related Quality of Life in Children with Epilepsy Study (HERQULES), a 2-year multicenter prospective cohort study (n = 374) with observations taken at baseline, and 6, 12, and 24 months after diagnosis. Construct validity and reliability were quantified using Spearman's correlation and intraclass correlation coefficient (ICC). Responsiveness was assessed using both distribution-based and anchor-based indices. The GASE Scale was at least moderately correlated (r ≥ 0.30) with several key clinical aspects and most strongly correlated with frequency and intensity of seizures and interference of epilepsy or drugs with daily activities (r > 0.30). Total variation in GASE Scale scores explained by seven core clinical aspects of epilepsy increased over time (R(2) = 28% at baseline to R(2) = 70% at 24 months). The GASE Scale had modest test-retest reliability (ICC range: 0.52-0.64) and was responsive to changes in clinical criteria (standardized response mean range: 0.49-0.68; probability of change range: 0.69-0.75; Guyatt's responsiveness statistic range: 0.56-0.84). The GASE Scale showed potential to discriminate "stable" and "changed" patients according to select criteria and to a composite score (area under the receiver operating characteristic [ROC] curve range: 0.50-0.67). Results offer additional evidence in support of the GASE Scale's validity, reliability, as well as responsiveness to changes in severity of epilepsy in children. We conclude that the GASE Scale is a potentially useful tool for assessing the severity of epilepsy in both clinical and research settings.

Reliability, Construct Validity, and Clinical Feasibility of the Activities-Specific Fall Caution Scale for Residential Living Seniors

To assess the validity and reliability of the stoma self-efficacy scale for Turkish-speaking individuals with stoma. Self-efficacy in stoma care is one of the most important variables requiring compliance for an increase in the quality of life and well-being of individuals with stoma. A methodological study. This study used translation and back translation for the scale's language equivalence and expert opinion for the content validity. An expert panel and 10 individuals with stoma evaluated the scale for face validity. The scale's reliability was assessed by internal consistency, Pearson correlation, and test-retest reliability in a sample of 174 individuals with stomas. The scale's construct validity was tested with confirmatory factor analysis and exploratory factor analysis. The content validity index was .96, and Cronbach's alpha was .95. In the test-retest analysis, the intraclass correlation coefficients were high. In the factor analysis, two factors emerged from the scale, and after the confirmatory factor analysis and scale modification, the fit indices of the model were found to provide a good level of validity. The Turkish version of the stoma self-efficacy scale is a valid and reliable tool to determine the levels of self-efficacy in individuals with stoma.

BackgroundBalance and gait problems are common and progressive in dementia. Use of a mobility aid provides physical support and confidence. Yet, mobility aid use in people with dementia increases falls three-fold. An assessment tool of mobility aid safety in people with dementia does not currently exist. The objectives of this study were: 1) to develop a tool for the evaluation of physical function and safe use of a 4-wheeled walker in people with dementia, and 2) to evaluate its construct and criterion validity, inter-rater and test-retest reliability and minimal detectable change.MethodsHealthcare professionals (HCP) experienced in rehabilitation of people with dementia participated in focus groups for item generation of the new tool, The Safe Use of Mobility Aid Checklist (SUMAC). The SUMAC evaluates physical function (PF) and safe use of the equipment (EQ) on nine tasks of daily life. Reliability was evaluated by HCP (n = 5) scored participant videos of people with dementia (n = 10) using a 4-wheeled walker performing the SUMAC. Inter-rater and test-retest reliability was assessed using intra-class correlation coefficients (ICC). Construct validity evaluated scores of the HCPs to a consensus HCP panel using Spearman’s rank-order correlations. Criterion validity evaluated SUMAC-PF to the Performance-Oriented Mobility Assessment (POMA) gait subscale using Spearman’s rank-order correlations.ResultsThree focus groups (n = 17) generated a tool comprised of nine tasks and the components within each task for physical function and safe use. Inter-rater reliability was statistically significant for SUMAC-PF (ICC = 0.92, 95%CI (0.81, 0.98), p < 0.001) and SUMAC-EQ. (ICC = 0.82, 95%CI (0.54, 0.95), p < 0.001). Test-retest reliability was statistically significant for SUMAC-PF (ICC = 0.89, 95%CI (0.81, 0.94), p < 0.001) and SUMAC-EQ. (ICC = 0.88, 95%CI (0.79, 0.93), p < 0.001). As hypothesized, the POMA gait subscale correlated strongly with the SUMAC-PF (rs = 0.84), but not EQ (rs = 0.39).ConclusionsThe focus groups and research team developed a tool of nine tasks with evaluation on physical function and safe use of a 4-wheeled walker for people with dementia. The SUMAC tool has demonstrated content validity for the whole scale and good construct and criterion validity for the SUMAC-PF and SUMAC-EQ. The subscores of the SUMAC demonstrated excellent to good inter-rater and test-retest reliability.

Objective and accurate assessment of the degree of ocular motor nerve palsy is helpful not only in the evaluation of prognosis, but also for the screening of treatment methods. However, there is currently no comprehensive measure of its severity. In this study, we designed the Ocular Motor Nerve Palsy Scale and investigated its validity and reliability. Six experts were invited to grade and evaluate the scale. The study recruited 106 patients with a definite diagnosis of unilateral isolated ocular motor nerve palsy. Three physicians evaluated the patients using the scale. One of the three physicians evaluated the patients again after 24 hours. The content validity index (CVI) and factor analysis were used to analyze the scale's construct validity. The intraclass correlation coefficient and Cronbach's alpha were used to evaluate the inter-rater and test-retest reliability and the internal consistency. The CVI results (I-CVI = 1.0, S-CVI = 0.9, P = 0.016, K* = 1) indicated good content validity. Factor analysis extracted two common factors that accounted for 85.2% of the variance. Furthermore, the load value of each component was above 0.8, indicating good construct validity. The Ocular Motor Nerve Palsy Scale was found to be highly reliable, with an inter-rater reliability intraclass correlation coefficient of 0.965 (P < 0.01), a test-retest reliability intraclass correlation coefficient of 0.976 (P < 0.01), and Cronbach's alpha values of 0.63-0.70. In conclusion, the Ocular Motor Nerve Palsy Scale with good validity and reliability can be used to quantify the severity of ocular motor nerve palsy. This study was registered at Chinese Clinical Trial Registry (registration number: ChiCTR-OOC-17010702).

Objective To assess the test–retest reliability, internal consistency, and construct validity of the 9-item Tampa Scale for Kinesiophobia in patients with chronic low back pain. Design Questionnaire validation study. Setting Study was conducted in an online environment. Participants We included people aged 18 to 50 years with self-reported low back pain lasting > three months and assessed the Pain-Related Catastrophizing Thoughts Scale and the 9-item Tampa Scale for Kinesiophobia. Main measures We used intraclass correlation coefficient, standard error of measurement, minimum detectable change, and Cronbach's alpha to assess the reliability and internal consistency of the 9-item Tampa Scale for Kinesiophobia. We tested correlations between the domains of the 9-item Tampa Scale for Kinesiophobia and the other variables to assess construct validity. Results A total of 174 participants with chronic low back pain were included in the analysis. No ceiling or floor effect was found. In terms of construct validity, there was a positive correlation between the domains of the 9-item Tampa Scale for Kinesiophobia and the other variables. In the reliability analysis, there was adequate test–retest reliability of the two domains of the 9-item Tampa Scale for Kinesiophobia: intraclass correlation coefficient = 0.99, standard error of measurement = 3.4%, and minimum detectable change = 9.6% for the activity avoidance domain; and intraclass correlation coefficient = 0.99, standard error of measurement = 3.5%, and minimum detectable change = 9.9% for the somatic focus domain. There was acceptable internal consistency (Cronbach's alpha ≥ 0.68) for both domains. Conclusion The 9-item Tampa Scale for Kinesiophobia has adequate measurement properties in patients with chronic low back pain.

Dental fear and anxiety (DFA) is a common, deterring problem affecting children, which has a significant negative impact on children's oral health, leading to avoidance of dental care, poor dental hygiene, and an increased risk of dental caries and other oral health problems. The Oddbods DFA assessment is an innovative, child-friendly instrument that has been developed to assess DFA in children. To evaluate the reliability and validity of the scale, and to examine the internal consistency, test-retest reliability, and criterion and construct validity of the scale. This study has assessed the reliability, criterion validity, and construct validity of the novel Oddbods anxiety assessment scale among 4-6-year-old children. Different samples were recruited to assess different criteria. A normative study was done to assess the distribution of age of the children according to anxiety levels. For assessing the test's retest reliability statistically, Statistical Package for the Social Sciences (SPSS) software version 23.0, Cronbach's α, interclass correlation coefficient, and t-test were used. For evaluating the criterion validity, the Spearman correlation coefficient was used. The Kaiser-Meyer-Olkin (KMO) test was used in an exploratory factor analysis to determine whether the sample size was sufficient for the factor analysis. The scale had a high positive correlation with the modified child dental anxiety scale (MCDAS), which is considered a gold standard, and a higher Cronbach's α value, which proved its internal consistency. It also showed a significant difference between anxious and nonanxious children, but there were no differences in the scores with respect to age. The present scale proved to be a very effective tool for assessing DFA among young children. It is important to identify children at risk of dental anxiety. This scale helps to follow-up on children for their innate DFA, evaluate the efficacy of dental anxiety interventions, enhance communication, and improve access to dental care by encouraging children to seek dental care without fear or hesitation, promoting preventive care and better oral health outcomes. Fathima A, Ravikumar R, Chellappa LR. Development of Cartoon-based Dental Anxiety Scale for Children: Validation and Reliability. Int J Clin Pediatr Dent 2024;17(7):796-801.

Purpose Translate, investigate reliability, and construct validity of the Brazilian Early Activity Scale for Endurance (EASE). Materials and methods Translation followed the international guidelines. Test–retest reliability was tested by 100 parents of children with cerebral palsy (CP): 18 months–5 years and 6–11 years. To determine construct validity, 94 parents of typically children completed the EASE. Statistical analysis included Bland–Altman, Intraclass Correlation Coefficient (ICC), Internal Consistency, and Floor and Ceiling Effect. Results The majority of the sample consisted of children with CP in GMFCS (IV–V). EASE showed good test–retest reliability for younger (ICC = 0.8) and excellent test–retest reliability for older children with CP (ICC = 0.9), and good internal consistency of 0.7 and 0.8 for the young and older group, respectively. Bland–Altman showed the bias close to zero, with no ceiling or floor effect. Regarding construct validity, younger children showed lower scores when compared to the older children. Endurance differed significantly between children with CP who were walking and those who were not walking and also for age groups. Children with CP showed lower endurance compared to typically participants in the same age group. Conclusions Brazilian EASE is reliable and valid to estimate endurance in children with CP. Results provide evidence of construct validity.

Validity and reliability of the italian-Neonatal skin risk assessment scale (i-NSRAS)

A composite pain scale for assessing and quantifying pain in rabbits (CANCRS) has been designed merging the Rabbit Grimace Scale (RbtGS) and a scale including clinical parameters (CPS). Construct validity and inter-rater reliability were assessed for CANCRS, for RbtGS and for CPS, in order to test their potential to detect pain in a clinical setting. Rabbits (n = 116) were either hybrids or purebreds and they were independently evaluated by two raters, who could be veterinarians (V) or veterinary medicine students (S). Score intervals determined four pain classes (No pain, Discomfort, Moderate pain and Severe pain) that matched presumptive pain classes associated with some pathological conditions. A chi-square test was used to assess the construct validity of the scales by checking how frequently scale results and presumptive pain classes matched. Sixty-nine patients were evaluated by one V and one S, whereas forty-seven rabbits were assessed by two V, in order to test inter-rater reliability. An intra-class correlation coefficient (ICC) was used to test reliability of the scales, whereas Cohen’s kappa tested inter-rater agreement for each parameter of the CANCRS. Construct validity results show that CANCRS and RbtGS efficiently reveal pain (P ≤ 0.05), while CPS does not (p > 0.05). Inter-rater reliability was very good for both CANCRS and CPS (ICC 0.88 V-V, 0.94 between V-S; ICC 0.97 V-V, 0.91 V-S) and good for RbtGS (ICC 0.77 V-V, 0.88 V-S); therefore, CPS reproducibility was better between veterinarians and students than between veterinarians. Inter-rater agreement between veterinarians and veterinary medicine students was moderate to very good for all the parameters included in the CANCRS (Cohen’s kappa >0,60). In conclusion, it is possible to state that the CANCRS has construct validity and it is a reliable tool for use in clinical practice, when coping with many rabbits with morphological differences. It is easy and fast to use and enriches the RbtGS with some clinical parameters that should be monitored during any clinical examination, allowing for capture of the multidimensional aspect of pain.

As a globally popular physical activity, swimming also presents challenges due to its inherent aquatic risks. Therefore, the cultivation of swimming competence emerges as a crucial strategy in preventing drowning incidents. This study aimed to develop and validate the Swimming Competence Assessment Scale in College Students (SCAS) to address the gap in structured swimming proficiency evaluation, essential for drowning prevention and water safety education. The research involved 160 full-time second-year college students, including 92 males (age: ) and 68 females (age: ), who underwent two swimming ability assessments. The evaluation covered fundamental swimming skills, including entry, submersion, rotation, prone and supine swimming, floating, and exiting the water. Exploratory Factor Analysis revealed goodness-of-fit for a two-factor model swimming coherent motion and swimming stable posture, which supported the construct validity. The inter-factor construct reliability (CR = 0.866, CR = 0.835) and the square root of Average Variance Extracted ( = 0.754, = 0.848) exceeded the standards for supporting convergent and discriminant validity. The inter-rater reliability (IRR = 0.542) and Cronbach's alpha (α = 0.840, α = 0.827) coefficient results have demonstrated the internal reliability of the SACS. Positive correlation between SCAS scores at pre-test and post-test provided evidence for SCAS's test-retest reliability (TRR = 0.825, TRR = 0.758). SCAS is a valid and reliable assessment scale. It assesses college students' swimming competence through two aspects: Swimming Coherent Motion and Swimming Stable Posture.

Movement quality assessed by the Body Awareness Rating Scale (BARS) is used as an indicator of health and self-efficacy in patients with long-lasting musculoskeletal and mental health problems. The objective of the study was to examine reliability and construct validity of the movement quality scale. 25 patients and 25 healthy persons were included. Internal consistency was examined by Cronbach's α, reliability by intraclass correlation coefficient (ICCagreement) and measurement error reported by standard error of measurement (SEM) and smallest detectable change (SDC). Construct validity was examined by testing hypotheses of moderate association between the observational scale and the self-report Short-Form Health Survey (SF-36) subscales and the General Perceived Self-Efficacy Scale (GPSES). A hypothesis about the difference in scores between groups being expected to differ in health states was tested. Internal consistency (α) was 0.92. Inter-tester reliability was ICC = 0.99 and SEM = 0.8. The test–retest reliability was ICC = 0.96 and SEM = 1.4, implying that improvement should be above 3.3 (SDC) to claim a treatment effect. BARS was moderately correlated (0.30 ≤ rs < 0.60) with most SF-36 subscales and GPSES. The patients demonstrated less movement quality than healthy persons. Evidence was provided of high internal consistency and reliability in qualified testers. Construct validity was indicated, as BARS reflected various aspects of health and self-efficacy.

Clinicians use the Activities-specific Balance Confidence Scale to understand balance confidence. A short-form Activities-specific Balance Confidence scale, was developed using the six most difficult tasks from the original Activities-specific Balance Confidence scale; however, short-form the short-form scale psychometrics and agreement with the original scale have yet to be explored in people with lower extremity amputations. To determine the relative and absolute reliability, construct validity, and agreement of the short-form Activities-specific Balance Confidence scale. Test-retest with a 2-week interval. Analysis for relative reliability and internal consistency was intraclass correlation coefficient and Cronbach's α, respectively. Absolute reliability was measured using standard error of measurement and minimal detectable change. Bland-Altman plots measured agreement between scales. Construct validity was evaluated against the L Test using a Pearson-product moment correlation. The short-form Activities-specific Balance Confidence (intraclass correlation coefficient = 0.92) and Activities-specific Balance Confidence (intraclass correlation coefficient = 0.91) scales had excellent relative reliability. Both scales demonstrated good internal consistency. Worse absolute reliability was observed in the short-form Activities-specific Balance Confidence scale. Construct validity against the L Test was confirmed. Bland-Altman plots indicated poor agreement between scales. Both scales exhibit excellent relative reliability and good internal consistency and construct validity. Poor agreement between short-form Activities-specific Balance Confidence and Activities-specific Balance Confidence indicates the scales should not be used interchangeably. Inadequate absolute reliability of the short-form Activities-specific Balance Confidence scale suggests the Activities-specific Balance Confidence should be the balance confidence scale of choice. Balance confidence is an important metric for our understanding of rehabilitation and community re-integration in people with lower extremity amputations. Due to inferior absolute reliability and a lack of appropriate items composing the short-form Activities-specific Balance Confidence scale, the full-scale Activities-specific Balance Confidence is recommended for the assessment of balance confidence in this population.

The Movement Disorder Society-UPDRS (MDS-UPDRS) was published in 2008, showing satisfactory clinimetric results and has been proposed as the official benchmark scale for Parkinson's disease. The present study, based on the official MDS-UPDRS Spanish version, performed the first independent testing of the scale and adds information on its clinimetric properties. The cross-culturally adapted MDS-UPDRS Spanish version showed a comparative fit index ≥ 0.90 for each part (I-IV) relative to the English-language version and was accepted as the Official MDS-UPDRS Spanish version. Data from this scale, applied with other assessments to Spanish-speaking Parkinson's disease patients in five countries, were analyzed for an independent and complementary clinimetric evaluation. In total, 435 patients were included. Missing data were negligible and moderate floor effect (30 %) was found for Part IV. Cronbach's α index ranged between 0.79 and 0.93 and only five items did not reach the 0.30 threshold value of item-total correlation. Test-retest reliability was adequate with only two sub-scores of the item 3.17, Rest tremor amplitude, reaching κ values lower than 0.60. The intraclass correlation coefficient was higher than 0.85 for the total score of each part. Correlation of the MDS-UPDRS parts with other measures for related constructs was high (≥ 0.60) and the standard error of measurement lower than one-third baseline standard deviation for all subscales. Results confirm those of the original study and add information on scale reliability, construct validity, and precision. The MDS-UPDRS Spanish version shows satisfactory clinimetric characteristics.

Objective: To examine internal consistency, test-retest reliability, floor/ceiling effects and construct validity of the Fatigue Assessment Scale (FAS), when self-administrated by persons with mild to moderate stroke.Method: The FAS was translated into Swedish and tested for psychometric properties when self-administrated by persons with mild to moderate stroke. Participants, consequently selected from the stroke unit admission register received a letter with three questionnaires: the FAS, Short Form Health Survey (SF-36) subscale for vitality and Geriatric Depression Scale, GDS-15. Within two weeks, a second letter with FAS was sent for re-test.Result: Seventy-tree persons with mild to moderate stroke participated in the study. Internal consistency was good (Cronbach’s alpha 0.82). The test and retest reliability of individual items showed that five items out of 10 items were good (weighted kappa > 0.60), four were moderate (0.40-0.60), and one was fair (0.22). The relative reliability between total scores was good (ICC 3.1 = 0.73) and the absolute reliability was nine points, meaning that a change of at least nine points in total score implies a real change of fatigue level. Correlation analysis showed that the Swedish FAS correlated with the SF-36 subscale for vitality (rs = - 0.73) and GDS-15 (rs = 0.62), suggesting convergent construct validity. There were no floor or ceiling effects.Conclusion: The Swedish translation of the FAS used as a self-administrated questionnaire is reliable and valid for measuring fatigue in persons with mild to moderate stroke.