Measuring medical student wellbeing longitudinally: a psychometric systematic review of commonly used scales

307 Talking about sex: identifying psycho-sexual concerns in the clinic

The International Index of Erectile Function (IIEF)—A Systematic Review of Measurement Properties

Validation of the Collaborative Practice Assessment Tool (CPAT) to assess the degree of inter-professional collaboration (IPC) in a Community Hospital in Singapore

ObjectiveTo identify and appraise published evidence of the measurement properties for epilepsy‐specific patient‐reported outcome measures (PROMs) of children's health‐related quality of life (HRQoL).MethodsWe searched multiple databases for studies evaluating the measurement properties of English‐language epilepsy‐specific PROMs of children's HRQoL. We assessed the methodological quality using the COnsensus‐based Standards for the selection of health Measurement INstruments (COSMIN) guidance. We extracted data about the content validity, construct validity, internal consistency, test‐retest reliability, proxy reliability, responsiveness, and precision, and assessed the measurement properties with reference to standardized criteria.ResultsWe identified 27 papers that evaluated 11 PROMs. Methodological quality was variable. Construct validity, test‐retest reliability, and internal consistency were more commonly assessed. Quality of Life in Childhood Epilepsy (QoLCE) questionnaires are parent‐reported and evaluated more than other PROMs; QoLCE‐55 has good and replicated evidence for structural and construct validity and internal consistency. Health‐Related Quality of Life Measure for Children with Epilepsy (CHEQoL) has both child and parent‐reported versions and good evidence of content, structural, and construct validity.SignificanceThis review identified two leading candidate epilepsy‐specific PROMs for measuring health‐related quality of life in children. Establishing evidence of the responsiveness of PROMs is a priority to help the interpretation of meaningful change scores.

Cross-cultural adaptation, reliability, and validity of the pain self-efficacy questionnaire - Hebrew version

BackgroundA robust insomnia screening and measuring tool is essential for accurately assessing and diagnosing insomnia in research and clinical settings. The Sleep Condition Indicator (SCI) is an initial screening tool designed to assess insomnia complaints according to the DSM-5 criteria. This study aims to systematically evaluate item content, psychometric performance, diagnostic performance, and overall application of the SCI through a methodological quality assessment of original validation studies. These findings offer valuable information for optimizing insomnia diagnosis, assessment, and monitoring.MethodsA comprehensive search was conducted for finding studies published from 2012 to 2024, in PubMed, EMBASE, CINAHL, and MEDLINE electronic databases, and citation searching in PubMed, SCOPUS, Web of Science, and Google Scholar. Full-text articles focusing on the translation, validation, and application of the SCI were included. The psychometric studies were assessed regarding their measurement properties and methodological quality, using the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines. The diagnostic studies were assessed using the Standard for Reporting of Diagnostic Accuracy (STARD) guidelines. Finally, studies in which the SCI was used for assessment or screening purposes provided general information on the application of the scale.ResultsWe identified 285 studies with over 720,000 participants that used the SCI, and 13 language versions of the SCI were employed across at least 31 regions. The most commonly assessed measurement properties of the SCI within 19 studies were structural validity, internal consistency, criterion validity, and reliability, with findings supporting a stable two-factor structure and credible overall psychometric properties. The SCI demonstrated adequate sensitivity and specificity in 14 studies evaluating its diagnostic performance, and a cut-off value of 16 was recommended for screening insomnia. Finally, the studies showed that the SCI is widely used across clinical and non-clinical settings and provides valuable information for assessing insomnia risks.ConclusionsThe SCI includes items that align with the most current diagnostic criteria for insomnia disorder from the DSM-5. This tool demonstrates excellent psychometric performance and strong diagnostic performance. Overall, the SCI provides useful information for screening, diagnosing, and monitoring insomnia, making it a valuable tool in both research and clinical settings.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12916-025-04285-7.

ObjectivesTo systematically review the psychometric properties of the Geriatric Oral Health Assessment Index (GOHAI) across age groups using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology. MethodsData: English peer-reviewed articles reporting studies of the development, translation, or validation of GOHAI. Sources: PubMed, Web of Science, and EMBASE from Jan 1990 until December 31, 2023. Methodological evaluation: based on COSMIN methodology. The results are presented overall and for 4 age groups (≥60 years, all ages, <60 years, ≤45 years). Structural validity was summarized qualitatively. Internal consistency and reliability were synthesized via random-effects meta-analysis of T-transformed Cronbach α values, and Fisher's Z transformed correlation coefficients. Construct validity and responsiveness were assessed using effect sizes. ResultsFour hundred ninety-seven records were identified, 72 underwent full-text assessment, resulting in 60 included reports. Structural validity was inconsistent across all age groups and overall. Internal consistency was sufficient with overall α = 0.81, and high evidence quality. Test-retest reliability was consistently sufficient across age groups with overall r = 0.84. For construct validity 361 hypotheses were assessed (37.4% for convergent-, 62.6% for known-groups validity). The percentage of confirmed hypotheses in ≥60-years, all ages, <60-years and ≤45-years were 75.5%, 66.7%, 78.9%, and 88.9%, respectively. Responsiveness was not assessed in the <60-years and ≤45-years age groups, leading to indeterminate overall rating with very low evidence quality. ConclusionsThis review affirms that GOHAI has sufficient psychometric properties as an oral health-related quality of life instrument in various age groups, but its responsiveness is scarcely researched and its utility for individual-level follow-up is limited. The measurement properties of oral health-related quality of life tools must be scrutinized in the changing demands of personalized and value-based dental care. (PROSPERO registration: CRD42022384132).

The Withdrawal Assessment Tool (WAT-1) is one of the most widely used clinician-reported outcome measures to evaluate iatrogenic withdrawal symptoms (IWS) in critically ill children. However, the WAT-1's measurement properties have not been aggregated. Aggregating psychometric research on the WAT-1 will enhance appropriate use, and outline gaps for future empirical research. The aim of this systematic review is to critically appraise, compare, and summarize the measurement properties and evidence quality, and describe the interpretability and feasibility of the WAT-1 for identifying IWS symptoms in critically ill children. A systematic search of Medline, Embase and CINAHL was conducted from inception to 15 April 2020. Study inclusion/exclusion, data extraction, and measurement property evidence and the modified GRADE quality scoring were applied according to the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines. Six studies were included in the review. There was sufficient, high-quality evidence for reliability, structural validity, criterion validity, measurement error, construct validity, and feasibility. More information is required to support the WAT-1's content validity, responsiveness, internal consistency, cross-cultural validity, and interpretability according to COSMIN guidelines. The results of this review indicate that the WAT-1 is a precise, easy to use measure of IWS in critically ill children despite some measurement property inconsistencies and gaps in the publication record. More information is required to support its content validity, responsiveness, internal consistency, cross-cultural validity, and interpretability.

Multiple patient-reported outcome measures (PROMs) for health-related quality of life (HRQL) exist for patients with psoriasis. Evidence for the content validity and other measurement properties of these PROMs is critical to determine which HRQL PROMs could be recommended for use. To systematically review the validity of HRQL-focused PROMs used in patients with psoriasis. Using PubMed and Embase, full-text articles published in English or Spanish on development or validation studies for psoriasis-specific, dermatology-specific, or generic HRQL PROMs were included. Development studies included original development studies, even if not studied in psoriasis patients per Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) recommendations. If a study included multiple diagnoses, more than 50% of patients had to have psoriasis or psoriasis-specific subgroup analyses available. Data extraction and analysis followed the COSMIN guidelines. Two independent reviewers extracted and analyzed the data, including PROM characteristics, quality of measurement properties (structural validity, internal consistency, cross-cultural validity, reliability, measurement error, criterion validity, construct validity, and responsiveness), and level of evidence. PROMs were classified into 3 levels of recommendations: (1) PROM recommended for use; (2) PROM requires further validation; and (3) PROM not recommended for use. Overall, 97 articles were identified for extraction. This included 19 psoriasis-specific, 8 skin-specific, and 6 generic PROMs. According to COSMIN standards, most measures identified received a B recommendation for use, indicating their potential but requiring further validation. Only the Rasch reduced version of the Impact of Psoriasis Questionnaire (IPSO-11 Rasch) received an A recommendation for use given that it had sufficient content validity, structural validity, and internal consistency. This study identified a significant lack of information concerning the quality of HRQL measures in psoriasis. This gap in knowledge can be attributed to the fact that traditional measures were developed using validation criteria that differ from the current standards in use. Consequently, additional validation studies in accordance with contemporary standards will be useful in aiding researchers and clinicians in determining the most suitable measure for assessing HRQL in patients with psoriasis.

Questionnaires remain the most feasible method for large-scale physical activity (PA) surveillance. However, previous systematic reviews concluded that existing questionnaires had unsatisfactory psychometric properties. This systematic review aimed to summarize and evaluate the measurement properties of self- and proxy-reported physical activity (PA) measures in children and adolescents published between 2018 and July 2024, thereby updating a previous review. This review also aimed to recommend the best available questionnaire(s) for young children (age < 6 years), children (age ≥ 6 to < 12 years), and adolescents (age ≥ 12 to < 18 years). The COnsensus-based Standards for the Selection of Health Measurement INstruments (COSMIN) Guidelines for Systematic Reviews of Patient-Reported Outcome Measures were followed for conducting and reporting this systematic review. PubMed, EMBASE, and SPORTDiscus databases were searched for papers published between 2018 and July 2024. The peer-reviewed papers were included if published in Arabic, Chinese, Czech, English, French, Hindi, Nepali, Portuguese, Spanish, Swedish or Thai and assessed at least one of the measurement properties of self- or proxy-reported PA measures in young children, children, and adolescents. Papers were excluded if they measured PA with interview or diary or reported construct validity against non-PA measures (e.g., body mass index). The results of studies from the previous systematic review that reported test-retest reliability and construct validity of the questionnaires included in this systematic review were added to the pooled qualitative analyses and meta-analyses. A total of 106 papers were included which reported 177 studies related to content validity (n = 31), construct validity including hypotheses testing (n = 80), test-retest reliability (n = 65), and responsiveness (n = 1) of 71 questionnaires. None of the included questionnaires met the COSMIN criteria for sufficient content validity. Questionnaires with satisfactory construct validity (correlation r ≥ 0.4) were found in young children (n = 2; e.g., the Outdoor Playtime Recall), children (n = 2; e.g., Self-rating Scale of Physical Activity Intensity for Preschool Children), and adolescents (n = 8; e.g., the Spanish version of Physical Activity Unit 7 Item Screener, the Czech version of Youth Activity Profile). Questionnaires with sufficient test-retest reliability (≥ 0.7) were found in young children (n = 2; e.g., the Movement Behaviour Questionnaire for Baby and Children), children (n = 3; e.g., Diet and Physical Activity Behaviors in the Feel4Diabetes Study), and adolescents (n = 5; e.g., the 24-Hour Movement Behavior Questionnaire). The Physical Activity Questionnaire for older Children and Adolescents had sufficient test-retest reliability based on pooled qualitative analysis and meta-analyses. The best available questionnaires were the Outdoor Playtime Recall (for young children) and the Physical Activity Questionnaire for Older Children and Adolescents for children and adolescents. This systematic review update did not identify a PA questionnaire that met COSMIN standards for both construct validity and test-retest reliability, partly due to the low methodological quality of the studies. Researchers should improve the methodological rigor of future psychometric studies, particularly for content validity, by adopting standardized guidelines (e.g., COSMIN). We also recommend: (1) using comparator tools that have demonstrated reliable measurement properties in populations similar to the target group; (2) formulating hypotheses in advance to confirm construct validity; (3) selecting appropriate intervals between test and retest and ensuring consistent test conditions; and (4) providing evidence of PA stability between test and retest. Lastly, when developing questionnaires to measure total PA, researchers should include all relevant domains of PA and assess their relevance during the content validation process.

PurposeTraumatic brain injury and spinal cord injury impact all areas of individuals’ quality of life. A synthesis of available evidence for the Traumatic Brain Injury Quality of Life (TBI-QoL) and Spinal Cord Injury Quality of Life (SCI-QoL) measurement systems could inform evidence-based clinical practice and research. Thus, we aimed to systematically review the literature of existing evidence on the measurement properties of SCI-QoL and TBI-QoL among rehabilitation populations.MethodsWe used the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) framework for evaluating measures to guide this systematic review. We searched nine electronic databases and registries, and hand-searched reference lists of included articles. Two independent reviewers screened selected articles and extracted the data. We used COSMIN’s thresholds to synthesize measurement properties evidence (insufficient, sufficient), and the modified GRADE approach to synthesize evidence quality (very-low, low, moderate, high).ResultsWe included 16 studies for SCI-QoL and 14 studies for TBI-QoL. Both measurement systems have sufficient content validity, structural validity, internal consistency and construct validity across nearly all domains (GRADE: high). Most SCI-QoL domains and some TBI-QoL domains have sufficient evidence of cross-cultural validity and test–retest reliability (GRADE: moderate-high). Besides the cognition domains of TBI-QoL, which have indeterminate evidence for measurement error and sufficient evidence for responsiveness (GRADE: high), there is no additional evidence available for these measurement properties.ConclusionRehabilitation researchers and clinicians can use SCI-QoL and TBI-QoL to describe and evaluate patients. Further evidence of measurement error, responsiveness, and predictive validity would advance the use and interpretation of SCI-QoL and TBI-QoL in rehabilitation.

ObjectivesPatient-reported outcome measures (PROMs) are often used to evaluate the outcome of treatment in patients with distal radial fractures. Which PROM to select is often based on assessment of measurement properties, such as validity and reliability. Measurement properties are assessed in clinimetric studies, and results are often reviewed without considering the methodological quality of these studies. Our aim was to systematically review the methodological quality of clinimetric studies that evaluated measurement properties of PROMs used in patients with distal radial fractures, and to make recommendations for the selection of PROMs based on the level of evidence of each individual measurement property.MethodsA systematic literature search was performed in PubMed, EMbase, CINAHL and PsycINFO databases to identify relevant clinimetric studies. Two reviewers independently assessed the methodological quality of the studies on measurement properties, using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Level of evidence (strong / moderate / limited / lacking) for each measurement property per PROM was determined by combining the methodological quality and the results of the different clinimetric studies.ResultsIn all, 19 out of 1508 identified unique studies were included, in which 12 PROMs were rated. The Patient-rated wrist evaluation (PRWE) and the Disabilities of Arm, Shoulder and Hand questionnaire (DASH) were evaluated on most measurement properties. The evidence for the PRWE is moderate that its reliability, validity (content and hypothesis testing), and responsiveness are good. The evidence is limited that its internal consistency and cross-cultural validity are good, and its measurement error is acceptable. There is no evidence for its structural and criterion validity. The evidence for the DASH is moderate that its responsiveness is good. The evidence is limited that its reliability and the validity on hypothesis testing are good. There is no evidence for the other measurement properties.ConclusionAccording to this systematic review, there is, at best, moderate evidence that the responsiveness of the PRWE and DASH are good, as are the reliability and validity of the PRWE. We recommend these PROMs in clinical studies in patients with distal radial fractures; however, more clinimetric studies of higher methodological quality are needed to adequately determine the other measurement properties.Cite this article: Dr Y. V. Kleinlugtenbelt. Are validated outcome measures used in distal radial fractures truly valid?: A critical assessment using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Bone Joint Res 2016;5:153–161. DOI: 10.1302/2046-3758.54.2000462.

Personal Growth Initiative (PGI), a cognitive and behavioural skill set for intentional growth, is often measured using the multidimensional Personal Growth Initiative Scale-II (PGIS-II). This systematic review examined its structural validity, reliability, measurement invariance, and construct validity. A literature search across multiple databases identified 15 studies evaluating the psychometric properties of the PGIS-II. Study quality was assessed with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias checklist (version 3.0). The specified psychometric properties were evaluated based on COSMIN criteria for good measurement properties, and a modified Grading, Recommendations, Assessment, Development, and Evaluation (GRADE) approach assessed the certainty of evidence. Findings showed structural validity and internal consistency variability, with some modifications to the first-order four-factor model lacking theoretical justification. A second-order four-factor structure and a bifactor model demonstrated moderate to high-quality evidence. Test–retest reliability was confirmed only for the Chinese (moderate quality) and Turkish (low quality) versions. Measurement invariance was supported for the English and Portuguese first-order four-factor models, as well as the English bifactor model. Construct validity was examined for seven versions, yielding mixed results. While some versions may be suitable for specific contexts, inconsistencies in psychometric evidence emphasise the need to further clarify the instrument's structure and psychometric performance in diverse populations through high-quality studies. Nevertheless, based on our findings, the bifactor model appears to be the most suitable structure for the PGIS-II, as it captures both the general PGI construct and its subdimensions, at least for now.

A critical need exists for developing a validated dermatologic-specific treatment satisfaction instrument. To evaluate the structural validity, internal consistency, construct validity, and test-retest reliability of the 7-item dermatology-specific treatment satisfaction (DermSat-7) instrument in patients with psoriasis. This survey study was conducted from July 2020 to April 2023 in dermatology outpatient clinics at the University of Southern California, Brigham and Women's Hospital, and Mount Sinai Union Square and included adults (aged ≥18 years) with psoriasis who were fluent in English. On day 1, the clinician at the study sites assessed psoriasis disease severity in person using the Psoriasis Area and Severity Index (PASI), body surface area (BSA), and Physician Global Assessment (PGA). On day 1, study participants completed the DermSat-7, the generic 9-item Treatment Satisfaction Questionnaire for Medication (TSQM-9), and the Dermatology Life Quality Index (DLQI). They also answered demographic questions and reported their own disease severity using the Patient Global Assessment (PtGA). On day 14 (±2 days), the patient then completed the DermSat-7 and PtGA a second time. The DermSat-7 is a 7-item self-administered instrument with a recall period of 14 days that assesses patient satisfaction with their treatments across various inflammatory dermatology diseases, including psoriasis. Construct validity, structural validity, internal consistency, and test-retest reliability of DermSat-7 were assessed as defined by the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) taxonomy and reported following the COSMIN reporting guideline for studies on measurement properties. The analysis included 142 patients with psoriasis (mean [SD] age, 51.1 [15.5] years; 77 males [54.2%]). Exploratory factor analysis and confirmatory factor analysis supported the unidimensionality of the DermSat-7 domains. The internal consistency of the effectiveness and convenience domains was high with a Cronbach α of 0.88 and 0.81, respectively. Regarding construct validity, differences between groups based on PASI/PGA scores were aligned with preexisting hypotheses, and the correlations between DermSat-7 and TSQM-9 subscores were strong to very strong (ρ = 0.75 for effectiveness; ρ = 0.66 for convenience; and ρ = 0.70 for overall satisfaction; all P < .001). Intraclass correlation was 0.85, indicating high test-retest reliability. This survey study found that the DermSat-7 may be a valid and reliable instrument for measuring treatment satisfaction in patients with psoriasis.

BackgroundPatient-reported outcome measures (PROMs) can provide valuable information which may assist with the care of patients with chronic kidney disease (CKD). However, given the large number of measures available, it is unclear which PROMs are suitable for use in research or clinical practice. To address this we comprehensively evaluated studies that assessed the measurement properties of PROMs in adults with CKD.MethodsFour databases were searched; reference list and citation searching of included studies was also conducted. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist was used to appraise the methodological quality of the included studies and to inform a best evidence synthesis for each PROM.ResultsThe search strategy retrieved 3,702 titles/abstracts. After 288 duplicates were removed, 3,414 abstracts were screened and 71 full-text articles were retrieved for further review. Of these, 24 full-text articles were excluded as they did not meet the eligibility criteria. Following reference list and citation searching, 19 articles were retrieved bringing the total number of papers included in the final analysis to 66. There was strong evidence supporting internal consistency and moderate evidence supporting construct validity for the Kidney Disease Quality of Life-36 (KDQOL-36) in pre-dialysis patients. In the dialysis population, the KDQOL-Short Form (KDQOL-SF) had strong evidence for internal consistency and structural validity and moderate evidence for test-retest reliability and construct validity while the KDQOL-36 had moderate evidence of internal consistency, test-retest reliability and construct validity. The End Stage Renal Disease-Symptom Checklist Transplantation Module (ESRD-SCLTM) demonstrated strong evidence for internal consistency and moderate evidence for test-retest reliability, structural and construct validity in renal transplant recipients.ConclusionsWe suggest considering the KDQOL-36 for use in pre-dialysis patients; the KDQOL-SF or KDQOL-36 for dialysis patients and the ESRD-SCLTM for use in transplant recipients. However, further research is required to evaluate the measurement error, structural validity, responsiveness and patient acceptability of PROMs used in CKD.