COSMIN Risk Of Bias Checklist Research Articles

Connor-Davidson Resilience Scale: a systematic review psychometrics properties using the COSMIN.

Psychometrical evaluation of persons of diverse contexts and different populations, including general or clinical. This review study aimed to evaluate the psychometrics quality of resilience scales. International and Iranian databases were searched with MESH terms, including "psychometric", "validity", "reliability", "Connor-Davidson resilience scale", "Resilience scale", for published articles up to 1 February 2023. For each of the selected studies, the risk of bias was evaluated using the COSMIN Risk of Bias Checklist. Then the COSMIN checklist was used to evaluate the entire text of the article for methodological quality. Considering the inclusion criteria, 80 documents were evaluated. According to the COSMIN's criteria for evaluating the risk of bias, the current study findings revealed the included studies' limitations in assessing the three versions of CD-RISC cross-cultural and content validity as well as their stability (e.g. conducting test re-test), whereas the majority of psychometric studies of CD-RISC-25, and CD-RISC-2 rated as very good or adequate in terms of structural validity. In terms of quality assessment of the included studies, the current study indicated that investigating the structural validity of the CD-RISC was mainly done based on exploratory factor analysis (EFA), and confirmatory factor analysis was absent. The general result indicates the acceptability of the quality of the studies. However, concerns for measurement properties such as responsiveness and criterion validity as well as the standard error of measurement have been neglected.

Common challenges and suggestions for risk of bias tool development: a systematic review of methodological studies

ObjectiveTo review the findings of studies that have evaluated the design and/or usability of key risk of bias (RoB) tools for the assessment of RoB in primary studies, as categorised by the LATITUDES Network (a searchable library of RoB tools for evidence synthesis): PROBAST, RoB2, ROBINS-I, QUADAS-2, QUADAS-C, QUAPAS, ROBINS-E, and the COSMIN RoB checklist. Study design and settingSystematic review of methodological studies. We conducted a forward citation search from the primary report of each tool, to identify primary studies aiming to evaluate the design and/or usability of the tool. Two reviewers assessed studies for inclusion. We extracted tool features into Microsoft Word and used NVivo for document analysis, comprising a mix of deductive and inductive approaches. We summarised findings within each tool and explored common findings across tools. ResultsWe identified 13 tool evaluations meeting our inclusion criteria: PROBAST (3); RoB2 (3); ROBINS-I (4); QUADAS-2 (3). We identified no evaluations for the other tools. Evaluations varied in clinical topic area, methodology, approach to bias assessment and tool user background. Some had limitations affecting generalisability. We identified common findings across tools for 6/14 themes: 1) challenging items (e.g. RoB2/ROBINS-I “deviations from intended interventions” domain), 2) overall RoB judgement (concerns with overall risk calculation in PROBAST/ROBINS-I), 3) tool usability (concerns about complexity), 4) time to complete tool (varying demands on time e.g. depending on number of outcomes assessed), 5) user agreement (varied across tools), and 6) recommendations for future use (e.g. piloting) and development (add intermediate domain answer to QUADAS-2/PROBAST; provide clearer guidance for all tools). Of the other eight themes, seven only had findings for the QUADAS-2 tool, limiting comparison across tools, and one (“re-organisation of questions”) had no findings. ConclusionEvaluations of key RoB tools have posited common challenges and recommendations for tool use and development. These findings may be helpful to people using or developing RoB tools. Guidance is necessary to support the design and implementation of future RoB tool evaluations.

Psychometric properties of the Braden scale to assess pressure injury risk in intensive care: A systematic review

ObjectiveTo analyse the psychometric properties of the Braden scale to assess pressure injury risk in adults in intensive care. DesignA systematic review was conducted, with literature searches undertaken in five electronic databases. No date limits were applied. Selection, data extraction and risk of bias assessment were completed by two reviewers independently. A customised data extraction template was used, with risk of bias conducted using the COSMIN Risk of Bias checklist. Data were analysed using narrative synthesis. ResultsThirty-four studies met inclusion criteria. Two studies reported internal consistency with Cronbach’s alpha ranging from poor (0.43) to good (0.85). For interrater reliability, only four studies reported intraclass correlation, ranging from 0.66 to 0.96 for Braden sum score. Three studies reported convergent validity, with strong associations found between the COMHON Index (r = 0.70), Cubbin-Jackson scale (r = 0.80), and Norton scale (r = 0.77), but contrasting associations with the Waterlow score (r = 0.22 to 0.72). A large majority of studies reported predictive validity (n = 29), with wide variability. Several studies investigated optimal cut-off scores, with the majority indicating this was in the range of 12–14. ConclusionsThis review demonstrates inconsistency in the psychometric properties of the Braden scale in ICU settings. Further research is needed to determine suitability of the Braden scale for ICU before it can be recommended as standard for clinical practice, including comparison with other ICU-specific risk assessment tools. Implications for clinical practiceWhen used in ICU, the reliability, validity and reported cut-off scores of the Braden scale are variable. As a predictive tool, the scale should be used cautiously. In ICU, the value of the Braden scale resides in its ability to identify patients that are most at risk of developing a pressure injury and to implement preventative measures to mitigate identified risk factors.

Evaluating caregiver-child interactions in low- and middle-income countries: a systematic review of tools and methods.

The United Nations Sustainable Development Goals (SDGs) has placed emphasis on improving early child development globally. This is supported through the Nurturing Care Framework which includes responsive caregiving. To evaluate responsive caregiving, tools to assess quality of caregiver-child interactions are used, however there is little information on how they are currently employed and/or adapted particularly in low- and middle-income countries (LMICs) where children have a greater risk of adverse outcomes. The aim of this review is to provide a comprehensive guide on methodologies used to evaluate caregiver-child interaction - including their feasibility and cultural adaptation. We conducted a systematic review of studies over 20years in LMICs which assessed caregiver-child interactions. Characteristics of each tool, their validity (assessed with COSMIN Risk of Bias checklist), and the quality of the study (Mixed Methods Appraisal Tool) are reported. We identified 59 studies using 34 tools across 20 different LMICs. Most tools (86.5%) employed video-recorded observations of caregiver-child interactions at home (e.g. Ainsworth's Sensitivity Scale, OMI) or in the laboratory (e.g. PICCOLO) with a few conducting direct observations in the field (e.g. OMCI, HOME); 13.5% were self-reported. Tools varied in methodology with limited or no mention of validity and reliability. Most tools are developed in Western countries and have not been culturally validated for use in LMIC settings. There are limited caregiver-child interaction measures used in LMIC settings, with only some locally validated locally. Future studies should aim to ensure better validity, applicability and feasibility of caregiver-child interaction tools for global settings.

The psychometric properties of the Six-Spot Step Test - a systematic review using the COSMIN guidelines.

Accurate and reliable balance measures are important for prescribing fall prevention treatments and monitoring their effectiveness. Thus, we aimed to systematically review the psychometric properties of the Six-Spot Step Test, an increasingly used measure of dynamic balance. A literature search using the free-text term "Six-Spot Step Test" was performed on 12 February 2024, in Medline, Embase, Rehabilitation & Sports Medicine and SPORTDiscus. Eligibility criteria were adults aged 18 or more, trials evaluating the psychometric properties of the Six-Spot Step Test, and English-language articles. Conference abstracts were excluded. Two investigators screened and selected data independently and assessed the methodological quality and evidence using the COSMIN Risk of Bias checklist and modified GRADE approach. One investigator extracted study characteristics such as design, population and psychometric properties. Of the 159 articles identified, 16, evaluating multiple measurement properties, were included in the final analysis. A total of 1319 people participated, including people affected by Stroke, multiple sclerosis, Parkison's disease, chronic inflammatory polyneuropathy and older adults with balance problems. Eight articles assessing reliability (n = 618, intraclass correlations coefficient ≥0.7, minimal detectable change = 22%) and 12 construct validity (n = 1082, 83% true hypothesis, area under the curve >0.7) exhibited sufficient methodological quality with high-level evidence, while two studies (n = 167) examining responsiveness showed very low evidence. Apart from responsiveness, robust evidence supports the reliability and validity of the Six-Spot Step Test for assessing dynamic balance in a specific group of individuals with neurological diseases and older adults. Further, it is considered feasible for clinical use.

Staff‐based measurement instruments of person‐centredness in settings of care for older people: A systematic review

AbstractBackgroundPerson‐centred care is widely endorsed as a promising approach for delivering high‐quality care to older people. However, the multitude of existing definitions and measurement tools, coupled with the continuous emergence of new tools, can create confusion and hinder precision in assessing this concept. This review was undertaken with a recognition of the crucial role that assessment quality plays in evaluations and improvements, particularly within the context of person‐centred care for older people.ObjectivesThis study aimed to systematically review staff‐based measures of person‐centredness in settings of care for older people. More specifically, the objectives were to provide description, methodological evaluation and synthesis of diverse conceptual understandings of person‐centredness encapsulated in these measurement tools.MethodsWe systematically searched the Cinahl, PsycInfo, PubMed, Scopus and Web of Science databases for English peer‐reviewed journal articles between 2000 and 2021. These articles discussed the creation of staff‐based questionnaires designed to assess the extent of person‐centred care. We excluded questionnaires meant for clients, patients or families, as well as non‐questionnaire scales. The measures were described, and their interpretations of person‐centred care were synthesised through a critical interpretive synthesis method. We evaluated methodological quality using a condensed COSMIN risk of bias checklist and adhered to PRISMA guidelines.ResultsThe review identified a total of 14 staff‐based measures. These measures exhibited varying levels of comprehensiveness, encompassing anywhere between 2 and 17 components. Furthermore, the number of items within the measures ranged from 11 to 62, and the sample sizes exhibited significant diversity, spanning from 58 to 1428. In terms of the components scrutinised by the scales regarding person‐centred care, our synthesis revealed the emergence of four distinct conceptual categories: care process, supportive care environment, relations and communication, and knowledge and attitudes. As for the methodological quality of the scales, it exhibited a notable degree of variation (i.e. from inadequate to very good).ConclusionsDiverse measures of person‐centredness vary in terms of comprehensiveness, aspects covered and methodological quality. Synthesising the concept through staff‐based measures offers a novel approach for researchers and practitioners, illuminating nuanced perspectives in person‐centred care.Implications for practiceThe synthesis enriches academic discussions and practical applications by dissecting components, ultimately enhancing care quality assessment and improvement. Further, this review is a valuable resource for unit managers and quality coordinators working in settings of care for older people, empowering them to make informed decisions tailored to their specific needs from a diverse array of available person‐centred care measures.

Measurement properties of cervical joint position error in people with and without neck pain: a systematic review and narrative synthesis

IntroductionProprioception can be impaired in people with neck pain. The cervical joint position sense test, which measures joint position error (JPE), is the most common test used to assess neck proprioception. The aim of this systematic review was to assess the measurement properties of this test for the assessment of people with and without neck pain.MethodsThis systematic review was registered prospectively on Prospero (CRD42020188715). It was designed using the COSMIN guidelines and reported in line with the PRISMA checklist. Two reviewers independently searched Medline, Embase, SportDiscus, and CINAHL Plus databases from inception to the 24th July 2022 with an update of the search conducted until 14th of October 2023. The COSMIN risk of bias checklist was used to assess the risk of bias in each study. The updated criteria for good measurement properties were used to rate individual studies and then the overall pooled results. The level of evidence was rated by two reviewers independently using a modified GRADE approach.ResultsFifteen studies were included in this review, 13 reporting absolute JPE and 2 reporting constant JPE. The measurement properties assessed were reliability, measurement error, and validity. The measurement of JPE showed sufficient reliability and validity, however, the level of evidence was low/very low for both measurement properties, apart from convergent validity of the constant JPE, which was high.ConclusionThe measure of cervical JPE showed sufficient reliability and validity but with low/very low levels of evidence. Further studies are required to investigate the reliability and validity of this test as well as the responsiveness of the measure.

Systematic Review of Explicit Instruments Measuring Nature Connectedness: What Do We Know and What is Next?

This systematic review assesses the methodological quality of manuscripts focusing on scales that explicitly measure nature connectedness. A literature search in six electronic databases was conducted using a search strategy based on PICO guidelines. Only peer-reviewed primary research available in English language, published between 2000 and 2021, meeting the scope of this review were included. Data from 35 studies were narratively analyzed. Their methodological quality was assessed using the COSMIN Risk of Bias checklist. Only five studies were rated as high/adequate quality. Based on the findings we make the following recommendations: (a) the need for the development of a more universal nature connectedness construct, (b) the requirement to increase the methodological quality of the scales, (c) the need to identify which the scales measure trait or state, (d) the need to increase the validate scales cross-culturally, and (e) the need to develop scales that can be employed with non-adult samples.

PROTOCOL: Psychometric properties of instruments for measuring elder abuse and neglect in community and institutional settings: A systematic review.

The psychometric properties of elder abuse measurement instruments have not been well-studied. Poor psychometric properties of elder abuse measurement instruments may contribute to the inconsistency of elder abuse prevalence estimates and uncertainty about the magnitude of the problem at the national, regional, and global levels. The present review will utilise the COSMIN taxonomy on the quality of outcome measures to identify and review the instruments used in measuring elder abuse, assess the instrument's measurement properties, and identify the definitions of elder abuse and abuse subtypes measured by the instrument. Searches will be conducted in the following online databases: Ageline, ASSIA, CINAHL, CNKI, EMBASE, Google Scholar, LILACS, Proquest Dissertation & Theses Global, PsycINFO, PubMed, SciELO, Scopus, Sociological Abstract and WHO Index Medicus. Relevant studies will also be identified by searching the grey literature from several resources such as OpenAIRE, BASE, OISter and Age Concern NZPotential studies by searching the references of related reviews. We will contact experts who have conducted similar work or are currently conducting ongoing studies. Enquiries will also be sent to the relevant authors if any important data is missing, incomplete or unclear. All quantitative, qualitative (that address face and content validity), and mixed-method empirical studies published in peer-reviewed journals or the grey literature will be included in this review. Studies will be included if they are primary studies that (1) evaluate one or more psychometric properties; (2) contain information on instrument development, or (3) perform content validity of the instruments designed to measure elder abuse in the community or institutional settings. Studies should describe at least one of the psychometric properties, such as reliability, validity and responsiveness. Study participants represent the population of interest, including males and females aged 60 or older in community or institutional settings (i.e., nursing homes, long-term care facilities, assisted living, residential care institutions, and residential facilities). Screening of titles, abstracts, and full texts of the selected studies will be evaluated based on the preset inclusion criteria by two reviewers. Two reviewers will be assessing the quality appraisal of each study using the COSMIN Risk of Bias checklist and the overall quality of evidence of each psychometric property of the instrument against the updated criteria of good measurement properties. Any dispute between the two reviewers will be resolved through discussions or consensus with a third reviewer. The overall quality of the measurement instrument will be graded using a modified GRADE approach. Data extraction will be performed using the data extraction forms adapted from the COSMIN Guideline for Systematic Reviews of Outcome Measurement Instruments. The information includes the characteristic of included instruments (name, adaptation, language used, translation and country of origin), characteristics of the tested population, psychometric properties listed in the COSMIN criteria, including details on the instrument development, content validity, structural validity, internal consistency, cross-cultural validity/measurement invariance, reliability, measurement error, criterion validity, hypotheses testing for construct validity, responsiveness and interoperability. We will perform a meta-analysis to pool psychometric properties parameters (where possible) or summarise qualitatively.

A systematic review of fear of falling and related constructs after hip fracture: prevalence, measurement, associations with physical function, and interventions

BackgroundHip fracture is a common and debilitating injury amongst older adults. Fear of falling (FoF) and related constructs (balance confidence and falls efficacy) may impede rehabilitation after hip fracture. An updated systematic review to synthesize existing literature on FoF after hip fracture is needed. This review focussed on four research questions: In the hip fracture population: (1) What is the prevalence of FoF?; (2) What FoF assessment tools are validated? (3) What is the relationship between FoF and physical function?; (4) What interventions are effective for reducing FoF?MethodsA systematic search was undertaken in EBSCO Health, Scopus and PsychINFO in January 2021 (and updated December 2022) for articles on FoF after hip fracture. Data in relation to each research question was extracted and analysed. The quality of the studies was appraised using the ‘Risk of Bias Tool for Prevalence Studies’, ‘COSMIN Risk of Bias checklist for Patient-reported outcome measures’, modified version of the ‘Appraisal Tool for Cross-sectional studies’, and the ‘Cochrane Risk of Bias 2’ tools for each research question, respectively.Results36 studies (37 articles) with 5099 participants were included (mean age 80.2 years and average 78% female). Prevalence rates for FoF after hip fracture ranged between 22.5% and 100%, and prevalence tended to decrease as time progressed post hip fracture. The ‘Falls Efficacy Scale – International’ (FES-I) and ‘Fear of Falling Questionnaire – Revised’ (FFQ-R) were found to be reliable, internally consistent, and valid tools in hip fracture patients. FoF after hip fracture was consistently associated with measures of physical function including balance, gait speed, composite physical performance measures and self-reported function. Ten of 14 intervention studies were considered high risk of bias. Exercise-based interventions with or without a psychological component were not effective in reducing FoF after hip fracture compared to a control condition.ConclusionFoF is prevalent after hip fracture and is consistently associated with poorer physical function. Only two instruments (FES-I and FFQ-R) have been validated for measuring FoF in the hip fracture population. However, there remains a need for larger, higher quality randomised controlled trials targeting FoF after hip fracture in order to guide clinical practice.Trial registrationPROSPERO registration: CRD42020221836.

The psychometric properties of nursing image measurement instruments: A systematic review.

To identify the measures assessing the nursing image, and to analyse, evaluate and synthesize the psychometric properties of these available instruments. A systematic review of the psychometric properties of instruments assessing the nursing image. The system review has been registered in the PROSPERO database with the registration number CRD42020221511. The systematic review was conducted according to COSMIN guidelines. Search strategies were run in CINAHL, MEDLINE, APA PsycINFO, Web of Science, Scopus, COSMIN systematic review database, Cochrane Library and China National Knowledge Infrastructure (CNKI). Two reviewers independently screened the studies, extracting the psychometric properties of the included study characteristics and instruments. The methodological quality of the studies, instrument measurement performance, risk of bias and grade of evidence were evaluated and disagreements were resolved via discussion. The search strategy yielded a total of 24 studies and 11 instruments assessing nursing image. None of the measures fulfilled all criteria in the COSMIN Risk of Bias checklist. The Nurses Self-Concept Instrument (NSCI) and the Nurses Self-Concept Questionnaire (NSCQ) were recommended for measuring the professional image of nursing, and the Nursing Brand Image Scale (NBIS) have the potential to be recommended for measuring a more comprehensive image of nursing. Every instrument evaluated in this review had different characteristics in the nursing image (e.g. the traditional image, the professional image, and the brand image). Therefore, the selection of the most appropriate instrument depends on the psychometrics, the context and the aim of the assessment.

Reliability and Validity of the Japanese Version of the Basel Assessment of Adherence to Immunosuppressive Medications Scale in Kidney Transplant Recipients.

We translated the BAASIS into Japanese and developed the Japanese version of the BAASIS (J-BAASIS) according to the International Society of Pharmacoeconomics and Outcomes Research task force guidelines. We analyzed the reliability (test-retest reliability and measurement error) and validity of the J-BAASIS (concurrent validity with the medication event monitoring system and the 12-item Medication Adherence Scale) referring to the COSMIN Risk of Bias checklist. A total of 106 kidney transplant recipients were included in this study. In the analysis of test-retest reliability, Cohen's kappa coefficient was found to be 0.62. In the analysis of measurement error, the positive and negative agreement were 0.78 and 0.84, respectively. In the analysis of concurrent validity with the medication event monitoring system, sensitivity and specificity were 0.84 and 0.90, respectively. In the analysis of concurrent validity with the 12-item Medication Adherence Scale, the point-biserial correlation coefficient for the "medication compliance" subscale was 0.38 (P < 0.001). The J-BAASIS was determined to have good reliability and validity. Using the J-BAASIS to evaluate adherence can help clinicians to identify medication nonadherence and institute appropriate corrective measures to improve transplant outcomes.

Psychometric Properties of Instruments to Measure the Well-being of Young Children: A Systematic Review Protocol

Background: Child well-being is an important outcome and has received attention from researchers for decades. Until recently, there has been difficulty in drawing conclusions from these studies because of the wide variety of measures used. Objective: This systematic review aims to summarize and assess the measurement properties of existing child well-being instruments presented in the literature. Methods: This systematic review will focus on studies that evaluated the psychometric properties of instruments to measure the well-being of children ages two to seven. The search strategy will aim to locate studies in the English language completed from 2000 to 2023. The databases to be searched include MEDLINE via PubMed, CINAHL Plus, and Psychology &amp; Behavioral Sciences Collection via EBSCOhost. Proquest Dissertations and Theses, Google Scholar, and ResearchGate will be used to search unpublished studies. Following the search, all identified citations will be collated in Mendeley. The full text of selected citations will be uploaded to JBI-SUMARI, assessed in detail against the inclusion criteria, and critically appraised using the COSMIN Risk of Bias checklist by two independent reviewers. Data will be extracted using JBI-SUMARI by one reviewer and verified by another. Findings will be reported using a narrative synthesis and tables. If possible, a meta-analysis will be performed. The evidence for each measurement property for each instrument will be compared against acknowledged standards for appropriate measurement characteristics using the COSMIN-proposed "criteria for good measurement properties." Expected Results: This systematic review will provide further evidence regarding the measurement properties of instruments used to measure the well-being of children, specifically in the early years. The findings of this study will be disseminated through a conference presentation and publication in a peer-reviewed journal. PROSPERO registration number: CRD4202342T8953.

Measurement properties of outcome measures used in neurological telerehabilitation: A systematic review using COSMIN checklist

Objective To summarize the measurement properties (reliability, validity, and responsiveness) and the clinical utility of measurement tools used in telerehabilitation in individuals with neurological conditions. Design Systematic review. Subjects Individuals with neurological conditions. Intervention Not applicable. Main measures The methodological quality of the studies using the COSMIN Risk of Bias Checklist, the quality of the measurement properties using the criteria for good measurement properties, and the clinical utility of the measurements using the Tyson & Connell scale. Results From the 22,188 identified studies, 47 were included. Forty-three measurement tools were identified. The main modes of administration were telephone and videoconference. Studies involved mostly individuals with stroke, multiple sclerosis, and Alzheimer's disease. Criterion validity and reliability were the most investigated measurement properties. None of the tools had their responsiveness investigated. Twenty-two measurement tools have at least one measurement property evaluated as “sufficient” in a study with appropriate methodological quality (“very good” or “adequate”). Nineteen measurement tools showed adequate clinical utility. Eight measurement tools, investigated in individuals with stroke, spinal cord injury or Alzheimer's disease, all administered by telephone, were recommended. Conclusion The present results can be used to assist in choosing appropriate measurement tools, both in research and clinical practice, during telerehabilitation in individuals with neurological conditions. Measurement error, content validity, structural validity, and responsiveness need to be further investigated. In addition, the measurement properties of tools used in telerehabilitation in other neurological conditions, such as Huntington's disease, should also be investigated. Registration number CRD42021257662.

Measurement properties, interpretability and feasibility of instruments measuring oral health and orofacial pain in dependent adults: a systematic review

BackgroundDependent adults have been shown to have a greater experience of oral health deterioration and orofacial pain. This is partly because their non-dental caregivers may not easily identify oral health problems and orofacial pain experienced by them. Thus, this systematic review aimed to investigate measurement properties, interpretability and feasibility of instruments assessing oral health and orofacial pain in dependent adults, which can be used by the non-dental caregivers to establish oral care plans for those who are dependent upon them.MethodsSeven bibliographic databases were searched: MEDLINE, Embase, CINAHL, CENTRAL, HTA, OATD and OpenGrey. Citations and reference lists of the included studies were also manually searched. Two authors independently screened titles and abstracts, and then full texts. A quality assessment of included studies was conducted independently by two authors using the COSMIN Risk of Bias checklist. The best evidence synthesis method was used to synthesise results from different studies for each measurement property per measurement instrument by integrating the overall rating for each measurement property per measurement instrument with its quality level of evidence.ResultsNineteen eligible studies were included, which reported the development, measurement properties’ evaluation, interpretability and feasibility of nine oral health and three orofacial pain measurement instruments. Methodological quality of the included studies ranged from very good to inadequate. None of the identified measurement instruments has been adequately and comprehensively tested.ConclusionsWhile several measurement instruments were identified in this systematic review, more evidence is needed to be able to more comprehensively evaluate these instruments. Among those identified, the OPS-NVI demonstrated sufficient construct validity, while the OHAT and the THROAT demonstrated sufficient reliability. These instruments therefore have potential for future use with more confidence once other measurement properties, interpretability and feasibility have been sufficiently tested and evaluated.

Protocol for a systematic review exploring the psychometric properties of self-report health-related quality of life and subjective wellbeing measures used by adolescents with intellectual disabilities

BackgroundWhilst there are studies that have systematically reviewed the psychometric properties of quality of life measures for children and young people with intellectual disabilities, these narrowly focus on disease or health conditions. The objective of this planned systematic review is therefore to collate, summarise, and critically appraise the psychometric properties of self-report health-related quality of life (HRQoL) and subjective wellbeing measures used by adolescents (aged 11–16) with an intellectual disability.MethodsWe designed and registered a study protocol for a systematic review of studies which explores the psychometric properties of self-report HRQoL and subjective wellbeing measures used by adolescents with intellectual disabilities. Electronic databases including PsycINFO, CINAHL, MEDLINE, and ERIC will be searched using predefined search terms to identify relevant studies. Quantitative and mixed-methods studies, and studies published in peer-reviewed journals or grey literature, will be included. Review papers, editorials, and case studies will be excluded. Eligible studies should identify self-report measures which assess HRQoL and subjective wellbeing among adolescents with intellectual disabilities. The methodological quality of the included studies will be assessed by applying the COSMIN Risk of Bias checklist. The quality of the evidence (i.e. the total body of evidence used for the overall ratings on each psychometric property of an instrument) will be evaluated in accordance with the modified GRADE guidelines.DiscussionThis systematic review will be among the first to systematically explore the psychometric properties of self-report HRQoL and subjective wellbeing measures used by adolescents with intellectual disabilities. By providing evidence-based knowledge about measures being used in HRQoL and subjective wellbeing research amongst this population, and more importantly how reliable and valid these measures are, the most suitable for use will be identified. Our findings will be of potential interest to clinicians, researchers, and service providers who need information about the methodological quality and the characteristics of measures to make informed decisions about the most reliable and valid tool for a specific purpose. The findings from this study will contribute to the knowledge surrounding available and appropriate measures to use for measuring HRQoL and subjective wellbeing of adolescents with intellectual disabilities, which are necessary to inform intervention development and future health policy.Systematic review registrationThe protocol has been registered at the International Prospective Register of Systematic Reviews (PROSPERO). The registration number is CRD42021231697.

Quality and efficacy of Multidisciplinary Team (MDT) quality assessment tools and discussion checklists: a systematic review

BackgroundMDT discussion is the gold standard for cancer care in the UK. With the incidence of cancer on the rise, demand for MDT discussion is increasing. The need for efficiency, whilst maintaining high standards, is therefore clear. Paper-based MDT quality assessment tools and discussion checklists may represent a practical method of monitoring and improving MDT practice. This reviews aims to describe and appraise these tools, as well as consider their value to quality improvement.MethodsMedline, EMBASE and PsycInfo were searched using pre-defined terms. The PRISMA model was followed throughout. Studies were included if they described the development of a relevant tool, or if an element of the methodology further informed tool quality assessment. To investigate efficacy, studies using a tool as a method of quality improvement in MDT practice were also included. Study quality was appraised using the COSMIN risk of bias checklist or the Newcastle-Ottawa scale, depending on study type.ResultsThe search returned 7930 results. 18 studies were included. In total 7 tools were identified. Overall, methodological quality in tool development was adequate to very good for assessed aspects of validity and reliability. Clinician feedback was positive. In one study, the introduction of a discussion checklist improved MDT ability to reach a decision from 82.2 to 92.7%. Improvement was also noted in the quality of information presented and the quality of teamwork.ConclusionsSeveral tools for assessment and guidance of MDTs are available. Although limited, current evidence indicates sufficient rigour in their development and their potential for quality improvement.Trial registrationPROSPERO ID: CRD42021234326.

Gait assessment tools for degenerative cervical myelopathy: a systematic review.

Degenerative cervical myelopathy (DCM) is a common progressive neurological disorder which may affect one's activities of daily living or even result in paraplegia/tetraplegia if left untreated. Currently, there is lack of consensus of the gait assessment tools for DCM. This systematic review aims to (I) provide an appraisal of the psychometric properties of the available gait assessment tools for DCM, (II) to assess their methodological quality according to The Consensus-based Standards for the selection of health Measurement COSMIN risk of bias checklist and (III) to assess each measurement property result against externally validated criteria. Six electronic full-text databases [PubMed (via NLM® database], Medline (via OvidSP), CINAHL (via Ebsco), EMBASE (via Ovid), PsycINFO (via CSA) and Web of Science (via Thomson Reuters)] were systematically searched from inception to June 2020. The methodological quality of each study was analysed using the COSMIN risk of bias checklist. The measurement property result and methodological quality of each study were evaluated. Twenty studies were included from 3,339 citations retrieved. Twelve assessment tools for assessing gait in DCM were identified. According to COSMIN criteria, only five studies (25%) included in this review were found to have "very good" methodological quality. For construct validity, five tools had "sufficient" quality. For reliability, two assessment tools [the Total modified Japanese Orthopaedic Association Score (Italian Translation) (mJOA-ITTotal) and the modified Japanese Orthopaedic Association (Italian Translation) Motor dysfunction of the Lower Extremity (mJOA-ITMDLE)] were rated as "sufficient" for interobserver reliability while six assessment tools (the 10 second step test (10 sec ST), 30 minute walk test (30MWT), foot tapping test, mJOA-ITTotal, mJOA-ITMDLE and the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire) were rated as "sufficient" for test-retest reliability. The JOA (6 scores) received a "sufficient" rating for internal consistency. No assessment was available for responsiveness, as only the effect size was available. Based upon current evidence, the mJOA in combination with an objective functional test (i.e., 30MWT) is recommended for clinicians assessing gait in DCM, although this may change with an increase in the number of studies completed. Given the importance of assessment tools possessing adequate measurement properties, a focus on studies in this area is warranted.

Psychometric Properties of Quality of Life Questionnaires for Patients with Breast Cancer-Related Lymphedema: A Systematic Review.

Backgrounds: Assessing quality of life (QoL) using a well-developed and validated questionnaire is an essential part of a breast cancer-related lymphedema (BCRL) treatment. However, a QoL questionnaire with the best psychometric properties is so far unknown. The aim of this systematic review is to evaluate the psychometric properties of the questionnaires measuring the QoL of patients with BCRL. Methods: A thorough search was performed to identify published studies in electronic databases such as Medline (via Ovid), EBSCOhost, PubMed, Scopus, and Web of Science, on 8 February 2022, by using search terms as follows: ‘quality of life’; ‘breast cancer’; ‘upper limb’; ‘lymphedema’; ‘questionnaire’; and ‘measurement properties.’ Two reviewers conducted article selection, data extraction, and quality assessment independently. The third reviewer helped solve any possible disagreements between the two reviewers. The COSMIN checklist and manual were used to assess the quality of included studies. Results: A total of nineteen articles with nine questionnaires were included and assessed using the COSMIN Risk of Bias checklist. Most studies only assessed content validity, structural validity, internal consistency, reliability, and construct validity. Lymph-ICF-UL showed the most ‘sufficient’ and ‘high’ quality of evidence ratings for its measurement properties. Conclusion: The most appropriate questionnaire for use based on our assessment is Lymph-ICF-UL.

Development and primary validation of the School Health Assessment Tool for Primary Schools (SHAT-PS).

BackgroundSchool health programs need to target all aspects of physical, psychological, and social well-being. Using a slightly modified version of the COSMIN Risk of Bias checklist, we developed and conducted the first validation of the School Health Assessment Tool for Primary Schools (SHAT-PS).MethodThe exploratory sequential mixed method was used in this study. In the first phase, scientific databases were systematically searched to find school health models and instruments and 65 interviews were conducted with school stakeholders. The Colaizzi’s method was used to code the qualitative data into themes. Then, a pool of items was created for each theme, rechecked by psychometric experts and then validated for content (i.e., relevance, clarity, and comprehensiveness) by psychometric experts and individuals of the target population (i.e., school personnel). In the second phase, classical test theory was utilized to analyze the validity and reliability of the resulting items from phase 1 among 400 individuals working at primary schools.ResultsThe coding of the interviews resulted in ten themes that we labeled based on the theoretical literature: school health policies, community connections, health education, physical activity, health services, nutrition, psychological services, physical environment, equipment and facilities, and school staff’s health. The items created for each theme ended up in an initial pool of 76 items. In the final stage of phase 1, 69 items remained after the content validity assessment by experts and school personnel. In phase 2, the SHAT-PS items were tested using maximum likelihood exploratory factor analysis and confirmatory factor analysis. Of the 69 items from phase 1, 22 items were removed due to low factor loadings. The results showed that the 8-factor model was the best solution (chi-square/df = 2.41, CFI = .98, TLI = .97, RMSEA = .06). The discriminant and convergent validity of the SHAT-PS were evaluated as satisfactory and the scale had high internal consistency (Cronbach’s alpha for all subscales > .93). The test-retest reliability was satisfactory—the intraclass correlation coefficient pooled was .95 (99% CI [.91–.98]). Moreover, the standard error of measurement resulted in an SEM pooled equal to 4.4. No discrepancy was found between subgroups of gender and subgroups of staffs’ positions at schools.ConclusionThe SHAT-PS is a valid and reliable tool that may facilitate school staff, stakeholders and researchers to evaluate the presence of the factors that promote health at primary schools. Nevertheless, in the process of validation, many of the items related to staff’s health were eliminated due to poor factor loadings. Obviously, staff health is an important factor in the measurement of school health. Hence, we recommend that the validity and reliability of the SHAT-PS in other cultures should be done using the original 76-item version.