Differences In Psychometric Properties Research Articles

Age-related differences in psychometric properties of World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0): a retrospective analysis.

The aim of this study was to detect a possible age-related differential item functioning (DIF) of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) among people with musculoskeletal disorders. This was a cross-sectional study of 1739 consecutive patients with chronic musculoskeletal pain at a university clinic. Difficulty and discrimination parameters were calculated for each of 12 items of the WHODAS 2.0 using item response theory. The presence of DIF was assessed both numerically and graphically. When considering differences in both difficulty and discrimination, a statistically significant DIF was observed for all the items except for the item 'washing' (P values <0.001). The DIF was mostly uniform. Items 'standing', 'household responsibilities', 'learning a new task', 'emotional affectedness', 'concentrating', 'washing' and 'dressing' showed better precision among older patients. Items 'walking', 'dealing with strangers', 'maintaining a friendship' and 'day-to-day work' were more informative among younger patients. Difficulty and discrimination parameters were alike for all 12 items. The DIF was mostly uniform. These results can be taken into account when applying the WHODAS 2.0 to people with musculoskeletal complaints, especially when the studied groups are predominated by people of certain age.

Return to Sports After Anterior Cruciate Ligament Reconstruction: Validity and Reliability of the SPORTS Score at 6 and 12 Months

Background:The Subjective Patient Outcome for Return to Sports (SPORTS) score is a single-item scale that measures athletes' ability to return to their preinjury sport based on effort and performance.Purpose/Hypothesis:The purpose of this study was to examine the psychometric properties of the SPORTS score and a modified score within the first year after anterior cruciate ligament reconstruction (ACLR). The modified version replaced “same sport” with “any sport” in the answer choices. It was hypothesized that both versions of the SPORTS score would have acceptable floor and ceiling effects and internal responsiveness, moderate convergent validity, and excellent test-retest reliability.Study Design:Cohort study (diagnosis); Level of evidence, 2.Methods:Patients were recruited preoperatively from 2 academic medical centers. The authors collected responses to the 1-item SPORTS scores at 6 and 12 months after ACLR and the Tegner activity scale, Lysholm knee score, Knee injury and Osteoarthritis Outcome Score (KOOS)–sport/recreation subscale, and Marx activity rating scale preoperatively and 6 and 12 months after ACLR. Ceiling and floor effects and responsiveness were assessed using descriptive statistics and cross-tabulations, respectively, at both follow-up time points. Spearman correlations and intraclass correlation coefficients were used to examine convergent validity and test-retest reliability, respectively.Results:Follow-up rates at 6 and 12 months were 100% and 99%, respectively. Test-retest follow-up was 77%. Floor effects for the SPORTS scores were not observed, while ceiling effects at 12 months ranged from 38% to 40%. Cross-tabulation of the SPORTS scores showed that 64% to 66% of patients reported a change in their score from 6 to 12 months, with significant differences noted between the proportions that improved versus worsened for return to any sport. Convergent validity was observed at 6 and 12 months via moderate correlations with the Tegner, Lysholm, KOOS–sport/recreation, and Marx scores (r = 0.31 to 0.47). Fair to good test-retest reliability (intraclass correlation coefficient, 0.58 and 0.60) was found at 12 months after ACLR.Conclusion:The SPORTS score appears to be a reliable, responsive, and valid 1-item scale that can be used during the first year after ACLR. No differences in psychometric properties were found between the SPORTS score and the modified version.

Differences in Psychometric Properties of Clinician- and Patient-Reported Outcome Measures for Atopic Dermatitis by Race and Skin Tone: A Systematic Review

The psychometric validity and reliability of widely used atopic dermatitis (AD) outcome measures across different races and ethnicities are unclear. We describe the rates of reporting race, ethnicity, and skin tone in studies testing the psychometric properties of AD outcome measures and compare the psychometric analyses across race, ethnicity, and skin tone. We systematically reviewed MEDLINE and EMBASE for studies reporting psychometric properties of clinician-reported or patient-reported outcome measures in AD (International Prospective Register of Systematic Reviews: CRD42021239614). Overall, 16,100 nonduplicate articles were screened; 165 met inclusion criteria. Race and/or ethnicity were reported in 55 (33.3%) studies; of those, race was assessed by self-report in 10 studies (6.1%) or was unspecified in 45 (27.3%). A total of 16 studies (9.7%) evaluated psychometric property differences by race, and only five (4.4%) of those did not recognize it as a limitation. Properties assessed across race, ethnicity, or skin tone were differential item functioning, convergent validity feasibility, inter-rater reliability, intrarater reliability, test‒retest reliability, and known-groups validity. Multiple instruments demonstrated performance differences across ethnoracial groups. This review highlights the paucity of race/ethnicity consideration for psychometric property testing in AD outcome measurement instruments. More AD outcomes instruments should be validated in diverse populations.

Screening for Posttraumatic Stress Symptoms in Young Refugees: Comparison of Questionnaire Data with and without Involvement of an Interpreter.

Background: The substantial number of young refugees who have arrived in Europe since 2015 requires rapid screening to identify those in need of treatment. However, translated versions of screening measures are not always available, necessitating the support of interpreters. The Child and Adolescent Trauma Screen (CATS) is a validated questionnaire for posttraumatic stress symptoms. Here, we report on the psychometric properties of the CATS in a sample of young refugees as a function of interpreter involvement. Methods: A total of N = 145 (Mage = 16.8, SD = 1.54; 93% male) were assessed with the CATS, with half of the screenings conducted with and half without interpreters. Post hoc analyses included calculating internal consistency using Cronbach’s α. We used confirmative factor analysis to investigate the factor structure. Results: The CATS total scale showed good reliability (α = 0.84). Differences in psychometric properties between the interpreter vs. the no interpreter group were minor and tended to be in favor of the interpreter group. Results of a confirmatory factor analysis were acceptable after the exclusion of items with low item-scale correlations. Conclusions: The sample and the administration of the assessment represent the situation of young refugees in Germany, where resources are low and translated versions not always available. The CATS may be a helpful screening tool for clinicians working with young refugees, even when administered with an interpreter. Limitations include the post hoc design of the analysis without randomization of participants and the lack of a third comparison group using translated questionnaire versions.

Risk Assessment in Juvenile and Young Adult Offenders: Predictive Validity of the SAVRY and SAPROF-YV.

Most juvenile risk assessment tools heavily rely on a risk-focused approach. Less attention has been devoted to protective factors. This study examines the predictive validity of protective factors in addition to risk factors, and developmental differences in psychometric properties of juvenile risk assessment. For a national Dutch sample of 354 juvenile and young adult offenders (16-26 years) risk and protective factors were retrospectively assessed at discharge from seven juvenile justice institutions, using the Structured Assessment of Violence Risk in Youth (SAVRY) and Structured Assessment of Protective Factors for violence risk – Youth Version (SAPROF-YV). Results show moderate validity for both tools predicting general, violent, and nonviolent offending at different follow-up times. The SAPROF-YV provided incremental predictive validity over the SAVRY, and predictive validity was stronger for younger offenders. Evidently both the SAVRY and SAPROF-YV seem valid tools for the assessment of recidivism risk in juvenile and young adult offenders. Results highlight the importance of protective factors, especially in juvenile offenders, emphasizing the need for a balanced risk assessment.

Are there gender-related differences in the psychometric properties of the Oswestry Disability Index?

Despite the wide body of research on the properties of the Oswestry Disability Index (ODI), only a few studies have investigated whether ODI scores can be interpreted similarly in both genders. A few previous studies suggested that the ODI may behave differently in different populations, e.g. in different age groups. The objective was to investigate gender-related differences in the psychometric properties of the ODI amongst patients with chronic low back pain. Observational cross-sectional cohort study. University outpatient Physical and Rehabilitation Medicine clinic. Consecutive patients seen in an outpatient Physical and Rehabilitation Medicine clinic at a university hospital between April 2014 and February 2017. Internal consistency was evaluated using Cronbach's alpha. Factor structure was investigated using exploratory factor analysis. Gender-related differences in psychometric properties of ODI items were assessed using item response theory analysis. The study included 912 patients, 579 women (63%), with an average age of 45.8 (SD 14.2) years old. The Cronbach's alpha for both genders was good at 0.88. The discrimination abilities of all 10 ODI items were mostly high to perfect for both men and women with only small fluctuations. The item information function curves were similar for most of the items. Exploratory factor analysis resulted in a unidimensional one-factor structure for both genders. The ODI appears to be a similarly unidimensional and internally consistent questionnaire in both genders without any substantial variability in the items' difficulty and discrimination. The ODI produces psychometrically similar results in both genders. Small and clinically hardly significant gender-related differences in the properties of ODI can be neglected.

Gender-related differences in psychometric properties of WHO Disability Assessment Schedule 2.0.

Objective of this study was to investigate the gender-related differential item function of 12-item WHODAS 2.0 amongst patients with chronic musculoskeletal pain. This was a cross-sectional survey study among 1,988 patients at a university Physical and Rehabilitation Medicine outpatient clinic. To assess DIF, WHODAS 2.0 items were dichotomized as `none' rated by respondents as `0' versus `any limitation' rated as `1,2,3 or 4'. The item response theory analysis was used to define discrimination and difficulty parameters of a questionnaire. The probit logistic regression was used to test uniformity of DIF between gender groups. The results of DIF analysis were presented and evaluated graphically as item characteristic curves based on 2-parameter IRT analysis of dichotomized responses. High to perfect discrimination ability was observed for all the items except one. Difficulty levels of eight items were shifted towards the elevated disability level, four items demonstrated a perfect difficulty property. Significant DIF between genders was observed in seven of 12 items. The detected DIFs were uniform. For item `household', `emotional affection' and `work', men had to experience slightly worse disability than women to achieve the same score. A reverse effect was observed for items `concentration', `washing', `dressing' and dealing with strangers. In this study, significant DIF between genders was found in seven of twelve items of 12-item WHODAS 2.0. amongst 1988 patients with chronic musculoskeletal pain. All the detected DIFs were uniform. Regardless gender-related DIF shown in seven out of 12 items, we recommend using and studying 12-item WHODAS 2.0 in different populations.

Assessing the accuracy of the Modified Checklist for Autism in Toddlers: a systematic review and meta-analysis.

The Modified Checklist for Autism in Toddlers (M-CHAT) could be appropriate for universal screening for autism spectrum disorder (ASD) at 18 months and 24 months. Validation studies, however, reported differences in psychometric properties across sample populations. This meta-analysis summarized its accuracy measures and quantified their change in relation to patient and study characteristics. Four electronic databases (MEDLINE, PsycINFO, CINAHL, and Embase) were searched to identify articles published between January 2001 and May 2016. Bayesian regression models pooled study-specific measures. Meta-regressions covariates were age at screening, study design, and proportion of males. On the basis of the 13 studies included, the pooled sensitivity was 0.83 (95% credible interval [CI] 0.75-0.90), specificity was 0.51 (95% CI 0.41-0.61), and positive predictive value was 0.53 (95% CI 0.43-0.63) in high-risk children and 0.06 (95% CI <0.01-0.14) in low-risk children. Sensitivity was higher for screening at 30 months compared with 24 months. Findings indicate that the M-CHAT performs with low to moderate accuracy in identifying ASD among children with developmental concerns, but there was a lack of evidence on its performance in low-risk children or at age 18 months. Clinicians should account for a child's age and presence of developmental concern when interpreting their M-CHAT score. The Modified Checklist for Autism in Toddlers (M-CHAT) performs with low-to-moderate accuracy in children with developmental concerns. There is limited evidence supporting its use at 18 months or in low-risk children.

Integrative Data Analysis of Gender and Ethnic Measurement Invariance in Nicotine Dependence Symptoms.

Little research has evaluated whether conflicting evidence for gender and racial/ethnic differences in nicotine dependence (ND) may be attributed to differences in psychometric properties of ND symptoms, particularly for young Hispanic smokers. Inadequate racial/ethnic diversity and limited smoking exposure variability has hampered research in young smokers. We used integrative data analysis (IDA) to pool DSM-IV ND symptom data for current smokers aged 12-25 (N = 20,328) from three nationally representative surveys (1999, 2000 National Surveys on Drug Use and Health (NSDUH) and Wave 1 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Moderated nonlinear factor analysis (MNLFA) tested symptom measurement invariance in the pooled sample containing greater ethnic and smoking exposure variability. There was study noninvariance for most symptoms. NESARC participants were more likely to report tolerance, using larger amounts or for longer periods, inability to cut down/quit, and more time spent smoking at higher levels of ND severity, but reported emotional/physical health problems at lower ND severity. Four symptoms showed gender or race/ethnicity noninvariance, but observed differences were small. An ND severity factor score adjusting for symptom noninvariance related to study membership, gender, and race/ethnicity did not differ substantively from traditional DSM-IV diagnosis and number of endorsed symptoms in estimated gender and race/ethnicity differences in ND. Results were consistent with studies finding minimal gender and racial/ethnic differences in ND, and suggest that symptom noninvariance is not a major contributor to observed differences. Results support IDA as a potentially promising approach for testing novel ND hypotheses not possible in independent studies.

Trauma-Exposed Community-Dwelling Women and Men Respond Similarly to the DAR-5 Anger Scale: Factor Structure Invariance and Differential Item Functioning.

Anger is associated with the development of posttraumatic stress disorder (PTSD) and with poor treatment outcomes. The Dimensions of Anger Reactions Scale-5 (DAR-5) has demonstrated preliminary evidence of unitary factor structure and sound psychometric properties. Gender-based differences in psychometric properties have not been explored. The current study examined gender-based factor structure invariance and differential item functioning of the DAR-5 and gender differences in PTSD symptoms as a function of anger severity using a community sample of adults who had been exposed to trauma. Data were collected from 512 trauma-exposed community-dwelling adults (47.9% women). Confirmatory factor analyses, Mantel-Haenszel χ(2) tests and a comparison of characteristic curves, and 2-way analyses of variance, respectively, were used to assess gender-based factor structure invariance, gender-based response patterns to DAR-5 items, and gender differences in PTSD symptoms as a function of anger. The unitary DAR-5 factor structure did not differ between men and women. Significant gender differences in the response pattern to the DAR-5 items were not present. Trauma-exposed individuals with high anger reported greater overall PTSD symptoms (p < .001), regardless of gender. The DAR-5 can be used to assess anger in trauma-exposed individuals without concern of gender biases influencing factor structure or item functioning. Findings further suggested that the established relationship between anger and PTSD severity did not differ by gender.

Hispanic parents' reading language preference and pediatric oral health-related quality of life

This study compared scores and psychometric properties from self-identified Hispanic parents who completed Pediatric Oral Health-related Quality of life (POQL) parent report-on-child questionnaires in Spanish or English. The study hypothesized that there were no differences in psychometric properties or POQL scores by parent reading language preference, controlling for dental needs, child's place of birth, age, insurance and use of care. POQL scores were computed, and the internal consistency, feasibility, factor structure and construct validity of the Spanish language version assessed. Hispanic parents (N = 387) of 8-14 year old children (mean age 10.2) completed the survey; 237 in Spanish and 150 in English. Internal consistency scores were higher (Cronbach α range = .86-.93) among Hispanic parents who completed the questionnaire in Spanish than in English (.66-.86). POQL scores from parents who completed questionnaires in Spanish were higher (worse) overall (6.03 vs. 3.82, P = 0.022), as were physical (11.61 vs. 6.54, P = 0.001) and role functioning domains (1.87 vs. 0.82, P = 0.029). Items for crying, pain, and eating were higher (P < 0.05) for the Spanish than the English completers. However, POQL scores were associated only with need for care (P = 0.05), parent reports of dental visit in the last year (P = 0.05) and worse oral health than a year ago (P = 0.002), controlling for reading language (not significant) and visit in last year in the final multivariate linear regression.

TV parenting practices: is the same scale appropriate for parents of children of different ages?

PurposesUse multidimensional polytomous item response modeling (MPIRM) to evaluate the psychometric properties of a television (TV) parenting practices (PP) instrument. Perform differential item functioning (DIF) analysis to test whether item parameter estimates differed across education, language, or age groups.MethodsSecondary analyses of data from three studies that included 358 children between the ages of 3 and 12 years old in Houston, Texas. TV PP included 15 items with three subscales: social co-viewing, instructive parental mediation, and restrictive parenting. The multidimensional partial credit model was used to assess the performance. DIF was used to investigate the differences in psychometric properties across subgroups.ResultsClassical test theory analyses revealed acceptable internal consistency reliability (Cronbach’s α: 0.72 to 0.83). More items displaying significant DIF were found across children’s age groups than parental education or language groups. A Wright map revealed that items covered only a restricted range of the distribution, at the easier to respond end of the trait.ConclusionsTV PP scales functioned differently on the basis of parental education, parental language, and child age, with the highest DIF among the latter. Additional research is needed to modify the scales to minimize these moderating influences. Some items may be age specific.

Translating the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM) into Lithuanian

Viliū nienė R, Evans C, Hilbig J, Pakalniškienė V, Danilevičiū tė V, Laurinaitis E, Navickas A. Translating the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM) into Lithuanian. Nord J Psychiatry 2012;Early Online:1–7. Background: There are no standardized tools in Lithuanian feasible for ongoing routine use to measure the effectiveness of psychotherapeutic treatment. The CORE-OM is a widely used 34-item self-report measure for such purpose. Aims: To explore the reliability, validity and sensitivity of the Lithuanian translation of CORE-OM questionnaire. Methods: A validation study of the CORE-OM was conducted in the psychiatric clinic attached to Vilnius University. A Lithuanian translation of the English original CORE-OM was prepared by a team of translators. Then 39 psychotherapy outpatients and 187 students were asked to complete the Lithuanian version of the CORE-OM; 66 were tested twice to determine test–retest stability. Analysis included both internal and test–retest reliability, acceptability, influence of gender, principal component analysis and criteria for reliable and clinically significant change. Results: Internal and test–retest reliability were good (0.61–0.94), though somewhat lower for the risk domain (α: 0.57–0.79, Spearman's rho 0.25–0.60). Differences between scores of the clinical and non-clinical samples were large and significant (P < 0.001). Some of the Lithuanian criteria for clinically significant change were a bit lower than those of the original UK criteria (e.g. well-being) and others higher (symptoms, functioning, overall score), illustrating the need for local exploration. Conclusions: In spite of small differences in psychometric properties from the original, the Lithuanian version of the CORE-OM was reliable and sensitive in both clinical and non-clinical settings. It has the potential to become a practical, sensitive and reliable tool for psychotherapists in Lithuania. • CORE-OM; outcome measures; psychotherapy; reliability; validation.

Psychometric properties of pain intensity scales comparing among postoperative adult patients, elderly patients without and with mild cognitive impairment in China

Background Western studies have shown that patients with mild or moderate cognitive impairment (CI) can use pain intensity scales to report pain reliably and validly, however, the qualities of pain intensity scales use in various age groups including elderly with CI are varied. In China, there is a lack of studies. Objective To compare psychometric properties of five evidence-supported pain intensity scales including the Verbal Descriptor Scale (VDS), the Numeric Rating Scale (NRS), the Faces Pain Scale (FPS), the Numeric Box-21 Scale (BS-21), and the Colored Analogue Scale (CAS) in postoperative adults varying in ages including elderly with mild CI. Design Descriptive comparative study. Setting A university-affiliated hospital in China. Participants Two hundred surgical patients were recruited purposively with 50 for each group: young adults, middle-aged adults, elderly without CI, and elderly with mild CI. Methods Participants rated the vividly remembered, current, worst, least, and average pain, and indicated scale preference and simplicity. Scale face validity, concurrent validity, convergent validity, and test–retest reliability were assessed. Fisher's exact tests were used to investigate whether face validity was related to different age groups and levels of CI. One-way ANOVA and Kruskal–Wallis test were used to test the differences of concurrent validity, convergent validity, and test–retest reliability coefficients of each pain scale among the four groups. Results Regarding face validity, the FPS was ranked best as nearly half of the patients selected it as both the most preferred and simplest scale and it had low errors; the VDS and the NRS were ranked following the FPS; however, the BS-21 and the CAS were ranked last. The concurrent validity, convergent validity, and test–retest reliability of all five pain scales were supported in use with the four groups. The differences in psychometric properties among the four groups were only found in face validity and test–retest reliability. Conclusion The findings support the psychometric properties of all five pain scales for pain assessment in Chinese adults including elderly with mild CI. However, the FPS appears to be the best, followed by the VDS and the NRS.

Neuroprotection Is Unlikely to Be Effective in Humans Using Current Trial Designs: An Opposing View

To summarize recent neuroprotective trials, there has been no useful balance of benefit over risk.1 It is premature to shoot the messenger without evidence either that the results have been misleading or that we have missed trends. Confirmatory trials and/or meta-analysis support the validity of the results, and similar designs have successfully revealed the risks and benefits of thrombolysis. Trial designs have been imperfect, but the message is accurate: the drugs or doses we tried were inadequate. We need safer and better drugs, we need to know when and how to use them, and we need to maximize the efficiency of our trials. All are possible with current designs.2 Originally, limited efficacy data from a single laboratory and an acceptable toxicity profile were sufficient to proceed to clinical development. Choice of dose range, the optimal duration of therapy, patient subgroup selection, and the likely extent of benefit were all reserved for testing in clinical trials. The misplaced optimism of such an approach is now recognized, however, and guidance on preclinical testing has been elaborated.3 Rigorous external scrutiny of preclinical data now occurs in the more informed companies,4 and clinical development is deferred pending resolution of any deficiencies. This is the first role of the (now mandatory) trial steering committee. The drug classes under investigation are evolving, and new approaches are still being discovered. Glutamate antagonists have been widely studied.1 While effective in small animal models, their short time window in the laboratory, failure to protect …

LINKING COGNITIVE HYPOTHESES AND PSYCHOMETRIC PROPERTIES: EFFECTS OF ITEM CONTEXT, GROUPING CUES AND SCALE RANGE ON RESPONSES TO SELF-REPORT INSTRUMENTS.

From recent cognitive research, we develop hypotheses about how format characteristics of self-report instruments affect interpretation, retrieval, judgment, and response processes. We test and support these hypotheses in three experiments - two involving field samples and one involving a laboratory sample - by examining predicted differences in psychometric properties across format conditions.