Internal Consistency Reliability Estimates Research Articles

Validity Evidence of the Reading Screening Test for Portuguese First Graders

This study aims to present validity evidence for the Reading Screening Test (TRL-Teste de Rastreio de Leitura) that assesses word and pseudoword reading. Participants were 94 Portuguese first graders (49 girls and 45 boys), assessed with the TRL and criterion measures – ALEPE subscales to assess words, pseudowords reading and Rapid Automatized Naming. Results from confirmatory factor analyses indicated that a two-factor measurement model yielded a good fit to the data. Favorable estimates of internal consistency reliability were obtained. Correlation coefficient results suggested that the measure was positively and statistically associated with another measure of reading assessment. These results revealed adequate evidence based on internal structure and evidence based on the relationship to other variables for the assessment of word reading accuracy among Portuguese first graders.

The brief (seven-item) eating disorder examination-questionnaire: Evaluation of a non-nested version in men and women.

Several recent studies have examined the psychometric properties of brief measures of eating disorder attitudes based on the Eating Disorder Examination Questionnaire (EDE-Q). A seven-item version (the EDE-Q7) has been proposed but, as yet, has only been investigated by looking at the items when presented as part of the longer EDE-Q (i.e., as a nested version). The current study presented the EDE-Q7 as a standalone instrument and examined factor structure fit and measurement invariance across male and female genders. University students (244 women; 155 men; 1 did not identify with either gender) completed questionnaires as part of two independent studies. All individuals completed the EDE-Q7 and measures of eating disorder behaviors. In a mixed-gender subsample (n = 286), measures of depression and eating disorder-specific quality of life were also included. Confirmatory factor analysis of the EDE-Q7 was conducted on males and females independently, in addition to estimates of internal consistency reliability and validity. Measurement invariance was assessed through multigroup confirmatory factor analysis. The EDE-Q7 demonstrated good internal consistency and findings supported measurement invariance by gender. In a mixed-gender subsample, the measure showed positive associations with depression and both eating disorder behaviors and eating disorder-specific quality of life. The present study adds to the literature supporting the psychometric properties of the EDE-Q7, extending this to use of the questionnaire as a standalone instrument. Measurement invariance suggests that the measure may be appropriate for college-age men and women, although future studies should establish psychometric properties more fully.

Assessing meaning & purpose in life: development and validation of an item bank and short forms for the NIH PROMIS®.

A sense of meaning and purpose is important for people living with acute and chronic illness. It can buffer the effects of stress and facilitate adaptive coping. As part of the Patient-Reported Outcomes Measurement Information System (PROMIS), we developed and validated an item response theory (IRT)-based measure of meaning and purpose in life. Informed by a literature review and patient and content-expert input, we wrote 52 items to assess meaning and purpose and administered them to a general population sample (n = 1000) along with the Meaning in Life Questionnaire-Presence of Meaning Subscale (MLQ-Presence) and the Life Engagement Test (LET). We split the sample in half for exploratory factor analysis (EFA) followed by confirmatory factor analysis (CFA). IRT analyses included assessments of differential item functioning (DIF). Participants had a mean age of 47.8years and 50.3% were male. EFA revealed one dominant factor and CFA yielded a good fitting model for a 37-item bank (CFI = 0.962, TLI = 0.960, RMSEA = 0.085). All items were free of sex, age, education, and race DIF. Internal consistency reliability estimates ranged from α = 0.90 (4-item short form) to α = 0.98 (37-item bank). The 8-item Meaning and Purpose short form was correlated with the MLQ-Presence (r = 0.89), the LET (r = 0.79), and the full PROMIS Meaning and Purpose item bank (r = 0.98). The PROMIS Meaning and Purpose measures demonstrated sufficient unidimensionality and displayed good internal consistency, model fit, and convergent validity. Further psychometric testing of the PROMIS Meaning and Purpose item bank and short forms in people with chronic diseases will help evaluate the generalizability of this new tool.

How satisfied are you with your job? Estimating the reliability of scores on a single‐item job satisfaction measure

AbstractEstimating the reliability of scores on single‐item measures can be difficult because commonly used internal consistency estimates of reliability cannot be calculated. When longitudinal data is available, statistical models can be used to decompose the variability in the latent variable at each wave into trait versus state variance. Then, reliability can be estimated as a ratio of the sum of the trait variance that is captured in repeated assessments over the total variance. The current study used latent trait‐state‐error models on a nine‐year longitudinal data (N = 5,003) to estimate the test–retest reliability of scores on a single‐item measure of job satisfaction. Results showed that job satisfaction scores were somewhat unreliable (rxx = .49–.59) and amenable to change.

PENGEMBANGAN ALAT UKUR KUALITAS HIDUP INDONESIA

This research aimed to develop a Kualitas hidup measurement tool in Indonesia. The research method used in this study is a combined method of qualitative and quantitative research (mixed method). The qualitative stage aimed at exploring the theme of kualitas hidup totaling 250 people. Meanwhile, participants in the quantitative stage aimed at identifying psychometric properties (validity and reliability) numbered 759 people. The data analysis technique used for qualitative data is open coding. Quantitative data consists of construct validity test using factorial validity with exploratory factor analysis (EFA), convergent validity, and known-group validity, and estimation of internal consistency reliability using Cronbach's Alpha. The EFA results show that the Kualitas hidup Indonesia measuring instrument consists of 9 factors and 30 items with a very high reliability coefficient (α = 0.88). Convergent validity in this study was carried out by correlating the Kualitas hidup Indonesia measuring tool with the WHOQOL-BREF measurement tool. Validity by known-group is done by comparing demographic data of age, sex, marital status, education level, employment status, and health conditions using One-Way ANOVA

Applicability of the Ego-Resilience Scale (ER89) in the Chinese Cultural Context: A Validation Study

This study examined the cross-cultural validity of the Ego-Resilience Scale (ER89) in the Chinese cultural context. The ER89 was translated and culturally adapted into Chinese by following the psychometric validation procedures, in an adolescent sample ( N = 943) of 13- to 18-year-olds. A series of psychometric analyses were conducted, including exploratory factor analysis (EFA), confirmatory factor analysis (CFA), analysis for measurement invariance across gender groups, analysis for criterion-related validity evidence, and internal consistency reliability estimates. The results supported the use of ER89 scale in the Chinese cultural context (ER89-C). The empirical findings suggest a two-factor structure of ER89-C (openness to life experiences [OL] and optimal regulation [OR]). The findings also revealed that ER89-C has the expected correlations with external and theoretically related constructs. Overall, ER89-C is shown to possess favorable psychometric characteristics for its use as an assessment tool for ego-resilience level of Chinese adolescents.

A psychometric evaluation of the Family Decision-Making Self-Efficacy Scale among surrogate decision-makers of the critically ill.

The purpose of this study was to report the psychometric properties, in terms of validity and reliability, of the Unconscious Version of the Family Decision-Making Self-Efficacy Scale (FDMSE). A convenience sample of 215 surrogate decision-makers for critically ill patients undergoing mechanical ventilation was recruited from four intensive care units at a tertiary hospital. Cross-sectional data were collected from participants between days 3 and 7 of a decisionally impaired patient's exposure to acute mechanical ventilation. Participants completed a self-report demographic form and subjective measures of family decision-making self-efficacy, preparation for decision-making, and decisional fatigue. Exploratory factor analyses, correlation coefficients, and internal consistency reliability estimates were computed to evaluate the FDMSE's validity and reliability in surrogate decision-makers of critically ill patients. The exploratory factor analyses revealed a two-factor, 11-item version of the FDMSE was the most parsimonious in this sample. Furthermore, modified 11-item FDMSE demonstrated discriminant validity with the measures of fatigue and preparation for decision-making and demonstrated acceptable internal consistency reliability estimates. This is the first known study to provide evidence for a two-factor structure for a modified, 11-item FDMSE. These dimensions represent treatment and palliation-related domains of family decision-making self-efficacy. The modified FDMSE is a valid and reliable instrument that can be used to measure family decision-making self-efficacy among surrogate decision-makers of the critically ill.

The Inventory of Callous Unemotional Traits: A reliability generalization meta-analysis.

The Inventory of Callous Unemotional Traits (ICU) is the most commonly used measure of Callous Unemotional (CU) traits. However, its internal consistency reliability estimates vary substantially across different studies. This article reports findings from a reliability generalization (RG) meta-analysis, which included 146 studies (N = 64,356), to estimate the overall Cronbach's alpha values of ICU scores. Mixed-effects moderator analyses were also conducted to investigate possible study characteristics that may influence alpha values. The findings showed that the mean alpha value of the ICU total and subscale scores were acceptable, ranging from .70 (unemotional subscale) to .81 (total score). Moderator analyses indicated that the mean and standard deviation of the total scores, age group, and administration format accounted for 35.51% of the total variability of the alpha values. The observer-report version had substantially higher reliability than the self-report version. We discuss the implications of these findings for future clinical research and practice. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Development of a Bidimensional Simpatía Scale for Use With Mexican American, Puerto Rican, and Cuban American Adults.

Through its influence on social interactions, simpatía may have a wide-ranging influence on Latinx health. Simpatía-which does not have a direct English translation-refers to being perceived as likeable, pleasant, and easygoing. Research to investigate the influence simpatía on Latinx health is limited, likely due to a lack of options for measuring simpatía among diverse Latinx populations. The goal of this research was to develop a bilingual, survey-based simpatía scale for use among ethnically diverse Latinx adults in health-related settings. Data were obtained through a telephone survey data of 1,296 Mexican American, Puerto Rican, and Cuban American adults living in the United States. Interviews were conducted in English and Spanish. Exploratory factor analysis, item response theory analysis, confirmatory factor analysis, and computation of estimates of internal consistency reliability were conducted to inform the development of the final simpatía scale. Results indicate that the final, nine-item, simpatía scale has high internal consistency (α = .83) and measurement invariance among Mexican American, Puerto Rican, and Cuban American adults. Two dimensions were identified, as indicated by a perceptions subscale and a behavior subscale. Cuban Americans were found to have the highest simpatía scores, followed by Puerto Ricans and Mexican Americans. Culture is often identified as a powerful potential influence on health-related behaviors, but measures are often not available to assess specific cultural traits. By developing a new tool for measuring simpatía, this research advances opportunities for understanding and promoting Latinx health.

An Application of Reliability Estimation in Longitudinal Designs Through Modeling Item-Specific Error Variance.

The purpose of the present study was to apply the methodology developed by Raykov on modeling item-specific variance for the measurement of internal consistency reliability with longitudinal data. Participants were a randomly selected sample of 500 individuals who took on a professional qualifications test in Saudi Arabia over four different occasions. Data were analyzed by use of confirmatory factor analysis, and item error variance was corrected for item specificity. The estimation of reliability involved composite index omega. Results indicated that the initially low and unacceptable levels of internal consistency reliability approached acceptable levels after accounting for item-specific variance. Findings were verified by testing whether the difference estimates of internal consistency reliability deviated from a zero-mean distribution using 10,000 replicated samples assuming a known (symmetric) or unknown (asymmetric) population distribution of the difference reliability coefficients. Percentage improvement reliability estimates indices were also estimated along with their 95% confidence intervals. Two appendices provide annotated Mplus syntax files for future use.

An Examination of the Psychometric Properties of the Reasons for Living Inventory within a Male Veteran Clinical Sample

Elevated suicide risk among veteran populations remains a significant public health concern. However, few suicide assessment measures have been validated for veterans. The current study evaluated the reliability and validity of the Reasons for Living Inventory (RFL) scores among veteran populations. The participants included male veterans (N = 421) from a broad range of ages, combat exposures, and history of suicide attempts. Participants completed the RFL and a set of additional self-report measures of relevant constructs in a cross-sectional design. Estimates of internal consistency reliability were adequate for scores on all the original RFL subscale scores. Exploratory factor analysis (EFA) and exploratory bifactor (bi-factor EFA) analyses provided detailed information regarding the 6-factor solution from the original validation studies with the RFL. Additional analyses identified potential correlates for the RFL total and subscale scores. Secondary analyses showed support for evidence of known-groups validity for the RFL total scale score. Overall, this study provides initial support for the RFL as a reliable and valid measure of protective factors in veterans. Future studies may wish to consider further validation of the current findings.

Further evidence for score reliability and validity of the Anxiety Depression Distress Inventory-27 scale

ABSTRACT We conducted several analyses with data from undergraduate students (N = 309) and active duty US Air Force Security Forces personnel (N = 273) to examine the utility of scores on the Anxiety Depression Distress Inventory-27 (ADDI-27). The three specific dimensions of the ADDI-27 include Positive Affect, Somatic Anxiety, and General Distress, each composed of nine relevant and representative items. Internal consistency reliability estimates for scores on the scales were strong across the study groups (coefficient-α values ≥ .80). Results of analyses using differential item functioning showed that the groups interpreted the contents of the ADDI-27 items similarly. At the scale-level analyses, the undergraduate student sample reported higher somatic and general distress symptoms compared to the Air Force sample. Evidence for concurrent validity was adequate. Examples of the concurrent measures were the meaning in life, mental health functioning, and sources of social support self-report instruments. Taken together, results support the use of the ADDI-27 for assessing clusters of somatic anxiety, depression, and general distress in the current study samples.

Adaptation and cross-cultural validation of the Spanish version of the Thyroid-Related Quality-of-Life Patient-Reported Outcome questionnaire

IntroductionThe ThyPRO questionnaire is the most widely used tool for measuring quality of life in patients with benign thyroid diseases. The purpose of this study was to adapt and validate a Spanish translation of the ThyPRO and its abbreviated version (ThyPRO-39). Material and methodsAdaptation to the Spanish language was performed using the forward–backward translation method, followed by a pretesting study on five representative patients. The final questionnaire (ThyPROes) was administered to 155 patients with thyroid disorders recruited in a tertiary Spanish hospital. Psychometric properties were evaluated by multitrait scaling and estimation of internal consistency reliability (Cronbach's alpha coefficient). Data from a previous sample of 902 Danish patients were used to analyze differential item functioning (DIF) between the Spanish and the original Danish versions of the questionnaire using ordinal logistic regression. ResultsThree of 85 items in ThyPROes and four of the 39 items in ThyPRO-39es lacked convergent validity, while lack of discriminant validity was found for in nine and 14 items of each version respectively. Cronbach's alpha was >0.7 for 12 of 13 scales in the ThyPRO and 10 of 12 scales in the ThyPRO-39es. Eight items in the ThyPROes were flagged with DIF (one with non-uniform DIF), as were two items in the ThyPRO-39es. DIF magnitude was small (explained variance in the item score <3%) in most cases, with a minor impact on scale scores. ConclusionsThe Spanish versions of the ThyPRO and ThyPRO-39 show acceptable psychometric properties and good cross-lingual validity, and are suitable for use in clinical studies.

Psychometric Fundamentals of the Social Skills Improvement System: Social–Emotional Learning Edition Rating Forms

This study described the development of the Social Skills Improvement System Social Emotional Learning Edition Rating Forms (SSIS SEL RF) for teachers, parents, and students. This new multirater assessment is a reconfiguration of the SSIS Rating Scales items inspired by the CASEL Social Emotional Competency framework. The internal structure and score reliability estimates were examined across three raters for a common sample of more than 200 individual children ages 3 to 18 years. Confirmatory factor analyses tested against the CASEL five-dimensional SEL theoretical model demonstrated adequate fit for the SSIS SEL Parent and Student RFs and mediocre fit of the Teacher RF. Internal consistency, test-retest, and interrater reliability estimates for scores on each of the SSIS SEL RFs all met or exceeded acceptable criteria. Thus, researchers and practitioners interested in measuring the social–emotional behavior of children ages 3 to 18 can expect reliable scores and structurally meaningful behavior content within the Collaborative on Academic Social Emotional Learning (CASEL) SEL competency framework. Limitations to the present findings and suggestions for future research conclude the report.

A validation of the Social Skills domain of the Social Skills Improvement System‐Rating Scales with Chinese preschoolers

AbstractThe study explored the validity of the Social Skills Improvement System‐Rating Scales (SSIS‐RS) in a sample of over 4,000 preschool children (aged 3–5 years old) in China. Multiple approaches were used to examine the validity of SSIS‐RS in the Chinese cultural context, including confirmatory factor analysis, convergent and discriminant validity evidence with external measures of learning and developmental outcomes, and internal consistency reliability estimates. The findings supported the SSIS‐RS 7‐factor structure (i.e., communication, cooperation, assertion, engagement, responsibility, empathy, and self‐control) when applied in the Chinese context, and provided strong empirical evidence that SSIS‐RS is a psychometrically sound measure for assessing the social skills of Chinese children. The latent profile analysis was used to provide a descriptive picture of the patterns of different social skills measured by SSIS‐RS among Chinese preschool children. Four classes best described the social skills presentations of children in this study: Lowest Social Skills (14%), Relatively Low Social Skills (41%), Relatively High Social skills (35%), and Highest Social Skills (10%). Implications for intervention practice and future research are discussed.

Cross cultural adaptation and validation of an Arabic version of selected PROMIS measures for use in rheumatoid arthritis patients

Aim of the workTo cross culturally adapt and validate an Arabic version of selected patient reported outcome information system (PROMIS) measures for use in rheumatoid arthritis (RA). Patients and MethodsOne-hundred RA patients were recruited. They were asked to complete a validated Arabic health assessment questionnaire (HAQ), visual analogue scale (VAS) of patient global assessment (PGA) and the translated Arabic version of selected PROMIS measures for use in RA. The items of PROMIS were translated and cross culturally adapted using general guidelines. A pretest sample of twenty RA patients was used for cognitive evaluation of translated version and estimation of internal consistency reliability with cronbachs-alpha. Convergent validity was assessed. Disease activity score-28 (DAS28) and clinical disease activity index (CDAI) were considered. Results: Patients were mostly females (94%) with a mean age of 41.5 ± 11.1 years and disease duration 6.3 ± 7.3 years. The level of education varied and extra-articular manifestations were present in 12%, rheumatoid factor was positive in 72%, the mean tender (8 ± 3.3) and swollen (5 ± 2.1) joint counts, the PGA was 6.7 ± 1.8, HAQ was 1.4 ± 0.7, the DAS28 was 5.4 ± 1.3 (2.7–8.5) while the CDAI was 27.1 ± 12.6 (5–64). The translated Arabic PROMIS showed good internal consistency and reliability (Cronbach's-α 0.7–0.9). There was a significant correlation between different domains of PROMIS (p < 0.01, r = 0.37–0.68) and of PROMIS domains with HAQ (p < 0.01, r = 0.37–0.85), PGA (p < 0.01, r = 0.3–0.67), (p < 0.01, r = 0.29–0.65) and CDAI (p < 0.01, r = 0.28–0.72). ConclusionThese data provide preliminary evidence of reliability and construct validity of the Arabic translated selected PROMIS measures for use in RA patients.

Patient-reported outcome domains for the esophageal CONDUIT report card: a prospective trial to establish domains

BackgroundHealth-related quality of life (QoL) deteriorates immediately after esophagectomy. Patients may benefit from periodic assessments to detect increased morbidity on the basis of subjective self-reports. Using input from patients and health care providers, we developed a brief prototype for the esophageal conduit questionnaire (Mayo Clinic Esophageal Conduit Outcomes Noting Dysphagia/Dumping, and Unknown outcomes with Intermittent symptoms over Time after esophageal reconstruction [CONDUIT] Report Card) and previously used it in comparative research. The present study aimed to expand its content and establish health-related QoL and symptom domains of a patient-reported postesophagectomy conduit evaluation tool.MethodsWe expanded tool content by selecting items measuring patient-reported symptoms from existing questionnaires or written de novo. A multidisciplinary group of clinician content-matter experts approved the draft tool, together with a designated patient advocate. The expanded tool was administered to patients postesophagectomy from March 1 to November 30, 2016. We established domains of conduit performance for score reporting through data analysis with exploratory factor analyses. We assessed psychometric properties such as dimensionality, internal consistency, and inter-item correlations in each domain and compared content coverage with other existing measures intended for this patient population. For data that were missing less than 50% of patient responses, the missing values were imputed.ResultsFive multi-item domains were established from data of 76 patients surveyed after esophagectomy; single items were used to assess stricture and conduit emptying. For every multi-item domain, dominance of 1 factor was present. Internal consistency reliability estimates for the domains were 0.87, 0.78, 0.75, 0.80, and 0.83 and average inter-item correlations were 0.40, 0.50, 0.40, 0.33, and 0.73 for dysphagia, reflux, dumping-gastrointestinal symptoms, dumping-hypoglycemia, and pain, respectively. Some items observed to have lower inter-item correlation were reworded or flagged for removal at future validation. For reflux and dumping-related hypoglycemia, additional items were written after these analyses.ConclusionsThe CONDUIT Report Card is a novel questionnaire for assessing QoL and symptoms of patients after esophageal reconstruction. It covers major symptoms of these patients and has good content validity and psychometric properties. The tool can be used to help direct patient care, guide intervention, and compare efficacy of different treatment options.Trial registrationClinicalTrials.gov identifier No. 02530983 on 8/18/2015.

The future disposition Inventory-24: reliability and validity estimates in a large sample of Chinese University students

BackgroundThis study was designed to assess the factor structure, internal consistency reliability, and preliminary psychometric properties of the Chinese version of the Future Disposition Inventory-24 (FDI-24) in a large sample of Chinese university students.MethodsWe translated the English version of the Future Disposition Inventory-24 (FDI-24) into Chinese and examined its factor structure, estimates of internal consistency reliability, and psychometric properties in a representative sample of university students. In particular, students (N = 2,074) from two universities in Shandong Province in China were identified using the multi-stage stratified sampling method. In addition to the FDI-24, we collected preliminary data using self-report instruments that included the Beck Hopelessness Scale (BHS) and a general sociodemographic information questionnaire.ResultsThe results of the internal consistency reliability estimates were adequate regarding the scores on the three FDI-24 subscales: Cronbach’s alpha = .89–.97, Omega total = .85–.96, Revelle’s Omega total = .88–.96, the greatest lower bound (GLB) = .89–.96 and Coefficient H = .86–.94. Bivariate correlation analyses showed evidence for criterion and discriminant validity. The 3-factor oblique-Geomin-rotation solution accounted for 62.92% of the total variance in the exploratory factor analysis (EFA). The exploratory structural equation modeling (ESEM) result showed that the 3-factor model provided adequate fit statistics for the sample data: the robust comparative fit index (R-CFI) was .959, robust Tucker Lewis index (R-TLI) was .946 and robust root mean square error of approximation (R-RMSEA) was .090.ConclusionThe FDI-24 has a satisfactory factor structure, reliability estimates, and satisfactory evidence of concurrent validity estimates for students with different demographic and cultural backgrounds. The FDI-24 holds promise for use in future investigations with Chinese students.

The Future Work-Life Balance Attitudes Scale: Assessing Attitudes on Work-Life Balance in Millennial College Women

The goal of this study was to construct a reliable and valid scale that assesses the work-life balance attitudes of millennial college women. The items that created the Future Work-Life Balance Attitudes Scale (FWLBAS) were based on the Kaleidoscope Career Model and proved similar to findings from a previous qualitative pilot study. The scale was administered to an online sample of 508 millennial college women in their senior year of college. The data were then analyzed via exploratory and confirmatory factor analyses, and internal consistency reliability estimates were generated. The scale showed high reliability. The exploratory and confirmatory factor analyses led to the development of three subscales, namely “defining working motherhood,” “work-life balance strategies,” and “influence of college personnel,” and revisions of the item content of the FWLBAS. This scale is the first work-life balance instrument of its kind focusing on the population of millennial college women.

Adaptation and cross-cultural validation of the Spanish version of the Thyroid-Related Quality-of-Life Patient-Reported Outcome questionnaire

IntroductionThe ThyPRO questionnaire is the most widely used tool for measuring quality of life in patients with benign thyroid diseases. The purpose of this study was to adapt and validate a Spanish translation of the ThyPRO and its abbreviated version (ThyPRO-39). Material and methodsAdaptation to the Spanish language was performed using the forward–backward translation method, followed by a pretesting study on five representative patients. The final questionnaire (ThyPROes) was administered to 155 patients with thyroid disorders recruited in a tertiary Spanish hospital. Psychometric properties were evaluated by multitrait scaling and estimation of internal consistency reliability (Cronbach's alpha coefficient). Data from a previous sample of 902 Danish patients were used to analyze differential item functioning (DIF) between the Spanish and the original Danish versions of the questionnaire using ordinal logistic regression. ResultsThree of 85 items in ThyPROes and four of the 39 items in ThyPRO-39es lacked convergent validity, while lack of discriminant validity was found for in nine and 14 items of each version respectively. Cronbach's alpha was >0.7 for 12 of 13 scales in the ThyPRO and 10 of 12 scales in the ThyPRO-39es. Eight items in the ThyPROes were flagged with DIF (one with non-uniform DIF), as were two items in the ThyPRO-39es. DIF magnitude was small (explained variance in the item score <3%) in most cases, with a minor impact on scale scores. ConclusionsThe Spanish versions of the ThyPRO and ThyPRO-39 show acceptable psychometric properties and good cross-lingual validity, and are suitable for use in clinical studies.