Assessment Instrument Research Articles

Instruments to Assess Transition Readiness Among Adolescents With Chronic Disease: A COSMIN Systematic Review of Measurement Properties.

Transition readiness is a key predictor of the success of the medical transition. There are numerous categories of assessment instruments for transition readiness in adolescents with chronic disease, but systematic integration and standardized evaluation of instruments are limited regarding measurement properties, complicating the selection of scientifically valid and reasonable instruments. This review aimed to critically appraise, compare, and summarize the transition readiness assessment instruments in adolescents with chronic diseases. A comprehensive search was conducted in 10 databases from their inception to September 3, 2023. The Consensus-based Standards for Selection of Health Measurement Instruments (COSMIN) systematic review guideline was used to evaluate the quality of the Patient-Reported Outcome Measures (PROMs) and to facilitate the recommendation of the most suitable measuring instruments. The total number of retrieved articles was 1798, out of which 74 were selected for full-text evaluation. Finally, a total of 41 articles were included, involving 22 transition readiness assessment instruments. Nine of the assessment instruments were generalized assessment instruments, whereas 13 were for specific chronic diseases. Because of insufficient or uncertain content validity and moderate or low quality of evidence, the 22 assessment instruments were recommended by grade B. This systematic review offers a comprehensive overview of the measurement characteristics of the transition readiness assessment instrument for adolescent patients with chronic illnesses, along with corresponding recommendations. The findings indicate that no instrument demonstrated superior performance over others. Consequently, future efforts should focus on developing additional high-quality instruments in accordance with COSMIN guidelines to evaluate transition readiness among this population precisely.

Attention–language interface in Multilingual Assessment instrument for Narratives

The current study employed the Multilingual Assessment Instrument for Narratives (MAIN) to test comprehension of narrative macrostructure in Russian in a visual world eye-tracking paradigm. The four MAIN visual narratives are structurally similar and question referents’ goals and internal states (IS). Previous research revealed that children’s MAIN comprehension differed among the four narratives in German, Swedish, Russian, and Turkish, but it is not clear why. We tested whether the difference in comprehension was (a) present, (b) caused by complicated inferences in understanding IS compared with goals, and (c) ameliorated by orienting visual attention to the referents whose IS was critical for accurate comprehension. Our findings confirmed (a) and (b) but found no effect of attentional cues on accuracy for (c). The multidimensional theory of narrative organization of children’s knowledge of macrostructure needs to consider the type of inferences necessary for IS that are influenced by subjective interpretation and reasoning.

Ketamine's Altered States Meta-Analysis: The Relationship Between Psychomimetic and Clinical Effects With Focus in Depression.

In recent years, there has been a significant focus on exploring the potential therapeutic impact of altered states of consciousness on treatment outcomes for mental illness, with the goal of enhancing therapeutic strategies and patient results. This meta-analysis was designed to investigate the potential link between the psychomimetic effects of ketamine and clinical outcomes in mental health, which adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eleven studies were selected for meta-analysis, and the main result did not find a significant correlation between the psychoactive effects of ketamine and clinical outcomes either in mental illness (n = 11; n's = 27; r = 0.06 [-0.05, 0.17]; P = 0.268) or depression exclusively (n = 10; n's = 25; r = 0.03 [-0.07, 0.13]; P = 0.561). High heterogeneity was found for general analysis (I2 = 80.78). Egger's regression did not indicate publication bias (intercept = 1.57; SE = 1.49, P = 0.30). No significant Kendall's rank correlation coefficient was observed (τ = 0.02, P = 0.88) indicating funnel plot symmetry. The sub-analyses, aimed at minimizing study variability by specifically examining factors such as patient disorders (limited to depression), methods of administration (exclusively intravenous), types of assessment instruments, and the timing of evaluations, also yielded no significant findings. This meta-analysis suggests that the altered states of consciousness experienced during ketamine sessions are not directly linked to clinical outcomes. However, it is important to acknowledge that the limited number of studies and their heterogeneity render this conclusion preliminary, warranting further investigation over time.

The Alzheimer's Association clinical practice guideline for the diagnostic evaluation, testing, counseling, and disclosure of suspected Alzheimer's disease and related disorders (DETeCD-ADRD): Validated clinical assessment instruments.

US clinical practice guidelines for the diagnostic evaluation of cognitive impairment due to Alzheimer's Disease (AD) or AD and related dementias (ADRD) are decades old and aimed at specialists. This evidence-based guideline was developed to empower all-including primary care-clinicians to implement a structured approach for evaluating a patient with symptoms that may represent clinical AD/ADRD. As part of the modified Delphi approach and guideline development process (7374 publications were reviewed; 133 met inclusion criteria) an expert workgroup developed recommendations as steps in a patient-centered evaluation process. The workgroup provided a summary of validated instruments to measure symptoms in daily life (including cognition, mood and behavior, and daily function) and to test for signs of cognitive impairment in the office. This article distills this information to provide a resource to support clinicians in the implementation of this approach in clinical practice. The companion articles provide context for primary care and specialty clinicians with regard to how to fit these instruments into the workflow and actions to take when integration of performance on these instruments with clinical profile and clinician judgment support potential cognitive impairment.

The Role of Kinesiotherapy in Enhancing Physical Performance and Self-Esteem: A Prospective Observational Study in Obese Adolescents

Obesity is a multifactorial chronic condition characterized by excessive fat accumulation, which adversely affects health and quality of life. This prospective observational study aimed to evaluate the impact of a 9-month tailored kinesiotherapy program on physical performance, body composition, and self-esteem in overweight and obese adolescents. Participants were divided into a study group (SG, n=40) and a control group (CG, n=40). The SG engaged in individualized kinesiotherapy sessions, while the CG maintained their usual activities. Both groups received education on the 5-2-1-0 rule for obesity prevention and management. Results indicated significant improvements in the SG, including enhancements in the 6-minute walk distance (6MWD), Timed Up-and-Go test (TUG), and Rosenberg Self-Esteem Scale (all p < 0.001). Notably, BMI and body fat percentage decreased significantly in the SG compared to the CG. Regression analysis revealed strong correlations between body composition, physical performance, and self-esteem improvements, particularly in girls and rural participants, highlighting the intervention's adaptability and effectiveness. Although limited by a relatively small sample size, short duration, and variability in adherence tracking, the study highlights the essential role of individualized physical activity programs in improving health outcomes. In conclusion, the findings from our study emphasize the significant role of individualized kinesiotherapy programs in improving physical and psychological health outcomes in overweight/obese adolescents. By integrating instrumental assessments, such as the BTS system, with subjective evaluations like PAQ-A and the Rosenberg scale, our study high-lights the multifaceted impact of physical activity on this vulnerable population.

Operationalising flexible planning coupled with ongoing assessment strategies. A pragmatic, longitudinal randomized study in U13 female volleyball team

Embracing a tailor-made approach to training, the aim of this study was to understand how ongoing adaptation and planning of training sessions (through bidirectional feedback between planning and assessment) contrasts with a more rigid planning with only 4-weeks adaptations, and how those differences impact on learning trajectories. A longitudinal, randomized design with a qualitative analysis was conducted during a full season with 24 girls from a U-13 volleyball team: an experimental group (E.G.) had daily adjusted planning and a contrast group (C.G.) had 4-weeks adjusted planning. Data analysis considered reflective diaries, field notes, video analysis and ongoing assessments using Game Performance Assessment Instrument, to gain a deeper understanding of athletes’ progression and identify their struggles. Based on ongoing and punctual assessment (through GPAI) the planning of the two groups diverged significantly in content and drill structure. Ongoing assessment allowed to solve, in E.G., unpredictable issues as well as develop flexible planning to adapt the specific drills and re-adapt the content. Those adaptations occurred in many ways such as: type of the drill, setting goals and changing the content of the session. In C.G., 4 weeks adaptations were permitted to moderate the extending disparities between rigid planning and ongoing adaptations, aiming to balance the group's levels. Our findings highlighted the importance of bidirectional feedback between assessment and planning, informing the coaches to possible adaptation of the training. Given the differences in learning rates, unforeseen circumstances and players’ characteristics, flexible planning and assessment is paramount to effectively steer the learning process.

Non-motor fluctuations in Parkinson's disease: underdiagnosed, yet important.

Non-motor fluctuations (NMF) in Parkinson's disease (PD) significantly affect patients' well-being. Despite being identified over two decades ago, NMF remain largely under-recognized, under-treated, and poorly understood. While they are often temporally associated with motor fluctuations (MF) and can share common risk factors and pathophysiologic mechanisms, NMF and MF are currently considered distinct entities. The prevalence and severity of NMF, often categorized into neuropsychiatric, sensory, and autonomic subtypes, vary significantly across studies due to the heterogeneous PD populations screened and the diverse evaluation tools applied. The consistent negative impact of NMF on PD patients' quality of life (QoL) underscores the importance of further investigation via focused and controlled studies, validated assessment instruments and novel digital technologies. High-quality research is essential to illuminate the complex pathophysiology and clinical nuances of NMF, ultimately enhancing clinicians' diagnostic and treatment options in routine clinical practice.

Adaptation and Validation of an Evaluation Instrument for Student Assessment of Veterinary Clinical Teaching.

There is a dearth of validated instruments for assessing clinical teaching in veterinary education. This study describes the development and validation of a veterinary-adapted Stanford Faculty Development Program 26 (SFDP-Vet22) instrument for student evaluation of veterinary clinical educators. Validity evidence was gathered in three specific categories: (a) content, (b) response process, and (c)internal structure. Content validity was supported by the educational theory and research underlying the Stanford Faculty Development Program 26 (SFDP-26) instrument. The process of adapting the SFDP-26 to the veterinary clinical education setting and piloting the SFDP-Vet22 supported validity in the response process, but straightlining indicated that some students ([Formula: see text]) did not use the instrument as intended. Validity in internal structure was supported by the result of exploratory factor analysis with a six-factor solution. This was performed using principal axis factoring extraction and direct oblimin oblique rotation ([Formula: see text]) on Box-Cox-transformed data. Twenty of the 22 items loaded in the predicted factors. Cronbach's alphas for each factor were above .846, mean inter-item correlations ranged from .594 to .794, and mean item-total correlations ranged from .693 to .854. The six-factor solution explained 75.5% of the variation, indicating a robust model. The results indicated that the control of session, communication of goals, and self-directed learning factors were stable and consistently loaded as predicted and that learning climate, evaluation, and feedback were unstable. This suggests the transference of these constructs from medical to veterinary education and supports the intended use: low-stakes decisions about clinical educator performance and identifying areas of potential growth of educators.

The Portuguese version of the social activities checklist

ABSTRACT Introduction Social participation of people with aphasia (PWA) is a growing concern in healthcare. The impacts of aphasia in social participation are well known, but in Portugal, the number of assessment instruments that evaluate these difficulties is scarce. Objectives To translate and adapt the Social Activities Checklist (SOCACT) to European Portuguese (SOCACT-EP), analyse its validity (content and concurrent) and reliability (internal consistency and testretest) in a group of PWA and a group of neurologically healthy people (NHP). Methodology Cognitive debriefing of the translation process and content validation of SOCACT-EP were conducted by an expert panel of 5 PWA, both individually and in a focus group; SOCACT-EP was analysed qualitatively and quantitatively (Content Validity Index – CVI). The concurrent validity and reliability study involved a group of 15 PWA and 30 NHP. Results The SOCACT- EP version was considered by PWA as easy to understand and fill-in, and with an adequate length. Most questions obtained a maximum value of CVI. For PWA, Cronbach’s α in the Social Activities section was 0.660, and for NHP, it was 0.773. The test-retest results revealed good reliability. For the concurrent validity, significant correlations were found between SOCACT-EP and the Communication Disability Profile participation items. Some social activities differed significantly between the groups. No differences could be found for the “formal” dimension. Conclusions SOCACT-EP content is of great importance to PWA, and its psychometric characteristics are very similar to those of the original version in English. Revisions and adaptations are still needed to ensure that the instrument accurately assesses social participation of individuals with varying degrees of aphasia.

Analisis Kesiapan Implementasi Rekam Medis Elektronik di Klinik Pratama Simpang Lima Husada

The Ministry of Health is committed to transforming the health system, including the transformation of health technology. One of these technological developments is Electronic Medical Records (EMR). The purpose of this study was to determine the readiness of EMR implementation at Simpang Lima Husada Primary Clinic. This study used the CAFP EHR Readiness Assessment instrument to assess the readiness of EMR implementation so as to improve service quality and workflow efficiency. This type of research is descriptive qualitative research. Informants were determined by purposive sampling technique on 14 respondents. The results of the Management Capacity readiness study obtained a score of 15, which is at level III, which means that management capacity is very ready. The readiness of Financial and Budgetary Capacity and Operational Capacity received a score of 12 at level II, indicating a fairly good cost analysis and sufficient staff and infrastructure capacity. Technology Capacity Readiness received a score of 28, which is at level II, indicating that information technology readiness is adequate. Organizational Capacity Readiness scored 28 at level II indicating a fairly good understanding of the value of EMR. Overall, Simpang Lima Husada Primary Clinic scored 95 out of a score range of 44-96 (level II) indicating it is quite ready to implement EMR based on the CAFP EHR Readiness Assessment.

Prevalence and unfavourable outcome of oral frailty in older adult: a systematic review and meta-analysis

Background and objectiveOral frailty (OF) refers to a decline in oral function amongst older adult that often occurs alongside declines in cognitive and physical abilities. We conducted a study to determine the prevalence and unfavourable outcomes of OF in the older adult population to provide medical staff with valuable insights into the associated disease burden.MethodsFrom inception to March 2024, we systematically searched six key electronic databases: PubMed, Web of Science, Embase, Cochrane Library, Scopus, and CINAHL to identify potential studies that reported the prevalence or unfavourable outcomes of OF amongst older adult. Studies that did not have accessible data were excluded. Two researchers worked independently to retrieve the literature, collect data, and evaluate the quality of the included studies. Data analysis was conducted using R Project 4.1.1 and Review Manager 5.3 software.ResultsWe identified 28 studies that met the inclusion criteria, including 27,927 older adult. The pooled prevalence of OF amongst older adult was 32% (95% confidence interval (CI): 0.24, 0.41). Subgroup analyses indicated that the setting, sample, design of studies, and assessment instruments influence the prevalence of OF. In addition, OF was associated with a high risk of physical frailty (odds ratio (OR) = 1.67; 95% CI: 1.38, 2.02), malnutrition (OR = 2.27; 95% CI: 1.75, 2.96), low dietary variety (OR = 1.98, 95% CI: 1.15, 3.39), and social withdrawal (OR = 1.42; 95% CI: 1.18, 1.71).ConclusionThis systematic review and meta-analysis revealed that OF is prevalent amongst older adult. OF may affect the prognosis of older adult and thus necessitates comprehensive assessment and management as part of an integrated approach.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=537884.

The impact of body mass index on rehabilitation outcomes after lower limb amputation.

To determine the effect of obesity on physical function and clinical outcome measures in patients who received inpatient rehabilitation services for lower extremity amputation. A retrospective review was performed on patients with lower extremity amputation (n = 951). Patients were stratified into five categories adjusted for limb loss mass across different levels of healthy body mass index (BMI), overweight, and obesity. Outcomes included the Inpatient Rehabilitation Facility Patient Assessment Instrument functional scores (GG section), discharge home, length of stay (LOS), therapy time, discharge location, medical complications and acute care readmissions. Deep learning neural networks (DLNNs) were developed to learn the relationships between adjusted BMI and discharge home. The severely obese group (BMI > 40 kg/m2) demonstrated 7%-13% lower toileting hygiene functional scores at discharge compared to the remaining groups (p < .001). The severely obese group also demonstrated 8%-9% lower sit-to-lying and lying-to-sitting bed mobility scores than the other groups (both p < .001). Sit-to-stand scores were 16%-21% worse and toilet transfer scores were 12%-20% worse in the BMI > 40 kg/m2 group than the other groups (all p < .001). Walking 50 ft with two turns was most difficult for the BMI > 40 kg/m2 group, with mean scores 7%-27% lower than the other BMI groups (p = .011). Wheelchair mobility scores for propelling 150 ft were worst for the severely obese group (4.9 points vs. 5.1-5.5 points for all other groups; p = .021). The LOS was longest in the BMI > 40 group and shortest in the BMI < 25 group (15.0 days vs. 13.3 days; p = .032). Logistic regression analysis indicated that BMI > 40 kg/m2 was associated with lower odds risk (OR) of discharge-to-home (OR = 0.504 [0.281-0.904]; p < .022). DLNNs found that adjusted BMI and BMI category were ranked 11th and 12th out of 90 model variables in predicting discharge home. Patients with severe obesity (>40 kg/m2) achieved lower functional independence for several tasks and are less likely to be discharged home despite higher therapy volume than other groups. If a patient is going home, obesity will pose unique demands on the caregivers and resources can be put in place to help reintegrate the patient into life.

Nutrition literacy profile among adolescents in Kuwait: a cross-sectional study

BackgroundAdolescent nutrition literacy and knowledge are associated with nutrient intake and obesity. With the rising prevalence of obesity in Kuwait, limited studies have assessed nutrition literacy among Kuwaiti adolescents. Therefore, this study aims to assess nutrition literacy among Kuwaiti adolescents and examine factors associated with nutrition literacy, such as body mass index (BMI) and dietary intake.MethodsA school-based cross-sectional study was conducted in public schools across Kuwait, enrolling a convenience sample of 375 adolescents (mean age = 15.6 years, 53.1% female participants). A self-administered questionnaire was used to collect relevant data. The Nutrition Literacy Assessment Instrument (NLit) score was used to assess nutrition knowledge and skills in making food choices.ResultsThe median NLit score among adolescents was 29 (IQR = 6). A large percentage (72.5%) of Kuwaiti adolescents demonstrated adequate overall nutrition literacy and scored adequately in the majority of NLit subscales. However, the majority of adolescents (73.3%) demonstrated inadequate nutrition literacy in understanding food labels. Predictors of NLit included BMI, place of residence, and smoking status. Moreover, the NLit score was negatively associated with the intake of sugar-sweetened beverages.ConclusionThis study’s findings may inform future research aimed at designing effective nutrition literacy interventions to enhance food choices among adolescents in Kuwait. The results of this study may also provide insights for policymakers and public health professionals to tailor food and nutrition programs to address the decline in food literacy skills and combat obesity.

Research trends of science process skills in Indonesian science education journals

Science process skills (SPS) are considered essential for scientific and technological eras nowadays. This study aims to provide information on how SPS in Indonesia have been researched from 2016 to 2022, including the number of studies conducted, research designs used, frequently addressed science topics, interventions, assessment instruments used, and data analysis techniques applied. We applied content analysis across numerous science education journals authored in Indonesia over 7 years. The analysed articles were filtered from 14 Indonesian science education journals selected from the SINTA database with SINTA 1-6 index ratings. Articles were searched using keywords such as "Science Process Skills and Science Education" and the selection resulted in the review of 86 articles. This up-to-date research has revealed a fluctuation in the number of articles mainly focused on SPS from year to year. Among those articles, quantitative research was the researchers' most popular method for examining SPS. 8th grade Junior High School (JHS) and 10th grade Senior High School (SHS) pupils were frequently chosen as study participants. The most frequently selected topic for the study of SPS were physics (38%), biology (33%), chemistry (9%), and unidentified topics (20%). Inquiry-based learning was the most common research focus, with test sheets and t-tests being the most frequently utilised for analysing data. This SPS review research is important to provide results to identify future areas of research and promote the development of SPS in science education. Several suggestions for future studies on SPS have been made based on the study's outcomes.

ESSD-ESGAR best practice position statements on the technical performance of videofluoroscopic swallowing studies in adult patients with swallowing disorders.

Videofluoroscopic swallowing studies (VFSS) remain the gold standard for the instrumental assessment of oropharyngeal swallowing disorders alongside flexible endoscopic evaluation of swallowing (FEES), requiring a high standard of quality and correct implementation. The current best practice position statements aim to guide the clinical practice of VFSS in individuals experiencing swallowing disorders. An international expert consensus panel with expertise in oropharyngeal dysphagia, comprised of radiologists, speech-language therapists, otolaryngologists, and other professionals in the field, convened by the European Society of Swallowing Disorders (ESSD) and the European Society of Gastrointestinal and Abdominal Radiology (ESGAR), developed best practice position statements. They were established using an online Delphi methodology involving an online panel discussion and item preparation and three consecutive rounds. Consensus was reached when ≥ 80% of the participants agreed on a specific recommendation. Eighteen best practice position statements were formulated, thereby establishing standard recommendations on the technical performance of VFSS. They cover VFSS planning, correct implementation, documentation, radiation protection, equipment and maintenance, and education and training. These position statements summarise the panel's deliberations and recommendations in performing VFSS, representing the agreed consensus of experts from ESSD and ESGAR. They provide a structured framework for optimising and standardising the performance of VFSS in patients with swallowing disorders. Question Significant regional and national differences in clinical practice when performing VFSS highlight the need for interdisciplinary recommendations to optimise patient care. Findings Eighteen statements were developed by representatives of the ESSD and the ESGAR. Clinical relevance These best practice position statements on the technical performance of VFSS may serve as a basis for standardising the procedure and ensuring high-quality service.

Development and Preliminary Testing of the Withdrawal Assessment Tool-Alpha 2 Agonist: An Assessment Instrument for Monitoring Iatrogenic Withdrawal Symptoms in Children Receiving an Alpha-2 Agonist

Objectives: To develop and conduct preliminary testing of the Withdrawal Assessment Tool-Alpha 2 Agonist (WAT-A2A) to monitor dexmedetomidine and clonidine withdrawal symptoms in acutely ill children. Design: Three-phase instrument development study. Phase 1: retrospective chart review of symptoms exhibited by children with documented dexmedetomidine withdrawal; phase 2: WAT-A2A instrument construction based on phase 1 data; and phase 3: prospective testing of the WAT-A2A in children weaning from alpha 2 agonists (A2As). Setting: Academic free-standing children’s hospital. Patients: Acutely ill children weaning from at least 5 days of dexmedetomidine. Excluded were children concurrently weaning other sedatives. Interventions: None. Measurements and Main Results: Phase 1: In 83 of 303 children weaning from at least 5 days of dexmedetomidine who had clinician documentation and were managed for A2A withdrawal, 88% (n = 72) exhibited at least a 20% increase in heart rate (HR), 83% (n = 69) exhibited agitation or change in usual state behavior, 46% (n = 38) exhibited at least a 20% increase in diastolic blood pressure (DBP), and when documented, 56% (27/48) exhibited tremors during their A2A withdrawal episode. Phase 2: The WAT-A2A was constructed, based on phase 1 data, and includes four items: HR, state behavior, DBP, and tremors. Phase 3: The WAT-A2A was tested and performed well in 82 children weaning from A2A. The total WAT-A2A score correlated with clinician subjective assessment of A2A withdrawal (Spearman correlation = 0.5; p &lt; 0.001). Inter-rater agreement, comparing paired ratings of prospectively collected WAT-A2A data, indicated moderate inter-rater reliability. Conclusions: Acutely ill children receiving sedation with an A2A for more than 5 days may develop physiologic dependence, requiring gradual dosing reductions. While further psychometric testing is advised, the WAT-A2A provides an objective instrument to help clinicians quantify dexmedetomidine withdrawal symptoms in acutely ill children may facilitate A2A weaning and limit unnecessary variation in practice.

Parental Assessment of Postsurgical Pain in Infants at Home Using Artificial Intelligence-Enabled and Observer-Based Tools: Construct Validity and Clinical Utility Evaluation Study.

Pain assessment in the infant population is challenging owing to their inability to verbalize and hence self-report pain. Currently, there is a paucity of data on how parents identify and manage this pain at home using standardized pain assessment tools. This study aimed to explore parents' assessment and intervention of pain in their infants at home following same-day surgery, using standardized pain assessment tools. This prospective study initially recruited 109 infant boys undergoing circumcision (same-day surgery). To assess pain at home over 3 days after surgery, parents using iOS devices were assigned to use the PainChek Infant tool, which is a point-of-care artificial intelligence-enabled tool, while parents using Android devices were assigned to use the Observer-Administered Visual Analog Scale (ObsVAS) tool. Chi-square analysis compared the intervention undertaken and pain presence. Generalized estimating equations were used to evaluate outcomes related to construct validity and clinical utility. Receiver operating characteristic analysis assessed pain score cutoffs in relation to the intervention used. A total of 69 parents completed postsurgery pain assessments at home and returned their pain diaries. Of these 69 parents, 24 used ObsVAS and 45 used PainChek Infant. Feeding alone and feeding with medication were the most common pain interventions. Pain presence over time reduced. In the presence of pain, an intervention was likely to be administered (χ22=21.4; P<.001), with a medicinal intervention being 12.6 (95% CI 4.3-37.0; P<.001) times more likely and a nonmedicinal intervention being 5.2 (95% CI 1.8-14.6; P=.002) times more likely than no intervention. In the presence of intervention, score cutoff values were ≥2 for PainChek Infant and ≥20 for ObsVAS. A significant effect between the use of the pain instrument (χ21=7.2, P=.007) and intervention (χ22=43.4, P<.001) was found, supporting the construct validity of both instruments. Standardized pain scores were the highest when a medicinal intervention was undertaken (estimated marginal mean [EMM]=34.2%), followed by a nonmedicinal intervention (EMM=23.5%) and no intervention (EMM=11.2%). Similar trends were seen for both pain instruments. Pain was reduced in 94.5% (224/237) of assessments where parents undertook an intervention. In 75.1% (178/237) of assessments indicative of pain, the score changed from pain to no pain, with PainChek Infant assessments more likely to report this change (odds ratio 4.1, 95% CI 1.4-12.3) compared with ObsVAS assessments. The use of standardized pain assessment instruments by parents at home to assess pain in their infants can inform their decision-making regarding pain identification and management, including determining the effectiveness of the chosen intervention. In addition to the construct validity and clinical utility of PainChek Infant and ObsVAS in this setting, feeding alone and a combination of feeding with medication use were the key pain intervention strategies used by parents.

Harmonizing two measures of adaptive functioning using computational approaches: prediction of vineland adaptive behavior scales II (VABS-II) from the adaptive behavior assessment system II (ABAS-II) scores

BackgroundVery large sample sizes are often needed to capture heterogeneity in autism, necessitating data sharing across multiple studies with diverse assessment instruments. In these cases, data harmonization can be a critical tool for deriving a single dataset for analysis. This can be done through computational approaches that enable the conversion of scores across various instruments. To this end, our study examined the use of analytical approaches for mapping scores on two measures of adaptive functioning, namely predicting the scores on the vineland adaptive behavior scales II (VABS) from the scores on the adaptive behavior assessment system II (ABAS).MethodsData from the province of Ontario neurodevelopmental disorders network were used. The dataset included scores VABS and the ABAS for 720 participants (autism n = 547, 433 male, age: 11.31 ± 3.63 years; neurotypical n = 173, 95 male, age: 12.53 ± 4.05 years). Six regression approaches (ordinary least squares (OLS) linear regression, ridge regression, ElasticNet, LASSO, AdaBoost, random forest) were used to predict VABS total scores from the ABAS scores, demographic variables (age, sex), and phenotypic measures (diagnosis; core and co-occurring features; IQ; internalizing and externalizing symptoms).ResultsThe VABS scores were significantly higher than the ABAS scores in the autism group, but not the neurotypical group (median difference: 8, 95% CI = (7,9)). The difference was negatively associated with age (beta = -1.2 ± 0.12, t = -10.6, p < 0.0001). All estimators demonstrated similar performance, with no statistically significant differences in mean absolute error (MAE) values across estimators (MAE range: 4.96–6.91). The highest contributing features to the prediction model were ABAS composite score, diagnosis, and age.LimitationsThis study has several strengths, including the large sample. We did not examine the conversion of domain scores across the two measures of adaptive functioning and suggest this as a future area of investigation.ConclusionOverall, our results supported the feasibility of harmonization. Our results suggest that a linear regression model trained on the ABAS composite score, the ABAS raw domain scores, and age, sex, and diagnosis would provide an acceptable trade-off between accuracy, parsimony, and data collection and processing complexity.

Assessing Professional Behaviors of Physician Assistant Students in Objective Structured Clinical Examinations: A Scoping Review.

Professionalism in physician assistant (PA) students is an essential behavior to assess during formative medical education. Objective structured clinical examinations (OSCEs) provide an opportunity to evaluate PA students performing professional behaviors within simulated clinical settings. This scoping review aims to explore insights the existing literature offers regarding evaluating the professional behaviors of PA students using an OSCE. A secondary objective is to identify gaps in the literature to clarify future research. This scoping review was conducted in March 2024. From January 2018 until March 2024, CINAHL, MEDLINE Ultimate, Health Source-Nursing/Education, and PubMed online databases were searched for publications in English. Records included research studying PA or medical students evaluated on professional behaviors using an OSCE or performance-based assessment instrument. Allied health profession students were excluded from the primary search because of their heterogeneous curriculum models outside the population of interest. This review includes 5 papers. All papers reported communication as a professional behavior measured in an OSCE or performance-based assessment. A consensus or formal definition of professional behavior is a notable absence in this scoping review. More definitive homogenous evidence is needed to assess the professional behaviors of PA students using an OSCE. This limits the guidance and educational standards for future health profession educators. Comprehensive research into professional behaviors among PA students is essential. Scholars must publish their findings on professionalism curriculum design and outcomes to facilitate a broader understanding and improvement in educating future PA professionals.

Assessing Student Characteristics With The Right Instruments: An Important Pathway To Implementing A Merdeka Curriculum In Indonesia

The implementation of Indonesia's Merdeka Curriculum necessitates a comprehensive understanding of student characteristics to support personalized learning experiences. This study explores the evaluation of student characteristics, assessment instruments, and their application in improving the learning process within the Merdeka Curriculum framework.To examine the evaluation of student characteristics, various assessment instruments, factors influencing instrument selection and application, and the benefits of evaluations in enhancing the learning process. This qualitative study employs a systematic literature review. The research steps include: 1) Collecting relevant literature from academic databases, focusing on journal articles, books, and government regulations related to the Merdeka Curriculum and student assessment; 2) Analyzing collected materials using content analysis techniques; 3) Synthesizing key themes and findings; 4) Validating results through data source triangulation and peer review. The study identifies key student characteristics for assessment, including cognitive abilities, learning readiness, motivation, learning styles, self-regulation, and social-emotional skills. Various assessment instruments are discussed, such as standardized tests, evaluation scales, performance-based assessments, interviews, and observations. Factors influencing instrument selection include assessment goals, student characteristics, and available resources. The benefits of student characteristic evaluations include informing adaptive instruction, providing targeted support, and monitoring student progress. Effective evaluation of student characteristics is crucial for implementing the Merdeka Curriculum and supporting student-centered learning in Indonesia. The study emphasizes the need for a shift towards process-oriented assessment and highlights the importance of collaboration among educational stakeholders to create an inclusive learning environment.