Measurement Instruments Research Articles

An international core outcome set for primary progressive aphasia (COS‐PPA): Consensus‐based recommendations for communication interventions across research and clinical settings

AbstractINTRODUCTIONInterventions to treat speech‐language difficulties in primary progressive aphasia (PPA) often use word accuracy as a highly comparable outcome. However, there are more constructs of importance to people with PPA that have received less attention.METHODSFollowing Core Outcome Set Standards for Development Recommendations (COSSTAD), this study comprised: Stage 1 – systematic review to identify measures; Stage 2 – consensus groups to identify important outcome constructs for people with PPA (n = 82) and care partners (n = 91); Stage 3 – e‐Delphi consensus with 57 researchers.RESULTSThe systematic review identified 84 Outcome Measurement Instruments. Core outcome constructs identified included: (1) Participate in conversations with family and friends, (2) get words out, (3) be more fluent, (4) convey a message by any means, and (5) understand what others are saying. Researchers were unable to reach a consensus on measurement instruments.DISCUSSIONFurther work is required to develop appropriate measurement instruments that address all core outcome constructs important to key stakeholders.Highlights We introduce new symptom‐led perspectives on primary progressive aphasia (PPA). The focus is on non‐fluent/agrammatic (nfvPPA) and semantic (svPPA) variants. Foregrounding of early and non‐verbal features of PPA and clinical trajectories is featured. We introduce a symptom‐led staging scheme for PPA. We propose a prototype for a functional impairment scale, the PPA Progression Planning Aid.

International intercomparison of Radon 222 activity concentration calibration facilities

The Coalition of International Radon Associations (COIRA) organised an inter-comparison of Rn-222 (radon) activity concentrations reported by calibration laboratories. A set of three AlphaGUARDs were used as transfer reference instruments against which to compare reported Rn-222 activity concentrations. Rn-222 activity concentration calibration facilities (sometimes termed chambers) from seven countries (Australia, US, Czech Republic, Spain, England, Sweden, Canada), and three continents participated in this project. The objective of the study was to provide information useful to calibration chamber operators and public health officials in the improvement of measurement and control systems, the maintenance of performance standards for measurements, and regulatory requirements for calibrations. This work builds upon and expands previous interlaboratory comparisons and provides data for estimating and using calibration uncertainty values as part of overall field error estimates and limits. A simple proportional difference between laboratories is presented here, calculated as the average for N hours of each hour’s difference between the laboratory’s concentration and the average of the three reference instruments. This percent difference ranged from less than 0.5% to just less than 8%. This work demonstrates that the ANSI/AARST standards limit of 8% for the estimated unexpanded (one sigma) individual calibration estimated uncertainty for continuous radon monitor calibration facilities in the US is achievable. However, given the few standards regarding calibration of Rn-222 activity concentration measurement instruments that themselves are often used to calibrate secondary and tertiary Rn-222 calibration facilities, there is a great need for continued interlaboratory comparisons to harmonise and document the calibration of Rn-222 activity concentrations.

Flattering or embarrassing your boss? An integrated perspective on newcomers' ingratiation, supervisors' responses, and work outcomes

SummaryIngratiation seems to be extremely useful in the initial stage of interpersonal interaction. Recently, scholars have drawn attention to the role of ingratiation in the special context of newcomer socialization, arguing that ingratiation can help newcomers build a positive image in the work setting. In this research, we first propose that two types of ingratiation—excessive ingratiation and seamless ingratiation—can be distinguished and develop a measurement instrument for them. Second, based on affective events theory, we explore how newcomers' excessive ingratiation and seamless ingratiation lead to different socialization outcomes by stimulating distinct emotional and behavioral responses from their supervisors. The results of two experiments and a multisource weekly survey conducted for 10 consecutive weeks reveal that newcomers' excessive ingratiation triggers supervisors' embarrassment and interaction avoidance, and ultimately hinders newcomer socialization; in contrast, seamless ingratiation evokes supervisors' pride and information sharing and ultimately promotes socialization outcomes. Supervisor narcissism weakens the relationship between excessive ingratiation and embarrassment but strengthens the relationship between seamless ingratiation and pride. Theoretical contributions, practical implications, and directions for future research are discussed.

An integrative approach to assessing buyer-supplier relationships: scale development and validation

PurposeThe research investigated relations between factors used to evaluate the quality of buyer-supplier relationships (BSRs): perceived performance of the supplier, satisfaction with supplier, and trust in the supplier; and to develop an instrument to evaluate BSRs (a BSRs evaluation scale).Design/methodology/approachWe applied the psychometric testing of the BSRs measurement using exploratory factor analysis and confirmatory factor analysis. We applied structural equation modeling (SEM) to understand the interrelations of factors underlying BSRs.FindingsThe BSRs evaluation scale consists of three factors: perceived performance of the supplier, satisfaction with the supplier, and trust in the supplier. The results provide empirical evidence of the validity, reliability, and generalizability of the presented measurement.Originality/valueThe study developed a novel measurement instrument that integrates BSRs’ multidimensional constructs. It explains and confirms the significant roles of satisfaction with the supplier, trust in the supplier, and perceived performance of the supplier in shaping the BSRs’ quality. Furthermore, we provide evidence that in BSRs goodwill- and competence-based trust integrate into a single factor.

The OPAD-perception framework: measuring perceptions of online personalized advertising

PurposeThe paper aims to develop and validate an instrument to measure users’ perceptions of online personalized advertising.Design/methodology/approachFirst, we identified 12 different aspects of online personalized advertisement and formulated candidate items through a literature review. A card sorting study and expert review were conducted to generate the initial scale items. We then conducted one survey (n = 308) to create a reliable measurement instrument and another (n = 296) to validate the instrument. Finally, we tested how the dimensions of the OPAD-Perception Framework can be used to differentiate between different levels of ad sensitivity, control/no control over the ad personalization process, and different levels of granularity of ad explanation.FindingsThe resulting OPAD-Perception Framework contains 49 Likert-formatted questions measuring ten distinct dimensions of online personalized advertising: reliability, usefulness, transparency, interactivity, targeting accuracy, accountability, creepiness, willingness to rely on, self-actualization, and persuasion.Originality/valueThe OPAD-Perception Framework can serve as a powerful tool to measure users’ attitudes toward online personalized advertising. This will enable advertisers and social media platforms to better support users’ privacy expectations and provide user-friendly interfaces for controlling the ad personalization process.

Adaptation of the Keirsey Temperament Sorter II (KTS-II) for the Chinese vocational university students majoring in preschool education

ABSTRACT The preschool education major in vocational universities serves as the core platform for cultivating students who are preparing to become applied early childhood teachers in China, but currently its education is too unified and ignores the differences among students. In addition, there is a lack of a measurement instrument to understand student differences. The purpose of this study is to adapt the English version of the Keirsey Temperament Sorter II (KTS-II) into the Chinese version in order to measure and understand the temperament types of Chinese vocational university students majoring in preschool education, so as to make it possible to conduct differentiated education based on student temperament differences. The adaptation procedure consists of three phases: (1) the scale translation phase; (2) the scale evaluation phase, including expert evaluation and target population pretesting; and (3) the scale testing phase, including initial testing and retesting. The results show that by removing six items from the original English version of the KTS-II, 64 items in the Chinese version of the KTS-II have been proven to have acceptable validity and reliability. The conclusions suggest that the Chinese version of the KTS-II can be used by relevant stakeholders in the preschool education major of Chinese vocational universities to distinguish student differences, and the scale adaptation procedure and methods in this study can serve as a theoretical reference for scale adaptors.

K-mean cluster analysis of the use of prepositional phrases for location, writing, reading, and understanding words presented in a three-dimensional, puzzled, and distorted form

The primary objective of this study is to examine the statistically homogeneous clustering in the hierarchical arrangement of the use of adverbial clauses for location, recognition, and comprehension of words presented in three-dimensional, rebus, and distorted forms. The study was conducted on a sample of 140 participants. The first subset of participants constituted the experimental group, consisting of 70 deaf students, while the second subset formed the control group, comprising 70 hearing students of the same chronological age. A battery of tests was utilized as a measurement instrument, including the “Test of Writing and Comprehending Adverbial Clauses for Location,” “Test of Reading, Writing, and Comprehending Words Presented in Three-Dimensional Form,” “Test of Reading, Writing, and Comprehending Words Presented in Rebus Form,” and “Test of Reading, Writing, and Comprehending Words Presented in Distorted Form.” In the descriptive analysis, frequencies of the total words achieved by both deaf and hearing participants were computed for the different types of measurement instruments employed. To identify the most robust homogeneity of participants concerning the applied variables, non-hierarchical and hierarchical Cluster Analyses were employed. The research results indicate a significant lag in the use of adverbial clauses for location, writing, reading, and understanding words presented in three-dimensional, rebus, and distorted forms among deaf children in comparison to their hearing peers. The Cluster Analysis revealed the most significant linkage between the variable “Number of used adverbial clauses for location” and the variable “Number of recognized words presented in three-dimensional form.” This link was clustered with the variable “Number of written words presented in rebus form” and the variable “Number of written words presented in three-dimensional form.” An analysis of variance for isolated clusters identified a statistically significant difference in the entire measurement space of adverbial clauses for location, three-dimensional, rebus, and distorted forms of words, with a level of statistical significance at p=0.00.

Systematic review of child maltreatment screening tools used by different occupational groups: a study protocol

BackgroundChild maltreatment (CM) encompasses physical, emotional or sexual abuse, physical or emotional/psychological neglect or intimate partner (or domestic) violence and is associated with adverse cognitive, behavioural, physical and social outcomes...

A critical review of perspective-taking measurement instruments

A critical review of perspective-taking measurement instruments

Burnout: a comprehensive review

AbstractBurnout has been the focus of extensive scientific research. The World Health Organization officially recognized burnout as an occupational phenomenon, defined as a syndrome resulting from chronic workplace stress that remains unmanaged and characterized by three dimensions: exhaustion, cynicism, and inefficacy. Existing literature highlights limitations in current measurement instruments for diagnostic purposes. These tools often yield scores that overlap with other conditions such as fatigue, anxiety, and depression. Chronic exposure to high job demands and low job resources emerges as the primary trigger for burnout. While individual characteristics (such as neuroticism) may increase susceptibility, specific personality traits associated with higher risk remain unclear. Burnout has adverse effects on both individuals and organizations. Typical interventions focus on stress relief and coping strategies to manage high job demands, but their effectiveness diminishes over time. Evidence from organizational interventions suggests that improving employees’ working conditions can reduce burnout risk. Combined interventions offer promise by creating a healthy work environment while empowering employees to handle occasional stress. Social partners should advocate for support in researching burnout, aiming for a clear diagnosis, effective treatment, and preventive measures to mitigate psychosocial risks in the workplace.Practical Relevance: The findings of this article highlight the importance of addressing both job demands and job resources to mitigate burnout in organizational settings. Implementing interventions that improve working conditions and provide adequate support can significantly reduce burnout risk and enhance employee well-being. Organizations should prioritize creating a healthy work environment and empowering employees with the necessary resources to manage workload effectively.

Measuring cultural friction in cross-border mergers and acquisitions using a microfoundation-based approach

Purpose Cultural friction (CF) was introduced by researchers to overcome the issues and challenges of cultural distance measurement in the context of cross-border mergers and acquisitions (CBMAs). However, this construct has proved itself to be problematic to operationalize. To address this challenge, this paper aims to elaborate on a CF measurement instrument based on individual perceptions in CBMAs. This study used a microfoundation approach to measure CF, relying on managers’ interactions in CBMA settings. Design/methodology/approach To develop and validate a CF measurement in the context of CBMAs, this study followed a classical procedure including items development, lab tests and one field-study and an assessment of the construct validity. Findings The final instrument developed for measuring CF is composed of six critical incidents with three associated items each. The factor analysis revealed that the scale used in the field-test measures two factors of CF: internal and external. Reliability and discriminant validity are tested, demonstrating a good discriminant validity of “external” CF. The final measurement can be used as a valid and reliable scale in further studies to assess CF in the context of CBMAs. Originality/value This paper’s originality lies in developing and validating a CF measurement instrument that does not rely on cultural distance frameworks. The resulting scale shows the interest in considering micro-individual perceptions – the microfoundation level – for analyzing an organizational phenomenon as culture in CBMA contexts. Using a micro-founded approach, this study offers promising avenues for researchers who wish to study cultural interactions in international settings.

Psychometric Testing of the Cross-Culturally Adapted Thai Version of the Caregiver Self-Efficacy in Contributing to Patient Self-Care Scale in Caregivers of Patients With Chronic Illnesses.

To evaluate the psychometric properties of the Caregiver Self-Efficacy in Contributing to Patient Self-Care Scale (CSE-CSC). The CSE-CSC scale was developed congruently with the Caregiver Contribution to Self-Care of Patient with Chronic Illness Inventory (CC-SC-CII) to assess caregiver self-efficacy (CSE), the motivation factor of caregiving. Its applicability in Asian populations, including Thailand, was limited. Psychometric tests were guided by COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) principles. This included translating the English version into Thai, following the principles of good practice for the translation and cultural adaptation process for patient-reported outcome (PRO) measures. Nine nursing experts evaluated the content validity. The analysis included caregivers of patients with chronic conditions from 16 primary care centres in Thailand. We tested the structural validity using exploratory factor analysis (EFA), confirmatory factor analysis (CFA) and concurrent validity for CC-SC-CII-v2. We tested the scale's reliability with methods for multidimensional and unidimensional constructs, the intraclass correlation coefficients (ICCs) and measurement error variance. Kappa coefficient (k = 1.00) indicated the scale's excellent content validity. The final analysis included a total of 407 samples. The EFA with the first split-half subsample (n = 194) extracted a two-dimensional structure. One reflected CSE in Maintenance and Monitoring behaviour and another captured CSE in Management behaviour. CFA with the second split-half subsample (n = 213) and the overall sample (n = 407) supported the scale's bidimensional model with high factor loadings. Each dimension and the overall CSE-CSC scale positively correlated with each scale and the overall CC-SC-CII-v2. McDonald's ω and Cronbach's α (both ranged from 0.91-0.94) indicated excellent internal reliability. Test-retest reliability showed ICCs between 0.95 and 0.96. Measurement error yielded satisfactory results. Testing of the Thai CSE-CSC scale supported validity and reliability, indicating that the scale can apply to Thai caregivers. This scale can be used in clinical practice and research to evaluate CSE in contribution to patient self-care.

Psychometric Properties of Social Climate in the Classroom Scale for University Students in Chile

Background: Classroom social climate is a significant phenomenon within educational contexts; however, it has predominantly been studied among high school students, with limited evidence available at the university level and, consequently, in the psychometric properties of measurement instruments. This study aimed to analyze the psychometric properties of the University Classroom Social Climate Scale (ECSA-U) among Chilean students from the La Araucanía region. Method: 422 students participated, responding to the adapted version of the ECSA-U and the Motivation subscale of the Motivation and Learning Strategies Questionnaire. Exploratory structural equation modeling (ESEM), reliability analyses, and correlation analyses were conducted to provide valid evidence for the Chilean University Classroom Social Climate Scale (ECSA-UCL). Results: The scale demonstrated a three-factor structure with good fit indicators, excellent reliability indices, and significant positive associations between the ECSA-UCL and the Motivation Subscale. Conclusions: The ECSA-UCL has proven valid and reliable for measuring the perception of Classroom Social Climate among Chilean university students, making it suitable for use as a measurement tool in studies or interventions that include this variable.

Uncovering the Daily Experiences of People Living With Advanced Cancer Using an Experience Sampling Method Questionnaire: Development, Content Validation, and Optimization Study.

The experience sampling method (ESM), a self-report method that typically uses multiple assessments per day, can provide detailed knowledge of the daily experiences of people with cancer, potentially informing oncological care. The use of the ESM among people with advanced cancer is limited, and no validated ESM questionnaires have been developed specifically for oncology. This study aims to develop, content validate, and optimize the digital Experience Sampling Method for People Living With Advanced Cancer (ESM-AC) questionnaire, covering multidimensional domains and contextual factors. A 3-round mixed methods study was designed in accordance with the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) and the European Organization for Research and Treatment of Cancer guidelines. The study included semistructured interviews with 43 people with stage IV breast cancer or stage III to IV lung cancer and 8 health care professionals. Round 1 assessed the appropriateness, relative importance, relevance, and comprehensiveness of an initial set of ESM items that were developed based on the existing questionnaires. Round 2 tested the comprehensibility of ESM items. Round 3 tested the usability of the digital ESM-AC questionnaire using the m-Path app. Analyses included descriptive statistics and qualitative content analysis. Following the first round, we developed an initial core set of 68 items (to be used with all patients) and a supplementary set (optional; patients select items), both covering physical, psychological, social, spiritual-existential, and global well-being domains and concurrent contexts in which experiences occur. We categorized items to be assessed multiple times per day as momentary items (eg, "At this moment, I feel tired"), once a day in the morning as morning items (eg, "Last night, I slept well"), or once a day in the evening as evening items (eg, "Today, I felt hopeful"). We used participants' evaluations to optimize the questionnaire items, the digital app, and its onboarding manual. This resulted in the ESM-AC questionnaire, which comprised a digital core questionnaire containing 31 momentary items, 2 morning items, and 7 evening items and a supplementary set containing 39 items. Participants largely rated the digital questionnaire as "easy to use," with an average score of 4.5 (SD 0.5) on a scale from 1 ("completely disagree") to 5 ("completely agree"). We developed the ESM-AC questionnaire, a content-validated digital questionnaire for people with advanced breast or lung cancer. It showed good usability when administered on smartphone devices. Future research should evaluate the potential of this ESM tool to uncover daily experiences of people with advanced breast or lung cancer, explore its clinical utility, and extend its validation to other populations with advanced diseases.

Development of a Large-Aperture Coordinate Precision Measurement Instrument Using Differential Geometric Error Weighting

The accuracy of traditional measuring machines is affected by the measuring range and sensitive geometric errors, and it is not possible to combine large caliber and high-precision measurements. This study proposes a differential geometric error-weighting method for designing a high-precision, large-diameter measuring machine. The machine utilized a zero-Abbe arm structure and applied the rigid body theory and small-angle hypothesis to model geometric errors. Weights were calculated for 23 geometric errors, identifying eight sensitive ones. A picometer-precision laser interferometer (quDIS) with a theoretical positioning accuracy of 0.2 nm/mm and standard flat rulers are used to ensure highly accurate positioning of the Y-axis/Z-axis of the measuring platform and reduce the straightness of both axes by approximately 75%, with radial and axial runout of the rotary table under 100 nm. The development and design method of the high-precision measuring machine proposed in this study is applicable to large-diameter high-precision flexible measurement, and the accurate control of measuring machine movement accuracy is realized by calculating the geometric error weights.

Accuracy Standards of Wearable Technologies for Assessment of Soccer Kicking: Protocol for a Systematic Literature Review.

Wearable technology is widely applied in performance monitoring, an integral part of sports and exercise sciences. The kick movement in soccer exemplifies a sports technique that could benefit from appropriate biomechanics assessment methodologies. However, the accuracy of wearables in quantifying soccer kick mechanics, particularly under field conditions, remains unclear. This study aims to present a protocol for a systematic review to discuss the measurement properties (validity, reliability, and/or accuracy aspects) of wearable technology systems explicitly used to measure ball-kicking features in soccer. This review protocol was preregistered in the Open Science Framework. A total of 2 authors will perform searches in major electronic databases using specific keyword combinations in PubMed, Physical Therapy and Sports Medicine, Web of Science, ProQuest, IEEE Xplore, EBSCOHost, and Scopus. Following a specific population, intervention, comparison, outcome framework (population: soccer players and/or collected human data in a football-related environment; intervention: at least 1 wearable used; comparator: criterion measures, repeated testing sessions and/or actual values; outcome: ball kicking data), studies will be screened based on predetermined inclusion and exclusion criteria. The methodological quality of the included studies will be assessed using the "consensus-based standards for the selection of health measurement instruments" checklist (in studies concerning validity or reliability) or the "quality assessment of diagnostic accuracy studies" tool (in studies concerning accuracy). Data extraction will be conducted to determine the level of evidence according to the "best evidence synthesis method," and an evidence gap map will be constructed. The Cohen κ coefficient will be used to estimate the interevaluator agreement. This ongoing systematic review has completed database searches and is currently in the screening phase. Depending on the number and consistency of studies, results may be presented by meta-analysis or qualitative synthesis, with subgroup analyses considering factors such as gender, age, and playing level. The final results are expected by July 2024, with manuscript submission anticipated by November 2024. Our study will provide a comprehensive summary of the highest level of evidence available on the use of wearables for the assessment of soccer kick mechanics, providing practical guidance for athletes and sports sciences professionals regarding the validity and reliability aspects of using wearable technology to measure ball-kicking features in soccer. OSF registries https://osf.io/zm3j6. DERR1-10.2196/57433.

Psychometric properties of the Pediatric Evaluation of Disability Inventory - Patient Reported Outcome: A cognitively accessible measure of functional performance.

To evaluate the structural validity, internal reliability, and measurement invariance of the Pediatric Evaluation of Disability Inventory - Patient Reported Outcome (PEDI-PRO), a measure of functional performance of discrete tasks required to participate in everyday life situations important for adulthood. This was a cross-sectional study with 306 young people aged 14 to 22 years (mean 18 years 10 months, SD 2 years 5 months) with developmental disabilities (43.1% autism spectrum disorder only, 23.9% intellectual disability, 17.6% other disability, 11.4% both autism spectrum disorder and intellectual disability, 3.9% missing) completed the PEDI-PRO. Following COnsensus-based Standards for selection of health Measurement INstruments (COSMIN) criteria, we conducted a confirmatory factor analysis, applied a Rasch rating-scale model, examined Cronbach's alpha, Rasch person reliability and separation coefficients, and differential item functioning (DIF). Structural validity was good for the daily activities and mobility domains, and acceptable for the social/cognitive domain. The 3-point Likert response scale functioned as intended. All domains demonstrated acceptable internal consistency on all criteria. One or two items in each domain demonstrated DIF, but the impact on all domain scores was less than 1.0 threshold. The cognitively accessible design and innovative conceptual measurement framework probably contributed to these promising findings. The PEDI-PRO addresses a gap in high-quality patient-reported outcome measures that assess priority outcomes for young people with developmental disabilities.

Measuring Muslim Lifestyle Using a Halal Scale

The background and motivation of the research presented in this article is the obligation of Public Theology to do justice to young Muslim refugees as a minority group in German society regarding the role of religiosity in the way they are coping with life. In the research process, the authors became increasingly aware that most instruments to measure religiosity have a Western and/or Protestant bias in that they are more interested in religious attitude than in religious practice and/or religious lifestyle, which is very important for Muslim religiosity. Therefore, this article focuses on the distinction between halal and haram as indicators of religious practice according to Muslim benchmarks. Both the concept and the operationalization of a two-dimensional instrument of living a halal life are described. The instrument distinguishes between the individual importance of halal goods (food, medicine, cosmetics) and services (doctors) and their availability in the local environment. Each of the two dimensions comprises four items. Construct validity is shown by confirmatory factor analysis (CFIrobust = 0.934, TLIrobust = 0.902, RMSEArobust = 0.114 [0.073; 0.156]) of a sample of N = 155 Muslim adolescents who have fled to Germany from Syria, Iraq and Afghanistan. External validity is tested by analyzing the correlation of the measurement instrument developed by the authors with the Centrality of Religiosity Scale. The presented halal instrument offers an approach to Muslim lifestyle that meets the orthopractic character of this religion. At the same time, it addresses the consequential dimension of religion within quantitative research.

Measurement invariance of the Child Behavior Checklist in autistic toddlers

BackgroundChallenging behavior has been examined in older children and adolescents with autism spectrum disorder (ASD), but less is known about these behaviors in toddlers, due in part to variability in measurement and limited instruments available for this population. To address this need, this study examined the psychometric properties of the Child Behavior Checklist (CBCL), a commonly used and widely validated measure of challenging behavior, in a group of toddlers with ASD. MethodParticipants included 496 toddlers aged 18–48 months with (n=398) and without (n= 100) a diagnosis of ASD. Psychometrics of the CBCL were analyzed including internal consistency, factor structure, and measurement invariance. ResultsConfirmatory factor analysis results indicated acceptable fit for the tested model, and internal consistency was largely acceptable. All levels of measurement invariance were tested for each subscale. The Emotional Reactivity, Anxious/Depressed, Withdrawn, and Aggressive Behavior subscales achieved scalar invariance, while the Attention Problems subscale achieved metric invariance, and the Somatic Complaints subscale did not achieve even configural invariance. ConclusionsResults indicate the current CBCL conceptualization of challenging behavior in autistic toddlers is consistent with such constructs in older autistic children and provide preliminary support for the use of the CBCL to assess for challenging behavior in toddlers with ASD. Measurement invariance (MI) analyses support the construct validity of the CBCL in toddlers with ASD. However, based on the results of the MI analyses, some caution is warranted with specific subscales when conducting group comparison analyses between toddlers with and without ASD.

LONG-TERM OUTCOMES OF CRITICALLY ILL PATIENTS WITH COVID-19: A SYSTEMATIC REVIEW

BackgroundSurvivors of critical illness are susceptible to long-term functional impairments following admission to an intensive care unit (ICU). In the context of the COVID-19 pandemic, there has been a surge in patients admitted to ICU with severe acute respiratory syndrome coronavirus type 2. The long-term consequences of critical illness due to COVID-19 illness remain unclear. Research QuestionTo determine the long-term outcomes of adult patients admitted to ICU for COVID-19. Study Design and MethodsWe searched Ovid MEDLINE and EMBASE using subject heading and free-text terms related to long-term outcomes of critically ill patients with COVID-19. We included all articles that reported original data on outcomes from 90 days onwards for adult patients admitted to ICU for COVID-19. Data extracted included study details, patient characteristics, outcomes reported, measurement tools used and timing of assessment. ResultsA total of 14,882 studies were screened, from which 134 studies fulfilled the selection criteria. Follow-up timepoints ranged from 90 days to 2 years following critical illness. Post-hospital mortality was the most reported outcome (n=60), with the general ICU cohort having an aggregate mortality rate of 35.5% (95% CI 34.7-36.2) at 90 days and 31.6% (95%CI 30.9-32.4) at 6 months. A plethora of other outcomes were assessed, including psychological function/mental health (n=49), persistent symptoms (n=47), quality of life (n=47), physical function (n=33) and cognitive function (n=31). For each outcome, different measurement tools were employed, making data synthesis across studies difficult. InterpretationImportant evidence gaps remain regarding the long-term health outcomes and healthcare needs for survivors of critical COVID-19 illness. This review found that mortality was the most reported long-term outcome. Significant heterogeneity was evident across studies in terms of outcomes assessed, measurement instruments used and the duration of follow-up. Future research requires increased consistency in outcomes assessed and measurement tools to inform clinical practice.