Items In Domain Research Articles

The Greek version of the Australian Pelvic Floor Questionnaire: Cross-cultural adaptation and validation amongst women with urinary incontinence

ObjectivesAs in Greek settings there is a need to develop validated patient-reported outcomes (PROs) for pelvic floor dysfunction, this study’s aim was to cross-culturally adapt and validate the Australian Pelvic Floor Questionnaire (APFQ) into Greek, a 42-item PRO for routine urogynaecological evaluation of four domains; bladder, bowel, prolapse and sexual function. Study designCross-cultural translation was completed through official multistage forward and back-translation process. Validation involved administering the adapted APFQ (APFQ_GR) to women visiting Greek community-based healthcare settings. International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) was also administered. Comparison between women with and without pelvic floor dysfunction (symptomatic versus control) was also undertaken for exploring discriminatory validity. Test-retest reliability was explored by re-administering APFQ_GR 10–15 days following initial testing and internal consistency was explored against each domain separately as well as total items’ score. ResultsGreek APFQ translation was successfully performed and piloted to a women sample with varying levels of education for comprehensibility, thus, satisfying the questionnaire’s face validity. 100 women (53.7 ± 13.1 years-old) participated in validation, 63 of which predominantly complained of urinary incontinence (UI) and 37 were asymptomatic. There were no ceiling effects. Floor effects were detected for women without symptoms. Moderate to very strong correlations were yielded between APFQ_GR total score and bladder domain, respectively, with ICIQ-UI SF single-item and total score (ρ = 0.403–0.758, p < 0.001), indicating satisfactory criterion-related validity. Moderate correlations were yielded for the sexual function domain with APFQ_GR total score and weaker correlations were found in the other two domains. Independent samples t-test yielded significant differences across the questionnaire’s scores (p < 0.001), indicating good discriminatory validity between symptomatic and asymptomatic women. Test-retest reliability was excellent (ICC3,1 = ≥0.998). Internal consistency was very good for each domain and total items’ score (Cronbach’s α = 0.714–0.924). ConclusionsThe Greek APFQ was proven appropriate, comprehensible, valid and reliable for women with urinary incontinence and can thus, be used across Greek healthcare settings. Prolapse and bowel domains merit further research.

A reporting quality evaluation of the clinical practice guidelines for bladder cancer based on the RIGHT checklist.

The Reporting Items for Practice Guidelines in Healthcare (RIGHT) checklist was developed to improve the reporting quality in clinical practice guidelines (CPGs). CPGs could provide the recommendations for key clinical issues with alternative care options and adherence to them could improve the outcomes. And, high reporting quality CPGs can assist health workers to incorporate the best evidence into the individual practice. There is no evaluation study on the reporting quality of CPGs in bladder cancer (BLCA). This study assessed the reporting quality of CPGs on BLCA and provided new insights for the development of CPGs in this disease. We conducted a systematic search in multiple literature databases, including PubMed, Wanfang, China National Knowledge Infrastructure (CNKI) and China Biology Medicine (CBM) as well as the medical associations and websites of guideline development organizations. Relevant CPGs published between January 2017 and December 2021 were identified. Four trained investigators independently screened the extracted documents to include all eligible CPGs and evaluated whether the items in the RIGHT checklist were reported in each CPG. Subsequently, the reporting rate of each CPG and item, as well as the mean reporting rate of each domain in the RIGHT checklist was calculated. A total of 23 CPGs related to BLCA were finally included, of which, 22 guidelines were written in English and 1 was published in Chinese. The mean reporting rate of the included CPGs was approximately 65%. The reporting rates of the items in each RIGHT domain were 77% for basic information domain, 75% for recommendations domain, 72% for evidence domain, 69% for background domain, 43% for funding and declaration and management of interest domain, 35% for review and quality assurance domain, and 41% for other information domain. The reporting rate was determined as the mean value in Office Excel 2019. The reporting quality of BLCA CPGs related to the domains of funding and declaration and management of interest domain, review and quality assurance domain, and other information domain is poor and warrants improvement in the future.

Validity and test-retest reliability of the Ugandan version of the Pediatric Evaluation of Disability Inventory (PEDI-UG) in children and youth with cerebral palsy.

Validity of the Ugandan version of the Pediatric Evaluation of Disability Inventory (PEDI-UG) was previously investigated on typically developing children. This study aimed to investigate the validity, test-retest reliability and minimal detectable change (MDC) of the PEDI-UG in children and youth (C&Y) with cerebral palsy (CP). A cross-sectional study design with 118 C&Y with CP (44.7% girls) aged 10months-22.5years were included in the study; 37 of them completed the PEDI-UG twice to investigate test-retest reliability, determined by calculating the intraclass correlation coefficient (ICC). Additionally, data from 249 typically developing children were used for differential item functioning (DIF) analysis. The validity of the PEDI-UG was investigated by Rasch analysis. The Kruskal-Wallis test and Spearman's correlation coefficient were calculated to investigate associations between PEDI-UG scores and external classification systems. The principal component analysis of residuals indicated unidimensionality in all domains. The ICC values were excellent (0.98-0.99), and the MDCs were less than 6 and 13 (on a 0-100 scale) for the functional skills and caregiver assistance parts, respectively. The four-category caregiver assistance rating scale fulfilled the criteria for the analysis of rating scale functioning. In total, 78 of 189 items in the functional skills domain and two items in the caregiver assistance domain demonstrated DIF between C&Y with CP and TD children. The Kruskal-Wallis test (p < 0.05) and Spearman's correlation (coefficients of -0.93 to -0.78) supported the validity of PEDI-UG. The current diagnose-specific version of PEDI-UG demonstrates evidence for validity as a measure of ability in C&Y with CP in Uganda and other similar settings, being a promising tool for use in clinical practice and research. Conversion tables and MDC values are provided to facilitate clinical adoption of the measure.

Body Function and Structure, Activity, and Participation Limitations of Lung Transplant Recipients Within the Scope of the International Classification of Functioning, Disability, and Health.

There is no study in the literature that specifically evaluates lung transplant recipients in the long-term under the framework of the International Classification of Functioning, Disability, and Health. The aim of this study was to evaluate the relationships between lung transplant recipient age, age at transplant, and comorbidity levels and the body structure and functions and the activity and participation levels of patients within the scope of the International Classification of Functioning, Disability, and Health. We evaluated 27 lung transplant recipients according to the International Classification of Functioning, Disability, and Health items in domain b (body functions), domain s (body structures), and domain d (activities and participation). For domain b, sleep functions, psychosocial status, respiratory functions, and upper and lower extremity exercise capacity were evaluated. Posture was evaluated for the s domain. Balance, arm functional capacity, health-related quality of life, and physical activity were evaluated for domain d. As the age of lung transplant recipients and the age at transplant increase, their sleep quality and respiratory functions decreased, and postural impairment increased. There was a negative correlation between age at transplant and functional exercise capacity (P < .05). As the comorbidity level of the recipient increases, the upper and lower extremity exercise capacity, physical activity level, and quality of life declined. There was a moderately positive correlation between the level of comorbidity and balance disorder (P < .05). We found the International Classification of Functioning, Disability, and Health framework to be useful for the evaluation and for planning pulmonary rehabilitation for lung transplant recipients; it can bring a new perspective to physiotherapists specialized in cardiopulmonary rehabilitation.

Thwarted belongingness, perceived burdensomeness, and acquired capability for suicide among university students of Bangladesh: Scales validation and status assessment.

BackgroundIdentification of prior mental events of suicide attempts has immense importance in suicide prevention. However, it has not been studied in Bangladesh as there was no available psychometrically valid instrument measuring it.ObjectivesWe aimed to test the psychometric properties of the interpersonal needs questionnaire (INQ-15) and acquired capability for suicide scale-fearlessness about death (ACSS-FAD) in Bangla along with the determination of the level of thwarted belongingness, perceived burdensomeness, and acquired capability for suicide.Materials and methodsWe collected data between 29 March and 14 April 2022 from 1,207 students of medical colleges and universities in Bangladesh by Google form. We assessed the psychometric properties of Bangla INQ and ACSS-FAD scales and examined factors associated with thwarted belongingness, perceived burdensomeness, and acquired capability for suicide.ResultsThe mean age of the participants was 22.82 ± 1.68 (range 18–29) years, 51% were females, 84% were graduate students, and 92% were unmarried. Both of the scales revealed acceptable levels of reliability. Confirmatory factor analysis revealed a two-factor structure of Bangla INQ after dropping three items from thwarted belongingness domain (item 9, 11, and 12) and a single factor structure for Bangla ACSS-FAD after dropping three items (item 1, 4, and 6). Perceived burdensomeness was significantly higher in females, students with a history of mental illness, family history of suicide, and the history of suicidal attempts. Fearlessness about death was significantly higher among females, non-Muslim participants, and history of suicidal attempts.ConclusionThe current study revealed psychometric properties of two suicide scales (INQ and ACSS-FAD) in Bangla that can be used in subsequent studies. Prevention strategies targeting to females, persons with psychiatric disorder, history of previous attempt(s) should be prioritized specially among the young age group.

Adaptive preference transfer for personalized IoT entity recommendation

• An IoT entity recommendation method based on adaptive preference transfer is proposed. • A lightweight user feedback feature embedding method is proposed to solve the problem of sparse user feedback. • The rigorous experiments are designed to verify the validity of the proposed method. Internet of Things (IoT) recommendation can effectively improve the convenience and intelligence of users in obtaining information about interested physical entities in a huge entity search space. However, existing transfer learning-based recommendation methods mainly focus on Internet resources and services, lack personalized transfer weight consideration for different user preferences, and fail to address the entity rating matrix sparsity problem, resulting in limited IoT entity recommendation performance. Thus, we design an adaptive preference transfer IoT entity (APTE) recommendation method in this paper. Firstly, considering various user preference characteristics, an adaptive dual-domain transfer model for item domain and social domain is designed to meet users’ personalized requirements. Then, a lightweight user feedback embedding method is proposed to mine the explicit and implicit features and to embed the entity rating matrix to solve the problem of sparse user feedback information. Simulation results demonstrate that APTE can effectively improve the recommendation performance compared with state-of-the-art baselines.

Personalized Recommendation of Online Shopping Products Based on Online Fast Learning through Latent Factor Model

In order to improve the personalized recommendation effect of online shopping products, this article combines online fast learning through latent factor model to construct a personalized virtual planning recommendation system for online shopping products. Moreover, this article improves on the ONMTF model. In the problem of cross-domain recommendation, this article clusters users and items in each data domain with hidden scoring patterns and learns common scoring patterns that can be shared between different data domains to deal with the data sparse problem that often occurs in recommender systems. The experimental research results show that cross-domain recommendation can indeed use the implicit semantics or topics between domains to share information and knowledge, thereby improving the accuracy of recommendation.

Analisis Keterampilan Berpikir Kritis Mahasiswa Melalui Model Blended-Project Based Learning Terintegrasi Keterampilan Abad 21 Berdasarkan Students Skill Level

Thinking ability is one of the skills that must be had by all people in facing the demands of the 21st century, namely critical thinking skills. This skill can be achieved by delivering the material more clear and objective. Thus, the purpose of this study is to know the effect of implementing blended PjBL integrated 21st century skills on students’ critical thinking skills. The sample of this study amounted to 39 students in the fifth semester of Biology Education at IAIN Palangka Raya with a non-equivalent control group design. The accumulation data of critical thinking skills was obtained by giving 20 items in the critical thinking domain in the form of pretest and posttest questions. The implementation of blended PjBL integrated 21st century skills is quite effective in the high-level class experimental class group, with the acquisition of N-gain = 56.75. This is reinforced by the results of hypothesis testing with the value of Sig. (2-tailed) = 0.000 0.05. It can be concluded that the implementation of blended PjBL integrated 21st century skills has a significant effect on students' critical thinking skills. The findings of this study is an alternative integrative model innovation between blended PjBL and 21st century skills-based on student skill level

Mapping exercise and status update of eight established registries within the TREatment of ATopic eczema Registry Taskforce.

The TREatment of ATopic eczema (TREAT) Registry Taskforce is a collaborative international network of registries collecting data of atopic eczema (AE) patients receiving systemic and phototherapy with the common goal to provide long-term real-world data on the effectiveness, safety and cost-effectiveness of therapies. A core dataset, consisting of domains and domain items with corresponding measurement instruments, has been developed to harmonize data collection. We aimed to give an overview of the status and characteristics of the eight established TREAT registries, and to perform a mapping exercise to examine the degree of overlap and pooling ability between the national registry datasets. This will allow us to determine which research questions can be answered in the future by pooling data. All eight registries were asked to share their dataset and information on the current status and characteristics. The overlap between the core dataset and each registry dataset was identified (according to the domains, domain items and measurement instruments of the TREAT core dataset). A total of 4702 participants have been recruited in the eight registries as of 1st of May 2022. Of the 69 core dataset domain items, data pooling was possible for 69 domain item outcomes in TREAT NL (the Netherlands), 61 items in A-STAR (UK and Ireland), 38 items in TREATgermany (Germany), 36 items in FIRST (France), 33 items in AtopyReg (Italy), 29 items in Biobadatop (Spain), 28 items in SCRATCH (Denmark) and 20 items in SwedAD (Sweden). Pooled analyses across all registries can be performed on multiple important domain items, covering the main aims of analysing data on the (cost-)effectiveness and safety of AE therapies. These results will facilitate future comparative or joint analyses.

Personality dysfunction in opiate addicts on opioid substitution treatment and the risk of HCV infection.

BackgroundImpulsivity, affective instability, and neglect of oneself and other people's safety as symptoms of personality dysfunction are associated with risky behaviors regarding the transmission of infectious diseases either sexually or by intravenous drug abuse.ObjectiveThe aim of this study was to analyze the association between hepatitis C virus (HCV) infection and personality dysfunction in opiate addicts on opioid substitution treatment.MethodsThis was a cross-sectional, observational investigation of patients over 18 years of age who were actively participating in opioid substitution treatment at five centers in Bosnia and Herzegovina. The occurrence of HCV infection was the primary study outcome, and personality functioning, the main independent variable, was assessed using the Severity Indices of Personality Problems (SIPP−118) questionnaire. The association between scores of personality functioning domains items and HCV infection status was determined by binary logistic regression analysis.ResultsPatients on opioid substitution therapy with HCV infection more frequently had personality disorders (OR 2.168, 95% CI 1.161–4.05) and were treated longer than patients without HCV infection (OR 1.076, 95% CI 1.015–1.14). HCV infection was associated with lower self-respect (OR 0.946, 95% CI 0.906–0.988), decreased capacity to have enduring relationships with other people (OR 0.878, 95% CI 0.797–0.966), and lower capability to cooperate with others (OR 0.933, 95%CI 0.888–0.98). On the other hand, except for self-respect, other elements of the Identity Integration domain (enjoyment, purposefulness, stable self-image, and self-reflexive functioning), when more functional, increased the risk of HCV infection.ConclusionsOur study demonstrates that opiate addicts on opioid substitution treatment have a higher risk of HCV infection if their personality is dysfunctional, especially in the aspects of self-respect, enduring relationships, and cooperativity. The risk is even higher in addicts who have an established diagnosis of any kind of personality disorder.

The readiness of public primary health care (PUSKESMAS) for cardiovascular services in Makasar city, Indonesia

BackgroundsThe increasing burden of cardiovascular disease (CVD) has become a major challenge globally, including in Indonesia. Understanding the readiness of primary health care facilities is necessary to confront the challenge of providing access to quality CVD health care services. Our study aimed to provide information regarding readiness to deliver CVD health services in public primary health care namely Puskesmas.MethodsThe study questionnaire was adapted from the World Health Organization (WHO) Service Availability and Readiness Assessment (SARA), modified based on the package of essentials for non-communicable disease (PEN) and the Indonesian Ministry of health regulation. Data were collected from all Puskesmas facilities (N = 47) located in Makassar city. We analysed relevant data following the WHO-SARA manual to assess the readiness of Puskesmas to deliver CVD services. Human resources, diagnostic capacity, supporting equipment, essential medication, infrastructure and guidelines, and ambulatory services domain were assessed based on the availability of each tracer item in a particular domain. The mean domain score was calculated based on the availability of tracer items within each domain. Furthermore, the means of all domains’ scores are expressed as an overall readiness index. Higher scores indicate greater readiness of Puskesmas to deliver CVD-related health care.ResultsPuskesmas delivers health promotion, disease prevention, and prompt diagnosis for cardiovascular-related diseases, including hypertension, diabetes, coronary heart disease (CHD), and stroke. Meanwhile, basic treatments were observed in the majority of the Puskesmas. Long-term care for hypertension and diabetes patients and rehabilitation for CHD and stroke were only observed in a few Puskesmas. The readiness score of Puskesmas to deliver CVD health care ranged from 60 to 86 for. Furthermore, there were 11 Puskesmas (23.4%) with a score below 75, indicating a sub-optimal readiness for delivering CVD health services. A shortage of essential medicines and a low capacity for diagnostic testing were the most noticeable shortcomings leading to suboptimal readiness for high-quality CVD health services.ConclusionClose cooperation with the government and other related stakeholders is required to tackle the identified shortcomings, especially the continuous monitoring of adequate supplies of medicines and diagnostic tools to achieve better CVD care for patients in Indonesia.

Dynamic changes of quality of life in muscle-invasive bladder cancer survivors

BackgroundTo explore the dynamic changes and effects of radical cystectomy on quality of life in muscle-invasive bladder cancer survivors.MethodsPatients with muscle-invasive bladder cancer were randomly recruited in this study. We used the World Health Organization Quality of Life-Brief questionnaire to assess consecutive patients’ quality of life. We applied kernel smoothing to illustrate the dynamic changes of the domain and item scores after treatment. Mixed-effects models were constructed to determine the effects of radical cystectomy on the scores of each item and domain of the World Health Organization Quality of Life-Brief questionnaire after controlling demographic and clinical factors.ResultsWe collected 397 repeated measurements of the World Health Organization Quality of Life-Brief questionnaire from 109 muscle-invasive bladder cancer patients. Forty-two of them received radical cystectomy. Patients with radical cystectomy exhibited higher levels of education, less co-morbidities (i.e., diabetes and heart diseases), but were associated with more malignancies. Construction of mixed-effects models showed patients with radical cystectomy and those with bladder sparing had similar scores in the three main domains and their items, except that of certain items of physical domain. By applying kernel smoothing method, we found that stage III–IV patients consistently showed higher scores on sleep and rest after radical cystectomy for more than 5 years. In contrast, stage II patients receiving radical cystectomy did not show a higher score on the “sleep and rest” item compared with those with bladder sparing operation.ConclusionsRadical cystectomy may result in sound sleep and rest, especially in those with stage III–IV bladder cancer.

Organisation, influence, and impact of patient advisory boards in rehabilitation institutions—an explorative cross-sectional study

BackgroundPatient participation is highlighted as an important facilitator for patient-centered care. Patient participation organised as patient advisory boards (PABs) is an integral part of health care institutions in Norway. More knowledge is needed on how PAB representatives experience patient engagement (PE) with regard to organisation, influence, and impact. The objective was to describe how PAB representatives experience their tasks, roles, and impact on decision-making processes and service delivery in the setting of rehabilitation institutions.MethodsPAB representatives recruited from rehabilitation institutions completed the Norwegian version of the generic Public and Patient Engagement evaluation tool (Norwegian abbreviation EBNOR). EBNOR is tested for reliability and validity with good results and comprises 35 items within four main domains, policies and practices, participatory culture, collaboration, and influence and impact that provide responses about PE-levels. The domain items are scored from “strongly disagree” to “strongly agree” on a five-point scale, in addition to a don’t know category. Items in the domain “influence and impact” are scored from “never” to “all of the time” on a four-point scale. Categorical data were summarized using frequencies and percentages, and response categories were collapsed into three PE-levels: barrier, intermediate, and facilitating level. Free-text responses were analysed according to principles of manifest content analysis, summed up, and used to elaborate the results of the scores.ResultsOf the 150 contacted PAB representatives, 47 (32%) consented to participate. The results showed that approximately 75% agreed that the organisation as a whole was strengthened as a result of patient participation. Four out of five domains were scored indicating a facilitating level; policies and practices (53%), participatory culture (53%), collaboration and common purpose (37%), and final thoughts (63%). The modal score in the domain influence and impact was in the intermediate PE-level (44%). Of a total of 34 codes from free text analyses, barriers to PE were coded 26 times, and PE facilitators were coded 8 times.ConclusionsThe findings indicate that most PAB representatives are satisfied with how rehabilitation institutions organise their PAB, but they still experience their impact as limited.

Development and Validation of an Attitude Toward Spending Time in Nature Scale

Time spent in nature (TSN) is related to improved health and well-being; however, many adults spend little time in nature. Interventions based on health behavior theories may be effective at increasing TSN. Attitudes toward a behavior have been shown to be a strong predictor of both intention and behaviors, but valid and reliable measures regarding these attitudes are lacking. The study aim was to develop a valid and reliable attitude toward TSN scale. This scale was developed using a sequential procedure: domain identification and item generation, content validity, question pretesting, survey administration, item reduction, factors extraction, dimensionality, reliability, and validity. The investigative team generated 49 unique items. Content validity and pretesting reduced the item set to 21. A countrywide sample of 2109 adults (50.3% male, median age = 58.1; 38.8% non-White) completed an online survey. Using split-half measures, principal components analysis indicated a three-factor solution: positive attitudes, negative attitudes, and concerns about being in nature. The factor structure was upheld in confirmatory factor analyses with strong internal consistency (α = 0.92 positive attitudes; 0.84 negative attitudes; 0.84 concerns). The scales were strongly related to intentions and TSN with large effect sizes. The study resulted in a reliable and valid three-factor attitudes toward spending time in nature scale that could be used to develop interventions to increase TSN.

Social recommendation via deep neural network-based multi-task learning

Recent years are witnessing the rapid development of social recommendation to improve the performance of recommender system, especially for cold start problem. Many of the existing social recommendation techniques utilize matrix factorization-based model, which would not essentially capture the complex nonlinear relationships for the user–item interactions and user–user interactions. Inspired by the successful application of deep neural networks on computer vision, natural language processing, and other tasks, deep learning is employed to model the social network-enhanced collaborative filtering problem. Although it has been proposed recently to model the nonlinear relationship by deep networks for collaborative filtering, it does not take the social relations between users into account. Accordingly, simultaneously modeling the social domain and item domain interactions is proposed by sharing user representation in two tasks as Social Regularized Neural Matrix Factorization (SoNeuMF). Comprehensive experiments on two real-world datasets show significant improvements of the proposed SoNeuMF framework with regard to recommendation accuracy against state-of-the-art methods.

Development and Validation of the Breast Cancer Scale QLICP-BR V2.0 Based on Classical Test Theory and Generalizability Theory.

ObjectiveThe aim of this study was to develop and validate the breast cancer scale among the system of quality-of-life instruments for cancer patients (QLICP-BR V2.0).MethodsProgrammed decision procedures and theories on instrument development were applied to develop QLICP-BR V2.0. A total of 246 breast cancer inpatients were investigated using QLICP-BR V2.0 from hospital admission until discharge. The reliability, validity, and responsiveness of the QLICP-BR V2.0 scale were evaluated by using the classical test theory combined with the generalizability theory (GT), including correlation analysis, multi-trait scaling analysis, factor analyses, t-tests, and also multivariate generalizability theory analysis.ResultsThe test–retest reliability of the total scale is 0.79, the Cronbach coefficient is 0.85, and the intra-class correlations coefficient is 0.88. The item–domain correlation analysis showed that the correlation coefficient between items and their own domain is greater than that with other domains except of item GSO4. The exploratory factor analysis showed that three principal components are obtained in the specific module. The outcome of the factor analysis coincides substantially with our theoretical conception. The score difference of each domain of the scale and the total scale before and after treatment is statistically significant (P < 0.05), with the standardized response mean of the total scale being 0.61. According to GT, the generalization coefficient of the scores in the 5 domains is between 0.626 and 0.768, and the reliability index is between 0.557 and 0.695.ConclusionQLICP-BR V2.0 exhibited reasonable degrees of validity, reliability, and responsiveness according to classical test and the generalizability theory. The number of items in the scale is appropriate.

Reporting quality of clinical practice guidelines on head and neck cancer: a systematic review.

BackgroundHead and neck cancer (HNC) comprises a heterogeneous group of cancers. In view of the distinct biological characteristics and treatment strategies, clinical physicians require high-quality clinical practice guidelines (CPGs) which could provide reliable recommendations on medical practices. We aimed to evaluate the reporting quality of CPGs in the field of HNC.MethodsWe developed rigorous search strategies before searching the domestic and international literature databases (n=568) including Medline (via PubMed), Chinese National Knowledge Infrastructure (CNKI) and Wanfang as well as websites of guideline organizations (n=8) published between January 1, 2018 to July 1, 2021 for appropriate guidelines on HNC. We included all evidence-based guidelines about HNC in English or Chinese. We excluded translations, summaries and interpretations of guidelines, as well as older versions of guidelines if an updated edition was available. Data were extracted and the reporting quality was evaluated by two investigators independently guided by the Reporting Items for Practice Guidelines in Healthcare (RIGHT) checklist.ResultsA total of 21 guidelines complied with the inclusion criteria. Items show distinctions with reporting proportions among seven RIGHT domains. The proportions of reported items in each RIGHT domain were 75.4% for basic information, 63.1% for background, 42.9% for evidence, 55.1% for recommendations, 42.9% for review and quality assurance, 26.2% for funding and declaration and management of interests, and 50.8% for other information.DiscussionThe average reporting quality of the recently published guidelines for HNC was moderate. Our research would help optimize the development processes of guidelines, resulting in high-quality guidelines for healthcare professionals.

Using customized PRO profiles to evaluate expected patient quality-of-life outcomes.

e18607 Background: Patient Reported Outcomes (PROs) are routinely employed in patient-focused drug development programs. However, PRO data are often under-utilized. Better approaches could employ trial data to describe expected patient outcomes. The objective of this work was to present a method for leveraging PRO-based patient profiles to project and thereby anticipate expected patient outcomes. Methods: A model-based approach to analyzing PRO scores allows for a more tailored approach to evaluating outcomes of interest. To demonstrate this approach, we analyzed PRO data from a Phase 3 trial of patients with prostate cancer randomized to either Hypofractionated 3D-CRT/MRT (experimental arm) or Conventionally Fractionated 3D-CRT/MRT (comparator arm). The outcome of interest was the difference between treatment arms on the Expanded Prostate cancer Index Composite (EPIC) urinary domain scores, defined on the sum of responses to 12 items. A longitudinal regression model was fit to EPIC scores at 6, 12, 24, and 60 months post-baseline. Patient profile variables (baseline EPIC urinary scores, treatment arm, age, race, clinical T-stage, and Gleason score) were included as predictors. For a particular patient profile of interest, expected EPIC urinary score at 6 months was estimated, as well as associated 95% confidence intervals, which allowed for an understanding of the range of likely outcomes for that particular patient profile. Results: n = 550 patients in the experimental arm and n = 542 patients in the comparator were analyzed. The difference in EPIC urinary scores between treatment arms at 6 and 12 months were computed, with higher scores reflecting greater symptom severity. The model estimated a difference of 2.12 points (p = 0.009) at 6 months and 2.16 points (p = 0.013) at 12 months, favoring the experimental arm. To illustrate how customized patient profiles can be used to better understand patient outcomes, a single profile is presented. At baseline, a patient receiving the experimental treatment, EPIC urinary score 98.0, age 57, white, clinical T-stage T2, Gleason score 6, could be expected to report an EPIC urinary score of 94.3 (92.06, 96.00) at 6 months based on the statistical model. In the observed trial data, one patient with this profile reported an EPIC urinary score of 93.8 at 6 months. The expected EPIC urinary score overestimated the observed score by only 0.53%, indicating the accuracy of the expected EPIC urinary scores. This corresponds to approximately one category decrease on two of the 12 domain items (i.e., a decrease in symptom severity). Conclusions: Well-established statistical methods can lead to improved clinician understanding of expected outcomes specific to a given patient profile. This would facilitate communication between clinician and patient regarding anticipated oncology treatment outcomes. Recommendations to support the use of these methods should be considered.

Psychometric Properties of the Scoliosis Research Society Questionnaire (Version 22r) Domains Among Adults With Spinal Deformity: A Rasch Measurement Theory Analysis.

ObjectiveAdult spinal deformity (ASD) have lower health-related quality of life (HRQoL) compared to the general population. Applying Rasch measurement theory (RMT), this study tested the revised Scoliosis Research Society-22 (SRS-22r) HRQoL instrument among symptomatic adult patients with degenerative spinal disorders and varying degrees of ASD. MethodsSRS-22r data from 637 outpatient spine clinic patients with degenerative spine conditions were investigated for unidimensionality, item/scale fit, differential item functioning (DIF), scale coverage/targeting, and person separation index (PSI) using RMT. ResultsUnidimensionality of the SRS-22r was not supported for either the total score or for 3 of its 5 domains. Item fit was acceptable for 11/22 items. The individual domains showed good coverage despite the degree of structural disorders. Ordered thresholds were achieved by merging response categories in some of the items. DIF towards age or sex was found in 11/22 items and in some domain items. The PSI exceeded 0.7 for the SRS-22r total score. ConclusionThe individual domain scores of the SRS-22r perform better than the total score providing good coverage and targeting among patients with ASD. Refinements of items and domains may improve the structural validity of the instrument to meet the criteria for measuring ASD patients, even when multidimensionality persists.

Ten steps toward a better personality science – a rejoinder to the comments

We respond to the comments (https://doi.org/10.5964/ps.9227) on our “Ten Steps” paper (https://doi.org/10.5964/ps.6029), focusing on the most prominent themes: (1) What motivates scientists?, (2) Consensus-building (Is our field ready? May there be adverse side-effects? How shall we do it?), (3) How may institutional change be facilitated?, (4) Diversity (of participants, stimuli, methodology, measures, and among researchers), (5) The reliability of our proposed scoring system, and (6) The real-world relevance of personality research. We stand by our call for more concerted consensus-building and offer a few clarifications in this regard. We also issue four specific calls to action to our colleagues in the field: (a) specify legitimate paths to greater consensus, (b) explicate what constitutes good “qualitative” research, (c) help establish a widely used, public domain item database, and (d) determine what the most important contemporary goals of personality research are.