Measurement Properties Research Articles

Creation and Validation of the MMQ-9: A Short Version of the Multifactorial Memory Questionnaire for Middle-Aged and Older Adults

ABSTRACT Objectives Memory concerns are common among older adults. The Multifactorial Memory Questionnaire (MMQ) is a well-validated participant-reported measure consisting of 57 items across three subscales assessing satisfaction with memory, self-perceived memory ability, and memory strategy use, respectively. Because short scales are often desired to accommodate clinical time constraints and reduce respondent burden, we created and evaluated 9-item versions of each subscale (MMQ-9). Methods In Study 1, we used an optimization strategy to identify subsets of items that maximized subscale reliability in a sample of 560 adults ages 50–90. In Study 2, we examined psychometric properties of the MMQ-9 in an independent sample of 638 adults ages 51–95. Results Internal consistency, test–retest reliability, and convergent and discriminant validity of each subscale met published criteria for good measurement properties. Confirmatory factor analysis validated the original factor structure. A hierarchical series of invariance models showed excellent fit, confirming robust measurement invariance across age, gender, and education. Conclusions The shortened MMQ-9 is a reliable, valid, and invariant measure of metamemory in middle-aged and older adults. Clinical Implications The MMQ-9 is a reasonable instrument of choice when brief yet psychometrically strong measures of participant-reported memory are required for clinical assessment of patients with memory concerns.

The Complex Nature of Ecotourist Experience and its Relationship with Pro-Environmental behavior in a National Park

Background and objective: Despite the increase in the number of studies related to visitor experiences and behavior in ecotourism and outdoor recreation settings, little empirical research has concentrated on how to identify the nature of ecotourists’ experiences within national park settings. Thus, the purpose of this study was to explore the complex nature of ecotourists’ experiences through personal, social, and environmental conditions, and to examine its relationship with pro-environmental behavior in natural environmental settings.Methods: For visitors, a questionnaire survey was administered to 396 adults who visited a national park in South Korea. Cronbach’s alpha coefficient scores were assessed to examine the reliability of ecotourist experiences. The confirmatory factor analysis (CFA) was utilized to explore the construct validity of the factor structure in the measurement variables. Pearson’s correlation coefficients were analyzed to examine the relationships between independent variables. Path analysis was used to examine the contributions of ecotourist experiences to satisfaction and pro-environmental behavior.Results: One of the most important findings is that ecotourist experiences scale shows relatively acceptable measurement properties and reasonable levels of fit. The results in the path model represented that ecotourist satisfaction had large effects on pro-environmental behavior. Based on the fit statistics in the proposed model, the relationship between the measurement variables provides a relatively good fit to the data and verify the convergent validity of the measures. Personal factor of ecotourist experience had significant effects on satisfaction. Additionally, satisfaction had a significant effect on pro-environmental behavior for ecotourists.Conclusion: The findings of the study provide empirical evidence that three dimensions of ecotourist experiences were significantly related to pro-environmental behavior through visitor satisfaction in natural environmental settings. Further study may need to explore the nature of visitor experience and its relationship with behavior of man-made structures in different settings.

Psychometric properties of self-reported measures of psychological birth trauma in puerperae: A COSMIN systematic review.

To identify and evaluate the psychometric properties of available patient-reported outcome measures (PROMs) of psychological birth trauma (PBT) in postpartum women. A literature search was carried out across eight databases-PubMed, Embase, Web of Science, CINAHL, PsycINFO, China National Knowledge Infrastructure (CNKI), Wanfang Database, and VIP Database for Chinese Technical Periodicals-covering studies published from the inception of each database up to 21 May 2024. English and Chinese language studies employing any research design and reporting at least one psychometric property of PBT in puerperae were included. Independent reviewers extracted data and followed the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines to evaluate three aspects of the included instruments: methodological quality, psychometric properties, and level of evidence assessed using the modified Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Thirty-one studies with twelve PROMs were included, measurement error, cross-cultural validity, and responsiveness were not reported for most PROMs. Nine PROMs received a Class B recommendation, based on their measurement attribute ratings and overall evidence quality. In contrast, the CTI, IES-R, and PBTAS with high-quality evidence for insufficient measurement properties, so received a Class C recommendation. This systematic review provisionally recommends the City BiTS as credible tool for assessing PBT in both clinical practice and research involving puerperae. However, further comprehensive studies are needed to conduct more comprehensive validations of the psychometric properties of existing PROMs.

The Children’s Somatic Symptoms Inventory-8: Psychometric Properties of a Brief Measure of Somatic Distress

Background: Children often present to primary and specialty care clinics with multiple somatic symptoms of nonspecific origin that can be highly distressing and prompt significant health service use. We evaluated the psychometric properties of the eight-item Children’s Somatic Symptoms Inventory (CSSI-8) as a brief measure of somatic distress that could be easily integrated into clinical systems. Method: Eight items from the 24-item CSSI were selected based on their representation of multiple bodily systems, association with high base rates, and ability to maximize the separation of the items’ Rasch measure scores. The psychometric quality of the eight-item scale was evaluated in 876 pediatric patients with chronic abdominal pain and a nonclinical sample of 954 school children using methods from three psychometric models (the classical test theory, Rasch modeling, and confirmatory factor analysis). Results: The CSSI-8 showed good measurement properties on an extensive array of psychometric criteria, had adequate Rasch person separation reliability for a brief instrument (rsep = 0.74–0.75), and distinguished between clinical and nonclinical youth. Girls in both groups had significantly higher CSSI-8 scores than boys. Norms for the clinical sample are presented. Conclusions: The CSSI-8 is a psychometrically sound measure suitable for use as a brief dimensional assessment of pediatric somatic distress.

Development and Measurement Properties of the Danish Translation of the Groin Hernia-Q: Protocol for a Validation Study

Background: The patient reported outcome questionnaire Abdominal Hernia-Q is probably the most thoroughly validated patient-reported outcome measure specifically developed for patients undergoing ventral hernia repair. The present study aims to adapt and validate the Danish translation of the Abdominal Hernia-Q for patients undergoing groin hernia repair: the Groin Hernia-Q. Methods: This validation study will involve a total of 250 participants and it is divided into two substudies. Substudy 1 will focus on adapting the Abdominal Hernia-Q into the Groin Hernia-Q and assessing its content validity using the QQ-10 questionnaire. Substudy 2 will evaluate the structural validity, internal consistency, test-retest reliability, measurement error and construct validity of the Groin Hernia-Q, while also utilizing and comparing the results to the Carolinas Comfort Scale and Short-Form 12. Participants will be recruited both in a clinical setting and electronically. Data collection will be conducted through the platform Research Electronic Data Capture (REDCap). In addition to questionnaire data, this study will also involve perioperative and patient-related data extracted from the Danish National Patient Registry and the Danish Hernia Database. This study is part of the AFTERHERNIA Project. Conclusion: This study will provide a comprehensive validation of the Groin Hernia-Q, ensuring it becomes a valuable tool for assessing patient-reported outcomes in patients undergoing groin hernia repair. The questionnaire will contribute significantly to improved patient care through the AFTERHERNIA Project.

Longitudinal validity of the Hyperhidrosis Quality of Life Index (HidroQoL©) in a phase IIIb clinical trial population with hyperhidrosis: responsiveness and meaningful change.

The Hyperhidrosis Quality of Life Index (HidroQoL ©) is a well-developed patient-reported outcome measure assessing the quality of life (QoL) impacts in hyperhidrosis, which has proven very good measurement properties, such as structural validity and internal consistency. We aimed to investigate responsiveness over time and estimate values for meaningful within-person change (MWPC) towards symptom improvement for different measurement time points (4 and 12 weeks), extending the existing validity evidence in patients with primary axillary hyperhidrosis. Data (from a phase IIIb clinical trial) was collected at baseline, week 4, week 8, week 12, week 28, week 52, and week 72. For the assessment of responsiveness, HidroQoL change scores were correlated with corresponding change scores of the Hyperhidrosis Disease Severity Scale (HDSS), the Dermatology Life Quality Index (DLQI), and the gravimetric sweat production based on a-priori formulated hypotheses. Furthermore, it was tested whether the different HDSS change score groups differed significantly from each other over time and whether the HidroQoL was sensitive towards these group differences over time. This was extended by the calculation of matched-pair tests and effect sizes to test significance for each change group separately. For the estimation of MWPC thresholds towards symptom improvement, different anchor-based and integrated approaches were used. In total, the sample was composed of 357 patients with primary axillary hyperhidrosis. For the assessment of responsiveness, 5 out of 14 a-priori hypotheses regarding the correlation of the change scores could be confirmed, whereas the rejected hypotheses only marginally differed from the expected values. Furthermore, regarding responsiveness, the HidroQoL showed sensitivity towards symptom improvement at each measurement time point. Effect sizes were large as expected (d ≥ 0.806). MWPC thresholds towards symptom improvement were proposed for two measurement time points: 5 (week 4) and 6 (week 12). Increasing MWPC values over time were observed. This study extends the evidence for the longitudinal validity of the HidroQoL up to 72 weeks and proposed MWPC thresholds for different time intervals (4 and 12 weeks) after baseline, aiding interpretability. Results concur with findings from previous validation studies.

Implementation of the Lupus Low Disease Activity State in Pediatric Rheumatology Care: The Role of the Visual Analog Scale.

We compared the measurement properties of a traditional physician global assessment of disease activity (PhGA) 10-cm visual analog scale (PhGA0-10) with that of the three-point numeric scale (PhGA0-3) in childhood-onset systemic lupus erythematosus (cSLE) as part of the childhood Lupus Low Disease Activity State (cLLDAS). We used a secondary data analysis from a convenience sample of 100 patients with cSLE followed every three months for up to seven visits. Ratings of PhGA0-10, PhGA0-3, parent assessment of patient well-being (ParGA) (range: 0= very poorly, 10 = very well), disease activity as measured by the SLE disease activity index 2000 (SLEDAI-2k), Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA) SLEDAI, and the British Isles International Lupus Activity Group index (BILAG; A = 9, B = 3, C = 1, D/E = 0) were compared. After linear transformation of PhGA0-10 to a 0 to 3 range (tPhGA0-10), the frequency of PhGA0-3 ≤1 was assessed to estimate the impact of scale type on the scoring of the cLLDAS. In 600 visits, the median (range) scores of PhGA0-10, PhGA0-3, SLEDAI-2k, SELENA-SLEDAI, and BILAG were 2 (0-10), 1(0-3), 4 (0-28), 4 (0-32), and 2 (0-28), respectively. PhGA0-10 and PhGA0-3 ratings were strong to moderately correlated with (r = 0.73; P < 0.0001) and with more variability for PhGA0-3 ≥2. SELENA-SLEDAI and SLEDAI-2k scores were moderately correlated with PhGA0-10 (r = 0.56/0.54; P < 0.0001). ParGA values were weakly correlated with all other measures considered (all r = -0.19 to -0.34). There were 490 of 600 visits with PhGA0-3 ≤1 and 497 of 600 visits with tPhGA0-10 ≤1 (κ (SE) =0.59 (0.04), McNemar P = 0.4). PhGA0-3 and PhGA0-10 have comparable measurement properties and yield almost identical cLLDAS rates when used in cSLE.

Evaluation of the measurement properties of the parental perceptions of children's exposure to tobacco smoke instrument translated and adapted to the Brazilian context.

Given the need to measure parents' perceptions of their children's exposure to tobacco smoke, the Parental Perceptions of Children's Exposure to Tobacco Smoke (PPE) instrument was developed and validated in Hebrew and later translated into English and Portuguese. The PPE has already been translated and adapted to the Brazilian context but a more robust sample is necessary to investigate the measurement properties. Thus, this study evaluated the measurement properties of the Brazilian version of the PPE instrument. Reliability and validity study were conducted with 161 parents with children up to 18 years of age. Perception of parental smoking status was investigated using analysis of variance. The instrument showed excellent reliability (Cronbach α = 0.92 and intraclass correlation coefficient = 0.91). The exploratory factor analysis identified 4 factors with a total accumulated variance of 71.6%. Confirmatory factor analysis validated this structure with 4 factors. It was necessary to exclude a question that presented low commonality. Analysis of variance demonstrated that nonsmoking and former smoking parents have similar scores, although they are higher than those of current smokers. Our findings provide evidence that the PPE version translated and adapted for the Brazilian context is a reliable and valid instrument. Thus, it can help us understand how parents cope with exposure to tobacco smoke.

Harnessing the potential of deep eutectic solvents in biocatalysis: design strategies using CO2 to formate reduction as a case study

IntroductionDeep eutectic solvents (DESs) have emerged as green solvents with versatile applications, demonstrating significant potential in biocatalysis. They often increase the solubility of poorly water-soluble substrates, serve as smart co-substrates, modulate enzyme stereoselectivity, and potentially improve enzyme activity and stability. Despite these advantages, screening for an optimal DES and determining the appropriate water content for a given biocatalytic reaction remains a complex and time-consuming process, posing a significant challenge.MethodsThis paper discusses the rational design of DES tailored to a given biocatalytic system through a combination of experimental screening and computational tools, guided by performance targets defined by solvent properties and process constraints. The efficacy of this approach is demonstrated by the reduction of CO2 to formate catalyzed by NADH-dependent formate dehydrogenase (FDH). By systematically analyzing FDH activity and stability, NADH stability (both long-term and short-term stability after solvent saturation with CO2), and CO2 solubility in initially selected glycerol-based DESs, we were able to skillfully guide the DES screening process.Results and discussionConsidering trade-offs between experimentally determined performance metrics of DESs, 20% solution of choline chloride:glycerol in phosphate buffer (ChCl:Gly80%B) was identified as the most promising solvent system for a given reaction. Using ChCl:Gly as a co-solvent resulted in an almost 15-fold increase in FDH half-life compared to the reference buffer and stabilized the coenzyme after the addition of CO2. Moreover, the 20% addition of ChCl:Gly to the buffer improved the volumetric productivity of FDH-catalyzed CO2 reduction in a batch system compared to the reference buffer. The exceptional stability of the enzyme in this co-solvent system shows great potential for application in continuous operation, which can significantly improve process productivity. Additionally, based on easily measurable physicochemical solvent properties and molecular descriptors derived from COSMO-RS, QSAR models were developed, which successfully predicted enzyme activity and stability, as well as coenzyme stability in selected solvent systems with DESs.

Oiling out and solubility measurement, molecular simulation and thermodynamic properties of d-tagatose in four aqueous binary solvent systems at 283.15 to 323.15 K

Solubility of D-Tagatose in four aqueous binary solvent systems from 278.15 K to 323.15 K was determined using the anti-solvent assisted gravimetric method. The solubility increases with temperature in all four binary solvents, with water, a good solvent, exhibiting a similar trend. In addition, the dissolution process generally follows the ’like dissolves like’ rule. The study indicates that the oiling out occurs when water exhibits a high molar fraction in water + 1-propanol, and water + isopropanol. Furthermore, we study the charge of the molecule using the molecular electrostatic potential surface (MEPS), aiming to analyze the molecular interactions. Then, to explain the dissolution behaviors of D-tagatose, the radial distribution function (RDF) by molecular dynamics simulations (MD) revealed a strong correlation between solute–solvent interactions and solubility, with significant solvent–solvent interactions. The solubility data was correlated using the modified Apelblat equation, Van’t Hoff equation, λh equation, and Jouyban-Acree model, with demonstrating the high consistency in the data. Finally, the thermodynamic properties revealed that the dissolution process of D-Tagatose is endothermic, and entropy-driven based on all positive values for ΔsolHo, ΔsolSo, ΔsolGo.

Psychometric Assessment of the Temporal Bisection Task with Discrete and Continuous Response Formats

Abstract The temporal bisection task has long been used to study time perception as well as measure individual differences in time perception ability. The task involves training participants on short and long reference durations before presenting intermediate durations and asking participants to classify them as ‘short’ or ‘long’. However, there is little information about how well the bisection task measures individual differences in timing ability. To bridge this gap, we assessed the psychometric properties of measures obtained from a classic temporal bisection task: Weber ratio and percent correct. Because measures with binary responses tend to require many trials to reach adequate reliability, we also assessed the psychometric properties of a modified bisection task which used a continuous response format. In this task, participants represented intermediate durations on a visual analogue scale. Estimation error was used as the outcome measure. Participants (n = 46) completed the classic and modified bisection tasks twice across two sessions approximately one week apart. The modified bisection task had excellent internal consistency and test–retest reliability, while the classic task had fair to good internal consistency and good test–retest reliability. Overall, estimation error had the highest reliability, followed by percent correct, and then Weber ratio. In terms of validity, there was excellent convergent validity between the classic and modified bisection tasks. As an exploratory analysis, we assessed how the number of trials affected the reliability of each outcome measure across the two tasks. Based on this, we make recommendations on how to optimize reliability for both tasks in future research.

Including the ergonomist's voice in integrating MSD prevention and psychological health and safety: Challenges, tools, and considerations

The purpose of this study was to gather ergonomists’ perspectives and experiences, describing current challenges and contextual considerations in risk assessment, exploring how ergonomists are currently integrating the multiple domains of ergonomics for MSD and/or psychological health and safety and highlighting key considerations in the design and format of future tools.In-depth, semi-structured interviews were conducted with twenty Canadian ergonomists to explore risk assessment tool use, favoured characteristics and format of tools, commonly addressed risk factors in their practice, and tools relating to both MSD prevention and psychological health and safety. The range of practitioner years of experience highlighted differing needs and approaches to the use and formatting of risk assessment tools. Practitioners reported using quantitative outcomes (levels of risk, values) from traditional physical tools complemented by a general observation of psychosocial or organizational factors. Though many respondents had not yet encountered the need for psychological injury assessment in their sectors it was identified as a quickly emerging area citing a need for valid and reliable tools. Practitioners noted a lack of available tools that integrated cognitive and psychosocial items presenting a future challenge for integrated tools that covered multiple ergonomic domains. Along with recommendations for future tool development, the authors reflect on the process of qualitative inquiry as an essential step in the risk assessment process. Future studies will be needed to develop and evaluate measurement properties of integrating psychosocial factors and their respective tools in traditional MSD assessment.

Measuring evidence-based practice knowledge, skills, attitudes, and behavior in students of manual therapy education programs: A scoping review of instruments and their measurement properties.

The purpose of this review was to identify assessment instruments and their measurement properties for assessing evidence-based practice (EBP) knowledge, skills, attitudes, and behavior among students of manual therapy education programs. 7 electronic databases were systematically searched from inception to May 19, 2023. (MEDLINE, EMBASE, CINAHL, ERIC, EBSCO Discovery, LISA, Google Scholar.) Search terms were subject headings specific to each database (MeSH in MEDLINE) and relevant to evidence-based practice, assessment tools/instruments, and manual therapy healthcare professions. Eligible studies included students of manual therapy education programs (chiropractic, physiotherapy, occupational therapy, osteopathy) and provided evidence supporting instrument measurement properties (reliability, validity). Titles and abstracts were screened by 2 reviewers. Data on each instrument and its properties were extracted and tabulated by 2 reviewers. Instruments were compared using the Classification Rubric for EBP Assessment Tools in Education (CREATE) framework including the 5 steps in the EBP model. Joanna Briggs Institute methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist were followed. 5 studies were identified, (3 physiotherapy, 2 chiropractic) Two studies used a physiotherapy-focused modification of the Fresno test. One study presented the Knowledge of Research Evidence Competencies instrument. Two studies presented original instruments. Instruments focused on the knowledge domain and did not assess all 5 EBP model steps. The current literature does not address all 5 steps of the EBP model. The identified instruments have the potential to ensure chiropractic institutions are graduating chiropractors who are highly skilled in evidence-based practice.

Polarization optical properties of suspended particles measurement in water by a polarized Scheimpflug lidar system

The polarization optical properties of suspended particles in water play a pivotal role in numerical simulation or real water medium detection. Polarized multi-wavelength oceanic lidar provides an effective method for characterizing the size, shape, and concentration of suspended particles. In this paper, we present a concise and effective optical approach to measure the information in the polarization of the lidar signal with 0°, 45°, 90°, and 135° polarization angles of suspended particles by laboratory experiments based on polarized Scheimpflug lidar system. This work uses typical suspended particles with different sizes and shapes as tracer particles to analyze particulate polarization information. Experiments with spherical or irregular silicon dioxide particles show that these particles can be effectively distinguished by analyzing the polarization optical properties of the backward scattering light. The laboratory system can classify suspended particles and may serve as a shipborne oceanic lidar or be used with submersibles.

Measurement properties of the Brazilian-Portuguese version of the PROMIS-29 questionnaire and the Impact Score in patients with chronic low back pain

BackgroundA task force from the US National Institute of Health aimed to establish parameters for surveys with patients with chronic low back pain (LBP) by recommending the use of the Patient-Reported Outcome Measurement Information System 29-item (PROMIS-29) questionnaire and the stratification according to the Impact Score. We aimed to assess the internal consistency, reliability, measurement error, construct validity and responsiveness of the Brazilian-Portuguese version of the PROMIS-29 questionnaire (version 2.1) and the Impact Score in patients with chronic LBP.MethodsA prospective cohort study was carried out with patients with chronic LBP who were receiving physiotherapy treatment in clinics in São Paulo and Vitória cities, Brazil. The sample included 102 patients with chronic LBP, aged between 18 and 80 years, and with the ability to read and write in the Brazilian-Portuguese language. Exclusion criteria were patients with serious spinal conditions, cognitive impairment, pregnant women, and patients who had undergone lumbar surgery within the past six months. The PROMIS-29 questionnaire, the 12-item Short-Form Health Survey and the Roland-Morris Disability Questionnaire were applied. The PROMIS-29 questionnaire was reapplied after 24 hours and 4 weeks.ResultsThe PROMIS-29 questionnaire showed Cronbach’s Alpha values between 0.81 (anxiety) and 0.91 (depression). The ICC2.1 ranged from 0.85 (95% CI: 0.77 to 0.89) to 0,97 (CI 95%: 0.95 to 0.98). The SEM values ranged between 0.85 (physical function) and 2.62 (ability to participate in social roles and activities). The Impact Score showed Cronbach’s Alpha, ICC2.1 and SEM values of 0.91, 0.97 (95% CI: 0.95 to 0.98) and 0.56, respectively. The PROMIS-29 questionnaire and the Impact Score showed sufficient construct validity. The PROMIS-29 questionnaire showed moderate responsiveness, while the Impact Score showed sufficient responsiveness.ConclusionsBoth the Brazilian-Portuguese version of the PROMIS-29 questionnaire and the Impact Score showed sufficient internal consistency, reliability, construct validity and responsiveness in Brazilian patients with chronic LBP. The results support the US National Institutes of Health’s recommendation to use the PROMIS-29 questionnaire and the Impact Score in patients with chronic LBP. We suggest that future studies evaluate the structural validity of the Brazilian-Portuguese version of the PROMIS-29 questionnaire.Clinical trial numberNot applicable.

Italian versions of the optimal screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF) and the Örebro Musculoskeletal pain screening questionnaire (ÖMPQ-21) and their short forms, in patients with low back pain: Cross-cultural adaptation, reliability and validity

BackgroundLow back pain (LBP) is a leading cause of disability worldwide. Early detection of prognostic factors using the Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF) or the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPQ-21) can predict improvement in pain and disability for patients with nonspecific LBP. ObjectivesTo translate and cross-culturally adapt the OSPRO-YF and the ÖMPQ-21 with their short versions into the Italian language and to test their measurement properties in patients with LBP. DesignClinimetric study. MethodsOSPRO-YF and ÖMPQ-21 were translated and administered to LBP patients with questionnaires on pain intensity, disability, pain self-efficacy, and pain catastrophizing. We evaluated test-retest reliability, measurement error, and construct validity. ResultsEighty-three patients with LBP were included. No floor or ceiling effects were reported. Test-retest reliability of the OSPRO-YF, the ÖMPQ-21, and their short forms were excellent. The measurement error analysis revealed a Standard Error of Measurement (SEM) of 6.7 points, a Minimal Detectable Change (MDC) of 18.6 points for ÖMPQ-21, a SEM of 2.3 points, and a MDC of 6.4 points for OSPRO-YF. The construct validity of the OSPRO-YF and ÖMPQ-21 and its 10-item short version was satisfactory and moderate. OSPRO-YF performed better than ÖMPQ-21 on all three measurement properties. ConclusionOSPRO-YF, ÖMPQ-21, and their short versions are reliable and valid for identifying ‘yellow flags’ in Italian patients with LBP, with the former generally performing better than the latter. Further research is needed to confirm their ability to predict outcomes in patients with LBP.

The Role of Servant Leadership, School Culture and Supervision System on Teacher Performance Mediated by Teacher Competence and Moderated by Good Scholl Governance

The research is an observational study aiming to test a model in which the effect of servant leadership as exogenous constructs; school culture and supervision system will affect teacher performance by mediating factor: competency, with oversight moderation variable. If anything, the need for leadership consistency and governance models which described by Inceoglu et al launched differs greatly according to institution of higher education executing research (Indonesian educational context) because how various cultural norms operate in relation to one another impacts teacher efficacy. This study uses a sample that involves different types of schools within Indonesia and applies Partial Least Squares Structural Equation Modeling (PLS-SEM) for the data analysis with focus on measurement properties as well correlations among variables. Results indicate that while effective supervision and governance, servant leadership as well as organizational culture contributes significantly to teaching performance at school; the combination of these elements are needed in nurturing a high-performing education system. Importantly, provision of effective leadership and governance at all levels of the system for ensuring optimum teacher effectiveness is strongly accorded here by this research. Further research is encouraged to investigate these trends and their influence on teacher performance over time using longitudinal methods.

Assessing the measurement properties of PROMIS Computer Adaptive Tests, short forms and legacy patient reported outcome measures in patients undergoing total hip arthroplasty.

The commonly used ('legacy') PROMs evaluating outcomes of total hip arthroplasty (THA), have several limitations regarding their measurement properties and interpretation of scores. One innovation in PROMs is the use of Computerized Adaptive Testing (CAT). The Patient-Reported Outcomes Measurement Information System (PROMIS®) is a validated system of CATs. The aim of this study was to assess the measurement properties of PROMIS and legacy instruments in patients undergoing THA. Patients in this multicenter study filled out a questionnaire twice, including Dutch-Flemish PROMIS v1.2 Physical Function (PROMIS-PF) and v1.1 Pain Interference (PROMIS-PI) CATs and short forms, PROMIS v1.0 Pain Intensity, and legacy PROMs (Hip disability and Osteoarthritis Outcome Score (HOOS), HOOS-Physical function Shortform (HOOS-PS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Oxford Hip Score (OHS), and two numeric rating scales measuring pain). The reliability, measurement precision (Standard Error of Measurement (SEM)), smallest detectable change (SDC), and burden of PROMIS instruments were presented head-to-head to legacy PROMs. Furthermore, construct validity was assessed. 208 patients were included. All instruments had a sufficient test-retest reliability (range ICC: 0.83-0.96). The SEM of PROMIS CATs and short forms ranged from 1.8 to 2.2 T-score points, the SEM of legacy instruments 2.6-11.1. The SDC of PROMIS instruments ranged from 2.1 to 7.3 T-score points, the SDC of legacy instruments 7.2-30.9. The construct validity of PROMIS CAT and short forms were found sufficient, except for the PROMIS-PI short form. The burden of PROMIS CATs was smaller than PROMIS short forms (range 4.8-5.2 versus 8-20 items, respectively). The burden of legacy instruments measuring physical functioning ranged from 5 to 40 items. The PROMIS-PF is less burdensome, with high measurement precision, and almost no minimal or maximal scores, and an equal reliability compared to legacy instruments measuring physical functioning in patients undergoing THA. The PROMIS Pain Intensity 1a is comparable to the legacy pain instruments in terms of burden, reliability and SDC. Measuring the construct Pain Interference may not have additional value in this population because of its high correlation with instruments measuring physical functioning. The SDC values presented in this study can be used for individual patient monitoring.

Validity, test-retest reliability, and responsiveness of the Indonesian version of FACIT-COST measure for subjective financial toxicity.

Financial toxicity describes the impairment of financial wellbeing in patients due to the burden of cancer diagnosis and care. The COST: A Functional Assessment of Chronic Illness Therapy Measure of Financial Toxicity (FACIT-COST) is the most widely used cancer-specific measure of subjective financial toxicity, having been validated in multiple languages, but not in Indonesian. This study aimed to validate the Indonesian version of FACIT-COST in a breast cancer sample. A single-center prospective cohort study was performed in Indonesia. Female breast cancer patients aged ≥ 18 undergoing treatment at baseline were invited to participate and followed for up to six months. The survey included the official Indonesian version of FACIT-COST (v2) which was administered to the patients by interviewers. Clinical information (e.g., metastasis status, disease duration) was provided based on medical records. The following measurement properties of FACIT-COST were tested: distributional characteristics, structural validity (principal component [PCA] and confirmatory factor analyses [CFA]), internal consistency reliability (Cronbach's alpha and McDonald's omega), known-groups validity (Mann-Whitney U or Kruskal-Wallis H test), test-retest reliability, and responsiveness to change. Overall, 300 female patients participated at baseline. No patients reported the best or worst possible FACIT-COST total scores. The PCA proposed a two-factor model structure for the instrument, which was confirmed by the CFA (RMSEA = 0.042, SRMR = 0.049, CFI = 0.99, TLI = 0.99). The internal consistency reliability of the two factors was considered adequate (Cronbach's alpha = 0.774-0.882, McDonald's omega = 0.786-0.888). The FACIT-COST total score significantly discriminated across the following known-groups: age, education, residential setting, income, employment, metastasis status, number of symptoms, and financial coping strategies. The FACIT-COST demonstrated excellent test-retest reliability (intraclass correlation coefficient = 0.96) and satisfactory responsiveness to change (standardized response mean and effect size ranges=|0.39| to |0.92|). This is the first study to validate the FACIT-COST in patients with breast cancer and to present the measurement properties of the Indonesian version of FACIT-COST. The Indonesian FACIT-COST demonstrates acceptable psychometric performance and shows potential as a valid measure of subjective financial toxicity. The instrument may serve as a valuable tool for informing health policies that focus on providing resource support to improve cancer care in Indonesia.

Clinician-Reported Negative Symptom Scales: A Systematic Review of Measurement Properties.

Negative symptoms of schizophrenia are correlated with reduction of normal function and lower quality of life. They were newly defined by the NIMH-MATRICS Consensus in 2005, dividing the rating tools to assess them into first-generation scales, developed before the Consensus, and second-generation scales, based on the recently introduced definitions. The COnsensus-based Standards for the selection of health Measurement Instrument (COSMIN) guidelines for systematic reviews were used to evaluate the quality of psychometric data of the first-generation scales that cover the 5 negative symptom domains of the NIMHS Consensus: the Scale for the Assessment of Negative Symptoms (SANS), the High Royds Evaluation of Negativity Scale (HEN), and the Negative Symptom Assessment-16 (NSA-16). The search strategy resulted in the inclusion of a total of 13 articles, 7 for the SANS, 4 for the NSA-16, and 2 for the HEN. For the SANS and the NSA-16, the overall results of the scales' measurement properties are mostly insufficient or indeterminate. The quality of evidence for the HEN is poor, due to a small number of validation studies/included patients. After applying the COSMIN guidelines, we do not recommend the usage of these first-generation scales to rate negative symptoms. At the minimum they require further validation.