Poor Items Research Articles

Selection and validation of a classification system for a child-centred preference-based measure of oral health-related quality of life specific to dental caries

BackgroundCaries Impacts and Experiences Questionnaire for Children (CARIES-QC) is a child-centred caries-specific quality of life measure. This study aimed to select, and validate with children, a classification system for a paediatric condition-specific preference-based measure, based on CARIES-QC.MethodsFirst, a provisional classification system for a preference-based measure based on CARIES-QC was identified using Rasch analysis, psychometric testing, involvement of children and parents, and the developer of CARIES-QC. Second, qualitative, semi-structured ‘think aloud’ validation interviews were undertaken with a purposive sample of children with dental caries. The interviewer aimed to identify whether items were considered important and easily understood, whether any were overlapping and if any excluded items should be reintroduced. Interview recordings were transcribed verbatim and thematic analysis conducted.ResultsRasch analysis identified poor item spread for the items ‘cross’ and ‘school’. Items relating to eating were correlated and the better performing items were considered for selection. Children expressed some confusion regarding the items ‘school’ and ‘food stuck’. Parent representatives thought that impacts surrounding toothbrushing (‘brushing’) were encompassed by the item ‘hurt’. Five items were selected from CARIES-QC for inclusion in the provisional classification system; ‘hurt’, ‘annoy’, ‘carefully’, ‘kept awake’ and ‘cried’. Validation interviews were conducted with 20 children aged 5–16 years old. Participants thought the questionnaire was straightforward and covered a range of impacts. Children thought an item about certain foods being ‘hard to eat’ was more relevant than one about having to eat more carefully because of their teeth and so the ‘carefully’ item was replaced with ‘hard to eat’.ConclusionFollowing child-centred modification, the preliminary five-item classification system is considered valid and suitable for use in a valuation survey. The innovative child-centred methods used to both identify and validate the classification system can be applied in the development of other preference-based measures.

Validation of a Brief Multi-Dimensional Assessment of Dementia Severity.

Briefer measures of symptoms and functional limitations may reduce assessment burden and facilitate monitoring populations of persons with dementia (PWD). Prospective follow-up study. University-based dementia care management program. 1,091 PWD. We assessed cognition (Mini Mental State Examination (MMSE)-11 tasks), neuropsychiatric symptom severity (Neuropsychiatric Inventory Questionnaire Severity Scale (NPIQ-S)-12 items), and functional ability (Activities of Daily Living (ADL)-6 items; Functional Activities Questionnaire (FAQ)-10 items). Item response theory was used to select subsets of items by identifying low item discrimination (<1.50), poor item fit (χ2 ), local dependence (LD), and with difficulty similar to other items. We estimated correlations between original and shorter scales and compared their associations with mortality. We added two symptoms (trouble swallowing, coughing when eating) reflecting late-stage dementia complications, created a multi-dimensional dementia assessment composite, and examined its association with mortality. Five MMSE tasks were eliminated: two with low discrimination, two with difficulty similar to other items, and one with poor fit. The remaining tasks were correlated with the full MMSE at r = 0.82. We retained three ADLs that were correlated with the total ADL set at r = 0.95 and kept five FAQ items that were not LD (correlation with full FAQ, r = 0.97). Associations with mortality were similar between the longer and shorter scales. A higher score on the composite (range 0-100) indicates worse dementia impact and was associated with mortality (hazard ratio (HR) per scale point: 1.03 (1.02-1.04)). These brief assessments and dementia composite may reduce administration time while preserving validity.

Development and psychometric testing of the career success in Nursing Scale.

To develop and test the psychometric properties of an instrument assessing career success in nurses. Despite the importance of achieving success in nursing, to date, this construct has been measured using unidimensional or generic scales not fully reflecting career success as perceived by nurses. This scale development study used a large sample of nurses across 10 hospitals in Tabriz, Iran. Items were generated based on existing literature and previous, research team-led, qualitative study, followed by testing content and face validity of the items. Exploratory factor analysis (N=530 nurses) then assessed the underlying structure of the scale, and reliability was tested using Cronbach's alpha and a 2-week test-retest correlation. From the initial 73 items, fourteen rated by experts as 'not relevant' and seven with poor face validity were deleted. Exploratory factor analysis further identified 13 poor items. The final 39-item solution extracted four robust career success factors: expected career progress, providing quality care, effective self-regulation, and person-organization fit. Cronbach's alpha and test-retest correlation showed excellent reliability. This multidimensional nursing-specific scale with very good psychometric properties is suitable for individual/group-based decisions. This instrument can assess current perceptions of career success in nurses, so work resources can be allocated to improve policies, services and training programmes to meet career aspirations of nurses and objectives of the organization. Having a robust scale of career success will enable future research in the field of career success as specific to nursing in a clinical setting.

The memory assessment clinics scale for epilepsy (MAC-E): A brief measure of subjective cognitive complaints in epilepsy

Objective The aim of this study was to conduct item reduction of the Memory Assessment Clinics Self-Rating Scale (MAC-S) to create a briefer measure that can be used to quickly evaluate subjective memory complaints in patients with epilepsy. Method: A total of 1333 adults with focal epilepsy completed the original 49-item MAC-S. The sample was randomly split into three subsamples, and a series of analyses (i.e. exploratory factor analysis, confirmatory factor analysis, and item response theory analyses) was conducted to identify an alternative factor structure, with a reduced number of items. A panel of 5 neuropsychologists independently reviewed the final model to assess appropriateness of each individual item as well as the factor loadings and overall factor structure. Final factor titles were subsequently decided as a group. Results: Five factors were identified: Attention, Working Memory, Retrieval, Semantic Memory, and Episodic Memory. The length of the MAC-S was reduced from 49 to 30 items, with items being removed because they failed to load onto any of the factors substantially, or because of poor item discrimination or threshold levels. Conclusions: The Memory Assessment Clinics Scale for Epilepsy (MAC-E), is an updated, brief measure of subjective memory functioning that can be used to efficiently assess relevant, every-day memory abilities in patients with epilepsy within both clinical and research settings.

Psychometric properties of a Spanish version of the 10-item Berger's stigma scale in Colombia: a validation study

Introduction: HIV-related stigma is detrimental to people living with HIV (PLH), and reducing it is essential for achieving an HIV/AIDS-free generation. Abbreviated stigma scales can improve the feasibility of surveys that broadly explore factors affecting PLH. This study tested the psychometric properties of a Spanish translation of the abbreviated 10-item Berger's HIV stigma scale. Methods: We recruited a sample of 105 PLH regularly attending a specialized clinic in Cali, Colombia. English-to-Spanish and Spanish-to-English back translation was performed of the Berger's 10-item HIV stigma scale. Exploratory and confirmatory factor analyses were carried out to assess its validity. Pre- and post-test reliability (15 days) was estimated with the intra-class correlation coefficient (ICC). Results: The Confirmatory Factor Analysis (CFA) was used to confirm a two-factor solution with three poor items removed, resulting in a 7-item HIV Stigma Scale. The resulting 7-item HIV stigma scale had a Cronbach's alpha of 0.73 with an ICC of 0.83 (CI 95%: 0.75–0.89). One factor loaded three items related to negative self-image (internalised stigma), and the other four items were related to personalized (enacted) HIV stigma. Both factors were related to depression and adherence to antiretroviral therapy. Conclusion: The Spanish translation of the 10-item HIV stigma scale did not perform well due to problems in items 4, 5, and 6. Rather, a modified 7-item version had a good fit with a two-factor loading in which both HIV stigma factors correlated significantly with depression and HIV medication adherence.

Studying the specifics of manipulation of financial statements in organizations of the construction sector

Subject. We identify the signs of manipulating the financial statements in the construction sector organizations. Objectives. We focus on developing the analytical procedures to detect the signs of financial statements manipulation, namely, the so-called window dressing. Methods. The methodological basis rests on general scientific principles and methods of research, like abstraction, generalization of approaches of domestic and foreign authors to the detection of manipulation of reporting, and statistical methods of information processing. Results. We developed a classification of methods for manipulation of unsound improvement of financial statements, assessed the likelihood of misstatement of financial statements, identified the elements of poor quality items, proposed a method to detect the manipulation of reporting, based on the comparison of substandard financial statement items with reliable items and/or non-financial indicators. We tested the methodology on the data of enterprises, operating in the construction sector. Conclusions. The study found that a likely manipulator is, usually, a micro-enterprise or a small company that does not have a credit limit, has significant relative performance of assets and liabilities of low quality, while showing high productivity and high return on assets at the average level of capital/labor ratio, and characterized by low investment and financial activity.

Application of Rasch Analysis to the Evaluation of the Measurement Properties of the Hearing Handicap Inventory for the Elderly.

The aim of this research was to evaluate the measurement properties of the Hearing Handicap Inventory for the Elderly (HHIE). The HHIE is one of the most widely used patient-reported outcome measures in audiology. It was originally developed in the United States in the 1980s as a measure of the social and emotional impact of hearing loss in older adults. It contains 25 items that are accompanied by a 3-point response scale. To date, the measurement properties of the HHIE have primarily been assessed via traditional psychometric analysis techniques (e.g., Cronbach's alpha and Principal Components Analysis). However, traditional techniques are now known to have several limitations in comparison to more modern approaches. Therefore, this research used a modern psychometric analysis technique, namely Rasch analysis, to evaluate the HHIE. Rasch analysis was performed on HHIE data collected from 380 adults with hearing loss. The participants were principally recruited from the participant database of the National Institute for Health Research Nottingham Biomedical Research Centre in the United Kingdom. Additional participants were recruited from two UK audiology clinics and the online forum of a UK hearing loss charity. Rasch analysis was used to assess the measurement properties of the HHIE (i.e., fit to the Rasch model, unidimensionality, targeting, and person separation reliability) and its individual items (i.e., response dependency, fit, Differential Item Functioning, and threshold ordering). The HHIE was found to have several strong measurement properties. Specifically, it was well-targeted and had high person separation reliability. However, it displayed poor fit to the Rasch model and was not unidimensional. The majority of the items were free of response dependency (i.e., redundancy) and were suited to the 3-point response scale. However, two items were found to be better suited to a dichotomous response scale. Furthermore, nine items were identified as being candidates for removal from the questionnaire, as they exhibited poor fit and/or Differential Item Functioning (i.e., item bias) associated with gender. The measurement properties of the HHIE could be improved by removing these items and adjusting the scores of the two items that require a dichotomous response scale. These amendments resulted in a 16-item version of the HHIE that had good fit to the Rasch model and that was unidimensional. It is vital to ensure that high-quality outcome measures are used in audiology research and practice. This study evaluated one of the foremost outcome measures in this field: the HHIE. The results demonstrated that the HHIE had several strong measurement properties. Amending the HHIE, such as by removing items exhibiting poor fit, could further enhance its quality. A unique aspect of this study was the application of Rasch analysis to the evaluation of the HHIE. It is recommended that future studies use modern techniques to develop and identify high-quality, hearing-specific outcome measures.

Evaluating Students' Use of Therapeutic Communication in Entry-Level Education: The Observer Version of the Clinical Assessment of Modes (CAM-Observer).

The Intentional Relationship Model (IRM) guides learning about therapeutic use of self. The observer version of the Clinical Assessment of Modes (CAM-Observer) may be used to evaluate students' therapeutic communication as the process is defined in the IRM. To assess the structural validity of the CAM-Observer. Cross-sectional, psychometric study. Master's in occupational therapy program. One hundred thirty-four entry-level students. The overall CAM-Observer and the individual subscales (Advocating, Collaborating, Empathizing, Encouraging, Instructing, Problem-Solving) were used to assess students' communication from the instructor's perspective. The overall CAM-Observer and six subscales demonstrated appropriate rating scale functioning and dimensionality. The Advocating subscale demonstrated poor item fit, floor effects, and low person separation. One Collaborating item demonstrated poor fit to the overall CAM-Observer and the Collaborating subscale, requiring revision. Instructing and Encouraging items were most likely to be endorsed by the instructor-observers, resulting in a ceiling effect for the Instructing and Encouraging subscales. The Advocating and Problem-Solving items were least likely to be endorsed by the instructor-observers. Except for the Problem-Solving subscale, the overall CAM-Observer and the individual subscales could reliably separate items according to difficulty. Except for the Advocating subscale, the overall CAM-Observer and the individual subscales could reliably separate people into high- and low-performance groups. The CAM-Observer offers a structurally valid and theoretically grounded assessment of students' therapeutic communication as the process is defined in the IRM. The CAM-Observer can be integrated into occupational therapy education to guide students' critical reflection on their interpersonal communication. The CAM-Observer offers a means of evaluating students' therapeutic use of self.

The Development and Validation of Science Achievement Test

Academic achievement is often regarded as a determinant of academic success. One of the most common assessment tools to evaluate the student achievement is through a well set achievement test. The main objective of the study was to develop and validate an achievement test in Science for senior secondary school students of grade 10. A Science Achievement Test (SAT) was developed by an excellent teacher in science subject based on Malaysia Science Curriculum Specification. The SAT consists of 50 multiple choice questions, which include the all 8 chapters in grade 10 science. The SAT had been validated by experts and analysed to check the difficulty index (p) and discrimination index (d), internal consistency reliability. Data were obtained from a purposive sampling of 50 students in a pilot study carried out in a secondary school in Sarawak, Malaysia. Based on the difficulty index, there are 12 easy items, 33 moderate items and 5 difficult items. 7 items found to be poor items and needed to be modified or removed due to the poor discriminating power. The reliability of SAT based on KR20 and Split half method showed the coefficient of 0.862 and 0.851 respectively. From the study, the SAT was a valid and reliable tool for measuring the students achievement in science. Keywords: Science achievement test, validity, reliability, difficulty index, discriminant index DOI: 10.7176/JEP/11-20-12 Publication date: July 31 st 2020

The Keratoconus Outcome Research Questionnaire: A Cross-Cultural Validation Study of the Danish Version.

To evaluate the psychometric properties of the Danish Keratoconus Outcome Research Questionnaire (KORQ). Phase 1: Rasch analysis assessed the original Danish KORQ. Phase 2: Reengineering of the Danish KORQ to optimize the psychometric properties and functioning of the KORQ. The KORQ was self-administered by 195 patients. Phase 1 displayed trouble with local dependency and poor item fit. In phase 2, local dependency was addressed, and acceptable item fit was obtained for both subscales by collapsing item pairs into superitems (A6+A7, A9+A17, and S6+S9) and deleting 2 items (S4 and S2). After these corrections, the inter-item range was 0.28 to 0.72 for activity limitation scale (AL-S) and 0.14 to 0.54 for symptoms scale (S-S). Ordered thresholds were present, except in items A11, S5, and S10. No differential item functioning was present. Person separation reliability was 0.93 for AL-S and 0.81 for S-S. The person-item maps showed that the target was slightly above the study population. The maximal corneal curvature was the clinical measure of keratoconus with the highest correlation of 0.33 for AL-S and 0.24 for S-S. Evaluating individual questions showed that patients had the most trouble seeing at distance, driving at night, and wearing rigid gas-permeable lenses, whereas the least troublesome areas were walking up/downstairs, doing household tasks, avoiding objects on their path, and doing their job. The revised Danish KORQ largely fulfilled the assumptions of the Rasch model and displayed satisfactory psychometric properties. The need to revise the Danish KORQ highlights that cross-cultural validation is of key importance when working with patient-reported outcomes.

Validating the Factor Structure of the Hindi Version of the Difficulties in Emotion Regulation Scale

The Difficulties in Emotion Regulation Scale (DERS) assesses emotion regulation among adults and adolescents, in healthy as well as clinical populations. However, its factor structure is a widely debated issue. Although earlier studies replicated the original six-factor structure, they pointed out psychometrically poor items in the DERS. The issue is further complicated by the findings of recent studies reporting a five- or even a four-factor structure of the DERS. Further, several studies have questioned the validity of the Awareness dimension of DERS and suggested excluding this dimension. Against this backdrop, the present study attempts to examine the factor structure of the Hindi version of the DERS (DERS-H) on 434 healthy participants (303 females, 131 males) of middle socio-economic status. Findings of the exploratory and confirmatory factor analyses (CFA) did not support either of the one-, six- or five-factor solutions. After excluding five psychometrically poor items (poor loadings and higher standardized residuals), the CFA though yielded a satisfactory fit for first-order six-factor model, the second-order model did not fit well. However, after removing the Awareness dimension, the first-order as well as the second-order modified five-factor models provided apt fits to the data. This modified DERS-H (and its five sub-domains) showed satisfactory reliability and validity as well as factor structure invariance across gender and age. The findings suggest that the modified DERS-H is a psychometrically sound tool (with stable factor structure) to measure the second-order construct of emotion regulation difficulties as well as its five first-order subdomains, particularly in the Indian cultural context.

Study on Factors Delaying Lead Time in the Apparel Supply Chain Management: A Case Study on the Order of Execution Strategies of a Garment Factory in Bangladesh

Bangladesh garments industry is searching out for ways to reduce lead time during apparel order execution for many rational reasons among which buyer's satisfaction, achieving target shipment date, and building a stable sector are some mentionable motives. One way to abridge lead time is to identify and analyze the root causes to delay in the approval period. Lead time refers to the time in between receiving order and dispatching to buyer. A number of reasons are responsible for delayed lead time. For instance, factory capacity, poor work force, raw material supply, wrong understanding about product details, miscommunication among inter-departments, longer approval period, lack of proper planning, submission of poor quality items, re-work, and re-submissions, etc. Among all of these reasons listed, longer approval period, submission of poor quality materials, re-work, and raw materialsupply hold the utmost importance. This study was based on the investigation of the abovementioned factors that reasonably delay lead time. A compliant garments industry was selected that receives order from a renowned buying office located in Germany. The ultimate customer of that buying office is also located in Germany who operates a number of lucrative stores in several countries in the globe. The study was carried out for an order with a quantity of 73,890 pcs. Results evinced that, due to longer approval period for submitted material (i.e., metal button, first styling sample), up to 24 days’ extension are required to extend for order execution. Besides, submission of poor quality sample and re-work (i.e., print strike-off, size set, and lab dip sample) lead up to 22 days extension. The raw material (i.e., fabric and trims) in-house period also delayed the total period. For the total order shipment, it required 45 days’ extension with respect to the given shipment date.

Reliability and Validity Testing of the Assessment of the Environment for Person-Centered Management of BPSD and Assessment of Policies for Person-Centered Management of BPSD Measures

The purpose of this study was to test the reliability and validity of the Assessment of the Environment for Person-Centered Management of BPSD and the Assessment of Policies for Person-Centered Management of BPSD. The sample included 35 long term care facilities. There was evidence of reliability based on internal consistency and test-retest reliability of both measures. There was some evidence of validity based on Rasch model testing and INFIT and OUTFIT statistics. Across both measures, there were six items that were endorsed as present by all facilities. The INFIT and OUTFIT statistics were all within the expected range of .5 to 1.5 with the exception of four high OUTFIT statistics for the Assessment of the Environment for Person-Centered Management of BPSD. For the Assessment of Policies for Person-Centered Management of BPSD, there were two items that had high INFIT statistics and six with low OUTFIT statistics and one with high OUTFIT statistics. Measure revisions are suggested including removal of some poor fitting items, items with no variance, and adding items to differentiate those very high in evidence of environments and policies that manage BPSD.

The NADINE Soft Skills Tests for Migrants, Refugees and Asylum Seekers: Cultural Adaptation and Preliminary Testing of Their Psychometric Properties

The present paper aims at assessing the linguistic and cultural adaptation and equivalency of the French, Farsi, Arabic and English versions of the NADINE1 Soft Skill Tests, which include four scales: interpersonal skills, organizational skills, personal skills, and entrepreneurial skills. The translation process included forward and backward translations. Three studies took place. In Study 1, both the source (English) and target versions of the tests were administered to 117 bilingual subjects. There were very few differences observed between the two versions of the tests, in all language versions, resulting in only a few items being revised. Study 2 aimed at determining the degree to which the items, the response scale and the instructions are comprehensible and culturally relevant to the target population. Three focus groups were formed, with 9, 9 and 7 participants respectively, who rated all items in terms of clarity and cultural relevance. The review resulted in minor changes in the instructions. In study 3, the Farsi, Arabic and French versions of the tests were administered to 120 migrants/refugees/asylum seekers. We calculated the discriminative power of each item and its contribution to the scale’s and subscale’s internal reliability coefficient. Moreover, we calculated Tucker’s congruence coefficient for each subscale to ensure cross-cultural equivalency. Items with poor discriminative power and items which reduced the reliability coefficients were eliminated. The remaining items had discriminative power between 0.20 and 0.80, while all reliability coefficients were above 0.70 (the vast majority being above 0.80). All Tucker’s phi coefficients were above the 0.90 cut-off point, with the exception of the Farsi-French and the Arabic-French comparison of one component. However, Tucker’s phi was above 0.80 which shows similarity. Results of all 3 studies support the case of linguistic and cultural equivalence between the different language versions of the tests. Therefore, all test versions are valid and reliable instruments that can be used by career practitioners to assess the level of soft skills of migrants, refugees and asylum seekers.

Схожи или отличны? Применение Item Response Theory для анализа теста «Синонимы» на выборке взрослых с опытом и без опыта институционализации

The lack of valid and standardized instruments, directed on an assessment of the language domain in adolescents and adults in Russia postulates the urgent necessity of their development. To fi ll this gap, the language battery, ARFA-RUS, was created and applied in a large project investigating the long-term consequences of raring in institutional care settings on human development. In the current study, an Item Response Theory (IRT) approach was used to examine the psychometric properties of the Synonyms Subtest of ARFA-RUS as the fi rst step of validation of the battery. IRT results demonstrated the test is reliable for the low-to-moderate levels of the assessed ability; yet, to capture a wider ability range, more diffi cult items are needed. The ARFA-RUS Synonyms Subtest was less suitable for the postinstitutionalized group of adults; in this group, the latent ability estimate explained a lower percentage of variance in comparison to adults raised in biological families. With regard to item-specifi c analyses, two items demonstrated paradoxical patterns with decreased probability of correct response at increased ability. In addition, one item was eliminated from the fi nal version of the Synonyms Subtest due to its poor item fi t and low discrimination value.

Analysis of Multiple-Choice Questions (MCQs): Item and Test Statistics from the 2nd Year Nursing Qualifying Exam in a University in Cavite, Philippines

Multiple Choice Questions (MCQs) is used extensively as a test format in nursing education.However, making MCQs still remains a challenge to educators. To avoid issues about itsquality, this should undergo item analysis. Thus, the study evaluated item and test qualityusing difficulty index (DIF) and discrimination indices (DI), with distractor efficiency (DE);determined the reliability using Kuder-Richardson 20 coefficients (KR20); and identifiedwhich valid measure was developed. The study was conducted among 41 level two nursingstudents in the College of Nursing. The qualifying examination comprised of 194 MCQs.Data were entered in Microsoft Excel 2010 and SPSS22 and were analyzed. According toDIF, out of 194 items, 115 (59.3%) had right difficulty and 79 (40.7%) were difficult.Regarding DI, 17 (8.8%) MCQs were considered very good items to discriminate the low andhigh performer students. While 21 (10.8%), 32 (16.5%), 24 (12.4%), and 100 (51.5%)demonstrated good, fair quality, potentially poor, and potentially very poor items,respectively. On the other hand, the number of items that had 100% distractor effectiveness is57 (29.4%), as 65 (33.5%), 49 (25.3%), and 23 (11.9%) revealed 66.6%, 33.3% and 0%,respectively. The reliability of the test using KR20 is 0.9, suggesting that the test is highlyreliable with considered good internal consistency. After careful analysis of each item, 55(28.35%) items were retained without revisions. Further, the stem of the 24 (12.37%) items,the distractors of the 66 (34.02%) items and both the stem and distractors of 46 (23.71%)items were modified, and 3 (1.55%) items were removed. The researcher recommends doingan analysis between upper and lower scorers and its relationship to DE. For future study, itwill be beneficial to explore other factors like student’s ability, quality of instructions, andnumber of students in relation to quality of MCQs.

Associations between Race, Discrimination, Community Violence, Traumatic Life Events, and Psychosis-Like Experiences in a Sample of College Students.

Self-report tools of psychosis-like experiences contribute to the understanding of psychosis and may aid in identification and prevention efforts across the severity spectrum. Current tools are likely limited by biases, leading to potential systematic health disparities. Principal component analyses in diverse samples of community participants reporting psychosis-like experiences may aid in the detection of measurement biases. The current study evaluated the fit of a two-component model for the Prime Screen, a self-report psychosis-like experiences measure, in a sample of Black (n = 82) and White (n = 162) community participants, and subsequently evaluated the relation of these components with measures of mental well-being, traumatic life experiences, community violence, and experiences of discrimination. Analyses indicated limited support for a two-component model of the Prime Screen, with four of the items showing high cross-loading across both components (“poor fit” items). Although many Prime Screen items correlated with mental well-being as expected, correlations between item scores and mental well-being were non-significant for poor fit items. Community violence emerged as a significant predictor of some individual item scores for both good and poor fit items, while discrimination predicted only some poor fit item scores. Results highlight the potential limitations of current self-report tools of psychosis-like experiences, as well as possible considerations for improvement for use in diverse populations.

Surveying Allied Health Professionals Within a Public Health Service: What Works Best, Paper or Online?

Poor response rate, self-selection bias, and item noncompletion negatively impact the generalization of results from surveys. This study examined differences in these factors between a paper and online survey among allied health clinicians. Clinicians within a large local health district were initially invited to complete the Research Capacity in Context Tool online via an e-mail link. Following a lower-than-expected response rate, potential selection bias, and item noncompletion, the survey was readministered in paper form to the same cohort of clinicians 6-12 months later. The response rate to the paper survey was higher than to the online survey (27.6% vs. 16.5%). Selection biases were evident, characterized by seniority and discipline: Junior clinicians responded at rates significantly less than expected to the online survey but as expected to the paper survey. Occupational therapists, speech pathologists, and podiatrists responded more highly to the online survey, while other disciplines responded more highly to the paper survey. The rate of item noncompletion was higher for online than paper survey (6.72% vs. 3.8% questions not completed, respectively), with patterns of noncompletion also differing. These data suggest paper surveys are likely to produce less biased and more generalizable data from allied health clinicians.

Measurement of patient satisfaction with physical therapy care: revisiting the semantic and dimensional structure equivalence of MedRisk instrument in the Brazilian context

Background MedRisk is one of the several available measurement tools developed to assess patient satisfaction with outpatient physical therapy services and has been adapted to different countries, including Brazil. However, the literature shows conflicting results regarding its dimensional structure. Objective To evaluate the Brazilian version of MedRisk for semantic equivalence to the original English version, followed by an assessment of its dimensional structure. Methods The original 18-item version was first submitted to translation and back-translation, followed by a pre-test on 55 patients (semantic equivalence phase). Another 326 patients were interviewed to assess the dimensional structure. An initial confirmatory factor analysis (CFA) was followed by exploratory structural equation modelling (ESEM). Results CFA was performed on the 16-item version agreed upon in the first phase, and indicated poor fit (RMSEA = 0.10, 90% CI: 0.08–0.12; CFI = 0.84; TLI = 0.79). The ensuing ESEM pointed to a four-factor structure, but five cross-loadings emerged, suggesting violation of the item factor specificity. High residual variances were also found in 3 items (≥0.70), which is indicative of poor item reliability. Conclusion Although semantic equivalence was achieved, several uncovered psychometric (configural and metric) shortcomings show that MedRisk still requires refinements before recommending its use in Brazilian health services.

Development of a New Instrument for Depression With Cognitive Diagnosis Models.

Most existing instruments for depression are developed based on classical test theory, factor analysis, or sometimes, item response theory, and focus on the accurate measurement of the severity of depressive disorder. Nevertheless, they tend to be less useful in supporting the decision based on ICD-10 or DSM-5 because of the lack of detailed information for symptoms. To gain rich and valid information at the symptom level, this article developed a depression test under the framework of cognitive diagnosis models (CDMs), referred to as CDMs-D. A total of 1,181 individuals were finally recruited and their responses were used to examine the psychometric properties of CDMs-D. After excluding poor items for statistical reasons (e.g., low discrimination, poor model-fit or having DIF), 56 items were included in the CDMs-D. The CDMs-D measures all ten symptom criteria for depression defined in ICD-10 and covers five domains of depression defined by Gibbons et al. (2012). Comparing with the existing self-report measures (such as PHQ-9, SDS, CES-D and so on), a distinguishing feature of the CDMs-D is that it can provide both overall information about the severity of depressive disorder and the assessment information about specific symptoms, which could be useful for diagnostic and interventional purposes.