Potential Items Research Articles

Development of Digital Health Gender and Sexual Health Literacy scale

Abstract Introduction Health literacy, as the ability to obtain, process and understand health information, including gender and sexuality awareness, appears to be underdeveloped in terms of measurement tools and thematic materials. The literature indicates the existence of serious deficits in gender and sexual health literacy at all levels, with implications for relationships with citizens and patients. Methods Delphi study agreement was conducted and a pool of potential scale items was generated, reflecting a range of skills and abilities within each domain. Items were carefully worded to ensure clarity, cultural sensitivity and relevance to different gender identities and sexual orientations. Expert review and cognitive pre-testing were employed to refine item wording, assess content validity, and ensure that the 10-item scale was comprehensible and relevant to the target population. Results The theoretical development of the 10-item Digital Health Gender and Sexual Health Literacy Scale was successfully completed. The scale items were designed to provide a comprehensive measure of an individual’s ability to navigate the digital landscape for gender and sexual health information. Conclusions The theoretical validation of the Digital Health Gender and Sexual Health Literacy Scale (DiGeSHeL) provides the community with a promising tool to assess individuals’ confidence and ability to use digital technologies for sexual health information and resources. However, further research is needed to validate the scale and test its reliability with a diverse group of participants. Once validated, this scale could be a valuable tool for sexual health promotion programmes to identify gaps and evaluate the impact of digital literacy interventions. Key messages • Gender and sexual literacy are crucial for health. • Health literacy as six vital sign.

CARD-SARC: mixed-method study to develop a disease-specific health-related quality of life tool for cardiac sarcoidosis

Abstract Introduction Sarcoidosis is a rare inflammatory condition caused by the formation of lumps (granulomas) of abnormal tissue in any organ, and can affect physical, functional, mental, social and economic aspects of life. People living with cardiac sarcoidosis (CS) are likely to have worse clinical outcomes and greater impairment on health-related quality of life (HRQoL) than other sarcoidosis manifestations. HRQoL is the main concern for people living with sarcoidosis. However, measuring HRQoL in people with CS is difficult as existing tools focus on other forms of sarcoidosis (for example, lung, eye or skin involvement) or for specific cardiac symptoms (for example, atrial fibrillation, angina or heart failure), but not specifically for CS. Purpose To develop a disease-specific patient-reported outcome measure (CARD-SARC) to assess the impact of CS on HRQoL. Methods A sequential exploratory mixed-method, multicentre observational cohort study using a clinimetric approach was conducted. The McMaster Framework for evaluative instruments involved three steps (item selection, item scaling and item reduction) which were complemented with recommendations from the consensus-based standards for the selection of health measurement instruments (COSMIN). The item-generation process connected data from quantitative (theory, research findings and systematic review) and qualitative components (qualitative semistructured interviews, clinical observations and experts’ opinion). A simultaneous triangulation (QUAN+qual) method was followed to ensure a comprehensive list of preliminary items. The formatting of items was guided by patient and public involvement (PPI) with a 2-weeks recall period. The item reduction strategy was led by PPI and an international multidisciplinary clinical CS-experts. Results 740 potential items were generated by converging all the different sources and techniques. After removal of duplicates and simultaneous triangulation, a preliminary list with 111 items was reviewed by the CS-expert panel with 26 members (including 11 pulmonologists, 7 cardiologists, 5 CS-patients and 3 specialist-nurses). After a consensus meeting, the CARD-SARC included 61 relevant items in six sections for pilot-testing: "functioning", "social, leisure and occupation", "emotional", psychological", "physical" and "healthcare/self-care". Conclusions This study combined a robust methodology with active PPI engagement to develop the first disease-specific HRQoL tool for CS. Each data source was planned independently, however the input from PPI members was critical during the simultaneous triangulation for item-generation. The contributions of CS-experts (members of the PPI group and clinical multidisciplinary experts) enhanced the content validity of the CARD-SARC. The CARD-SARC has the potential to influence clinical management and treatment options, future research and health-economic stakeholders’ decisions for CS.

How to measure the general Environmental Health Literacy

Abstract Background Many environmental factors, both natural or man-made, are associated with health risks. To make informed decisions about these potential risks, certain skills and competencies are necessary. The concept of Environmental Health Literacy (EHL) which integrates aspects of Science Literacy, Health Literacy and Environmental Literacy encompasse these competencies. To assess to what extent individuals or groups are environmental health literate, a general Environmental Health Literacy Scale is necessary. To the best of our knowledge, there is no validated instrument to measure general EHL. Methods Two phases of scale construction were conducted: 1) Item development with deductive methods which includes a literature review and assessment of existing scales resulting in two suitable studies for scale construction. Included items were translated to German language. 2) Scale development with pre-testing of items followed by applying potential items (n = 38) to a sample of of 454 students. Internal consistency (Cronbach’s alpha), Kaiser-Meyer-Olkin Criterion (KMO), Bartlett’s test, Velicer’s minimum average partial (MAP) test for number of underlying factors and Exploratory Factor Analysis using Principal Component Analysis with oblimin rotation and stepwise item reduction were assessed. Results Velicer’s MAP identified 3 factors, Cronbach’s alpha = .92, KMO = .92, Bartlett’s Test revealed significant correlation. Seven items were removed from the scale due to low factor loadings (< .3). Factor 1 (access) explains 18% of variance, factor 2 (knowledge) 12% and factor 3 (reflection) 10%, respectively. Overall, the model explains 40% of variance. Model fit represented by RMSEA index = .05. Conclusions A new general EHL scale has been developed and proven to be suitable for a students sample. This marks the first step towards a validated tool for multiple purposes. Cultural adaptation as well as multiple language validations are in process. Key messages • The process towards a general Environmental Health Scale has started. • The development of a validated EHL scale will improve understanding on whether the general population or subgroups are able to gain, understand and act upon information regarding environmental health.

No evidence hunting bait increases American black bear population growth in Maine, USA

AbstractAmerican black bear (Ursus americanus) populations are increasing throughout much of North America. Use of multiple harvest methods, including hunting over bait, is intended to increase harvest success rates to meet harvest and population management objectives. However, black bear population growth can be influenced by food availability, and some speculate the use of bait may inadvertently increase bear abundance through food resource supplementation. We collected hair from black bears captured from 2005–2019 and a selection of potential food items, including those used as bait from 3 study areas in Maine, USA, with different levels of human influence. We used stable isotope analysis of the black bear hair and food item samples to evaluate the contribution of different identified food groups to the diet of individual bears. We found no evidence that greater contribution of human food resources, including bait, increased the number of cubs per litter for reproductive females or that human foods comprised a greater part of the diet in years when natural food resources were less abundant. Approximately 69% of black bear harvest occurred over bait. We found the probability of reproductive‐age females to be harvested increased with average representation of human foods with high carbon enrichment (including bait) in their diet, but the relationship was weak, likely because of sampling constraints. Additionally, the probability of being harvested was greater in years when natural food resources were scarce. We conclude that bait is not available on the landscape in large enough amounts or for a sufficient amount of time in Maine to substantially influence female reproduction. Our results indicate hunting over bait is an effective tool in a state that is attempting to maintain a stable bear population via harvest, and dispels conjecture that hunting over bait may increase cub production and offset the intention of harvest.

The brief scale of existential loneliness: scale development and psychometric evaluation

AbstractLoneliness is a common and distressing experience which has an existential dimension. Existential loneliness is understudied and a brief, valid measure which is grounded in experiences of the phenomenon and captures its distressing nature is needed. This study therefore developed the Brief Scale of Existential Loneliness. Scale items were developed based on a literature review and qualitative inquiry. Potential items were reviewed by academic experts, experts by experience, and potential participants for relevance and clarity. Scale structure was assessed through exploratory and confirmatory factor analysis with 714 participants (17–84 years old, M = 42.25, SD = 20.22) and reliability and validity were investigated. Tests of dimensionality revealed a 6-item unidimensional scale. The scale possesses high internal consistency and construct validity. Consistent with predictions, scale scores are negatively correlated with meaning in life and positively correlated with loneliness (broadly defined), poor mental health, emptiness, and related constructs. The Brief Scale of Existential Loneliness is a short, valid, and reliable measure of existential loneliness which may be usefully employed alongside measures of other loneliness dimensions.

Enhancing Precision in Predicting Magnitude of Differential Item Functioning: An M-DIF Pretrained Model Approach

Despite numerous studies on the magnitude of differential item functioning (DIF), different DIF detection methods often define effect sizes inconsistently and fail to adequately account for testing conditions. To address these limitations, this study introduces the unified M-DIF model, which defines the magnitude of DIF as the difference in item difficulty parameters between reference and focal groups. The M-DIF model can incorporate various DIF detection methods and test conditions to form a quantitative model. The pretrained approach was employed to leverage a sufficiently representative large sample as the training set and ensure the model’s generalizability. Once the pretrained model is constructed, it can be directly applied to new data. Specifically, a training dataset comprising 144 combinations of test conditions and 144,000 potential DIF items, each equipped with 29 statistical metrics, was used. We adopt the XGBoost method for modeling. Results show that, based on root mean square error (RMSE) and BIAS metrics, the M-DIF model outperforms the baseline model in both validation sets: under consistent and inconsistent test conditions. Across all 360 combinations of test conditions (144 consistent and 216 inconsistent with the training set), the M-DIF model demonstrates lower RMSE in 357 cases (99.2%), illustrating its robustness. Finally, we provided an empirical example to showcase the practical feasibility of implementing the M-DIF model.

COVID-19 research response to immediate demands: setting priorities with key stakeholders to enable health services research in NSW, Australia

PurposeCOVID-19 has caused unprecedented disruption to health systems. There is much to be gained by capturing what was learned from changes and adaptations made by health services and systems. The Ministry of Health in New South Wales (NSW), Australia, sought to prioritise health services research (HSR) to address critical issues arising from the COVID-19 pandemic. We tested a priority setting methodology to create priorities for a specific funding opportunity and to extract generalisable lessons.Design/methodology/approachA virtual roundtable meeting of key stakeholders was held in June 2020. We used a modified Nominal Group Technique (NGT) for priority setting, with potential items (n = 35) grouped under headings. Data was analysed through a reflective deliberative process.FindingsWe engaged 89 senior policy makers, health service executives, clinicians and researchers in the roundtable. The NGT proved an efficient method with participants reaching consensus on eight priorities. Findings included strong support for learning from the rapid response to COVID-19 and addressing needs of vulnerable populations and the health workforce. Opinions differed about strategic areas investment and where learnings should be via internal evaluation rather than funded research. Three of the eight recommended priorities were included in the funding opportunity.Research limitations/implicationsCoronavirus disease 2019 (COVID-19) required unprecedented change and adaptations within health systems, and rapid, applied health services research can help to create, understand and (where relevant) sustain change beyond the immediate impact of the pandemic. While final decisions may be dependent on a wider range of considerations by government, stakeholder enthusiasm for engagement in priority setting exercises may be dampened if they do not perceive their application in decision-making.Practical implicationsA modified nominal group technique can be used to set research priorities in constrained conditions by engaging large numbers of stakeholders in rankings and then using an online delivery of a roundtable and to reach consensus on priorities in real time. Recommended priorities for health services research can be readily generated through rapid engagement but does not guarantee their application.Social implicationsAustralia’s swift response to COVID-19 pandemic in 2020 was perceived as a relative success due to the rapid public health and policy response and a relatively low number of cases. This response was underpinned by systematic knowledge mobilisation including support for targeted and prioritised health services research to fill knowledge gaps.Originality/valueSetting priority processes can provide rich, engaged input to support government funding decisions about HSR. A wide range of dynamic and iterative processes influence decision-making in a rapidly evolving situation in the health system response to COVID-19. It is crucial to consider how major investment decisions will support a value-based healthcare system.

Development of a Hospice Perceptions Instrument for Diverse Patients and Families: Establishing Content and Face Validity.

For many, the perception of "hospice" is synonymous with "death." Even clinicians struggle to have conversations that distinguish between hospice and palliative care for fear that discussing hospice may diminish hope. To date, there are no existing measurement tools to evaluate patient and family perceptions of hospice care. This research aimed to develop a Hospice Perceptions Instrument (HPI) to capture these perceptions among diverse patients and families. Building on previous studies and literature, 79 potential items were drafted for the instrument. Our interprofessional team independently and collectively evaluated these, resulting in 36 items rated on a 5-point Likert scale. Overarching domains include (1) hospice philosophy and definitions; (2) hospice services; (3) values; and (4) counter-perceptions. Sixteen national subject matter experts from various professions and roles were invited to participate in the content-validity index and five hospice caregivers were invited to participate in face validity. Fourteen experts responded, with ten meeting inclusion criteria: one physician, four nurses, three social workers, and two chaplains. Six of the ten identified as Black. Three items were removed (I-CVI ranged from 0.5-06), and nine items were revised (I-CVI ranged from 0.6-07). The overall Content Validity Index (CVI) was 0.83, indicating excellent content validity. After revisions, five hospice caregivers assessed face validity and no changes were made based on feedback. Results reveal a disconnect between professional expertise and patient/family voices related to hospice perceptions. Development of this instrument invites a better understanding of perceptions leading to new opportunities for patient/family engagement.

A Reporting Checklist for Discrete Choice Experiments in Health: The DIRECT Checklist.

Reporting standards of discrete choice experiments (DCEs) in health have not kept pace with the growth of this method, with multiple reviews calling for better reporting to improve transparency, assessment of validity and translation. A key missing piece has been the absence of a reporting checklist that details minimum standards of what should be reported, as exists for many other methods used in health economics. This paper reports the development of a reporting checklist for DCEs in health, which involved a scoping review to identify potential items and a Delphi consensus study among 45 DCE experts internationally to select items and guide the wording and structure of the checklist. The Delphi study included a best-worst scaling study for prioritisation. The final checklist is presented along with guidance on how to apply it. This checklist can be used by authors to ensure that sufficient detail of a DCE's methods are reported, providing reviewers and readers with the information they need to assess the quality of the study for themselves. Embedding this reporting checklist into standard practice for health DCEs offers an opportunity to improve consistency of reporting standards, thereby enabling transparency of review and facilitating comparison of studies and their translation into policy and practice.

Brain fog assessment in patients recovered from COVID-19 in China: a development and validation study

Background Post coronavirus disease 2019 (COVID-19) pandemic, the widespread emergence and persistence of brain fog has led to a decline in people’s productivity and quality of life. However, the clinical characteristics of COVID-19-associated brain fog are unclear, and standardized assessments are lacking. This study aims to develop a scale for brain fog assessment and support clinical practice and research. Methods The 17-item Brain Fog Assessment (BFA) scale was developed using a standardized methodology, including literature review, focus group discussions (FGDs), expert evaluation, and psychometric validation. Eighteen potential items were generated following the literature review. These items were subsequently refined during FGDs, which included input from patients, caregivers, and multidisciplinary experts in neurology, cognitive neuroscience, and psychology. After thorough deliberation and expert evaluation, the item pool was finalized into a 17-item scale. We recruited 1,325 patients recovered from COVID-19 from Chinese communities. Psychometric properties were assessed by reliability and validity analysis. Results Exploratory factor analysis of the BFA scale revealed a three-factor mode comprising ‘cognitive decline’ (nine items), ‘confusion − disorientation’ (five items), and ‘fatigue’ (three items). The internal consistency of each factor was strong (Cronbach’s α: 0.82–0.92). Confirmatory factor analysis showed that the model fit, convergent validity, and discriminant validity of the scale were satisfactory. The test-retest reliability was strong (intraclass correlation coefficient = 0.84). Criterion-related validity analysis showed a strong correlation to the Wood Mental Fatigue Inventory (r = 0.70, p < 0.001). Individuals with a higher BFA score tended to score lower on the Montreal Cognitive Assessment (r = −0.23, p = 0.015). Conclusions We established a novel BFA scale to quantify multiple clinical aspects of COVID-19-associated brain fog. Using the BFA scale, fatigue and declining performance in memory, attention, and thought were identified as the main symptoms of COVID-19-associated brain fog. This scale has potential implications for disease monitoring and therapy development for individuals with COVID-19-associated brain fog.

Designing Patient-Reported Measures of Fertility: Cognitive Interview Findings from Adolescents and Young Adults with Cancer.

Purpose: Fertility concerns (FC) are central to the well-being of many adolescent and young adult (AYA) cancer survivors. Clinical conversations about FC and fertility preservation are suboptimal, increasing patient distress. The goal of this project was to establish content validity and comprehensibility of self-report questions on FCs for AYAs with cancer. Methods: Following best practices, we conducted: (1) item identification, refinement, and generation; (2) translatability and reading level review; and (3) cognitive interviews. Items were reviewed by five AYAs in each round of cognitive interviews. Results: A systematic search yielded 63 measures and 873 items. Fifty items were subsequently modified to enhance clarity and relevance, representing subdomains of psychological and social/relational FC. Flesch-Kincaid analysis found 31 items written above the 6th grade level, which were subsequently revised. Translatability review resulted in the modification of 3 items. During cognitive interviews, 76% of AYAs found items easy to answer with 52% describing them as "very easy" and 24% as "somewhat easy." Sixty percent of participants indicated the items captured their experiences. The majority of those who reported items only somewhat reflected or did not reflect their experiences suggested items were simply not applicable for their particular case. Conclusion: This study is a critical step toward the foundation for an FC measurement system that is reliable, flexible, developmentally appropriate, comprehensible, translatable, and interpretable. Subsequent steps include psychometric testing to examine the construct validity and reliability of the FC items and calibration to enable the application of computer-adaptive testing and short form development. The evaluation will include potential item response bias by age range, gender identity, and race/ethnicity.

The development of a disease-specific patient-reported outcome measure (CARD-SARC) to assess the impact of cardiac sarcoidosis on health-related quality of life

Abstract Introduction Sarcoidosis is a rare inflammatory condition caused by the formation of lumps (granulomas) of abnormal tissue in any organ, and can affect physical, functional, mental, social and economic aspects of life. People living with cardiac sarcoidosis (CS) are likely to have worse clinical outcomes and greater impairment on health-related quality of life (HRQoL) than other sarcoidosis manifestations. HRQoL is the main concern for people living with sarcoidosis. However, measuring HRQoL in people with CS is difficult as existing tools focus on other forms of sarcoidosis (for example, lung, eye or skin involvement) or for specific cardiac symptoms (for example, atrial fibrillation, angina or heart failure), but not specifically for CS. Purpose To develop a disease-specific patient-reported outcome measure (CARD-SARC) to assess the impact of CS on HRQoL. Methods A sequential exploratory mixed-method, multicentre observational cohort study using a clinimetric approach was conducted. The McMaster Framework for evaluative instruments was combined with the consensus-based standards for the selection of health measurement instruments (COSMIN) recommendations, involving three steps: item selection, item scaling and item reduction. The item-generation process used simultaneous triangulation (QUAN+qual) method, connecting quantitative data (theory, research findings and systematic review) with complementary qualitative components (interviews, clinical observations and experts’ opinion). The formatting of items was guided by patient and public involvement (PPI). The item reduction strategy was led by PPI and an international multidisciplinary clinical CS-experts. Results 740 potential items were generated by converging all the different sources and techniques. After removal of duplicates and simultaneous triangulation, a preliminary list with 111 items was reviewed by the CS-expert panel (including 11 pulmonologists, 7 cardiologists, 5 CS-patients and 3 specialist-nurses). After a consensus meeting, the CARD-SARC included 61 relevant items in six sections for pilot-testing: "functioning", "social, leisure and occupation", "emotional", psychological", "physical" and "healthcare/self-care". Conclusions This study used a robust methodology and active PPI involvement to develop the first disease-specific HRQoL tool for CS. The engagement and contributions of the PPI group in each step of the framework enhanced the content validity of the CARD-SARC. The CARD-SARC has the potential to influence clinical management and treatment options, future research and health-economic stakeholders’ decisions for CS.

The Knowledge, Attitudes, and Practices of Healthy Eating Questionnaire: a pilot validation study in Chinese families.

Identifying the knowledge, attitudes, and practices (KAP) gaps of healthy eating can inform the design of effective interventions. This study aimed to test the validity and psychometric properties of a KAP of Healthy Eating Questionnaire (KAP-HEQ) tailored to the Chinese culture. The dimensions and potential items of each KAP scale were identified from published KAP and health literacy questionnaires, which were supplemented by the findings of a previous qualitative healthy eating study. Content validity of the KAP-HEQ was evaluated by eight experts and eight Chinese parent-adolescent dyads in Hong Kong through content validity ratio (CVR), content validity index (CVI), and qualitative feedback. The feasibility, construct validity, reliability, and sensitivity of the KAP-HEQ were evaluated in this pilot study among 60 adolescent-parent dyads (120 persons) through an online survey. The first 30 dyads who completed the KAP-HEQ were invited to repeat the KAP-HEQ 2 weeks later to assess the test-retest reliability. The final 44-item KAP-HEQ was completed in 10-15 min by both adolescents and their adult parents. The CVR ranged from -0.38 to 1, and the CVI ranged from 0.56 to 1. Over 80% of the items achieved convergent validity (a significantly positive correlation with its hypothesized scale) and discriminant validity (a higher correlation with its hypothesized scale than with the other two scales). Cronbach's alpha for the internal consistency of the Overall, Attitude, and Practice scales was >0.7, while that of the Knowledge scale was 0.54. The intraclass correlation coefficient (ICC) on test-retest reliability of the Overall and individual scales were all >0.75 except that of the Knowledge scale (ICC = 0.58). The significant differences in KAP scale scores with small to large effect sizes were found between known groups as hypothesized, except the Attitude score between groups by household income, which supported the sensitivity of the KAP-HEQ. The KAP-HEQ has shown good validity, reliability, and sensitivity among Chinese adolescents and adults, which can be applied to evaluate KAP status and gaps to inform the design and assess the effectiveness of healthy eating interventions.

Proximity to non-crop vegetation increases estimates of predation frequency but not beetle numbers

Removal of non-crop vegetation (e.g., forest and grassland patches) to expand crop fields is detrimental to the natural enemies of crop pests, like the ground beetle family (Coleoptera: Carabidae), that use these areas for foraging and overwintering. An argument for maintaining non-crop vegetation is its potential to support the supply of ecosystem services, like pest control, to the surrounding crop. Pest control services from non-crop areas are usually measured using the activity-density of natural enemy species, a proxy measure for predatory activity. Evidence that predators such as ground beetles are attacking pests in crops has been less frequently studied. We distributed sentinel prey (fake ‘caterpillars’ made to look like potential prey items) along with pitfall traps at 300 stations using a spatially and temporally replicated design across 20 field sites in Alberta, Canada. The potential for pest attacks by carabids was estimated through bite marks on the sentinels. Using generalized additive modelling, we found that non-crop vegetation positively impacts carabid predation, but activity density of carabids does not explain the relationship. Instead, the non-crop vegetation affects predation frequency, likely by promoting predatory behaviours. These findings exemplify the importance of closer indicators of ecosystem services delivery than activity-density and provide evidence of the potential that ground beetles have in supplying pest control ecosystem services within agroecosystems.

Towards the Improvement of Patient Experience Evaluation Items for Patient-Centered Care in Head and Neck Cancer: A Qualitative Comparative Study.

Owing to long-term treatment, frequent consultations, and complications, the evaluation of patients with head and neck cancer (HNC) must be improved. This study explored an opportunity for improving patient experience (PE) evaluation of patients with HNC to achieve a patient-centered, integrative evaluation model based on patient needs. The study comprised four phases: (1) a systematic literature review of PE factors for patient quality of life (QoL) and establishment of PE factor categories as a framework, (2) a review of current cancer or HNC PE evaluation tools, (3) identification of potential PE evaluation items based on patient needs by conducting user research, and (4) suggestion of integrative HNC PE evaluation items through expert validation. As a result, the 39 potential items were initially identified from the literature review and user research. After conducting two survey rounds with experts, 25 items were suggested as HNC PE evaluation items. These underscore the importance of highlighting the patient's participation, the medical staff's comprehensive information delivery, empathy, and collaborative communication, the hospital's support of communication channels, the medical environment for patient emotional support, the education program, and systematic patient satisfaction data management. PE evaluation items that consider the diverse perspectives of stakeholders involved in HNC treatment and factors of comprehensive PE will contribute to improving HNC patient-centered care (PCC).

The Ottawa clinical fear of recurrence instruments: Ascreener, self-report, and clinical interview.

Clinical fear of cancer recurrence (FCR) was recently defined by a group of experts during a Delphi study. Five criteria were agreed upon, namely: (a) high levels of preoccupation, (b) high levels of worry, (c) that are persistent, (d) hypervigilance and hypersensitivity to physical sensations that e) may result in functional impairment. No existing instruments comprehensively capture all these criteria for clinical FCR. To remedy this gap, a set of three patient-reported outcome instruments including a one-item screener, self-report questionnaire, and semi-structured clinical interview, named the Ottawa Clinical Fear of Recurrence instruments, were developed. To do so, the research team first conducted a literature review of potential items. Additional FCR experts discussed the content of the screener and interview. The self-report's items were assessed for content validity by the same expert panel using Likert ratings and the Content Validity Index to narrow down the number of items. The three instruments were piloted with a group of cancer survivors to assess face validity following the European Organization for Research and Treatment of Cancer recommendations. The literature review and content validity assessment led to a final draft pre-pilot of 23 potential items for the self-report questionnaire. The instruments were piloted. Pilot study participants suggested changing wording and response options (particularly for the self-report) for greater clarity. Based on the feedback received, minor modifications were made, mostly for the self-report. In general, content and face validity for the three instruments were good for both experts and cancer survivors.

Response Surface Methodology (RSM) for Optimizing Protein Extraction from Housefly (Musca domestica) Larvae Fed with Toad and Its Structural Characterization.

With the global population on the rise, an escalating interest exists in environmentally sustainable and friendly protein sources. Insects have emerged as multifaceted resources, viewed not only as potential food items, but also as sources of traditional medicines and proteins. This study utilized response surface methodology (RSM) to ascertain the optimal extraction conditions for proteins from Musca domestica used in toad feeding, denoted as MDPs-T. The yield of MDPs-T was elevated to 18.3% ± 0.2% under these optimized conditions. Subsequently, the particle size, ζ-potentials, and structures of MDPs-T were analyzed and compared with the proteins derived from Musca domestica fed on a normal diet (MDPs-ND). This comparative analysis utilized a range of advanced techniques, involving UV spectroscopy, Fourier transform infrared spectroscopy (FT-IR), X-ray diffraction (XRD), high-performance gel permeation chromatography (HPGPC), and scanning electron microscopy (SEM). The outcomes have revealed a marginal disparity in the physical and chemical properties between MDPs-T and MDPs-ND. Derosination led to a reduction in the particle size of the MDPs by 10.98% to 62.81%. MDPs-T exhibited a higher proportion of low-molecular-weight components relative to MDPs-ND. Additionally, in a comparative analysis of amino acids, MDPs-T displayed a greater abundance of essential and total amino acids relative to MDPs-ND. Consequently, MDPs-T holds potential as a valuable food supplement for human consumption or as a nutrient-rich feed supplement for animals.

Exploring potential EQ-5D bolt-on dimensions with a qualitative approach: an interview study in Hong Kong SAR, China

PurposeThe introduction of bolt-on dimensions in EQ-5D instruments is growing common, but most bolt-on studies have targeted the diseased population and obtained bolt-on from other existing Health-related Quality of Life (HRQoL) instruments. As the qualitative approach offers important evidence to support the consistency and design of the potential bolt-on items, this paper studies the Hong Kong SAR community’s perception of the current EQ-5D-5 L instrument and identifies potential bolt-on via a qualitative approach.MethodsA representative sample mix was recruited based on the age group, gender, and education level composition of the Hong Kong SAR community by quota sampling. Semi-structured interviews were conducted and the interviews were transcribed and coded to identify emergent and recurrent themes.ResultsThirty interviews were conducted and the majority of the interviewees considered the EQ-5D-5 L insufficiently comprehensive to illustrate their HRQoL. While some key HRQoL aspects included in the EQ-5D matched with the community’s HRQoL perception, respondents showed concern about the potential overlap of the existing HRQoL dimension, the optimal number or attributes, and the appropriateness of the EQ-VAS. Among the potential bolt-on dimensions that emerged, ‘Sleep’, ‘Interpersonal Relationship’, and ‘Satisfaction’ were the key potential bolt-on dimensions identified and emphasized in the interviews.ConclusionsThe qualitative findings of the study illustrate the possible gap between EQ-5D-5 L measurements and community HRQoL perception, while the findings support the development of EQ-5D bolt-on dimensions in the target community with content and face validity.

Consolidated Health Economic Evaluation Reporting Standards for Interventions That Use Artificial Intelligence (CHEERS-AI)

ObjectivesEconomic evaluations (EEs) are commonly used by decision makers to understand the value of health interventions. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS 2022) provide reporting guidelines for EEs. Healthcare systems will increasingly see new interventions that use artificial intelligence (AI) to perform their function. We developed Consolidated Health Economic Evaluation Reporting Standards for Interventions that use AI (CHEERS-AI) to ensure EEs of AI-based health interventions are reported in a transparent and reproducible manner. MethodsPotential CHEERS-AI reporting items were informed by 2 published systematic literature reviews of EEs and a contemporary update. A Delphi study was conducted using 3 survey rounds to elicit multidisciplinary expert views on 26 potential items, through a 9-point Likert rating scale and qualitative comments. An online consensus meeting was held to finalize outstanding reporting items. A digital health patient group reviewed the final checklist from a patient perspective. ResultsA total of 58 participants responded to survey round 1, 42, and 31 of whom responded to rounds 2 and 3, respectively. Nine participants joined the consensus meeting. Ultimately, 38 reporting items were included in CHEERS-AI. They comprised the 28 original CHEERS 2022 items, plus 10 new AI-specific reporting items. Additionally, 8 of the original CHEERS 2022 items were elaborated on to ensure AI-specific nuance is reported. ConclusionsCHEERS-AI should be used when reporting an EE of an intervention that uses AI to perform its function. CHEERS-AI will help decision makers and reviewers to understand important AI-specific details of an intervention, and any implications for the EE methods used and cost-effectiveness conclusions.

Evaluation of the Posttraumatic Stress Disorder Checklist for DSM-5 across United States and India samples: An item response theory analysis using the graded response model.

The Posttraumatic Stress Disorder (PTSD) Checklist for DSM-5 (PCL-5) is frequently used to assess PTSD symptoms. Extending its psychometric investigations across distinct samples (United States and India), the aims of the present study included investigating the item characteristics, person fit, and differential item functioning (DIF) across the two samples. We (a) conducted item analysis using the graded response model to examine item characteristics (thresholds and discrimination parameters) and (b) examined person fit to determine participants' response patterns. The U.S. sample included 176 trauma-exposed individuals seeking mental health treatment, and the Indian sample included 148 trauma-exposed ex-military personnel. Results indicated low discrimination for Item 8 and low but acceptable discrimination for Item 17 for the U.S. and Indian samples, respectively. Across both samples, the most unused response categories were the middle-point or extreme (higher severity) categories (all response categories were better utilized in the Indian sample), and half the participants exhibited person misfit. Supplemental DIF analysis indicated that five items exhibited DIF indicating potential item bias; however, effect sizes for DIF were negligible. Although the PCL-5 demonstrated strong psychometric properties and showed promise for use across the samples differing on cultural and demographic characteristics, some of the items and the number of categories used to measure them could be revisited to create a more efficient instrument. (PsycInfo Database Record (c) 2024 APA, all rights reserved).