Predictive Validity Research Articles

Prospectively predicting violent and aggressive incidents in prison practice with the Risk Screener Violence (RS-V): Results from a multisite prison study.

Preventing in-prison violence and maintaining a safe environment is an important goal within prison settings. Screening for violence risk may provide a valuable addition to reach this goal. Within the Dutch prison system, the Risk Screener Violence (RS-V) has become an important new element in overall risk management. Prior research shows that RS-V scores are a sound predictor of institutional violence and aggression of incarcerated persons. Whereas previous studies predominantly analyzed retrospective file-based data, the present study includes RS-Vs rated by prison employees in real-life prison practice shortly after implementation. The RS-Vs of 956 detained individuals from 25 Dutch prisons were analyzed. Disciplinary reports were consulted to measure violent and aggressive incidents during 4 months after the screening. In addition, detention duration (length of stay in prison before the screening) was included as an additional variable. Results of the present prison practice study show good predictive values of the RS-V ratings for violent and aggressive incidents during prison stay. The predictive validity was similar for prisoner-to-prisoner assault as well as prisoner-to-staff assault. In addition, the predictive validity of the RS-V scores did not differ between individuals with a longer detention duration versus individuals with a shorter detention duration. This multisite prison practice study is an important step in the further validation of the RS-V and shows that the RS-V is a valuable tool in determining who is more likely to show institutional violence. Nonetheless, it remains important to continually monitor the implementation and correct application of the RS-V in prison practice. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Proenkephalin improves risk prediction in acute coronary syndromes: derivation and external validation of the KID-ACS risk score

Abstract Background Early assessment of renal and mortality risk in patients with acute coronary syndromes (ACS) is essential to guide treatment decisions according to international guidelines. Circulating proenkephalin (PENK) is a stable opioid metabolite with fast response to changes in kidney function. Purpose This study examined the predictive value of PENK for acute kidney injury (AKI) and mortality in patients presenting with acute coronary syndromes (ACS). Methods Plasma PENK levels were measured using a validated sandwich immunoassay in a prospective multicentre ACS cohort from Switzerland (n = 4 787) and in validation cohorts from the UK (n = 1 141) and Czechia (n = 920). A biomarker-enhanced risk score for simultaneous prediction of both in-hospital acute kidney injury (AKI) and 30-day death (KID-ACS score) with model coefficients adjusted to the outcome was derived and externally validated. In the development of the in-hospital AKI model, patients from one participating study centre were reserved for external validation (Swiss validation cohort). Results Circulating PENK ranked among the top predictors of renal outcomes and mortality in patients with ACS. Accounting for established risk factors and risk models, circulating PENK levels at presentation were independently associated with in-hospital AKI (per log2 increase: adjusted odds ratio [OR] 1.56, 95% CI 1.14 – 2.12, P = 0.005) and with 30-day mortality (per log2 increase: adjusted OR 2.69, 95% CI 1.89 – 3.84, P < 0.001). Dynamic changes in PENK levels within the first 12-24 hours after presentation were strongly and independently associated with in-hospital AKI (increase vs. decrease: adjusted OR 2.83, 95% CI 1.98 – 4.05, P < 0.001). The simple 6-item KID-ACS risk score for in-hospital AKI and 30-day mortality integrates PENK levels at presentation and showed an AUC of 0.72 (95% CI 0.68 – 0.76) for in-hospital AKI, and of 0.91 (95% CI 0.87 – 0.95) for 30-day mortality in the derivation cohort. Upon external validation, KID-ACS had similarly high performance for in-hospital AKI (Swiss validation cohort: AUC 0.73, 95% CI 0.70 – 0.77; Czech validation cohort: 0.74, 95% CI 0.68 – 0.80) and 30-day mortality (UK validation cohort: AUC of 0.87, 95% CI 0.82 – 0.91; Czech validation cohort: 0.91, 95% CI 0.87 – 0.94). The simple 6-item KID-ACS score was non-inferior to established risk models and significantly outperformed the CA-AKI risk score in predicting in-hospital AKI (Zurich cohort: delta AUC 0.11, 95% CI 0.07 – 0.15, P = 0.001) and the GRACE 2.0 in predicting 30-day mortality (UK cohort: delta AUC 0.05, 95% CI 0.01 – 0.09, P = 0.027). Conclusions Circulating PENK was identified as independent predictor of in-hospital AKI and 30-day mortality in patients with ACS. The simple 6-item KID-ACS risk score integrates circulating PENK levels and provides a novel tool for simultaneous assessment of renal and mortality risk in patients presenting with ACS.Independent Predictive Value PENKPerformance and validation of KID-ACS

Frailty and MECKI score in predicting mortality in advanced heart failure

Abstract Background Physical frailty (PF), characterized by decreased physiological reserves and increased vulnerability to stressors, has emerged as a significant predictor of adverse outcomes in heart failure (HF). The MECKI (Metabolic Exercise Cardiac Kidney Index) score, a composite index derived from cardiopulmonary exercise testing parameters and renal function, has shown promise in predicting outcomes in HF patients. Purpose The aim of the study is to evaluate the independent prognostic role of the MECKI score and PF on mortality in patients with advanced heart failure (AHF). Methods Ninety-one patients with AHF were enrolled, including 42 on the heart transplant waiting list, 10 undergoing evaluation for listing, and 49 removed from the list due to transplant contraindications or reaching age limits. All patients included in the study were on medically optimized therapy. MECKI score assessment was conducted upon enrollment, along with hematological and biochemical evaluations including creatinine, hemoglobin, Na+, and NT-pro-BNP levels. Patients also underwent echocardiography assessing ejection fraction (EF), TAPSE, Inferior Vena Cava (IVC) diameters, and PASP. Additionally, all patients performed the 6-minute walk test (6MWT) and cardiopulmonary exercise testing with assessment of VO2max and VE/VCO2. Frailty was assessed based on modified Fried criteria. Results The mean age was 56.5±11.2 years. Mean NYHA class was 2.7±0.6, EF was 28.8±7.6, TAPSE was 17.5±4.2, and NT-proBNP was 2912.2±3249.0. Mean VO2max was 12.0±3.5 ml/kg/min, and mean distance walked during 6MWT was 278.8±137.2 meters. Mean frailty score was 3.2±1.2 while mean MECKI score was 15.2±14,2. During a mean follow-up of 32.0±15.3 months, there were 21 deaths, 15 patients received heart transplants, and 1 patient underwent LVAD implantation. Stratified data for mortality showed statistically significant differences in deceased patients compared to survivors regarding NYHA class (3.2±0.3 vs 2.6±0.7; p<0.001), Frailty Index (4.4±0.7 vs 2.7±1.13; p<0.001), NT-proBNP (5425.0±2863.0 vs 1731.0±1618.0; p<0.001), VE/VCO2 (42.7±12.3 vs 35.0±9.1; p<0.003), and MECKI score (29.4±15.2 vs 11.2±11.2; p<0.001). Linear regression analysis demonstrated a significant positive correlation for Frailty Index and MECKI score with age, NYHA class, VE/VCO2, IVC, and NT-proBNP, while showing a negative correlation with TAPSE, VO2max, and 6-minute walk test. Cox regression analysis on mortality demonstrated the predictive role of Frailty (HR=2.121; 95%CI=1.017-4.421; p=0.045) and MECKI score (HR=1.043; 95%CI=1.009-1.079; p=0.014) independently from age, sex, NYHA class, NT-proBNP, EF, TAPSE, VO2max, 6MWT, and IVC diameter. ROC curves demonstrated an AUC of 0.896 for MECKI score and mortality, and 0.884 for Frailty Index and mortality. Conclusions The MECKI score and physical frailty are both valid independent predictors of mortality in patients with advanced heart failure.

Development and validation of the Behavioral Determinants of Deprescribing Questionnaire (BDDQ)

Abstract Background Deprescribing is a strategy to optimize medication use. While health behaviour can successfully be predicted by health behavior theories, the literature on deprescribing relies almost exclusively on questionnaires that measure attitudes only, such as the Beliefs about Medicines Questionnaire and the Patients Attitudes Towards Deprescribing, resulting in poor predictive validity. The aim of this study was to develop a new tool to measure the psychological determinants of deprescribing among people aged over 60, based on concepts derived from health behaviour theories. Methods A draft self-report questionnaire was developed consisting of 64 questions measuring 11 dimensions representing determinants of deprescribing. As well as previous deprescribing experience, current deprescribing behaviour and willingness to deprescribe. Face validity was assessed by asking 10 health professionals and 13 of older people to complete the questionnaire and comment in a small group discussion, resulting in the removal of 18 items. Construct validity was assessed on a sample of 103 participants aged over 60, using exploratory factor analysis (EFA). Internal consistency was assessed via Cronbach’s alpha. Results The EFA could confirm 11 dimensions explaining 70,5% of the total variance, but revealed poor loadings for several items and inadequate alphas (<.50) for two factors. Removal of items and these two dimensions resulted in 26 items measuring 9 dimensions, all showing acceptable internal consistencies (between .52 and .77): perceived risk; relatives’ involvement; deprescribing concerns; attitudes; medication beliefs; healthcare support; perceived difficulties; motivation to comply; communication accessibility. Conclusions This study produced a conceptually based and psychometrically validated questionnaire to assess behavioural determinants of deprescribing. It provides for a more comprehensive investigation of deprescribing intentions and behaviour of older adults. Key messages • A conceptually sound, psychometrically validated questionnaire (BDDQ) was developed. • BDDQ can be used for a more comprehensive study of de-prescribing in older people.

Cross-species translational paradigms for assessing positive valence system as defined by the RDoC matrix.

Functions associated with processing reward-related information are fundamental drivers of motivation, learning, and goal-directed behavior. Such functions have been classified as the positive valence system under the Research Domain and Criteria (RDoC) criteria and are negatively impacted across a range of psychiatric disorders and mental illnesses. The positive valence system is composed of three comprehensive categories containing related but dissociable functions that are organized into either Reward Responsiveness, Reward Learning, or Reward Valuation. The presence of overlapping behavioral dysfunction across diagnostic mental disorders is in-part what motivated the RDoC initiative, which emphasized that the study of mental illness focus on investigating relevant behavior and cognitive functions and their underlying mechanisms, rather than separating efforts on diagnostic categories (i.e., transdiagnostic). Moreover, the RDoC approach is well-suited for preclinical neuroscience research, as the rise in genetic toolboxes and associated neurotechnologies enables researchers to probe specific cellular targets with high specificity. Thus, there is an opportunity to dissect whether behaviors and cognitive functions are supported by shared or distinct neural mechanisms. For preclinical research to effectively inform our understandings of human behavior however, the cognitive and behavioral paradigms should have predictive, neurobiological, and pharmacological predictive validity to the human test. Touchscreen-based testing systems provide a further advantage for this endeavor enabling tasks to be presented to animals using the same media and task design as in humans. Here, we outline the primary categories of the positive valence system and review the work that has been done cross-species to investigate the neurobiology and neurochemistry underlying reward-related functioning. Additionally, we provide clinical tasks outlined by RDoC, along with validity and/or need for further validation for analogous rodent paradigms with a focus on implementing the touchscreen-based cognitive testing systems.

Supplemental Material for Comparing Predictive Validity of Youth Level of Service/Case Management Inventory Scores in Indigenous and Non-Indigenous Canadian Youth

Supplemental Material for Comparing Predictive Validity of Youth Level of Service/Case Management Inventory Scores in Indigenous and Non-Indigenous Canadian Youth

Factor structure and validation of the electronic form of the Oxford Happiness Questionnaire in patients with COVID-19

Background and Objectives: Background and Aim: Validity Scale Validation can help identify coronavirus disease patients; therefore, the aim of this study was to evaluate the validation of the electronic form of the Oxford Happiness Questionnaire in patients with COVID-19. Methods: This study is instrumental psychometrics that the statistical population includes all patients in 19 cases in Tehran. The number of samples was determined based on psychometric criteria to be 100 for the predictive validity section and 251 for the convergence validity section. Samples were selected by cluster sampling. Research data were collected electronically through two questionnaires of happiness (Oxford) and happiness of positive psychological characteristics by sending the questionnaire link to the participants' mobile phones. To evaluate the validity of the scale, content validity, convergence, and factor analysis methods were used. The reliability of the scale was assessed by internal consistency methods and class reliability. Results: The results of exploratory factor analysis showed that the researcher-made questionnaire consists of three factors and has good validity and reliability. The second-order confirmatory factor analysis also confirmed the three-factor model. This questionnaire was administered along with the short form of the Oxford Happiness Scale, which had 13 items of good reliability and validity. Conclusion: The Oxford Happiness Scale in COVID-19 patients can be used to assess happiness in COVID-19 patients.

CACNA1A haploinsufficiency leads to reduced synaptic function and increased intrinsic excitability.

Haploinsufficiency of the CACNA1A gene, encoding the pore-forming α1 subunit of P/Q-type voltage-gated calcium channels, is associated with a clinically variable phenotype ranging from cerebellar ataxia, to neurodevelopmental syndromes with epilepsy and intellectual disability. To understand the pathological mechanisms of CACNA1A loss-of-function variants, we characterized a human neuronal model for CACNA1A haploinsufficiency, by differentiating isogenic induced pluripotent stem cell lines into glutamatergic neurons, and investigated the effect of CACNA1A haploinsufficiency on mature neuronal networks through a combination of electrophysiology, gene expression analysis, and in silico modeling. We observed an altered network synchronization in CACNA1A+/- networks alongside synaptic deficits, notably marked by an augmented contribution of GluA2-lacking AMPA receptors. Intriguingly, these synaptic perturbations coexisted with increased non-synaptically driven activity, as characterized by inhibition of NMDA and AMPA receptors on micro-electrode arrays. Single-cell electrophysiology and gene expression analysis corroborated this increased intrinsic excitability through reduced potassium channel function and expression. Moreover, we observed partial mitigation of the CACNA1A+/- network phenotype by 4-aminopyridine, a therapeutic intervention for episodic ataxia type 2. Positive modulation of KCa2 channels could reverse the CACNA1A+/- network electrophysiological phenotype. In summary, our study pioneers the characterization of a human induced pluripotent stem cell-derived neuronal model for CACNA1A haploinsufficiency, and has unveiled novel mechanistic insights. Beyond showcasing synaptic deficits, this neuronal model exhibited increased intrinsic excitability mediated by diminished potassium channel function, underscoring its potential as a therapeutic discovery platform with predictive validity.

Development and validation of a measure for father involvement during early childhood in a resource-limited context

BackgroundGlobally, there is mounting evidence about the importance of father involvement for improving child and family wellbeing. However, there are limited measurement tools available for assessing father involvement in low-resource settings globally. The objective of this study was to develop and validate a scale for measuring fathers’ engagement in caregiving activities for young children and families in rural Kenya.MethodsWe used baseline data collected in February–March 2023 from a cluster-randomized controlled trial of a parenting intervention aimed at improving early child development in Nyamira and Vihiga counties in Western Kenya. The analytic sample comprised 460 primary caregivers of children under 18 months of age (91.3% mothers) who were in a relationship with a male caregiver of the young child (i.e., father). The primary caregiver reported on the 25-item father involvement scale. We conducted exploratory and confirmatory factor analyses to determine the dimensionality of the measure and estimated latent variable regression models to assess construct and predictive validity in terms of associations with sociodemographic factors, other paternal and maternal psychosocial measures, and early child development outcomes.ResultsThe scale had a four-factor structure representing father involvement in (1) childcare activities, (2) play and affection, (3) household chores, and (4) early learning activities. Each factor showed good internal consistency reliability and evidence of multiple forms of validity. The four factors were associated with child and household sociodemographic characteristics and more positive paternal and maternal psychosocial outcomes. Father involvement across all four domains was associated with higher early child cognitive, language, motor, and socioemotional development scores.ConclusionsOur findings highlight the multidimensional nature of fathers’ caregiving roles in the lives of young children and their families. We establish a valid tool for assessing father involvement in rural Western Kenya that has potential for use in other similar contexts.

A Demand-Driven Analysis of the Determinants of P2P Accommodation hosts’ Business Performance: Scale Development and Validation

ABSTRACT Hosts of peer-to-peer (P2P) accommodations often struggle to accurately assess guests’ perceptions of their performance due to the lack of valid measurement scales. This study aims to address this gap by developing and validating a 20-item scale to measure P2P hosts’ business performance as perceived by their guests. The scale encompasses five domains: living environment, authenticity, platform incentives, guests’ civility, and amenity quality. This study also examines the predictive validity of these dimensions by assessing their effects on customer satisfaction, which varies by traveling party. By enhancing the understanding of P2P accommodation performance measurement and extending cue utilization theory, this study provides valuable insights for future research on hospitality business performance and effective performance evaluation in the P2P accommodation sector.

Understanding How Coming Out Goes Well for Sexual and Gender Minorities

ABSTRACT Coming out is often seen as a positive event that bolsters well-being for sexual and gender minorities (SGMs). However, the relationship between coming out and well-being is more complex among SGMs. We set out to evaluate the reliability and validity of two recent scales related to coming out: the Coming Out Vigilance and Positive Coming Out Responses scales. Using a sample of 437 SGMs and supporting previous work, we found evidence supporting the reliability and convergent, divergent, predictive, and incremental validity of both scales. Both scales evidenced substantial relationships with well-being, with the Coming Out Vigilance scale being related to all facets of well-being except relationships, and the Positive Coming Out Responses scale being related to all facets of well-being. Most importantly, we found that the scales accounted for variation in well-being above and beyond that accounted for by LGBTQ+ Hypervigilance and Parental Acceptance, respectively. Finally, we did not find evidence that the Coming Out Vigilance scale moderated the relationship between outness and well-being, nor did we find evidence that the Positive Coming Out Responses scale mediated the relationship between outness and well-being.

Supplemental Material for A Worldwide Test of the Predictive Validity of Ideal Partner Preference Matching

Supplemental Material for A Worldwide Test of the Predictive Validity of Ideal Partner Preference Matching

Validation of an Actuarial Instrument to Predict Repeat Family Violence for Frontline Police: Calibration, Discrimination and Classification Performance of the VP-SAFvR

Abstract Purpose Police are increasingly tasked with identifying, responding to, and preventing intimate partner and family violence (IPFV). Several police organisations have adopted validated risk assessment instruments to assist frontline police officers to assess and manage the risk of future IPFV. This paper reports a population-based evaluation of the predictive and discriminative validity of an actuarial risk assessment instrument, the Victoria Police Screening Assessment for Family Violence Risk (VP-SAFvR), used by frontline police officers in Victoria, Australia. Methods The entire population (n = 38,454) of family violence reports (FVRs) where police used the VP-SAFvR between 1 September 2019 and 31 March 2020 were tracked for 365 days to ascertain whether the VP-SAFvR was able to predict subsequent family violence and discriminate between cases with and without subsequent family violence. Calibration and survival analysis was performed on the instrument. Results Approximately 33% of the sample was involved in subsequent IPFV over the 12 month outcome period. In line with the development (McEwan et al., 2019) and validation (Spivak et al., 2020) studies of the same instrument, the results show the VP-SAFvR continues to provide adequate consistent discriminative and predictive performance across time. The AUC for repeat IPFV was 0.65, with the recommended threshold score of 4 (or above) identifying 75% of individuals involved in repeat family violence and correctly screening out approximately 50% of non-repeat cases. Conclusions The paper extends the previous research on VP-SAFvR by providing some indication that the tool is well-calibrated. Incidence curves show the largest increase in repeat family violence among those scoring above threshold occurs in the first 90 days post index. The implications and limitations of the study are discussed.

Immune regulation and prognostic prediction model establishment and validation of PSMB6 in lung adenocarcinoma

Lung cancer is one of the most common malignant tumors, and patients are often diagnosed at an advanced stage, posing a substantial risk to human health, so it is crucial to establish a model to forecast the prognosis of patients with lung cancer. Recent research has indicated that proteasome 20S subunit 6 (PSMB6) may be closely associated with anti-apoptotic pathways, and proliferation transduction signals in tumor cells of different tumors. However, the precise role of PSMB6 in the immunoregulatory processes within lung adenocarcinoma (LUAD) is yet to be elucidated. By analyzing the TCGA database, we discovered a positive correlation between the expression of PSMB6 and tumor growth trends, and lung adenocarcinoma patients with elevated PSMB6 expression levels had a worse prognosis. Our findings suggest a close correlation between PSMB6 expression levels, immune cell infiltration and immune checkpoint gene expression, which suggests that PSMB6 may become a new independent prognostic indicator. In addition, we developed a prognostic model of PSMB6-regulated immune infiltration-associated genes by analyzing the link between PSMB6 and the immune microenvironment. This model can not only predict the prognosis of lung adenocarcinoma but also forecasts the patient’s reaction to immunotherapy. The validity of this research outcome has been confirmed by the GSE31210 and IMvigor210 cohorts. Analysis of the Kaplan-Meier Plotter database indicates that individuals with elevated levels of PSMB6 expression exhibit a poorer prognosis. Additionally, in vitro experiments demonstrated that knockdown of PSMB6 inhibits the proliferation, migration, and invasion of lung adenocarcinoma cells while promoting their apoptosis. Overall, our findings suggest that PSMB6 could remarkably influence the management and treatment of lung adenocarcinoma, opening new avenues for targeted immunotherapeutic strategies.

15 Predictive validity of two developmental screening tools at the 18-month visit and neurodevelopmental consultation at an average age of 8 years

Abstract Background The Canadian Paediatric Society (CPS) recommends an enhanced 18-month well-baby visit incorporating a developmental screening tool to stimulate discussion with parents, and notes that a widely used tool is the Nipissing District Developmental Screen (NDDS). For early detection of autism spectrum disorder, the CPS notes that a commonly used screening tool is the Infant Toddler Checklist (ITC). Objectives To examine the predictive validity of the ITC and NDDS at the 18-month visit using later neurodevelopmental consultation as the criterion measure; and examine whether positive developmental screening was associated with health care utilization (HCU). Design/Methods Using a prospective design, parents completed the ITC and the NDDS at the 18-month visit in primary care practices. Seven types of HCU were collected from health administrative databases, via linkage using the child’s health insurance number, including: neurodevelopmental consultation, special paediatric consultation, scheduled primary care visit billings, unscheduled primary care or minor visit billings, other non-primary care visit billings, hospitalizations, and emergency department visits. Covariates included child and family characteristics. We calculated screening test properties (using neurodevelopmental consultation as the criterion) and used multivariable negative binomial regression to estimate rate ratios (RR) for each of the 7 types of HCU. Results For both the ITC (n=1460) and NDDS (n=802) cohorts, mean age at screening was 18 months and mean age at follow up was 8 years. Of the ITC cohort, 11% were screen positive, 2.6% had a neurodevelopmental consultation. A positive ITC had 40% sensitivity (95% CI 24%-57%), 90% specificity (95% CI 88%-91%), 10% false positive rate (95% CI 9%-12%). A positive ITC was associated with 6 of 7 types of HCU, including neurodevelopmental consultation (RR=2.78, 95% CI 1.37-5.67). Of the NDDS cohort, 36% were screen positive, 2.5% had a neurodevelopmental consultation. A positive NDDS had a sensitivity of 50% (95% CI 27%-73%), specificity of 65% (95% CI 61%-68%), false positive rate of 35% (95% CI 31%-40%). A positive NDDS was associated with only 1 of 7 types of HCU: unscheduled primary care or minor visit billings 1.24 (95% CI 1.01, 1.53, p=0.04). Conclusion The predictive validity of the ITC was stronger than the NDDS due to high specificity and low false positive rates. The low sensitivity of the ITC is similar to other screening tools used at 18 months, highlighting the importance of ongoing developmental surveillance. The false positive rate of the NDDS is unacceptably high for a screening tool.

Days at Home After Traumatic Brain Injury: Moving Beyond Mortality to Evaluate Patient-Centered Outcomes Using Population Health Data.

Administrative data are invaluable for assessing outcomes at the population level. However, there are few validated patient-centered outcome measures that capture morbidity following traumatic brain injury (TBI) using these data. We sought to characterize and validate days at home (DAH) as a measure to quantify population-level outcomes after moderate to severe TBI. We additionally assessed the earliest feasible outcome assessment period for patients with TBI using this outcome measure. This multicenter retrospective cohort study used linked health administrative data sources to identify adults with moderate to severe TBI presenting to trauma centers in Ontario, Canada, between 2009 and 2021. DAH at 180 days (DAH180 days) reflects the total number of days spent alive and at home excluding the days spent institutionalized across care settings. Construct validity was determined using hierarchical quantile regression to assess the associations between clinical and injury covariates with DAH180 days. Predictive validity was assessed using Spearman rank correlation. We estimated minimally important difference (MID) in DAH180 days to aid with outcome measure interpretability. There were 6,340 patients who met inclusion criteria. Median DAH180 days was 70 days (interquartile range 0-144). Mortality occurred in 2,162 (34.1%) patients within 90 days following injury. Patients in the lower DAH180 days group were more commonly older (absolute standardized difference [ASD] = 0.68) with higher preinjury health resource utilization (ASD = 0.36) and greater injury severity (ASD = 0.81). Increased baseline health resource utilization (-10.1 days, 95% CI -17.4 to -2.8, p = 0.0041), older age (-4.6 days, 95% CI -5.7 to -3.4, p < 0.001), higher cranial injury severity (-84.6 days, 95% CI -98.3 to -71.0, p < 0.001), and major extracranial injuries (-14.2 days, 95% CI -19.5 to -8.93, p < 0.001) were significantly associated with fewer DAH180 days. DAH180 days was positively correlated with DAH at up to 3 years (r = 0.91, 95% CI 0.90-0.92) and negatively correlated with direct health care expenditure (rs = -0.89, 95% CI -0.88 to -0.90). The average MID estimated from anchor-based and distribution-based methods was 18 days. We validate DAH180 days as a potentially useful outcome measure with construct, predictive, and face validity in a population with moderate to severe TBI. Given the intensity of acute care requirements for patients with TBI, our work highlights DAH180 days as a feasible and sufficiently responsive outcome measure.

Statistical monitoring applied to data science in classification: continuous validation in predictive models

PurposeThis study aims to analyze the performance of quality indices to continuously validate a predictive model focused on the control chart classification.Design/methodology/approachThe research method used analytical statistical methods to propose a classification model. The project science research concepts were integrated with the statistical process monitoring (SPM) concepts using the modeling methods applied in the data science (DS) area. For the integration development, SPM Phases I and II were associated, generating models with a structured data analysis process, creating a continuous validation approach.FindingsValidation was performed by simulation and analytical techniques applied to the Cohen’s Kappa index, supported by voluntary comparisons in the Matthews correlation coefficient (MCC) and the Youden index, generating prescriptive criteria for the classification. Kappa-based control charts performed well for m = 5 sample amounts and n = 500 sizes when Pe is less than 0.8. The simulations also showed that Kappa control requires fewer samples than the other indices studied.Originality/valueThe main contributions of this study to both theory and practitioners is summarized as follows: (1) it proposes DS and SPM integration; (2) it develops a tool for continuous predictive classification models validation; (3) it compares different indices for model quality, indicating their advantages and disadvantages; (4) it defines sampling criteria and procedure for SPM application considering the technique’s Phases I and II and (5) the validated approach serves as a basis for various analyses, enabling an objective comparison among all alternative designs.

Predicting language, cognition, and social skills in individuals with Autism spectrum disorder using the Arabic validation of Gilliam Autism Rating scale-Third Edition

The Gilliam Autism Rating Scale-Third Edition (GARS-3) has emerged as a pivotal instrument in the diagnostic assessment of Autism Spectrum Disorder (ASD), with its utility extending across linguistic and cultural boundaries. This study endeavors to adapt and validate the GARS-3 for the Arabic-speaking population, addressing the paucity of culturally congruent diagnostic tools in the Arab world. The primary objective is to validate the Arabic version of GARS-3 (A-GARS-3) to assess children with and without ASD, ensuring the scale’s reliability and validity within the target population. A methodical cross-sectional study design was employed, encompassing a sample of 178 participants from both educational and clinical settings in Saudi Arabia. The process involved direct translation, expert panel review, back-translation, and pilot testing to ensure semantic equivalence and cultural relevance. Data were collected using the A-GARS-3, and analyses included Exploratory and Confirmatory Factor Analysis (EFA and CFA), internal consistency reliability measures, and a One-Way Analysis of Variance (ANOVA) to establish concurrent validity. The A-GARS-3 demonstrated high internal consistency (Cronbach’s alpha = 0.971; McDonald’s omega = 0.972) and strong construct validity, with factor loadings and model fit indices substantiating the factor structure. Predictive validity was confirmed through significant correlations between the Autism Index and the subscales, particularly in the domains of social interaction and communication. The A-GARS-3 is a psychometrically sound instrument that offers reliable assessment for ASD within the Arab cultural context. The positive validation outcomes indicate that the scale is an effective, culturally adapted tool for the localized diagnosis of ASD. The validated scale has significant implications for enhancing ASD screening and diagnostic practices in Arabic-speaking regions, potentially improving early diagnosis and intervention strategies.

Costs and benefits of item reduction: The abridgment of the Emotion Regulation Questionnaire (ERQ)

Shortening existing instruments is a highly required procedure, as short scales may have several advantages over the long versions, especially in time and/or resources restrictions. However, abbreviated forms may be weaker than their parent versions from both content coverage and psychometric robustness. Also, the abridgment of instruments is often lacking in methodological strictness, and the potential drawbacks of the shortened scales are rarely reported. The current study aims to describe the whole process of scale shortening, emphasizing the potential costs and benefits, in terms of balance between time-resource savings and loss of validity and reliability. We shortened the Emotion Regulation Questionnaire (ERQ), involving a sample of 459 participants (53.2% males). Item reduction was driven by searching to preserve the content breadth of the construct and scale's psychometric quality. Our results supported the two-factor structure of the measure (Cognitive Reappraisal and Expressive Suppression), χ2(8) = 11.357 ns, CFI = 0.995, TLI = 0.990, RMSEA = 0.030 (0.000–0.067), SRMR = 0.031, and three items were selected for each subscale. The two intended factors showed good levels of reliability (α > 0.710). A latent variable model was performed to evaluate how the original ERQ and our proposed short version (ERQS) were related to depression, anxiety, and stress: A similar pattern of associations was found, with Cognitive Reappraisal (negatively) and Expressive Suppression (positively) reporting significant but weak associations. The ERQ-S can be beneficial over the original version, as it effectively assesses the two emotion regulation strategies with a trivial loss in reliability and predictive validity.

Utility of the Vestibular/Ocular Motor Screening in Military Medicine: A Systematic Review.

The Vestibular/Ocular Motor Screening (VOMS) was created as a brief clinical screening tool for identifying vestibular and ocular motor symptoms and impairments post-concussion. It was found to have predictive validity in correctly identifying concussed athletes from healthy controls. In 2018, the Military Acute Concussion Evaluation 2 (MACE2) replaced the original Military Acute Concussion Evaluation (MACE); the most prominent change between the MACE and MACE2 was the addition of the VOMS. Despite its adoption into military medicine, it is not known if the addition of the VOMS to the MACE2 is acutely helpful, and if it provides additional information for diagnosis, prognosis, and/or management. The purposes of this systematic review were: (1) to determine the utility of the VOMS in correctly identifying concussed individuals, particularly as it pertains to military medicine; (2) to explore the extent to which the VOMS can inform concussion prognosis; and (3) to establish the value of the VOMS as a measure for monitoring the evolution of symptoms throughout a service member's course of care. A comprehensive search of PubMed was performed from January 1, 2014 through August 16, 2023. Articles were included if they researched concussion or a related health condition or healthy controls and administered the VOMS. Articles were excluded if they discussed health conditions other than concussion; did not administer the VOMS; or were written in languages other than English. The tools used to assess methodological quality and risk of bias varied according to study design. Articles were classified into three primary domains: diagnosis, prognosis, and/or rehabilitation/recovery over time. A total of 231 articles were retrieved and 3 were duplicates, leaving 228 articles for review. Of the 228 articles screened, 100 relevant full-text articles were assessed for eligibility. Fifty-nine articles met our inclusion and exclusion criteria while the other 41 articles were rejected. Thirty-two articles helped to inform diagnosis, 15 prognosis, and 16 rehabilitation/recovery over time. The VOMS had excellent internal consistency and moderate to good test-retest reliability; however, a false-positive rate of 21.9% was found. Most studies indicated that a positive VOMS was associated with a delayed recovery. Several studies indicated that VOMS scores improved with targeted, active interventions and/or a symptom-guided progressive return to activity. The greatest limitation was the paucity of published evidence in the military population. More research is needed on the use of the VOMS in service members.