Scale Format Research Articles

Psychometric evaluation of the Signs of Depression Scale with a revised scoring mechanism in stroke patients with communicative impairment

Objectives: To investigate (1) the diagnostic value of the Signs of Depression Scale (SODS) in a Likert scale format and (2) whether the Likert scale improves the diagnostic value compared with the original dichotomous scale. Design: Cross-sectional multicentre study. Setting: One general and one university hospital in the Netherlands. Subjects: A total of 116 consecutive hospitalized stroke patients, of whom 53 were patients with communicative impairment. Main measures: Depression was diagnosed with the Composite International Diagnostic Interview (CIDI) administered to the patients’ relatives. The Barthel Index (BI) was used as an external validator. Results: The correlation between the CIDI and the SODS-Likert or the SODS was small (rb = 0.18), and the correlation between the Barthel Index and the SODS-Likert (rs = −0.30) or the SODS (rs = −0.33) was moderate. For both instruments, the discriminatory power for diagnosing depression when compared with the CIDI was best at a cut-off score of ⩾2. The internal consistency of the SODS-Likert was acceptable (α = 0.69) and slightly higher than that of the SODS (α = 0.57). The inter-rater reliability of the SODS-Likert and the SODS was acceptable (intraclass correlation coefficient (ICC) 0.66 and ICC 0.80, respectively). The clinical utility was rated good. Conclusion: The diagnostic value of the SODS did not improve using a Likert scale format. However, the diagnostic value of the original dichotomous SODS is reasonable for the initial mood assessment of stroke patients with communicative impairment.

Forced-Choice Personality Measures and Academic Dishonesty: a Comparative Study

Extant research (e.g., Wilks et al. 2016; Williams et al. 2010) has shown personality to be a predictor of engagement in academic dishonesty. The current study seeks to determine whether the type of personality measure affects predictive efficacy by comparing single stimulus and forced-choice measures of personality using a sample of 278 undergraduate students in two U.S. universities. Students scoring high on conscientiousness reported as engaging in fewer academic cheating behaviors than those scoring low on conscientiousness regardless of whether conscientiousness was measured using the forced-choice or single stimulus scale format. In addition, the forced-choice and single stimulus measures each contributed significant unique variance to prediction of academic dishonesty. For agreeableness, scores on the single stimulus measure were negatively correlated with academic dishonesty whereas there was a positive relationship found for the forced-choice measure. Overall, the forced-choice format of the Occupational Personality Questionnaire 32r (OPQ32r) did not show higher validities than the single stimulus IPIP counterpart in predicting self-reported academic dishonesty. Implications for future research and management education are discussed.

Malleability of taste perception: biasing effects of rating scale format on taste recognition, product evaluation, and willingness to pay

Product-related cues, such as brand or price, can influence consumers’ taste perception. Going beyond this observation, we examine the extent to which a stimulus-extrinsic factor, such as the format of the measurement tool on which consumers describe attributes of a taste sample, influences concurrent taste perception, and in turn, later taste recognition, overall product evaluation, and willingness to pay (WTP). The results of two experiments show that rating scale format (i) influences consumers’ concurrent impression of a taste sample, (ii) systematically biases later identification of the sample in a taste recognition test, and (iii) affects overall product evaluation and WTP. However, scale format (iv) does not influence ratings and downstream judgments when consumers are highly knowledgeable in the product domain. These findings demonstrate that the experience of taste is fleeting and not well represented in memory, and that like other subjective experiences, taste needs to be reconstructed based on accessible cues.

Perception of Fish Sentience, Welfare and Humane Slaughter by Highly Educated Citizens of Bogotá, Colombia and Curitiba, Brazil.

Discussions on farm animal welfare have become frequent, especially in developed countries. The aim of this research was to study the perception of fish sentience, welfare and slaughter by highly educated citizens from Bogotá, Colombia, and Curitiba, Brazil. An online survey with 12 questions presented as open-ended, multiple choice and 5-point Likert-type scale formats was available to respondents. Answers from 395 participants in Bogotá and 387 in Curitiba were analyzed, and results are presented in the order Bogotá followed by Curitiba. The percentage of participants who perceived fish as sentient animals was 79.7% and 71.8%. The classification of sentience perception among taxonomic groups seems in accordance with the phylogenetic proximity to humans, suggesting participants were more likely to perceive sentience in mammals than in other animals. The descending order related to the highest perception of fish suffering in different scenarios was fishing with hook and line (75.6%, 70.6%); municipal live fish fair (68.7%—only in Curitiba); fish-and-pay ponds (59.7%, 54.4%); fish kept as laboratory animals (58.0, 48.1%); fish farming (35.7, 36.8%); fish in pet stores (35.5%, 26.1%); production of ornamental fish (19.3%, 21.8%); fish in aquarium exhibits (18.8%,16.9%); and fish kept as pets (12.4%,12.3%). Lack of knowledge about the conditions of capture, handling, transport and sale of ornamental fish may justify the perception of low level of suffering in the last scenarios. Regarding humane slaughter, 57.0% and 55.0% of respondents were unaware of the issue. After reflection induced by the questionnaire, 76.0% and 72% of participants believed that fish should be included in humane slaughter regulations. This study presents original data suggesting that respondents from Bogotá and Curitiba consider fish as sentient beings. The perception of suffering in specific scenarios challenges common activities. Recognition of suffering also endorses humane slaughter regulations to reduce pain in a large number of individuals of fish slaughtered annually for human consumption in Colombia and Brazil.

Comparison of Rating Scales in the Development of Patient-Reported Outcome Measures for Children with Eye Disorders

ABSTRACTBackground: A rating scale is a critical component of patient-reported outcome instrument design, but the optimal rating scale format for pediatric use has not been investigated. We compared rating scale performance when administering potential questionnaire items to children with eye disorders and their parents. Methods: Three commonly used rating scales were evaluated: frequency (never, sometimes, often, always), severity (not at all, a little, some, a lot), and difficulty (not difficult, a little difficult, difficult, very difficult). Ten patient-derived items were formatted for each rating scale, and rating scale testing order was randomized. Both child and parent were asked to comment on any problems with, or a preference for, a particular scale. Any confusion about options or inability to answer was recorded. Results: Twenty-one children, aged 5-17 years, with strabismus, amblyopia, or refractive error were recruited, each with one of their parents. Of the first 10 children, 4 (40%) had problems using the difficulty scale, compared with 1 (10%) using frequency, and none using severity. The difficulty scale was modified, replacing the word “difficult” with “hard.” Eleven additional children (plus parents) then completed all 3 questionnaires. No children had problems using any scale. Four (36%) parents had problems using the difficulty (“hard”) scale and 1 (9%) with frequency. Regarding preference, 6 (55%) of 11 children and 5 (50%) of 10 parents preferred using the frequency scale. Conclusions: Children and parents found the frequency scale and question format to be the most easily understood. Children and parents also expressed preference for the frequency scale, compared with the difficulty and severity scales. We recommend frequency rating scales for patient-reported outcome measures in pediatric populations.

Performance appraisal and performance management: 100 years of progress?

We review 100 years of research on performance appraisal and performance management, highlighting the articles published in JAP, but including significant work from other journals as well. We discuss trends in eight substantive areas: (1) scale formats, (2) criteria for evaluating ratings, (3) training, (4) reactions to appraisal, (5) purpose of rating, (6) rating sources, (7) demographic differences in ratings, and (8) cognitive processes, and discuss what we have learned from research in each area. We also focus on trends during the heyday of performance appraisal research in JAP (1970-2000), noting which were more productive and which potentially hampered progress. Our overall conclusion is that JAP's role in this literature has not been to propose models and new ideas, but has been primarily to test ideas and models proposed elsewhere. Nonetheless, we conclude that the papers published in JAP made important contribution to the filed by addressing many of the critical questions raised by others. We also suggest several areas for future research, especially research focusing on performance management. (PsycINFO Database Record

Psychometric properties of the Female Sexual Function Index in the visual analogue scale format.

The study was conducted in three phases. In Phase 1, the instrument was adapted by two independent researchers, generating two versions, which were evaluated by a committee of six experts. The FSFI-VAS, resulting from this first phase, was used in a pilot study with 45 women. In Phase 2, the FSFI-Likert (original format) and FSFI-VAS questionnaires were administered to 246 women recruited to the study. Tests of reproducibility (test-retest/phase 3), internal consistency, discriminant validity and construct validity were applied. In Phase 1, the pilot study showed that there were no doubts and difficulties completing the FSFI-VAS. In Phase 2, the Spearman rank (validity) test showed high correlation between the total scores on the FSFI-Likert and FSFI-VAS (0.87). The results of the internal consistency test were between 0.66 and 0.88, and the results of the construct validity test indicated a good value (0.73). The discriminant validity test was also appropriate. In Phase 3, the lowest intraclass correlation coefficient value was 0.81. The FSFI-VAS has internal consistency, construct validity, discriminant validity and reproducibility adequate to assess female sexual dysfunction in young women.

Attitude of engineering students towards engineering drawing: A case study

The effects of attitude as it relates to engineering students’ learning in engineering drawing was looked into in this study. All the engineering students from the four engineering departments of Federal University of Agriculture Abeokuta, Nigeria were considered as the study population. However the participants were a total of 152 engineering students. The research instrument was a pre-tested self-administered questionnaire. The questionnaire was structured using close-ended Likert 5-point attitude scale format for it’s relatively easy to design, high degree of reliability and validity in using Likert technique. The data obtained was analysed using frequency, percentage, mean score and standard deviation techniques on Standard Package for Social Scientists (SPSS) 16.0, software. The analysed data showed that the students have positive attitude to engineering drawing as a subject and teaching methodology. They were unsure about classroom environment and background information but obviously negative about the instructional and educational items.

Proving content validity of self-regulated learning scale (The comparison of Aiken index and expanded Gregory index)

This study aims to prove the content validity of the self-regulated learning (SRL) scale using Likert model and multiple-choice model with content validity coefficient based on expert assessments with Aiken formula and expanded Gregory formula. In this study, the SRL scale with Likert and multiple-choice model are developed using the same outline/format. There are three experts who assess the items' relevancy using indicators of both scale formats. The results of the expert assessments are then used to calculate the coefficient of the validity with Aiken formula and the expanded Gregory formula. The results showed that the content validity coefficient based on expert assessment on Likert and multiple-choice format with Aiken formula is at 0.9 for each, while using the Aiken formula and expanded Gregory formula, the coefficient is 0.6 for Likert, and 0.8 for multiple-choice.

Development and validation of the daily fatigue cancer scale (DFCS): Single-item questions for clinical practice

Cancer-Related Fatigue (CRF), subjective symptom, is considered the most prevalent and disabling in cancer. To help caregivers better understand it, we developed and evaluated the psychometric properties of a visual analog scale to assess daily CRF. In our qualitative study, we conducted interviews with caregivers, patients and scientists (N=30) to generate items and select the scale's format. We then administered the final scale to a sample of 104 patients hospitalized for cancer surgery. In our quantitative study, we evaluated psychometric items with standardized questionnaires to compare and identify the construct validity of our fatigue scale. Because clinicians need a cutoff to diagnose fatigue in daily care, we also analyzed the scale's sensitivity. Correlations evidenced good construct validity for our scale, with r=0.886 (p>0.01), confirming that both physical fatigue and psychological fatigue (r=0.768) were effectively measured. The Receiver Operating Curve (ROC) showed good sensitivity and specificity (>0.80), giving clinicians a threshold to identify tired patients, with only a 3% chance of misdiagnosis. The Daily Fatigue Cancer Scale is a good tool to detect patient fatigue and improve patient care.

Impact of Combined Sensory and Cognitive Training on Static and Dynamic Balance in Older Adults

Objective: Evaluation and diagnosis are determinants of treatment outcome; therefore, diagnostic tools should be accurate. The purpose of the present research is construction and norm-finding of a rating scale for the diagnosis of attention deficit hyperactivity disorder (ADHD). Method: A checklist based on behavioral symptoms of ADHD from clinical sources was constructed, based on interview with patients and the medical records. After being studied by specialists, this checklist was reduced to items and arranged in a rating scale format. The study population included Tehran's elementary school students (boys and girls) from which a sample of 800 children was chosen in a random-cluster manner. Then teachers were asked to rate the students according to the scale characteristics. After two weeks, the subjects were tested and interviewed using a corrected form of the scale, the rating scale of Swanson, Nolan and Pelham (SNAP-IV) and Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). After data analysis the scale was reduced to 23 items. Results: According to the results of the analysis, the scale had two factors: The first factor was hyperactivity that explained 37.41%, and the second factor was attention deficit that explained 33.78% of the total variance . Cronbach's alpha was 0.96 and the alpha of the two subscales, hyperactivity and attention deficit, was 0.94 and 0.96, respectively. Spearman-Brown Coefficient was 0.78 and scale coefficient correlation with a similar from (SNAP-IV) was 0.82. Criterion validity coefficient of the scale was 0.76 and the content validity of the scale was confirmed by the experts. According to sensitivity analysis of the trait, the cutoff point of the scale was 35. Considering the above findings, we can safely use the above scale in clinical studies. Conclusion: Considering the obtained values in the psychometric indexes and the consensus among specialists on the basis of test content validity and also considering the calculation methods of the cutoff point, we can safely use this scale in different clinical situations, epidemiological studies, and other researches and also for studying ADHD children especially when teachers deal with evaluation of children behavior.

Servqual Model as Performance Evaluation Instrument for Small and Medium Sized Enterprises (SME): Evidence From Customers in Nigeria

It is the intention of this study to ascertain if SERVQUAL model can serve as an instrument for measuring performance of small and medium scale enterprises in Nigeria. The study adopted the Kano model as the theoretical framework. Empirical works on service quality and customer satisfaction were reviewed. Survey research design was adopted and conducted with the use of structured questionnaire designed in a 5 point likert scale format ranging from strongly agree, agree, strongly disagree, disagree and undecided. Twelve (12) small and medium scale enterprises operating in six geo-political zones of Nigeria were judgmentally selected, from where a sample of 60 was drawn using Taro Yamane formula. The questionnaire was validated and its reliability established. Data presentation and analysis was carried out using tables and simple percentages. Chi-square statistic; a nonparametric technique was employed in the test of the three hypotheses formulated to guide the study. This led to rejection of the three null hypotheses indicating that: Service quality dimensions has relationship with performance of small and medium scale enterprises; tangibility, reliability, responsiveness, assurance and empathy services can be used to measure performance of small and medium scale enterprises. This justifies that SERVQUAL dimensions; tangibility, reliability, responsiveness, assurance and empathy are indicators of customer satisfaction, implying that they can be employed as performance evaluation tools for small and medium scale enterprises. It is recommended that small and medium scale enterprises should direct their operations in line with SERVQUAL dimensions, if they want to achieve customer satisfaction and business performance.

Impact of the Number of Scale Points on Data Characteristics and Respondents’ Evaluations: An Experimental Design Approach Using 5-Point and 7-Point Likert-type Scales

A remarkable deal of social research is based on data collected through the use of Likerttype scales. The optimal number of response categories in Likert-type scales has been subject to an academic debate for years. This article studies the differences between 5- and 7-point Likert-type scales using the SERVPERF Scale, which was developed by Cronin and Taylor in 1992, as the measuring instrument. A pretest-posttest control group experimental design was used to test whether the differently pointed response categories lead to any statistical differences in data characteristics, dimensional structure of the scale and data fit. Results do not show any statistically significant differences in terms of normality and reliability whereas different dimensional structures are achieved for the 5- and 7-point scale formats of SERVPERF using Exploratory Factor Analysis. ANCOVA results reveal that the number of response categories is not affective on the participants’ evaluations of SERVPERF. The results of confirmatory factor analysis show that the best fit is achieved for the 7-point SERVPERF.

Response Scales in Voting Advice Applications: Do Different Designs Produce Different Outcomes?

Voting Advice Applications (VAAs) represent popular election campaign tools in many countries, enabling voters to discover which party or candidate provides the best match with their political preferences. This article examines the effects of design choices on these tools by focusing on the response scale that is used to measure the policy positions of parties and voters. We analyze the impact of scale length on the advice generated by these tools using user data from a VAA developed for the 2014 Dutch local elections. We transform the original 101-point scale into several alternative scale formats and determine if this leads to a different voting recommendation. We also examine the suitability of alternative scales for creating spatial models, which are often employed by VAAs. We show that the response scale has a potentially profound impact on the resulting advice (with voters receiving different VAA outcomes depending on the scale length), except for voters with an extremist response style. The findings have practical implications for the design of these tools: outcomes should be presented as a preference list, rather than focusing on the “best match.”

Development of a measure of hypodontia patients’ expectations of the process and outcome of combined orthodontic and restorative treatment

ObjectivesTo devise and assess the psychometric properties of a measure that investigates hypodontia patients’ expectations of the process and outcome of combined orthodontic/restorative treatment. SettingSpecialised secondary care facility for individuals with hypodontia. Materials and methodsMixed research design with three phases: (a) Thematic analysis of data from individual interviews with 25 hypodontia patients/16 parents to generate the questionnaire items. (b) Questionnaire design, assessment of readability and face/content validity with 10 patients. (c) Survey of 32 new hypodontia patients to determine the internal consistency of the measure. ResultsThree main themes related to the treatment process emerged from the qualitative data: ‘hypodontia clinic’, ‘orthodontic treatment’ and ‘restorative treatment’. Three main themes were also revealed relating to treatment outcome: ‘changes in appearance’, ‘psychosocial changes’ and ‘functional changes’. A 28 item questionnaire was constructed using a mix of visual analogue scale (VAS) and categorical response format. The Flesch reading ease score of the measure was 78, equivalent to a reading age of 9–10 years. Face and content validity were good. The overall Cronbach’s alpha was 0.80 while for the treatment process and treatment outcome subscales it was 0.71 and 0.88 respectively. ConclusionsA patient-based measure of the process and outcome of combined orthodontic/restorative treatment for hypodontia patients has been developed which has good face and construct validity and satisfactory internal consistency. Clinical significancePatient expectations of treatment are important in determining not only their satisfaction with treatment outcomes but also their engagement with the clinical process. This questionnaire is a first step in operationalising the expectations of hypodontia patients through assessment tools that can then determine whether pre-treatment counselling is required and aid the consent and treatment planning process, thus improving the quality of treatment provided by approximating the expectations the patients hold to their actual experience.

Student perception of academic and professional development during an introductory service-learning experience

ObjectivesTo document students’ perceptions of academic and professional growth in a P1 service-learning introductory pharmacy practice experience (SL IPPE) in a College of Pharmacy in Philadelphia, PA. MethodsStudent perceptions of academic and professional growth in a service-learning course completed at two selected sites were retrospectively assessed through the Survey Monkey platform. The retrospective survey included 24 questions, including 5-point Likert-type scale format answers, and an open ended question concerning the overall perceived educational impact of this SL IPPE. Percentages, means, medians, and standard deviations were calculated to describe results. The paired sample t test, Wilcoxon signed-rank analysis and chi-square test were used to compare ranked data and nominal data, respectively. ResultsResponse rate was 86% (25/29). Over 80% reported improved knowledge of cultural sensitivity, health literacy, health awareness, disease prevention, lifestyle modification, and written and verbal communication skills. Students’ perceptions of their ability to improve care, organization, or education increased from 56% initially to 92% upon completion (p < 0.001). Overall, 92% of the students perceived themselves as likely to extremely likely to apply learned lessons to future experiences. ConclusionsFindings suggest a confirmed benefit of this service-learning course in perceived strengthening of students’ academic and professional growth. The authors concluded that while the course design, assignments, and activities could remain unchanged, the survey could be implemented for each and every SL IPPE site at this College of Pharmacy, in order to compare results and impact of students’ perception of development separately and overall.

Analyse de la structure factorielle de la version brève du questionnaire de personnalité schizotypique (SPQ-B) – format Likert – en population générale en France

IntroductionThe main objective of the study was to explore the factorial structure of the French version of the Schizotypal Personality Questionnaire-Brief (SPQ-B) in a Likert format, in a representative sample of the general population. In addition, differences in the dimensional scores of schizotypy according to gender and age were analyzed. As the study in the general population of schizotypal traits and its determinants has been recently proposed as a way toward the understanding of aetiology and pathophysiology of schizophrenia, consistent self-report tools are crucial to measure psychometric schizotypy. A shorter version of the widely used Schizotypal Personality Questionnaire (SPQ-Brief) has been extensively investigated in different countries, particularly in samples of students or clinical adolescents, and more recently, a few studies used a Likert-type scale format which allows partial endorsement of items and reduces the risk of defensive answers. MethodA sample of 233 subjects representative of the adult population from an urban area near Paris (Créteil) was recruited using the “itinerary method”. They completed the French version of the SPQ-B with a 5-point Likert-type response format (1=completely disagree; 5=completely agree). We examined the dimensional structure of the French version of the SPQ-B with a Principal Components Analysis (PCA) followed by a promax rotation. Factor selection was based on Eigenvalues over 1.0 (Kaiser's criterion), Cattell's Scree-plot test, and interpretability of the factors. Items with loadings greater than 0.4 were retained for each dimension. The internal consistency estimate of the dimensions was calculated with Cronbach's α. In order to study the influence of age and gender, we carried out a simple linear regression with the subscales as dependent variables. ResultsOur sample was composed of 131 women (mean age=52.5±18.2 years) and 102 men (mean age=53±18.1 years). SPQ-B Likert total scores ranged from 22 to 84 points (mean=43.6±13). Factor analysis resulted in a 3-factor solution that explained 47.7% of the variance. Factor 1 (disorganized; 10 items) included items related to “odd behavior”, “odd speech”, as well as “social anxiety”, one item of “constricted affect” and one item of “ideas of reference”. Factor 2 (interpersonal; 7 items) included items related to “no close friends”, “constricted affect”, and three of the items of “suspiciousness”. Factor 3 (cognitive-perceptual; 5 items) included items related to “ideas of reference”, “magical thinking”, “unusual perceptual experiences” and one item of “suspiciousness”. Coefficient α for the three subscales and total scale were respectively 0.81, 0.81, 0.77 and 0.88. We found no differences in total schizotypy and the three dimensions scores according to age and sex. ConclusionFactor analysis of the French version of the SPQ-B in a Likert format confirmed the three-factor structure of schizotypy. We found a pure cognitive perceptual dimension including the most representative positive features. As expected, “Suspiciousness” subscale is included in both positive and negative dimensions, but mainly in the negative dimension. Surprisingly, “social anxiety” subscale is included in the disorganized dimension in our analysis. The SPQ-B in a Likert format demonstrated good internal reliability for both total and subscales scores. Unlike previous published results, we did not find any influence of age or gender on schizotypal dimensions.

Tipping the scales: educating surgeons about medical malpractice

BackgroundIn Pennsylvania, medical malpractice premiums are a major cost to surgeons. Yet surgeons often have little if any education in the basics of tort litigation or how to manage their risk. This work describes one approach for educating academic faculty surgeons on current concepts of medical malpractice and provide some guidance on how to “tip the scales of justice”; or minimize the risks of being named in a malpractice claim. Materials and MethodsThe course had five parts: the basics of medical malpractice, the cost of malpractice insurance, current departmental claims experience, strategies for decreasing the risk of being named in a claim, and an overview of malpractice reforms. An anonymous seven question survey was cast in a five-point Likert scale format. A weighted average of 4.5 or above was considered satisfactory. Two free text questions asked about positive and negative aspects of the course. ResultsEighty of 95 (84%) faculty attended either in person or by reviewing a web-based video. Quantitatively, five of seven questions had a weighted average of more than 4.5 (n = 48, response rate = 60%). Qualitatively, the course was reviewed very favorably. ConclusionsThe high percentage of participation and overall survey results suggest that the course was successful. This course was one facet of an approach to decrease the risk of malpractice claims. Unique aspects of this course include an emphasis on state law, department-specific data, and strategies to minimize risk of future claims. Given the state-specific nature of malpractice claims and litigation, individual departments must particularize similar presentations.

The Rainbow Scale for Assessing Breast Ptosis: Validation of Three Different Views.

Photographic scales have become an increasingly used tool in objectively assessing outcomes in aesthetic surgery. However, no online photographic scale for assessing breast ptosis has been developed yet that is readily available. This study was designed to validate the online Rainbow Scale for the assessment of breast ptosis for the anterior-posterior (AP), lateral, and oblique views. For the five grades of the Rainbow Scale format, standardized reference photographs were selected. Six plastic surgeons rated 15 photographs for each view three times. Intra- and inter-observer agreements were calculated by using the weighted kappa coefficient and differences in intra- and inter-observer agreements between the three views were assessed for statistical significance using the Kruskal-Wallis test. The mean intra-observer agreements were 0.91 (range, 0.82-0.98) for the AP view, 0.88 (range, 0.77-1.00) for the oblique view, and 0.86 (range, 0.74-0.97) for the lateral view and did not vary significantly between all three views. The mean inter-observer agreements were 0.88 (range, 0.77-0.95) for the AP view, 0.84 (range, 0.72-0.94) for the oblique view, and 0.82 (range, 0.58-0.95) for the lateral view. The mean inter-observer agreements of the AP view varied significantly from the oblique view (P = .012) and the lateral view (P = .001). The Rainbow Scale for breast ptosis has been validated for the AP view, the lateral view, and the oblique view and is reproducible and reliable for the assessment of breast ptosis in three different views in an online setup. 4 Diagnostic.

Assessing Mathematics Self-Efficacy

The present study tested whether a reduced number of categories is optimal for assessing mathematics self-efficacy among middle school students using a 6-point Likert-type format or a 0- to 100-point format. Two independent samples of middle school adolescents ( N = 1,913) were administered a 24-item Middle School Mathematics Self-Efficacy Scale using either a 101-point or a 6-point response scale format. The findings suggest that the two different response scale formats were optimally represented by a 4-point scale and supported when samples were pooled. Results provide tentative evidence that middle school students make use of only 4 scale points and that the items on this scale are best matched with adolescents with average to below-average mathematics self-efficacy. Implications for the measurement of self-efficacy and related motivation constructs are discussed, and replications with a 4-point scale using category descriptors for each scale point are needed.