Total Score Correlations Research Articles

The Validity-Reliability Study of Turkish Version of Electronical Symptom Screening Tool (8-18) in SSPedi-Pediatric Patients with Cancer

Objective: The first step in symptom management is symptom screening which is necessary to keep the symptom under control. This study aimed to determine the validity and reliability of the Turkish version of the Electronic Symptom Screening Tool in Pediatrics for children aged 8-18 (SSPedi 8-18) with cancer. Methods: The research was conducted between September 2020 and June 2021. The sample in our study consists of 80 children (8-18 years) with cancer. For content validity, the scale was first translated into Turkish and then adapted using Davis’ correspondence analysis technique. The construct validity of the scale was assessed using the Barlett test and Kaiser-Mayer Olkin. For the scale’s reliability, Cronbach Alpha Reliability Coefficient, Equivalent Forms Method, bisection method and Item Total Score Correlation Coefficient correlation tests were analyzed. Before starting the study, ethics committee approval and written permits from institutions and individuals were obtained. Results: The content validity index was found between 0.93 and 1. The reliability of the scale of the equivalent form method was r:0.57, and bisection method was r:0.85 and the Cronbach internal consistency coefficient of scale=0.86. The correlation coefficient between the items and the total score was greater than r=0.20. The Kaiser-Meyer-Olkin coefficient was 0.82. The χ2 value (Bartlett test) was statistically significant (p= .001). Conclusion: The SSPedi 8-18 is a reliable and valid tool that can be used to assess the symptoms of Turkish children with cancer. Nurses’ use of the scale while providing nursing care to children diagnosed with cancer and their families will guide them in objectively determining symptoms, understanding the relationship between symptoms, and managing symptoms.

Validation of the delirium diagnostic tool-provisional (DDT-Pro) in geriatric medical inpatients with diagnostic permutations of the 3Ds with and without delirium

ObjectiveValidations of brief delirium tools have not included analysis of psychiatric disorders comorbidities or control groups. We validated the Delirium Diagnostic Tool-Provisional (DDT-Pro) in 422 geriatric inpatients with high incidence of depression and/or dementia. MethodsCross-sectional study using two delirium reference standards, DSM-5-TR and Delirium Rating Scale-Revised-98 (DRS-R98). We assessed concurrent and construct DDT-Pro validity too. ResultsThere were 117 (27.7%) delirium cases using DDT-Pro, 104 (24.6%) per DSM-5-TR and 93 (22.0%) per DRS-R98; 133 patients (31.5%) had depression and 105 (24.9%) dementia, some comorbid with delirium. DDT-Pro accuracy (AUC under ROC curve) ranges were 88.3–95.9% vs DSM-5-TR and 92.7–95.0% vs DRS-R98 for whole sample and four diagnostic groups, without statistical differences. DDT-Pro ≤6 had the most balanced sensitivity-specificity for delirium diagnosis against both DSM-5-TR and DRS-R98 with similar specificity but higher sensitivity for DRS-R98 than DSM-5-TR delirium, with the highest values in patients with depression and dementia (≥92% sensitivity, ≥81% specificity). Positive and negative likelihood ratios support diagnostic strength. Concurrent validity was high reflected by significant correlations (p < 0.001) of DDT-Pro total and item scores with DRS-R98 and Delirium Frontal Index scores, highest in groups with comorbid depression and/or dementia. The DDT-Pro represented a single construct for delirium demonstrated by one factor with high item loadings and high internal consistency reliability of its items. ConclusionsThe DDT-Pro demonstrated strong performance metrics in general hospital elderly inpatients with preexisting depression and/or dementia, which is unique among brief delirium tools. Its optimized cutoff score was the same as in other populations.

Validity and Reliability of an Arabic Version of the Survey Instrument for Natural History, Aetiology and Prevalence of Patellofemoral Pain Studies: A Cross-Sectional Study.

Knee pain, specifically patellofemoral pain (PFP), may lead to limitations in physical activity and social participation. Identifying knee pain that is attributed to PFP is not an easy job for healthcare professionals. To overcome this issue, The Survey Instrument for Natural History, Aetiology and Prevalence of Patellofemoral Pain (SNAPPS), which is a self-reporting questionnaire instrument, was designed to identify PFP in many languages. However, the Arabic version of the SNAPPS is not validated yet. This study was performed to assess the validity and reliability of the Arabic version of the SNAPPS (A-SNAPPS). A cross-sectional study was conducted to achieve the study goals. To assess reliability, 38 participants were asked to complete the A-SNAPPS two times on the same day with a 30 min break in between. Convergent validity of the A-SNAPPS was assessed by exploring the correlations of the SNAPPS total score with the visual analogue scale (VAS) scores, including VAS for usual pain, VAS for worst pain, and VAS for pain during activities such as jumping, running, ascending and descending stairs, and squatting. The validity test findings suggested that SNAPPS has a strong correlation with the VAS during ascending and descending stairs (r = 0.71) and moderate correlations during jumping (r = 0.54) and squatting (r = 0.57). The test-retest reliability ICC was 0.92, indicating a very strong test-retest reliability of the A-SNAPPS. The A-SNAPPS was cross-culturally adapted and validated, demonstrating very strong reliability.

The association between addiction profile and early maladaptive schemas among individuals with opioid use disorder

ABSTRACT Background and objective Opioid use disorder (OUD) is a global problem and factors that play a role in its development and treatment outcomes need to be examined. We aimed to compare early maladaptive schemas (EMS) in individuals with OUD with a control group and to investigate the effects of these variables on the addiction profile. Methods Eighty-one participants with a diagnosis of OUD and 81 control participants were included in the study. The sociodemographic data form and Young Schema Inventory Short Form-3 were used as data collection tools for both groups. In addition, the Addiction Profile Index (API) was applied to the OUD group. Results A statistically significant difference was identified in 11 of the 14 schema domains. We found a statistically significant positive correlation in the API total scores of OUD patients with the areas of failure, social isolation/insecurity, and nesting/addiction schemas. Conclusions OUD patients were characterized with more prominent maladaptive schemas compared to the control group. When evaluating individuals with OUD, it would be beneficial to determine the dominant schema areas and consider them in designing treatment programs. In addition, new methods should be developed to examine the effects of schemas on complex events such as dependency.

Comparison of consistency in acute stroke: Automated ASPECT score software tools and manual consensus scores

PurposeThe Alberta Stroke Program Early Computed Tomography Score (ASPECTS) is a standardized semi-quantitative scoring system. It is widely used to assess the extent of acute ischemic stroke (AIS). We evaluated the consistency of three automatic software packages with the overall and region-specific manual ASPECTS scores of AIS patients. MethodsRetrospectively, we gathered patients who presented with stroke symptoms between February 2019 and June 2022, and 174 cases were eventually included in the trial. Two radiologists reviewed the NCCT images independently; After four weeks, the same two radiologists began randomly reviewing the DWI images, discussed different scores and give consistent results as ground truth. ResultsMedian ASPECTS of the expert consensus reading was 7 (5–9). Good to excellent correlation of ASPECTS total scores among the three software tools (0.70, 0.74 and 0.83). Correlation among ground truth and Rapid-ASPECTS, RealNow-ASPECTS, ShuKun-ASPECTS (ICC = 0.51, Cronbach's α = 0.53), (ICC = 0.60, Cronbach's α = 0.70) and (ICC = 0.52, Cronbach's α = 0.64) respectively. The AUCs for Rapid, RealNow and ShuKun were 0.61, 0.67, and 0.62 respectively. The region-specific results showed a poor to good correlation. The correlations between the non-dominant and dominant cerebral hemispheres and the ground truth were statistically different (P < 0.05). ConclusionsOverall, the scoring consistency between the three automated scoring software and the ground truth is comparable, with RealNow-ASPECTS being no less consistent and effective than Rapid-ASPECTS and ShuKun-ASPECTS, and even better than both. But the consistency grade that still is developable.

The reliability, validity and clinical utility of the Clinical Outcomes in Routine Evaluation – ten-item version (CORE-10) in post-acute patients with stroke

Objective To explore the validity, reliability, and clinical utility of the Clinical Outcomes in Routine Evaluation – ten-item version (CORE-10: a ten-item questionnaire designed to measure psychological distress) in a stroke inpatient sample and calculate reliable and clinically significant change scores. Setting A post-acute stroke rehabilitation ward in the East of England. Participants A total of 53 patients with stroke, capable of completing the CORE-10 as part of their routine clinical assessment. Exclusion criteria included moderate to severe aphasia and/or alexia. Main measures Alongside the CORE-10, the Patient Health Questionnaire – 9, the Hospital Anxiety and Depression Scale, the Centre for Epidemiological Studies-Depression Scale, and the Beck Depression Inventory Second Edition were used as concurrent measures. Results To assess reliability, the internal consistency and test–retest reliability of the CORE-10 were calculated. The average number of days between CORE-10 test–retest administrations was 2.84 (SD = 3.12, Mdn = 1). Concurrent validity was assessed by examining correlations between the CORE-10 and comparable measures, and clinical utility was assessed using the criteria of Burton and Tyson (2015). The internal consistency (Cronbach’s alpha) for the CORE-10 was .80, and test–retest reliability interclass correlation coefficient was .81. Total score correlations between the CORE-10 and concurrent measures ranged from r = .49 to r = .89. The CORE-10 achieved the maximum score (i.e. 6/6) on criteria for clinical utility. Calculations demonstrated a reliable change index of nine points and a clinically significant change cut point of 12 on the CORE-10. Percentiles for CORE-10 total scores are reported. Conclusions This study provides preliminary support for the CORE-10 as a valid and reliable measure that has clinical utility for screening distress in inpatients with stroke.

Validity and reliability of the Swedish version of the Leicester Cough Questionnaire in unexplained chronic cough

BackgroundCough is considered chronic when it lasts for >8 weeks. When no medical explanation can be found it is often called unexplained chronic cough (UCC), which may affect health-related quality of life (HRQOL). This study aimed to assesses the validity and reliability of the Swedish version of the Leicester Cough Questionnaire (LCQ-S) in patients with UCC. MethodsSeventy-six consecutively selected patients with UCC replied to: a local questionnaire; the LCQ-S; a Visual Analog Scale (VAS) for cough; the Swedish version of the Hull Airway Reflux Questionnaire (HARQ-S); and the Chemical Sensitivity Scale for Sensory Hyperreactivity (CSS-SHR). To evaluate the reproducibility of the LCQ-S, the VAS and LCQ-S were answered again after two to four weeks. ResultsSeventy-four patients (17 men) answered the questionnaires at baseline. Concurrent validity for LCQ-S was regarded as moderate with the VAS for cough and HARQ-S. Internal consistency using Cronbach's alpha was high for the LCQ-S total score (0.92) and satisfactory for the LCQ-S domains (0.78–0.83). Reliability and reproducibility were analysed in 57 patients (14 men). Intra-class correlation for the LCQ-S total score and domains showed strong reliability (≥0.92), without any significant differences over time. The standard error of measurement and the smallest real difference were 1.26 and 3.49, respectively. The Bland-Altman plot showed no systematic change in the mean values. ConclusionsThe LCQ-S has good validity and reliability and can be used in clinical settings to evaluate HRQOL in Swedish-speaking adult patients with UCC.

The Validity of the Thai Electronic Version of the Montreal Cognitive Assessment (MoCA)

AbstractElectronic cognitive assessment tools are essential in screening and managing patients’ disease progression in clinical practices. Neurocognitive disorders, particularly mild cognitive impairment (MCI) and Alzheimer’s Dementia (AD), can be assessed using the Montreal Cognitive Assessment (MoCA) [1, 2]. A digital version of the MoCA could help reduce the burden on healthcare providers, increase accessibility, and maximize its utility, especially in countries that lack medical staff such as Thailand. This pilot study aimed to establish the concurrent validity between the electronic version of the MoCA‐Thai (eMoCA‐Thai), developed by the authors of this paper, to the original paper‐and‐pencil version (MoCA‐Thai) in adults who are cognitively normal (CN), have MCI, and have AD. 54 adults between the ages of 60 to 90 attending a dementia clinic were administered both the eMoCA‐Thai and the standard MoCA‐Thai one week apart. The primary outcome measures include the total scores and all subscale scores of the two test versions. Correlations and differences between scores were analyzed using concordance correlation coefficients (CCC) and various parametric t‐tests. Results show that there is high correlation for total MoCA scores with a CCC of 0.919 and a mean difference of ‐0.204 (‐6.311, 5.904). All the cognitive subdomain scores had moderate to high CCC of more than 0.4. The differences in average total score (22.81±7.49 for the MoCA‐Thai and 23.02±7.99 for the eMoCA‐Thai) were not statistically significant (p = 0.633), indicating no differences between the MoCA scores of both versions. When comparing total MoCA scores between participant groups, both CN and MCI had acceptable correlations (CCC &gt;0.2) with a mean difference of 0.355 (‐4.720, 5.429) and ‐1.643 (9.001, 5.715), respectively, whilst AD had excellent correlation (CC &gt;0.8) with a mean difference of 0.111 (‐6.496, 6.717). Subdomain scores between participant groups were not statistically significantly different except for Delayed Recall for all participants combined (p&lt;0.05). In conclusion, there is adequate concurrent validity between the MoCA‐Thai and eMoCA‐Thai, making it a useful tool to help improve workflow and increase accessibility.

The Water Swallow Test and EAT-10 as Screening Tools for Referral to Videofluoroscopy.

Videofluoroscopy (VFS) is the gold standard in evaluating dysphagia. Water swallow tests (WST) and the Eating Assessment Tool (EAT-10) are commonly used in dysphagia screening. We aimed to determine the feasibility of WST and EAT-10 as screening tools for referral to VFS. Patients (n = 150, median age: 70.0 years, range: 19-92 years, 58.7% female) referred to VFS completed the WST and EAT-10 before the examination. In the WST, we evaluated both the qualitative parameters (coughing, possible change in voice) and quantitative parameters (average drinking bolus size, swallowing speed). Correlations of EAT-10 total scores and WST parameters to the VFS findings were analyzed both individually and combined. In the WST, the most specific (89.7%) predictor of normal VFS findings was the absence of coughing, and the most sensitive (79.1%) parameter to predict abnormal findings was a bolus size of ≤20 mL. Using a combination of coughing and a bolus size ≤20 mL (simplified WST), the sensitivity of predicting abnormal findings increased to 83.5%. The most sensitive (84.6%) predictor of penetration/aspiration was failing any parameter in the WST. Lack of coughing indicated an absence of penetration/aspiration with an 82.5% specificity. Swallowing speed or combining the EAT-10 results with the WST results did not enhance the sensitivity or specificity of the WST for predicting the VFS results. Coughing and average drinking bolus size are the most important parameters in WST when screening for referral to VFS, whereas the swallowing speed does not seem to be useful. The WST is superior to EAT-10 in predicting VFS findings. 4 Laryngoscope, 134:1349-1355, 2024.

Using the Fantastic Reality Ability Measurement to cope with epidemics: a Turkish validity and reliability study

PurposeThis study was conducted to adapt the Fantastic Reality Ability Measurement (FRAME) into Turkish.Design/methodology/approachIn the sample of this methodological study, 213 participants were included.FindingsThe factor loading of the tool was within the appropriate range (0.53–0.94). Its Cronbach's alpha was 0.975, and the item total score correlations ranged between 0.594 and 0.881.Originality/valueThe evaluation of the Turkish version of the FRAME revealed that it could be used as a valid and reliable measurement tool in Turkish population.

Translation and validation of the Italian version of the Wisconsin Stone Quality of Life Questionnaire (I-WISQOL) for assessing quality of life in patients with urolithiasis

Urolithiasis is a chronic condition, and it has been associated with a significant negative impact on patients' health-related quality of life (HRQOL). Several tools to assess patients' HRQOL have been validated in Italian, however disease-specific HRQOL instruments are still lacking. We aimed to develop and validate the Italian version of the WISQOL (I-WISQOL) in patients with urolithiasis. The Italian version of the WISQOL was developed in a multistep process involving primary translation, back-translation, and pilot testing among a group of patients (N.=10). Patients presenting with urolithiasis were prospectively recruited from the outpatient stone clinics and completed both questionnaire WISQOL and SF-36. Demographic information, as well as medical and surgical data, were obtained through an interview. Internal consistency of the I-WISQOL was obtained with Cronbach's α. Correlation of total scores of the I-WISQOL and SF36 was assessed to determine convergent validity using Spearman Rho. Correlations between clinical variables and results from the I-WISQOL were analyzed to descriptively assess the association of interest. A total of 93 participants were evaluated and completed the Italian version of the I-WISQOL. The I-WISQOL demonstrated excellent internal consistency (Cronbach's α 0.95) and good convergent validity with the validated SF-36 (Spearman Rho r=0.70, P<0.001). Using ANOVA analysis, a significant decline in WISQOL Score was noted with the increasing number of renal colics (P=0.0543), ER visits (P=0.037), number of inpatient hospitalization (P=0.025). At multivariate analysis, worse WISQOL total score was predicted by a greater number of renal colic events (ß=-4.92 [-8.81-1.04], P=0.014) and by a greater number inpatient hospitalization (ß=-7.31 [-14.35 -0.26], P=0.042). The I-WISQOL is an internally consistent and valid instrument to assess HRQOL in Italian-speaking patients with kidney stones. Its use in clinical practice should be implemented in order to tailor the management of each patient.

The Quick Inventory of Depressive Symptomatology, Adolescent Version (QIDS-A17): A Psychometric Evaluation.

The current study aimed to evaluate the psychometric features of the Quick Inventory of Depressive Symptomatology, Adolescent version (QIDS-A17) and the clinician-rated Children's Depression Rating Scale-Revised (CDRS-R). Altogether, 103 outpatients (8 to 17 years) completed the self-report QIDS-A17-SR. Clinician interviews of adolescents (QIDS-A17-C (Adolescent)) and of parents (QIDS-A17-C (Parent)) were combined to create the QIDS-A17-C(Composite) and the CDRS-R. All QIDS-A17 measures and the CDRS-R evidenced high total score correlations and internal consistency. Factor analysis found all four measures to be unidimensional. Item Response Theory (IRT) analysis found results that complemented the reliability results found in CTT. All four also demonstrated discriminant diagnostic validity based on logistic regression and ANOVA analyses. The psychometric properties of the self-report and composite versions of the QIDS-A17 suggest acceptability as a measure of depression in adolescents either as a measure of depressive symptoms or severity of illness in adolescents. The self-report version may be a helpful tool in busy clinical practices.

Validity and reliability studies of the Indonesian version of Atrial Fibrillation Severity Scale (AFSS)

BackgroundIn the atrial fibrillation (AF) population, worsened quality of life (QOL) has been reported even before complications occur. Symptom-based questionnaires can be used to evaluate AF treatment. The Atrial Fibrillation Severity Scale (AFSS) was first developed in Canada in English, which is not the main language in Indonesia. This study aims to test the reliability and validity of the Indonesian version of the Atrial Fibrillation Severity Scale (AFSS).MethodsTranslation of the AFSS from English to Indonesian was done using forward and backward translation. The final version was then validated with the Short Form-36 (SF-36) questionnaire, and a test-retest reliability study was done in a 7-14-day interval.ResultsAn Indonesian version of AFSS was achieved and deemed acceptable by a panel of researchers. This version is reliable and valid, with Cronbach’s α of 0.819, Intraclass Correlation Coefficient (ICC) ranging from 0.803 to 0.975, and total score correlation ranging from 0.333 to 0.895. Pearson’s analysis of AFSS and SF-36 revealed that the total AF burden domain was poorly correlated with role limitations due to emotional problems (r:0.427; p < 0.01) and pain (r:0.495; p < 0.01). The symptom severity domain was poorly correlated with physical functioning (r:-0.335; p < 0.01), role limitations due to emotional problems (r:0.499; p < 0.01), pain (r:0.458; p < 0.01), and total SF-36 score (r:-0.361; p < 0.01). Total AFSS score was moderately correlated with role limitations due to emotional problems (r:0.516; p < 0.01) and pain (r:0.538; p < 0.01). The total AFSS score was poorly correlated with the European Heart Rhythm Association (EHRA) score (r:0.315; p < 0.01).ConclusionThe Indonesian version of AFSS has good internal and external validity with good reliability.

Development and psychometric evaluation of the Ketogenic Diet Management Scale for Children with Epilepsy-Parent Form

ABSTRACT This study was conducted to develop a measurement tool to achieve ketogenic diet management in parents of children with epilepsy and examine its Turkish psychometric properties. The study was conducted on 317 parents using a descriptive correlational method. Data analysis and evaluation were performed using factor analysis, Cronbach’s alpha, and item – total score correlation. The scale consists of 20 items and unidimensional factor. As a result of the exploratory factor analysis, the total explained variance of the unidimensional factor was 63.809%. Cronbach’s alpha coefficient of the scale was 0.971. The four-weeks test-retest reliability evaluated with intra-class correlation was 0.87. Confirmatory factor analysis indicated, the model fit index results were recorded as follows: 0.95 as the Goodness-of-Fit Index; comparative fit index, 0.96 and normed fit index, 0.94. The study determined that the Ketogenic Diet Management Scale for Children with Epilepsy-Parent Form is a measurement tool that can be used by health professionals and that is used to evaluate parents’ ketogenic diet knowledge.

The Gut Dysmotility Questionnaire for Parkinson's disease: Insights into development and pretest studies.

A total of 48% of patients with Parkinson's disease (PD) present symptoms of gastrointestinal dysfunction, particularly constipation. Furthermore, gastrointestinal tract (GIT)-related non-motor symptoms (NMSs) appear at all stages of PD, can be prodromal by many years and have a relevant impact on the quality of life. There is a lack of GIT-focused validated tools specific to PD to assess their occurrence, progress, and response to treatment. The aim of this study was to develop and evaluate a novel, disease- and symptom-specific, self-completed questionnaire, titled Gut Dysmotility Questionnaire (GDQ), for screening and monitoring gastrointestinal dysmotility of the lower GIT in patients with PD. In phase 1, a systematic literature review and multidisciplinary expert discussions were conducted. In phase 2, cognitive pretest studies comprising standard pretests, interviews, and evaluation questionnaires were performed in patients with PD (n = 21), age- and sex-matched healthy controls (HC) (n = 30), and neurologists (n = 11). Incorporating these results, a second round of cognitive pretests was performed investigating further patients with PD (n = 10), age- and sex-matched HC (n = 10), and neurologists (n = 5). The questionnaire was adapted resulting in the final GDQ, which underwent cross-cultural adaptation to the English language. We report significantly higher GDQ total scores and higher scores in five out of eight domains indicating a higher prevalence of gastrointestinal dysmotility in patients with PD than in HC (p < 0.05). Cognitive pretesting improved the preliminary GDQ so that the final GDQ was rated as relevant (100/100%), comprehensive (100/90%), easy to understand concerning questions and answer options (100/90%), and of appropriate length (80/100%) by neurologists and patients with PD, respectively. The GDQ demonstrated excellent internal consistency (Cronbach's alpha value of 0.94). Evidence for good construct validity is given by moderate to high correlations of the GDQ total score and its domains by intercorrelations (r s = 0.67-0.91; p < 0.001) and with validated general NMS measures as well as with specific items that assess gastrointestinal symptoms. The GDQ is a novel, easy, and quick 18-item self-assessment questionnaire to screen for and monitor gastrointestinal dysmotility with a focus on constipation in patients with PD. It has shown high acceptance and efficacy as well as good construct validity in cognitive pretests.

Development of a New Measure of Housing Security: The REDD-CAT Housing Security Measure.

Housing security is a key social determinant of behavior related to health outcomes. The purpose of this study was to develop a new patient-reported outcome measure that evaluates aspects of housing security for use in the Re-Engineered Discharge for Diabetes-Computer Adaptive Test (REDD-CAT) measurement system. Qualitative data, literature reviews, and cross-sectional survey study. A total of 225 people with T2DM provided responses to the items in this item pool. A new item pool that evaluates important aspects of housing security was developed using stakeholder data from focus groups of persons with T2DM. For the Housing Affordability scale, factor analysis (both exploratory and confirmatory) supported the retention of six items. Of these items, none exhibited sparse cells or problems with monotonicity; no items were deleted due to low item-adjusted total score correlations. For the six affordability items, a constrained graded response model indicated no items exhibited misfit; thus, all were retained. No items indicated differential item functioning (examined for age, sex, education, race, and socioeconomic status). Thus, the final Affordability item bank comprised six items. A Housing Safety index (three items) and a Home Features index (eight items) were also developed. Reliability (i.e., internal consistency and test-retest reliability) and validity (i.e., convergent, discriminant, and known-groups) of the new measures were also supported. The REDD-CAT Housing Security Measure provides a reliable and valid assessment of housing affordability, safety, and home features in people with type 2 diabetes mellitus. Future work is needed to establish the clinical utility of this measure in other clinical populations.

Comparability of Objective Structured Clinical Examinations (OSCEs) and Written Tests for Assessing Medical School Students' Competencies: A Scoping Review.

Objective Structured Clinical Examinations (OSCEs) and written tests are commonly used to assess health professional students, but it remains unclear whether the additional human resources and expenses required for OSCEs, both in-person and online, are worthwhile for assessing competencies. This scoping review summarized literature identified by searching MEDLINE and EMBASE comparing 1) OSCEs and written tests and 2) in-person and online OSCEs, for assessing health professional trainees' competencies. For Q1, 21 studies satisfied inclusion criteria. The most examined health profession was medical trainees (19, 90.5%), the comparison was most frequently OSCEs versus multiple-choice questions (MCQs) (18, 85.7%), and 18 (87.5%) examined the same competency domain. Most (77.5%) total score correlation coefficients between testing methods were weak (r < 0.40). For Q2, 13 articles were included. In-person and online OSCEs were most used for medical trainees (9, 69.2%), checklists were the most prevalent evaluation scheme (7, 63.6%), and 14/17 overall score comparisons were not statistically significantly different. Generally low correlations exist between MCQ and OSCE scores, providing insufficient evidence as to whether OSCEs provide sufficient value to be worth their additional cost. Online OSCEs may be a viable alternative to in-person OSCEs for certain competencies where technical challenges can be met.

Individual participant data meta-analysis to compare EPDS accuracy to detect major depression with and without the self-harm item

Item 10 of the Edinburgh Postnatal Depression Scale (EPDS) is intended to assess thoughts of intentional self-harm but may also elicit concerns about accidental self-harm. It does not specifically address suicide ideation but, nonetheless, is sometimes used as an indicator of suicidality. The 9-item version of the EPDS (EPDS-9), which omits item 10, is sometimes used in research due to concern about positive endorsements of item 10 and necessary follow-up. We assessed the equivalence of total score correlations and screening accuracy to detect major depression using the EPDS-9 versus full EPDS among pregnant and postpartum women. We searched Medline, Medline In-Process and Other Non-Indexed Citations, PsycINFO, and Web of Science from database inception to October 3, 2018 for studies that administered the EPDS and conducted diagnostic classification for major depression based on a validated semi-structured or fully structured interview among women aged 18 or older during pregnancy or within 12 months of giving birth. We conducted an individual participant data meta-analysis. We calculated Pearson correlations with 95% prediction interval (PI) between EPDS-9 and full EPDS total scores using a random effects model. Bivariate random-effects models were fitted to assess screening accuracy. Equivalence tests were done by comparing the confidence intervals (CIs) around the pooled sensitivity and specificity differences to the equivalence margin of δ = 0.05. Individual participant data were obtained from 41 eligible studies (10,906 participants, 1407 major depression cases). The correlation between EPDS-9 and full EPDS scores was 0.998 (95% PI 0.991, 0.999). For sensitivity, the EPDS-9 and full EPDS were equivalent for cut-offs 7–12 (difference range − 0.02, 0.01) and the equivalence was indeterminate for cut-offs 13–15 (all differences − 0.04). For specificity, the EPDS-9 and full EPDS were equivalent for all cut-offs (difference range 0.00, 0.01). The EPDS-9 performs similarly to the full EPDS and can be used when there are concerns about the implications of administering EPDS item 10.Trial registration: The original IPDMA was registered in PROSPERO (CRD42015024785).

The Self-Evaluation of Negative Symptoms in Differentiating Deficit Schizophrenia: The Comparison of Sensitivity and Specificity with Other Tools

Introduction: Psychometric properties of the Self-evaluation of Negative Symptoms (SNS) in subjects with the deficit subtype of schizophrenia (SCZ-D) have not been investigated so far. This study had the following aims: (1) to assess psychometric properties of SNS in subjects with SCZ-D and (2) to explore the usefulness of SNS, in comparison with other clinical characteristics, in screening for SCZ-D. Methods: Participants were 82 stable outpatients with schizophrenia, including 40 individuals with SCZ-D and 42 individuals with the non-deficit subtype (SCZ-ND). Results: Internal consistency was acceptable-to-good in both groups. Factor analysis revealed two dimensions (apathy and emotional). There were significant positive correlations of the SNS total score with the subscore of negative symptoms from the Positive and Negative Syndrome Scale (PANSS) and significant negative correlations with scores of the Social and Occupational Functioning Assessment Scale (SOFAS) in both groups, indicating good convergent validity. The following measures were found to be appropriate screening tools for differentiating SCZ-D and SCZ-ND (p < 0.001): the SNS total score (area under the curve [AUC]: 0.849, cut-off ≥16, sensitivity: 80.0%, specificity: 78.6%), the PANSS subscore of negative symptoms (AUC: 0.868, cut-off ≥11, sensitivity: 90.0%, specificity: 78.6%), and the SOFAS (AUC: 0.779, cut-off ≤59, sensitivity: 69.2%, specificity: 82.5%). Also, adding the SOFAS (cut-off ≤59) to the SNS (cut-off: ≥16) further improved sensitivity and specificity (AUC: 0.898, p < 0.001, sensitivity = 87.5%, specificity = 82.2%). Cognitive performance and age of psychosis onset were not found to be suitable measures for differentiating SCZ-D and SCZ-ND. Conclusion: The present findings indicate that the SNS has good psychometric properties in subjects with SCZ-D and those with SCZ-ND. Moreover, the SNS, the PANSS, and the SOFAS might be used as screening tools for SCZ-D.

Improving access to assessments of early motor development in local languages: polish adaptation of the Early Motor Questionnaire

A child’s motor development progresses very dynamically. It is crucial to develop freely available parent-report measures of motor development that can be easily used globally to measure motor skills and identify children in need of interventions. This paper presents the adaptation and validation of the Early Motor Questionnaire, which consists of gross motor (GM), fine motor (FM), and perception–action integration (PA) subscales, to the Polish language (EMQ-PL). Study 1 (online, cross-sectional, N = 640) assessed psychometric properties of the EMQ-PL and its value in identifying children referred to physiotherapy. Results reveal excellent psychometric properties of the EMQ-PL and differences in GM and total age-independent scores between children that were and were not referred for physiotherapy. Study 2 (in-person assessment, longitudinal, N = 100) showed high correlations of GM and total scores with Alberta Infant Motor Scale.Conclusion: Overall, the EMQ can be easily adapted to local languages and has the potential for use as a screening tool in global health contexts.What is Known:• Parent-report questionnaires - especially those available free of charge - can potentially improve the rapid assessment of motor skills in young children worldwide.• Translation, adaptation and validation of freely available parent-report measures of motor development to local languages are important for local populations.What is New:• Early Motor Questionnaire can be easily adapted to local languages and has the potential for use as a screening tool in global health contexts.• The polish version of the Early Motor Questionnaire has excellent psychometric properties and highly correlates with infants’ age and Alberta Infant Motor Scale scores.