Early identification of individuals with Body dysmorphic disorder (BDD) is essential to direct them to appropriate care and to reduce the chance of developing or maintaining comorbid psychiatric... Show moreEarly identification of individuals with Body dysmorphic disorder (BDD) is essential to direct them to appropriate care and to reduce the chance of developing or maintaining comorbid psychiatric disorders (like an eating disorder (ED)). The present study aimed to develop a simple screener, the Body Dysmorphic Disorder Screener for DSM-5 (BDDS-5), to overcome existing screeners' limitations and test its psychometric properties.The BDDS-5 consists of 12 statements with dichotomous answer options. Specific attention is paid to the readability of the screener for those with lower reading skills. Additional eating disorder screening questions (S section) were added to investigate whether these questions are necessary for detecting potential BDD cases. Finally, the factor structure, internal consistency, and validity of the BDDS-5 were examined within populations with a high risk of screening positive for BDD or ED. Principal axis factor analysis showed that two factors accounted for 63.5% of the variance. The factor analysis was based on polychoric correlation. Based on the BDDS-5, 33 persons (14% of N = 235) were screened as likely BDD cases. Nineteen persons were excluded as potential BDD cases based on the eating disorder related question (question D). Based on the S-section, this turned out to be largely correct for the majority, however, in 8% (n = 4) of the cases BDD was probably missed. The convergent validity appeared to be high (r > 0.80) with three other BDD measures.The BDDS-5 is a valid and widely applicable screener for BDD that may help in the early detection of BDD. The BDDS-5 uses simple wording and is thus suitable for people 8 years and older. Show less
Background Contemporary pulmonary embolism (PE) research, in many cases, relies on data from electronic health records (EHRs) and administrative databases that use International Classification of... Show moreBackground Contemporary pulmonary embolism (PE) research, in many cases, relies on data from electronic health records (EHRs) and administrative databases that use International Classification of Diseases (ICD) codes. Natural language processing (NLP) tools can be used for automated chart review and patient identification. However, there remains uncertainty with the validity of ICD-10 codes or NLP algorithms for patient identification.Methods The PE-EHR+ study has been designed to validate ICD-10 codes as Principal Discharge Diagnosis, or Secondary Discharge Diagnoses, as well as NLP tools set out in prior studies to identify patients with PE within EHRs. Manual chart review by two independent abstractors by predefined criteria will be the reference standard. Sensitivity, specificity, and positive and negative predictive values will be determined. We will assess the discriminatory function of code subgroups for intermediate- and high-risk PE. In addition, accuracy of NLP algorithms to identify PE from radiology reports will be assessed.Results A total of 1,734 patients from the Mass General Brigham health system have been identified. These include 578 with ICD-10 Principal Discharge Diagnosis codes for PE, 578 with codes in the secondary position, and 578 without PE codes during the index hospitalization. Patients within each group were selected randomly from the entire pool of patients at the Mass General Brigham health system. A smaller subset of patients will also be identified from the Yale-New Haven Health System. Data validation and analyses will be forthcoming.Conclusions The PE-EHR+ study will help validate efficient tools for identification of patients with PE in EHRs, improving the reliability of efficient observational studies or randomized trials of patients with PE using electronic databases. Show less
Willik, E.M. van der; Breda, F. van; Jaarsveld, B.C. van; Putte, M. van de; Jetten, I.W.; Dekker, F.W.; ... ; Terwee, C.B. 2022
Background The Patient-Reported Outcomes Measurement Information System (PROMIS (R)) has been recommended for computerized adaptive testing (CAT) of health-related quality of life. This study... Show moreBackground The Patient-Reported Outcomes Measurement Information System (PROMIS (R)) has been recommended for computerized adaptive testing (CAT) of health-related quality of life. This study compared the content, validity, and reliability of seven PROMIS CATs to the 12-item Short-Form Health Survey (SF-12) in patients with advanced chronic kidney disease.Methods Adult patients with chronic kidney disease and an estimated glomerular filtration rate under 30 mL/min/1.73 m(2) who were not receiving dialysis treatment completed seven PROMIS CATs (assessing physical function, pain interference, fatigue, sleep disturbance, anxiety, depression, and the ability to participate in social roles and activities), the SF-12, and the PROMIS Pain Intensity single item and Dialysis Symptom Index at inclusion and 2 weeks. A content comparison was performed between PROMIS CATs and the SF-12. Construct validity of PROMIS CATs was assessed using Pearson's correlations. We assessed the test-retest reliability of all patient-reported outcome measures by calculating the intraclass correlation coefficient and minimal detectable change.Results In total, 207 patients participated in the study. A median of 45 items (10 minutes) were completed for PROMIS CATs. All PROMIS CATs showed evidence of sufficient construct validity. PROMIS CATs, most SF-12 domains and summary scores, and Dialysis Symptom Index showed sufficient test-retest reliability (intraclass correlation coefficient >= 0.70). PROMIS CATs had a lower minimal detectable change compared with the SF-12 (range, 5.7-7.4 compared with 11.3-21.7 across domains, respectively).Conclusion PROMIS CATs showed sufficient construct validity and test-retest reliability in patients with advanced chronic kidney disease. PROMIS CATs required more items but showed better reliability than the SF-12. Future research is needed to investigate the feasibility of PROMIS CATs for routine nephrology care. Show less
The Video Engagement Scale (VES) is a quality indicator to assess engagement in experimental video-vignette studies, but its measurement properties warrant improvement. Data from previous studies... Show moreThe Video Engagement Scale (VES) is a quality indicator to assess engagement in experimental video-vignette studies, but its measurement properties warrant improvement. Data from previous studies were combined (N = 2676) and split into three subsamples for a stepped analytical approach. We tested construct validity, criterion validity, reliability, and measurement invariance. Confirmatory factor analysis (CFA) reiterated poor fit of the previously suggested subscales. An alternative 2-factor structure is presented, which was cross-validated and further shortened (VES-sf). Reliability of both subscales (Immersion, Emotional Impact) was very high (alpha > .86). Multi-group CFAs demonstrated partial and complete measurement invariance among male/female and differently educated participants respectively. Invariance between healthy versus ill participants was not established, but CFAs supported the VES-sf structure in both groups separately. To conclude, we provide the VES-sf with sound measurement properties and demonstrated the appropriateness of comparing certain subgroups. Overall, we recommend the VES-sf to assess engagement/ecological validity in video-vignette research. Show less
Physical activity potentially improves health outcomes in patients with chronic kidney disease (CKD) and recipients of kidney transplants. Although studies have demonstrated the beneficial effects... Show morePhysical activity potentially improves health outcomes in patients with chronic kidney disease (CKD) and recipients of kidney transplants. Although studies have demonstrated the beneficial effects of physical activity and exercise for primary and secondary prevention of non-communicable diseases, evidence for kidney patients is limited. To enlarge this evidence, valid assessment of physical activity and exercise is essential. Furthermore, CKD is associated with a decline in physical function, which may result in severe disabilities and dependencies. Assessment of physical function may help clinicians to monitor disease progression and frailty in patients receiving dialysis. The attention on physical function and physical activity has grown and new devices have been developed and (commercially) launched on the market. Therefore the aims of this review were to summarize different measures of physical function and physical activity, provide an update on measurement instruments and discuss options for easy-to-use measurement instruments for day-to-day use by CKD patients. This review demonstrates that large variation exists in the different strategies to assess physical function and activity in clinical practice and research settings. To choose the best available method, accuracy, content, preferable outcome, necessary expertise, resources and time are important issues to consider. Show less
The ability to learn a foreign language, language aptitude, is known to differ between individuals. To better understand second-language learning, language aptitude tests, tapping into the... Show moreThe ability to learn a foreign language, language aptitude, is known to differ between individuals. To better understand second-language learning, language aptitude tests, tapping into the different components of second-language learning aptitude, are widely used. For valid conclusions on comparisons of learners with different language backgrounds, it is crucial that such tests be language neutral. Several studies have investigated the language neutrality of the freely available LLAMA tests (Granena, 2013; Rogers et al., 2016, 2017). So far, comparing a number of L1 backgrounds, including those using different writing systems such as Arabic and Mandarin, no significant differences between participants have been found. However, until now, neither participants with agglutinative language backgrounds nor with first-language backgrounds that use multiple writing systems have been included. Therefore, this study selected participants from three different first-language backgrounds: Dutch (non-agglutinative, phonogram/Latin alphabet), Hungarian (agglutinative, phonogram/Latin alphabet), and Japanese (agglutinative, phonogram/syllabic alphabet and logogram/Japanese kanji). The participants performed three subsets of the LLAMA test. Significant differences between the groups were found on two of these tests: The ability to implicitly recognize sounds (LLAMA_D subtest) and inductive grammar learning ability (LLAMA_F), but no differences were found on vocabulary learning ability (LLAMA_B). Additionally, for LLAMA_B, the number of languages learnt was a significant covariate, confirming earlier findings that some subtests seem to be linked to language learning experience. We discuss the implications of our findings on the validity of the LLAMA_D and LLAMA_F subtests. Show less
OBJECTIVE The 6-minute walking test (6WT) is used to determine restrictions in a subject's 6-minute walking distance (6WD) due to lumbar degenerative disc disease. To facilitate simple and... Show moreOBJECTIVE The 6-minute walking test (6WT) is used to determine restrictions in a subject's 6-minute walking distance (6WD) due to lumbar degenerative disc disease. To facilitate simple and convenient patient self-measurement, a free and reliable smartphone app using Global Positioning System coordinates was previously designed. The authors aimed to determine normative values for app-based 6WD measurements.METHODS The maximum 6WD was determined three times using app-based measurement in a sample of 330 volunteers without previous spine surgery or current spine-related disability, recruited at 8 centers in 5 countries (mean subject age 44.2 years, range 16-91 years; 48.5% male; mean BMI 24.6 kg/m(2), range 16.3-40.2 kg/m(2); 67.9% working; 14.2% smokers). Subjects provided basic demographic information, including comorbidities and patient-reported outcome measures (PROMs): visual analog scale (VAS) for both low-back and lower-extremity pain, Core Outcome Measures Index (COMI), Zurich Claudication Questionnaire (ZCQ), and subjective walking distance and duration. The authors determined the test-retest reliability across three measurements (intraclass correlation coefficient [ICC], standard error of measurement [SEM], and mean 6WD [95% CI]) stratified for age and sex, and content validity (linear regression coefficients) between 6WD and PROMs.RESULTS The ICC for repeated app-based 6WD measurements was 0.89 (95% CI 0.87-0.91, p < 0.001) and the SEM was 34 meters. The overall mean 6WD was 585.9 meters (95% CI 574.7-597.0 meters), with significant differences across age categories (p < 0.001). The 6WD was on average about 32 meters less in females (570.5 vs 602.2 meters, p = 0.005). There were linear correlations between average 6WD and VAS back pain, VAS leg pain, COMI Back and COMI subscores of pain intensity and disability, ZCQ symptom severity, ZCQ physical function, and ZCQ pain and neuroischemic symptoms subscores, as well as with subjective walking distance and duration, indicating that subjects with higher pain, higher disability, and lower subjective walking capacity had significantly lower 6WD (all p < 0.001).CONCLUSIONS This study provides normative data for app-based 6WD measurements in a multicenter sample from 8 institutions and 5 countries. These values can now be used as reference to compare 6WT results and quantify objective functional impairment in patients with degenerative diseases of the spine using z-scores. The authors found a good to excellent test-retest reliability of the 6WT app, a low area of uncertainty, and high content validity of the average 6WD with commonly used PROMs. Show less
Stolwijk, C.; Essers, I.; Bosch, F. van den; Dougados, M.; Etcheto, A.; Heijde, D. van der; ... ; ASAS-COMOSPA Study Grp 2020
Objective. To confirm validity of the Self-administered Comorbidity Questionnaire modified for patients with SpA (mSCQ), and assess whether validity improves when adding items on extra-articular... Show moreObjective. To confirm validity of the Self-administered Comorbidity Questionnaire modified for patients with SpA (mSCQ), and assess whether validity improves when adding items on extra-articular manifestations (EAMs), i.e. uveitis, psoriasis, and IBD, and osteoporosis and fractures.Methods. Data from the Assessment in SpondyloArthritis international Society COMOrbidities in SPondyloArthritis study were used. Criterion validity of presence of EAMs, osteoporosis and fractures was assessed as agreement (kappa) between patients' self-reported and physician-confirmed disease. Construct validity of the mSCQ including EAMs, osteoporosis and/or fractures (SpA-SCQ) was assessed by testing hypotheses about correlations with demographics, physical function, work ability, health utility and disease activity, and was compared with construct validity of the rheumatic disease comorbidity index.Results. In total, 3984 patients contributed to the analyses. Agreement between patient-reported and physician-reported EAMs was substantial to almost perfect (uveitis kappa = 0.81, IBD kappa = 0.73, psoriasis kappa = 0.86). Agreement for osteoporosis (kappa = 0.38) and fractures (kappa = 0.39) was fair. As hypothesized, the mSCQ correlated moderately to weakly with age, physical function, work limitations and health utility, and very weakly with disease activity. In contrast to our hypothesis, adding EAMs, osteoporosis and/or fractures to the mSCQ decreased correlations with several external constructs, especially among patients with peripheral SpA. Correlations with the different constructs were stronger for the both mSCQ and SpA-SCQ (r(BASFI) = 0.34; r(EQ-5D) = -0.33) compared with the rheumatic disease comorbidity index (r(BASFI) = 0.24; r(EQ-5D) = -0.21).Conclusion. The mSCQ is a valid self-report instrument to assess the influence of comorbidities on health outcomes in patients with SpA. Adding EAMs and/or osteoporosis or fractures does not improve validity of the mSCQ. Show less
Empirically capturing sociocultural interpretations—situated interpretations of linguistic expressions shared among members of a group—can be difficult for two reasons: First, the interpretations... Show moreEmpirically capturing sociocultural interpretations—situated interpretations of linguistic expressions shared among members of a group—can be difficult for two reasons: First, the interpretations themselves cannot be directly observed and, second, the contexts that enable these interpretations cannot be defined independently of them. Yet, the reality of such interpretations attested in piece after piece of empirical research calls for an explanation. This article outlines a bottom-up methodology that seeks to extract context-sensitive definitions of, on one hand, sociocultural interpretations and, on the other hand, the context variables that covary with them, from the data itself. Uptake-based definitions of sociocultural interpretations are empirically verifiable and include speaker, context, and addressee contributions to the bringing about of a certain sociocultural interpretation. Dynamic definitions of macro-social variables (gender, age, class, ethnicity, region, etc.) can emerge by gradually abstracting over the minimal contexts that are found to enable particular sociocultural interpretations. The article outlines with examples how this methodology can be applied to spoken conversational data, as well as some of its limitations. Show less
Introduction Accurate assessment of joint health in persons with haemophilia is crucial. Several haemophilia-specific measurement tools are available, but an overview of the measurement properties... Show moreIntroduction Accurate assessment of joint health in persons with haemophilia is crucial. Several haemophilia-specific measurement tools are available, but an overview of the measurement properties is lacking. Aim To provide an overview of the measurement properties of haemophilia-specific measurement tools to assess clinical joint health. Methods MEDLINE and EMBASE were searched for reports on reliability, validity or responsiveness of the World Federation of Haemophilia Orthopedic Joint Score (WFH), Colorado Physical Examination Score (CPE), joint examination score by Petrini (PJS) and Hemophilia Joint Health Score (HJHS). Methodological quality of the studies was assessed using an adapted COSMIN checklist. Results The search yielded 2905 unique hits, and 98 papers were included. The methodological quality of the included studies was limited. The HJHS was studied most extensively, which yielded limited evidence for good internal consistency and structural validity, moderate evidence for hypothesis testing in adults and conflicting evidence for hypothesis testing in children. Reliability, measurement error and responsiveness were rated unknown due to low COSMIN scores. For the CPE and PJS, we found limited to moderate evidence for good responsiveness and conflicting evidence for hypothesis testing. Conclusion Only patchy evidence is available on the quality of measurement properties of all haemophilia-specific joint health scores. Although significant gaps in the evidence for all instruments remain, measurement properties of the HJHS were most extensively studied and show no drawbacks for use in clinical practice. This review forms the basis for further research aimed at the assessment of measurement properties of measurement tools to assess joint health. Show less
Many researchers use Cronbach's alpha to demonstrate internal consistency, even though it has been shown numerous times that Cronbach's alpha is not suitable for this. Because the intention of... Show moreMany researchers use Cronbach's alpha to demonstrate internal consistency, even though it has been shown numerous times that Cronbach's alpha is not suitable for this. Because the intention of questionnaire and test constructers is to summarize the test by its overall sum score, we advocate summability, which we define as the proportion of total test variation that is explained by the sum score. This measure is closely related to Loevinger's H. The mathematical derivation of summability as a measure of explained variation is given for both scale and dichotomously scored items. Using computer simulations, we show that summability performs adequately and we apply it to an existing productive vocabulary test. An open-source tool to easily calculate summability is provided online (https://sites.google.com/view/summability). Show less
Introduction: Standardized assessments are widely used by speech pathologists in clinical and research settings to evaluate the language abilities of school-aged children and inform decisions about... Show moreIntroduction: Standardized assessments are widely used by speech pathologists in clinical and research settings to evaluate the language abilities of school-aged children and inform decisions about diagnosis, eligibility for services and intervention. Given the significance of these decisions, it is important that assessments have sound psychometric properties.Objective: The aim of this systematic review was to examine the psychometric quality of currently available comprehensive language assessments for school-aged children and identify assessments with the best evidence for use.Methods: Using the PRISMA framework as a guideline, a search of five databases and a review of websites and textbooks was undertaken to identify language assessments and published material on the reliability and validity of these assessments. The methodological quality of selected studies was evaluated using the COSMIN taxonomy and checklist.Results: Fifteen assessments were evaluated. For most assessments evidence of hypothesis testing (convergent and discriminant validity) was identified; with a smaller number of assessments having some evidence of reliability and content validity. No assessments presented with evidence of structural validity, internal consistency or error measurement. Overall, all assessments were identified as having limitations with regards to evidence of psychometric quality.Conclusions: Further research is required to provide good evidence of psychometric quality for currently available language assessments. Of the assessments evaluated, the Assessment of Literacy and Language, the Clinical Evaluation of Language Fundamentals-5th Edition, the Clinical Evaluation of Language Fundamentals-Preschool: 2nd Edition and the Preschool Language Scales-5th Edition presented with most evidence and are thus recommended for use. Show less
Galen, K.P.M. van; Timmer, M.A.; Kleijn, P. de; Fischer, K.; Foppen, W.; Schutgens, R.E.G.; ... ; Win Study Grp 2017
Background: Questionnaires are widely used to assess the mental health status of refugees, whereas their construct validity largely remains unexplored. Objective: This study examined the construct... Show moreBackground: Questionnaires are widely used to assess the mental health status of refugees, whereas their construct validity largely remains unexplored. Objective: This study examined the construct validity of two widely-used instruments for the assessment of PTSD symptoms (Harvard Trauma Questionnaire [HTQ]; 16 items) and symptoms of anxiety and depression (Hopkins Symptom Check list-25 [HSCL-25]; 25 items) among Dutch and refugee patients with different linguistic backgrounds. Method: We applied exploratory factor analyses and measurement invariance analyses to test construct validity.Participants (n =1 256) were divided into five linguistic groups defined by language family, including four non-western linguistic groups (Indo-Iranian [n = 262], NigerCongo [n = 134], Semitic [n = 288], and South Slavic languages [n = 199]) and one western linguistic group (Germanic languages; Dutch [n = 373]). Results: Exploratoryfactoranalysisyieldeda3-factorstructureoftheHTQanda2-factorstructure of the HSCL-25. Measurement invariance 20 analyses on the HTQ showed strong measurement invariance across the groups of refugee patients. However, Dutch patients reported milder symptom severity on most items of the HTQ. Measurement invariance analyses on the HSCL-25 (not conducted in Dutch patients) indicated partial strong measurement invariance across refugee patients. Conclusion: We conclude that mental health constructs measured by the HTQ and the HSCL25 25 are to a large extent interpreted in a similar way by refugee patients. This indicates that these instruments can be applied in non-western refugee patient populations, and that local idioms of distress and inherent response patterns may not play a major role when applying the HTQ and the HSCL-25 in these populations. Yet, whereas meaningful comparisons of observed PTSD and depression scores between groups of refugee patients with different non30 western linguistic background are feasible, comparisons between patients with a western and nonwestern linguistic background, as well as comparisons of anxiety scores, are likely to be biased. Future studies need to establish whether the commonly used cut-off scores of both questionnaires apply for refugee patients with non-western linguistic backgrounds. Show less
Bertens, A.S.; Moonen, J.E.F.; Waal, M.W.M. de; Foster-Dingley, J.C.; Ruijter, W. de; Gussekloo, J.; ... ; Craen, A.J.M. de 2017
