2044 Investigation of patient-reported outcomes following ACL reconstruction using Rasch analysis

OBJECTIVES/SPECIFIC AIMS: The knee injury osteoarthritis and outcomes survey (KOOS) is a commonly used instrument to measure patient-reported quality of life (QOL) post-ACLR. The purpose is to evaluate the psychometric properties of the QOL subscale of the KOOS. METHODS/STUDY POPULATION: Rasch analysis of KOOS QOL subscale from 39 individuals 1–2 years post ACLR was conducted. Measurement properties and model fit of the rating scale, items, and persons were evaluated. Relationship of item difficulties and person measures was evaluated using probability curves and item maps. Reliability indicators were also examined. RESULTS/ANTICIPATED RESULTS: All items demonstrated infit and outfit mean squares and standard z-scores. The majority of persons (n=38, 97.4%) demonstrated fit to the Rasch model. However, ceiling effects were noted (n=4, 10.26%), indicating some participants report higher QOL than is measurable. The mean person measure was 1.73 logits higher than the mean item measure: this sample is skewed toward higher QOL. Person reliability was adequate (0.67) and person separation was 1.42. Calculation of person strata revealed that the KOOS QOL separated participants into 2 strata. DISCUSSION/SIGNIFICANCE OF IMPACT: Although all items of the KOOS QOL fit the model, not all categories of the rating scale were used. Overall, this sample reported high QOL, which is to be expected given the time since ACLR. If participants with a broader range of time since ACLR were included, that the KOOS QOL could identify additional person strata.

Download Full-text

KOOS-JR Demonstrates Psychometric Limitations in Measuring Knee Health in Individuals After ACL Reconstruction

Sports Health A Multidisciplinary Approach ◽

10.1177/1941738118812454 ◽

2018 ◽

Vol 11 (3) ◽

pp. 242-246 ◽

Cited By ~ 2

Author(s):

Jennifer L. Hunnicutt ◽

Brittany N. Hand ◽

Chris M. Gregory ◽

Harris S. Slone ◽

Michelle M. McLeod ◽

...

Keyword(s):

Rasch Model ◽

Rasch Analysis ◽

Rating Scale ◽

Short Form ◽

Model Fit ◽

Measurement Properties ◽

Factor Analysis Model ◽

Ceiling Effects ◽

The Mean ◽

The Rasch Model

Background: Measurement properties of the short form of the Knee injury and Osteoarthritis Outcome Score (KOOS-JR) are not established in individuals after anterior cruciate ligament reconstruction (ACLR). The purpose of this study was to determine the extent to which the KOOS-JR measures the construct of knee health in individuals post-ACLR using Rasch analysis. Hypothesis: The KOOS-JR will fit the Rasch model, but significant ceiling effects will be present. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: Rasch analysis of the KOOS-JR from 166 individuals 10 months post-ACLR was conducted. Unidimensionality, a key criterion of the Rasch model, was evaluated using confirmatory factor analysis. Model fit of the rating scale, items, and persons were evaluated. Mean square fit statistics ≥1.6 and standardized z-scores ≥2.0 were indicative of person or item misfit. Additionally, reliability indicators including person reliability and separation indices were examined. Results: The KOOS-JR fit the criteria of unidimensionality. All items demonstrated model fit; however, ceiling effects were noted (n = 36; 22%). Person reliability was low (0.47). Calculation of person strata revealed that the KOOS-JR did not separate participants into more than 1 stratum. The mean person measure was 3.56 logits higher than the mean item measure, indicating that this sample is skewed toward increased knee health. Conclusion: Although the KOOS-JR represented a unidimensional construct with items and persons fitting the Rasch model, several limitations were noted: ceiling effects, low person reliability, and poor person differentiation. Ceiling effects indicate that many individuals in this sample experienced better knee health than the KOOS-JR items were able to measure. Clinical Relevance: Evaluating the measurement properties of the KOOS-JR is necessary to determine its clinical value in sports medicine. In later stages after ACLR recovery, administration of the KOOS-JR may not be adequate.

Download Full-text

Rasch Analysis of the Norwegian Version of the Occupational Balance Questionnaire in a Sample of Occupational Therapy Students

Occupational Therapy International ◽

10.1155/2021/8863453 ◽

2021 ◽

Vol 2021 ◽

pp. 1-11

Author(s):

Tore Bonsaksen ◽

Marte Ørud Lindstad ◽

Carita Håkansson ◽

Petra Wagman ◽

Reinie Cordier

Keyword(s):

Occupational Therapy ◽

Rasch Analysis ◽

Rating Scale ◽

Demographic Variables ◽

Measurement Properties ◽

Occupational Therapy Students ◽

Norwegian Version ◽

Item Functioning ◽

Best Fitting

Background. Recently, the Occupational Balance Questionnaire developed in Sweden was translated into Norwegian. No studies to date have examined the measurement properties of the Norwegian version of this questionnaire. Aim. The study is aimed at examining the psychometric properties of the Norwegian version of the Occupational Balance Questionnaire, the OBQ11-N. Methods. Along with sociodemographic data, 180 occupational therapy students enrolled at two Norwegian universities completed the OBQ11-N as well as one question each related to health and quality of life and some sociodemographic variables. Rasch analysis was employed for examining rating scale functioning, item and person validity, dimensionality, and differential item functioning. Results. Item categories were ordered, but there were potential gaps in the measurement of the construct. Person reliability was fair, whereas item reliability was low. Point biserial correlations were positive, indicating that all items contributed to the construct. Factor loadings were low for two items, and there were indices of a second underlying dimension and item redundancy. Many people were not aligned with the items, and some items functioned differently across various demographic variables. Conclusion and Significance. The OBQ11-N did not function as an adequate measure of occupational balance in a sample of students. Potentially, the detected measurement problems may be solved by adding more relevant items to a larger item pool, from which the best fitting items should be selected.

Download Full-text

Apathy Measures in Older Adults and People with Dementia: A Systematic Review of Measurement Properties Using the COSMIN Methodology

Dementia and Geriatric Cognitive Disorders ◽

10.1159/000515678 ◽

2021 ◽

pp. 1-13

Author(s):

Clare Burgon ◽

Sarah Elizabeth Goldberg ◽

Veronika van der Wardt ◽

Catherine Brewin ◽

Rowan H. Harwood

Keyword(s):

Systematic Review ◽

Older Adults ◽

Rating Scale ◽

Measurement Properties ◽

Evaluation Procedure ◽

Measurement Instruments ◽

Health Measurement ◽

Eligibility Criteria ◽

People With Dementia ◽

Patient Reported

Background: Apathy is highly prevalent in dementia and is also seen in mild cognitive impairment and the general population. Apathy contributes to failure to undertake daily activities and can lead to health problems or crises. It is therefore important to assess apathy. However, there is currently no gold standard measure of apathy. A comprehensive systematic review of the measurement properties of apathy scales is required. Methods: A systematic review was registered with PROSPERO (ID: CRD42018094390). MEDLINE, Embase, PsycINFO, and CINAHL were searched for studies that aimed to develop or assess the validity or reliability of an apathy scale in participants over 65 years, living in the community. A systematic review was conducted in line with the COnsensus-based Standards for the selection of health Measurement INstruments procedure for reviewing patient-reported outcome measures. The studies’ risk of bias was assessed, and all relevant measurement properties were assessed for quality. Results were pooled and rated using a modified Grading of Recommendations Assessment, Development, and Evaluation procedure. Results: Fifty-seven publications regarding 18 measures and 39 variations met the eligibility criteria. The methodological quality of individual studies ranged from inadequate to very good and measurement properties ranged from insufficient to sufficient. Similarly, the overall evidence for measurement properties ranged from very low to high quality. The Apathy Evaluation Scale (AES) and Lille Apathy Rating Scale (LARS) had sufficient content validity, reliability, construct validity, and where applicable, structural validity and internal consistency. Conclusion: Numerous scales are available to assess apathy, with varying psychometric properties. The AES and LARS are recommended for measuring apathy in older adults and people living with dementia. The apathy dimension of the commonly used Neuropsychiatric Inventory should be limited to screening for apathy.

Download Full-text

Measurement properties of patient-reported outcome measures (PROMs) in hyperhidrosis: a systematic review

Quality of Life Research ◽

10.1007/s11136-021-02958-3 ◽

2021 ◽

Author(s):

Michaela Gabes ◽

Helge Knüttel ◽

Gesina Kann ◽

Christina Tischer ◽

Christian J. Apfelbacher

Keyword(s):

Systematic Review ◽

Clinical Trials ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Measurement Properties ◽

High Quality ◽

High Quality Evidence ◽

Patient Reported ◽

Quality Evidence

Abstract Purpose To critically appraise, compare and summarize the quality of all existing PROMs that have been validated in hyperhidrosis to at least some extend by applying the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology. Thereby, we aim to give a recommendation for the use of PROMs in future clinical trials in hyperhidrosis. Methods We considered studies evaluating, describing or comparing measurement properties of PROMs as eligible. A systematic literature search in three big databases (MEDLINE, EMBASE and Web of Science) was performed. We assessed the methodological quality of each included study using the COSMIN Risk of Bias checklist. Furthermore, we applied predefined quality criteria for good measurement properties and finally, graded the quality of the evidence. Results Twenty-four articles reporting on 13 patient-reported outcome measures were included. Three instruments can be further recommended for use. They showed evidence for sufficient content validity and moderate- to high-quality evidence for sufficient internal consistency. The methodological assessment showed existing evidence gaps for eight other PROMs, which therefore require further validation studies to make an adequate decision on their recommendation. The Hyperhidrosis Disease Severity Measure-Axillary (HDSM-Ax) and the short-form health survey with 36 items (SF-36) were the only questionnaires not recommended for use in patients with hyperhidrosis due to moderate- to high-quality evidence for insufficient measurement properties. Conclusion Three PROMs, the Hyperhidrosis Quality of Life Index (HidroQoL), the Hyperhidrosis Questionnaire (HQ) and the Sweating Cognitions Inventory (SCI), can be recommended for use in future clinical trials in hyperhidrosis. Results obtained with these three instruments can be seen as trustworthy. Nevertheless, further validation of all three PROMs is desirable. Systematic review registration PROSPERO CRD42020170247

Download Full-text

Association of Progressive Supranuclear Palsy Rating Scale with Progressive Supranuclear Palsy Quality of Life Scale

Neurodegenerative Diseases ◽

10.1159/000514519 ◽

2021 ◽

pp. 1-8

Author(s):

Alexander Pantelyat ◽

Lenora Higginbotham ◽

Liana Rosenthal ◽

Diane Lanham ◽

Vanessa Nesspor ◽

...

Keyword(s):

Quality Of Life ◽

Clinical Trials ◽

Progressive Supranuclear Palsy ◽

Rating Scale ◽

Linear Regression Analysis ◽

Disease Evolution ◽

Quality Of Life Scale ◽

Patient Reported ◽

Scale Scores

Introduction: There is growing interest in using patient-reported outcomes as end points in clinical trials, such as the progressive supranuclear palsy quality of life (PSP-QoL) scale. However, this tool has not been widely validated and its correlation with validated motor scales has not been explored. To evaluate the potential utility of using PSP-QoL as an outcome, it is important to examine its relationship with a standard scale used to evaluate neurologic parameters, such as the PSP Rating Scale. Methods: PSP-QoL and PSP Rating Scale scores were gathered from 60 clinically diagnosed PSP patients, including patients with Richardson syndrome PSP (PSP-RS, n = 43) and those with non-RS PSP variants (n = 17). Linear regression analysis adjusted for age, sex, and disease duration was used to evaluate the cross-sectional relationship between the total and subscale scores of the 2 instruments. Results: Among 60 PSP patients, there was a significant correlation between total PSP-QoL and PSP Rating Scale scores. The physical and mentation subscales of each instrument also demonstrated significant correlations. Comparisons among PSP subtypes indicated that worsening PSP-QoL Total and Physical subscale scores correlated with worsening PSP Rating Scale gait subscale scores more strongly for the non-RS PSP variants than for PSP-RS. Discussion: There is a significant association between the total scores and many of the subscale scores of the PSP-QoL and the PSP Rating Scale. Additionally, the relationship between these measures may differ for PSP-RS and non-RS variants. These findings suggest that the PSP-QoL may be useful in clinical trials as a patient-reported outcome measure. Large prospective multicenter studies utilizing the PSP-QoL are necessary to examine its relationship to disease evolution and changes in the PSP Rating Scale.

Download Full-text

Patient-Reported Outcome Measures for Post-mastectomy Breast Reconstruction: A Systematic Review of Development and Measurement Properties

Annals of Surgical Oncology ◽

10.1245/s10434-020-08736-8 ◽

2020 ◽

Vol 28 (1) ◽

pp. 386-404 ◽

Cited By ~ 1

Author(s):

C. F. Davies ◽

R. Macefield ◽

K. Avery ◽

J. M. Blazeby ◽

S. Potter

Keyword(s):

Systematic Review ◽

Breast Reconstruction ◽

Content Validity ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Measurement Properties ◽

Future Studies ◽

Patient Reported ◽

Eortc Qlq

Abstract Background Breast reconstruction (BR) is performed to improve outcomes for patients undergoing mastectomy. A recently developed core outcome set for BR includes six patient-reported outcomes that should be measured and reported in all future studies. It is vital that any instrument used to measure these outcomes as part of a core measurement set be robustly developed and validated so data are reliable and accurate. The aim of this systematic review is to evaluate the development and measurement properties of existing BR patient-reported outcome measures (PROMs) to inform instrument selection for future studies. Methods A PRISMA-compliant systematic review of development and validation studies of BR PROMs was conducted to assess their measurement properties. PROMs with adequate content validity were assessed using three steps: (1) the methodological quality of each identified study was assessed using the COSMIN Risk of Bias checklist; (2) criteria were applied for assessing good measurement properties; and (3) evidence was summarized and the quality of evidence assessed using a modified GRADE approach. Results Fourteen articles reported the development and measurement properties of six PROMs. Of these, only three (BREAST-Q, BRECON-31, and EORTC QLQ-BRECON-23) were considered to have adequate content validity and proceeded to full evaluation. This showed that all three PROMs had been robustly developed and validated and demonstrated adequate quality. Conclusions BREAST-Q, BRECON-31, and EORTC QLQ-BRECON-23 have been well-developed and demonstrate adequate measurement properties. Work with key stakeholders is now needed to generate consensus regarding which PROM should be recommended for inclusion in a core measurement set.

Download Full-text

The Relationship between Restless Legs Syndrome and Quality of Life in Patients with Myasthenia Gravis

European Neurology ◽

10.1159/000502002 ◽

2019 ◽

Vol 81 (3-4) ◽

pp. 205-208

Author(s):

Monica F. Ataide ◽

Carolina da Cunha-Correia ◽

Katia C.L. Petribú

Keyword(s):

Quality Of Life ◽

Myasthenia Gravis ◽

Restless Legs Syndrome ◽

Rating Scale ◽

Cross Sectional Study ◽

Cross Sectional ◽

Restless Legs ◽

Study Population ◽

Clinical Conditions

Background: Restless legs syndrome (RLS) is characterized for an uncomfortable sensation in legs and an irresistible desire to move them. This disorder has been more recently recognized in patients with myasthenia gravis (MG) and can interfere with the quality of life (QOL). Objectives: The aims of this study are to describe the prevalence of RLS and its severity and influence on the QOL in patients with MG. Method: This was a cross-sectional study conducted from May to June 2016 in Recife, Brazil. A sample of 42 patients was interviewed using a sociodemographic questionnaire, MG QOL questionnaire-15 and The RLS Rating Scale. Results: RLS was present in 47.6% of patients and of these 40.5% met moderate to severe RLS criteria. Patients were 45 years on average (SD ± 14.4) and women represented 57.1% of the study population. Among patients with RSL, the quality-of-life scores were worse (p = 0.010) on average. There was no association of RLS with the duration of MG, use of immunosuppressant or clinical conditions that could mimic the occurrence of RLS. Conclusion: RLS is a prevalent condition in patients with MG, and may be severe enough to negatively impact QOL.

Download Full-text

Patient Satisfaction and Short-Term Outcome in Elective Cranial Neurosurgery

Neurosurgery ◽

10.1227/neu.0000000000000931 ◽

2015 ◽

Vol 77 (5) ◽

pp. 769-776 ◽

Cited By ~ 11

Author(s):

Elina Reponen ◽

Hanna Tuominen ◽

Juha Hernesniemi ◽

Miikka Korja

Keyword(s):

Patient Satisfaction ◽

Quality Of Care ◽

Health Status ◽

Patient Experience ◽

University Hospital ◽

Term Outcome ◽

Major Morbidity ◽

Patient Reported ◽

Relationship Of

Abstract BACKGROUND: Patient-reported experience is often used as a measure for quality of care, but no reports on patient satisfaction after cranial neurosurgery exist. OBJECTIVE: To study the association of overall patient satisfaction and surgical outcome and to evaluate the applicability of overall patient satisfaction as a proxy for quality of care in elective cranial neurosurgery. METHODS: We conducted an observational study on the relationship of overall patient satisfaction at 30 postoperative days with surgical and functional outcome (modified Rankin Scale [mRS] score) in a prospective, consecutive, and unselected cohort of 418 adult elective craniotomy patients enrolled between December 2011 and December 2012 at Helsinki University Hospital, Helsinki, Finland. RESULTS: Postoperative overall (subjective and objective) morbidity was present in 194 (46.4%) patients; yet almost 94% of all study patients reported high overall satisfaction. Low overall patient satisfaction at 30 days was not associated with postoperative major morbidity in elective cranial neurosurgery. Dependent functional status (mRS score ≥3) at 30 days, minor infections, poor postoperative subjective overall health status, and patient-reported severe symptoms (double vision, poor balance) may contribute to unsatisfactory patient experience. CONCLUSION: Overall patient satisfaction with elective cranial neurosurgery is high. Even 9 of 10 patients with postoperative major morbidity rated high overall patient satisfaction at 30 days. Overall patient satisfaction may merely reflect patient experience and subjective postoperative health status, and therefore it is a poor proxy for quality of care in elective cranial neurosurgery.

Download Full-text

Patient Reported Outcome Measures Assessing Health-Related Quality Of Life in Dupuytren´S Disease: A Systematic Review

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol05-i01/803 ◽

2020 ◽

Vol 5 (01) ◽

Author(s):

Diego Gómez Herrero ◽

Rafael Sanjuan-Cerveró ◽

Pedro Vazquez-Ferreiro ◽

Francisco Javier Carrera-Hueso ◽

Marina Sáez-Belló ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Outcome Measures ◽

Patient Reported Outcome Measures ◽

Measurement Properties ◽

Health Related Quality ◽

Patient Reported ◽

Related Quality ◽

Health Related

Objective: The objective of this study is to carry out a systematic review of the outcome measures reported by the patient that are used to measure the quality of life of patients with Dupuytren´s disease (DD), assessing their relevance and effectiveness. Methods: A systematic literature search was carried out in the PubMed®, Web of Sciencie®, SciELO®, EMBASE®, Google Scholar® and Cochrane® databases. We searched for peer-reviewed articles evaluating health related quality of life (HR-QoL) in patients with DD diagnosed and/or treated until April 1, 2017, for English or Spanish language. The following keywords were used: “Dupuytren´s disease (MeSH)” AND “health related quality of life (MeSH)”. The documents were eligible for inclusion if they described data on the HR-QoL domains in relation to diagnosis or treatment of DD after a revision process by two independent authors. The checklist (STROBE) was used to evaluate the quality of the works. Results: From 352 identified articles were finally selected 26 studies in the systematic review, mostly European. A total of nine outcomes measures specifically reported by the patient were identified: DASH (used in 13 of the 26 selected studies), Quick-DASH (8/26), MHQ (7/26), briefMHQ (1/26), URAM (4/26), POS-HAND/ARM (1/26), SDSS (1/26), DDSP (1/26) and CHFS (1/26) questionnaires. We analyze their quantitative results to evaluate the effectiveness and evaluate the methodological quality of the studies on the measurement properties of the results reported by patients related to health. Conclusion: More work is urgently needed in these areas before we can reach a consensus on which instrument is the best to assess functional deterioration and improvement in patients with DD.

Download Full-text

General Health Status, Quality Of Life and Social Support of Young Athletes and Young Non-Athletes in Yazd

Social Behavior Research & Health ◽

10.18502/sbrh.v3i1.1037 ◽

2019 ◽

Author(s):

Seyed Saeed Mazloomy Mahmoodabad ◽

Nahid Ardian ◽

Hadi Eslami

Keyword(s):

Quality Of Life ◽

Social Support ◽

General Health ◽

P Value ◽

Young Athletes ◽

Health Quality ◽

Study Population ◽

Health Quality Of Life ◽

The Mean

Background: One of the factors influencing the level of general health and quality of life of individuals, is the level of social support that people enjoy. Given the importance of general health, quality of life and the amount of social support and their relationship with the level of physical activity in young people in Yazd province counties were studied. Methods: The study population of this descriptive, cross-sectional study consisted of 15- to 29-year-old people. Given the study population, sample size was calculated for the counties Yazd, Mehriz, Ardakan and Meybod separately. Methods: A total of 1533 people were selected by cluster sampling, and a person aged 15-29 years from each family completed the questionnaire. The questionnaire used, in addition to demographic questions, included three sections general health questionnaire (GHQ-28), Multidimensional Scale of Perceived Social Support, and World Health Organization Quality Of Life Brief (WHOQOL-BREF). The data were analyzed by SPSS18, nonparametric statistical tests and Pearson's correlation. Results: The mean general health score of youth was 30.82 (9.56) and the mean scores of their quality of life and social support were 38.32 (8.67) and 42.64 (7.73), respectively. Mental health, quality of life and social support were significantly associated with education level (P-value ≤ 0.001). The quality of life of young athletes was higher than that of young non-athletes (P-value ≤ 0.001). General health and social support were higher in women than in men (P-value ≤ 0.001). Conclusion: The general health level of Yazd youth is higher than the cut-off point and not optimal, but based on social and cultural conditions in this province, the levels of social support and quality of life were found to be satisfactory. Planning to increase the level of vitality and exercise in different fields can be an opportunity to improve the general health of young people.

Download Full-text