Veränderungsmessung mit der Kurzform des OPD-Strukturfragebogens (OPD-SFK)

2021 ◽  
Author(s):  
Laura Lübke ◽  
Eva Flemming ◽  
Robert Mestel ◽  
Oliver Masuhr ◽  
Ulrich Jaeger ◽  
...  
Keyword(s):  
Effect Size ◽  
Real Difference ◽  
Standardized Response Mean

AbstractDas transdiagnostische Konzept der Ich- bzw. Persönlichkeitsstruktur spielt in der psychodynamischen Krankheitslehre eine zentrale Rolle, gelten doch viele psychische und psychoso-matische Störungen als Ausdruck struktureller Vulnerabilitäten und Defizite. Daher kommt der Strukturdiagnostik eine besondere Bedeutung zu, gerade unter differenzialindikatorischen und behandlungstechnischen Aspekten. Weil Veränderungen der Persönlichkeitsstruktur auch als Therapieziel immer mehr Beachtung finden, sollten strukturdiagnostische Verfahren änderungssensitiv sein, um diese angemessen zu erfassen. Die Kurzform des OPD-Strukturfragebogens (OPD-SFK) wird zwar aufgrund ihrer Anwendungsökonomie klinisch und wissenschaftlich vielfach eingesetzt, ist bisher jedoch nicht auf ihre Eignung zur Veränderungsmessung analysiert worden. Zwei große, unabhängige und diagnostisch heterogene Stichproben stationärer Psychotherapiepatienten (N=1183 bzw. 967) wurden bei Aufnahme und Entlassung mit dem OPD-SFK untersucht. Als Indikatoren der Änderungssensitivität wurden die Standardized Effect Size (SES), der Standardized Response Mean (SRM) sowie die Smallest Real Difference (SRD) berechnet. Für den OPD-SFK Gesamtwert sowie die Subskalen wurden in beiden Stichproben Veränderungseffekte in niedriger Größenordnung gefunden (SES zwischen 0,23 und 0,48 sowie SRM zwischen 0,27 und 0,53). Zudem wurde gezeigt, dass mit dem OPD-SFK größere Veränderungen für Patienten mit strukturellen Störungen nachweisbar sind als für jene mit geringen Strukturdefiziten und dass die Gruppenunterschiede signifikant sind. Mittels der SRD wurde in beiden Stichproben ein Anteil von 22% signifikant strukturell verbesserter Patienten ermittelt. Trotz einiger methodenkritischer Aspekte legen die Befunde nahe, dass sich der OPD-SFK bei stationären Psychotherapiepatienten eignet, um Veränderungen persönlichkeitsstruktureller Fähigkeiten zwischen Beginn und Abschluss der Behandlung abzubilden. Da Untersuchungen zur Änderungssensitivität anderer strukturdiagnostischer Verfahren ausstehen, können bislang keine empirisch abgesicherten Empfehlungen formuliert werden, welches Instrument am besten therapeutisch induzierte Veränderungen in der Persönlichkeitsstruktur erfasst.

RESPONSIVENESS OF THE EQ-5D TO CLINICAL CHANGE: IS THE PATIENT EXPERIENCE ADEQUATELY REPRESENTED?

2014 ◽  
Vol 30 (1) ◽  
pp. 10-19 ◽  
Author(s):  
David Tordrup ◽  
Jean Mossman ◽  
Panos Kanavos
Keyword(s):  
Patient Experience ◽  
Effect Size ◽  
Significant Proportion ◽  
Well Being ◽  
Economic Evaluations ◽  
Health State ◽  
Clinical Change ◽  
Standardized Response Mean ◽  
Life Years ◽  
Wide Range

Objectives: In many economic evaluations and reimbursement decisions, quality-adjusted life-years (QALYs) are used as a measure of benefit to assess effectiveness of novel therapies, often based on the EQ-5D 3-level questionnaire. As only five dimensions of physical and mental well-being are reflected in this tool, significant aspects of the patient experience may be missed. We evaluate the use of the EQ-5D as a measurement of clinical change across a wide range of disorders from dermatological (acne) to life-threatening (metastatic cancers).Methods: We analyze published studies on the psychometric properties of the EQ-5D 3-level questionnaire, extracting information on the Visual Analogue Scale versus Index score, Standardized Response Mean, and Effect Size. These are compared with ranges generally accepted to represent good responsiveness in the psychometric literature.Results: We find that only approximately one in five study populations report subjective health state valuation of patients within 5 percent of the score attributed by the EQ-5D index, and more than 40 percent of studies report unacceptable ceiling effects. In the majority of studies, responsiveness of the EQ-5D index was found to be poor to moderate, based on Effect Size (63 percent poor–moderate) and Standardized Response Mean (72 percent poor–moderate).Conclusions: We conclude that the EQ-5D index does not adequately reflect patient health status across a range of conditions, and it is likely that a significant proportion of the subjective patient experience is not accounted for by the index. This has implications for economic evaluations of novel drugs based on evidence generated with the EQ-5D.

Favorable Responsiveness of the Hand10 Questionnaire to Assess Treatment Outcomes for Lateral Epicondylitis

2018 ◽  
Vol 23 (02) ◽  
pp. 205-209 ◽  
Author(s):  
Takanobu Nishizuka ◽  
Katsuyuki Iwatsuki ◽  
Shigeru Kurimoto ◽  
Michiro Yamamoto ◽  
Tetsuro Onishi ◽  
...  
Keyword(s):  
Visual Analogue Scale ◽  
Treatment Outcomes ◽  
Effect Size ◽  
Analogue Scale ◽  
Lateral Epicondylitis ◽  
The Other ◽  
Pain Visual Analogue Scale ◽  
Standardized Response Mean

Background: The aim of our study was to compare the responsiveness of the Hand10 questionnaire and the Pain visual analogue scale (VAS) for the assessment of lateral epicondylitis. Methods: The standardized response mean and effect size were used as indicators of responsiveness, measured at baseline and after 6 months of treatment. Among the 54 patients enrolled, 28 were treated using a forearm band, compress and stretching, with the other 26 patients treated using compress and stretching. Results: The standardized response mean and the effect size were 1.18 and 1.38, respectively, of the Hand10 and 1.39 and 1.75, respectively, for the Pain VAS. Conclusions: The responsiveness of both tests was considered to be large, based on Cohen’s classification of effect size, supporting the use of the Hand10 questionnaire to assess treatment outcomes for lateral epicondylitis.

Comparative responsiveness of the Hand 20 and the DASH-JSSH questionnaires to clinical changes after carpal tunnel release

2013 ◽  
Vol 39 (2) ◽  
pp. 145-151 ◽  
Author(s):  
K. Iwatsuki ◽  
K. Nishikawa ◽  
M. Chaki ◽  
A. Sato ◽  
A. Morita ◽  
...  
Keyword(s):  
Carpal Tunnel ◽  
Effect Size ◽  
Carpal Tunnel Release ◽  
Japanese Version ◽  
Standardized Response Mean ◽  
Tunnel Syndrome ◽  
Effect Of Treatment ◽  
Clinical Changes ◽  
Open Carpal Tunnel Release ◽  
Hand Scale

This study compared the responsiveness of the Hand 20 and the Japanese version of the disabilities of the arm, shoulder and hand (DASH-JSSH) questionnaires in carpal tunnel syndrome. The scores before and 3 months after surgery were used to calculate the standardized response mean and effect size. Of 57 patients enrolled in the study, 13 underwent open carpal tunnel release and 44 had endoscopic carpal tunnel release. The standardized response mean and the effect size of the Hand 20 scale were 0.60 and 0.54, respectively, and those of the disabilities of the arm, shoulder and hand scale were 0.39 and 0.36, respectively. Compared with the Disabilities of the Arm, Shoulder and Hand questionnaire, the Hand 20 questionnaire appears to have better responsiveness for assessing the effect of treatment by carpal tunnel release.

Validation of the Swedish Version of Western Ontario Osteoarthritis of the Shoulder Index

2021 ◽  
Author(s):  
Kristofer Hallberg ◽  
Björn Salomonsson
Keyword(s):  
Correlation Coefficient ◽  
Effect Size ◽  
Shoulder Arthroplasty ◽  
Pearson’S Correlation Coefficient ◽  
Standardized Response Mean ◽  
Arthroplasty Registry ◽  
Patient Reported ◽  
Ceiling Effects ◽  
Floor Effects ◽  
Pearson's Correlation

Abstract BackgroundThe Western Ontario of the Shoulder index (WOOS) is a patient-reported, disease-specific instrument, designed to measure quality of life in patients with osteoarthritis of the shoulder. The Swedish Shoulder Arthroplasty Registry (SSAR) uses WOOS and EuroQoL 5-dimensions 3 levels (EQ-5D-3L) as patient reported outcome measures. The purpose of this study was to test the validity, responsiveness, and reliability of the Swedish translation of WOOS for patients with osteoarthritis of the shoulder.MethodsData was collected from three shoulder arthroplasty studies performed during 2005-2013, with 23, 21, and 19 patients respectively. Forms were collected preoperatively, and postoperatively between 12 and 24 months. WOOS and EQ-5D-3L were used in all three studies. Additionally, the Oxford Shoulder Score (OSS) (n=23) was used in one study, and the Constant-Murley score (CMS) (n=40) in two of the studies. Validity was analysed by calculating Pearson’s correlation coefficient (PCC). Cronbach’s alpha (CA) was used to estimate internal consistency and reliability. The responsiveness of WOOS was measured by calculating effect size and standardized response mean. To assess the performance of WOOS over time, we present repeated measures of WOOS in the registry over a 10-year period.ResultsThe validity analysis showed excellent correlations of WOOS to CMS, OSS and EQ-5D 3L, with Pearson’s correlation coefficient of 0.72, 0.83, and 0.62 respectively (P<0.001). There were adequate floor effects in the sport and lifestyle domains preoperatively, and adequate ceiling effects in all domains postoperatively. There were no floor effects and adequate ceiling effects for total WOOS. Analyzing reliability, Cronbach’s alpha was 0.95 for the pre- and postoperative WOOS scores combined. The analysis of responsiveness for WOOS showed an effect size of 2.52 and a standardized response mean of 1.43.The individual results measured by WOOS within the registry shows stable levels from 1 to 10 years.ConclusionThe Swedish translation of WOOS is valid, reliable, and responsive for use in a clinical setting for patients with glenohumeral osteoarthritis treated with shoulder arthroplasty, and we regard it as an appropriate instrument for use in the Swedish Shoulder Arthroplasty Registry.

Responsiveness of five measures of arm function in acute stroke rehabilitation

2018 ◽  
Vol 32 (8) ◽  
pp. 1098-1107 ◽  
Author(s):  
Angela Vratsistas-Curto ◽  
Catherine Sherrington ◽  
Annie McCluskey
Keyword(s):  
Action Research ◽  
Effect Size ◽  
Stroke Rehabilitation ◽  
Large Range ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Range Effect ◽  
Manual Muscle Test ◽  
Standardized Response Mean ◽  
Block Test

Objective: To determine the responsiveness of five arm function measures in people receiving acute inpatient stroke rehabilitation. Design: Inception cohort study. Setting: Comprehensive stroke unit providing early rehabilitation. Subjects: A total of 64 consecutively admitted stroke survivors with moderately severe disability (Modified Rankin Scale score median (interquartile range (IQR)): 4.0 (1.0)). Main measures: Responsiveness was analyzed by calculating effect size, standardized response mean and median-based effect size. Floor/ceiling effects were calculated as the percentage of participants scoring the lowest/highest possible scores. Results: Average length of stay and number of therapy days were 34 (SD = 27.9) and 12 (SD = 13.1), respectively. Box and Block Test and Functional Independence Measure–Self-Care showed the highest responsiveness with values in the moderate–large range (effect size = 1.09, standardized response mean = 1.07 and median-based effect size = 0.76; effect size = 0.94, standardized response mean = 1.04 and median-based effect size = 1.0). Responsiveness of Action Research Arm Test and Upper Limb–Motor Assessment Scale were moderate (effect size = 0.58, standardized response mean = 0.69 and median-based effect size = 0.59; effect size = 0.62, standardized response mean = 0.75 and median-based effect size = 0.67). For Manual Muscle Test, responsiveness was in the small–moderate range (effect size = 0.42, standardized response mean = 0.59 and median-based effect size = 0.5). Box and Block Test showed the largest floor effect on admission (28%), and Action Research Arm Test and Manual Muscle Test showed the largest ceiling effect on discharge (31%). Conclusion: These five measures varied in their ability to detect change with responsiveness ranging from the small to large range. Box and Block Test and Functional Independence Measure–Self-Care showed a greater ability to detect change; both demonstrated moderate–large responsiveness.

Evaluation von Gesundheitsförderungsprogrammen - Methodische Stolpersteine und pragmatische Empfehlungen

2000 ◽  
Vol 8 (1) ◽  
pp. 18-24 ◽  
Author(s):  
Gert Kaluza ◽  
Hans-Henning Schulze
Keyword(s):  
Effect Size ◽  
Power Analysis ◽  
Prävention Und Gesundheitsförderung ◽  
Size Display ◽  
Methodische Probleme

Zusammenfassung. Die Evaluation von Interventionen zur Prävention und Gesundheitsförderung stellt ein zentrales Aufgabenfeld der gesundheitspsychologischen Forschung dar. Häufige methodische Probleme entsprechender Evaluationsstudien betreffen 1. Ausgangswert-Unterschiede bei nicht randomisierten Studiendesigns, 2. Abhängigkeit von Beobachtungen bei Gruppeninterventionsstudien, 3. Kapitalisierung von Irrtumswahrscheinlichkeiten aufgrund einer Vielzahl von abhängigen Variablen und 4. Beurteilung der praktischen Relevanz statistisch signifikanter Interventionseffekte. Zu deren pragmatischer Lösung werden u.a. 1. die Anwendung kovarianzanalytischer Auswertungsstrategien, 2. die Berechnung von Intraclass-Korrelationen und ggf. eine Datenauswertung auf der Ebene der Gruppenmittelwerte, 3. eine Reduktion der Anzahl der abhängigen Variablen mittels Hauptkomponentenanalyse sowie eine Alpha-Adjustierung unter Berücksichtigung der Teststärke (“compromise power analysis”) und 4. die Umrechnung gängiger Effektstärken in prozentuale Erfolgsraten (“binomial effect size display”) empfohlen.

The Level of Reaction Time Determines the ERP Correlates of Auditory Negative Priming

2006 ◽  
Vol 20 (3) ◽  
pp. 186-194 ◽  
Author(s):  
Susanne Mayr ◽  
Michael Niedeggen ◽  
Axel Buchner ◽  
Guido Orgs
Keyword(s):  
Reaction Time ◽  
Negative Priming ◽  
Effect Size ◽  
Priming Effect ◽  
Reaction Times ◽  
Negative Priming Effect ◽  
Episodic Retrieval ◽  
Time Level ◽  
Fast Reactions ◽  
Priming Condition

Responding to a stimulus that had to be ignored previously is usually slowed-down (negative priming effect). This study investigates the reaction time and ERP effects of the negative priming phenomenon in the auditory domain. Thirty participants had to categorize sounds as musical instruments or animal voices. Reaction times were slowed-down in the negative priming condition relative to two control conditions. This effect was stronger for slow reactions (above intraindividual median) than for fast reactions (below intraindividual median). ERP analysis revealed a parietally located negativity of the negative priming condition compared to the control conditions between 550-730 ms poststimulus. This replicates the findings of Mayr, Niedeggen, Buchner, and Pietrowsky (2003) . The ERP correlate was more pronounced for slow trials (above intraindividual median) than for fast trials (below intraindividual median). The dependency of the negative priming effect size on the reaction time level found in the reaction time analysis as well as in the ERP analysis is consistent with both the inhibition as well as the episodic retrieval account of negative priming. A methodological artifact explanation of this effect-size dependency is discussed and discarded.

Clinically Meaningful Change

Methodology ◽  
2019 ◽  
Vol 15 (3) ◽  
pp. 97-105
Author(s):  
Rodrigo Ferrer ◽  
Antonio Pardo
Keyword(s):  
Effect Size ◽  
False Negative ◽  
False Negative Rate ◽  
Point Of View ◽  
Skewed Distribution ◽  
Effect Sizes ◽  
False Negatives ◽  
Large Size ◽  
Before And After ◽  
Post Test

Abstract. In a recent paper, Ferrer and Pardo (2014) tested several distribution-based methods designed to assess when test scores obtained before and after an intervention reflect a statistically reliable change. However, we still do not know how these methods perform from the point of view of false negatives. For this purpose, we have simulated change scenarios (different effect sizes in a pre-post-test design) with distributions of different shapes and with different sample sizes. For each simulated scenario, we generated 1,000 samples. In each sample, we recorded the false-negative rate of the five distribution-based methods with the best performance from the point of view of the false positives. Our results have revealed unacceptable rates of false negatives even with effects of very large size, starting from 31.8% in an optimistic scenario (effect size of 2.0 and a normal distribution) to 99.9% in the worst scenario (effect size of 0.2 and a highly skewed distribution). Therefore, our results suggest that the widely used distribution-based methods must be applied with caution in a clinical context, because they need huge effect sizes to detect a true change. However, we made some considerations regarding the effect size and the cut-off points commonly used which allow us to be more precise in our estimates.

How to Detect Publication Bias in Psychological Research

2019 ◽  
Vol 227 (4) ◽  
pp. 261-279 ◽  
Author(s):  
Frank Renkewitz ◽  
Melanie Keiner
Keyword(s):  
Publication Bias ◽  
Effect Size ◽  
Statistical Power ◽  
Type I Error ◽  
Psychological Research ◽  
Type I ◽  
True Effect Size ◽  
Questionable Research Practices ◽  
True Effect ◽  
Meta Analyses

Abstract. Publication biases and questionable research practices are assumed to be two of the main causes of low replication rates. Both of these problems lead to severely inflated effect size estimates in meta-analyses. Methodologists have proposed a number of statistical tools to detect such bias in meta-analytic results. We present an evaluation of the performance of six of these tools. To assess the Type I error rate and the statistical power of these methods, we simulated a large variety of literatures that differed with regard to true effect size, heterogeneity, number of available primary studies, and sample sizes of these primary studies; furthermore, simulated studies were subjected to different degrees of publication bias. Our results show that across all simulated conditions, no method consistently outperformed the others. Additionally, all methods performed poorly when true effect sizes were heterogeneous or primary studies had a small chance of being published, irrespective of their results. This suggests that in many actual meta-analyses in psychology, bias will remain undiscovered no matter which detection method is used.

The Relationship Between Immorality and Cleansing

2018 ◽  
Vol 49 (5) ◽  
pp. 303-309 ◽  
Author(s):  
Jedidiah Siev ◽  
Shelby E. Zuckerman ◽  
Joseph J. Siev
Keyword(s):  
Effect Size ◽  
Meta Analysis ◽  
Weighted Mean ◽  
The Relationship

Abstract. In a widely publicized set of studies, participants who were primed to consider unethical events preferred cleansing products more than did those primed with ethical events ( Zhong & Liljenquist, 2006 ). This tendency to respond to moral threat with physical cleansing is known as the Macbeth Effect. Several subsequent efforts, however, did not replicate this relationship. The present manuscript reports the results of a meta-analysis of 15 studies testing this relationship. The weighted mean effect size was small across all studies (g = 0.17, 95% CI [0.04, 0.31]), and nonsignificant across studies conducted in independent laboratories (g = 0.07, 95% CI [−0.04, 0.19]). We conclude that there is little evidence for an overall Macbeth Effect; however, there may be a Macbeth Effect under certain conditions.

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