Disablement in the Physically Active Scale Short Form-8: psychometric evaluation

Abstract Background Patient-centered care and evidence-based practice (EBP) are core competencies for health care professionals. The importance of EBP has led to an increase in research involving clinical outcomes; current recommendations emphasize collecting patient focused measures, thus increasing the need for psychometrically sound patient reported outcome measures (PROMs) of health. Disablement has been identified as a valuable multi-dimensional construct for patient care. The Disablement in the Physically Active Scale Short Form-8 (DPA SF-8) has been proposed as a tool to be used in the physically active population that assesses a physical summary component of health and a quality of life component however, further analysis is necessary to ensure the instrument is psychometrically sound. Methods Confirmatory factor analyses (CFAs) were conducted on the DPA SF-8 at each time point to ensure factor structure. Reliability of the scale and internal consistency of the subscales were assessed, and a minimal detectable change (MDC) calculated. Additionally, a minimal clinically important difference (MCID) was also established, and invariance testing across three time points and groups was conducted. Results The CFAs at all three visits exceeded recommended model fit indices. The interclass correlation coefficient value (.924) calculated indicated excellent scale reliability and Cronbach’s alpha for subscales PHY and QOL were within recommend values. The MDC value calculated was 5.83 and the MCID for persistent injuries were 2 points and for acute injuries, 3 points. The DPA SF-8 was invariant across time and across subgroups. Conclusions The DPA SF-8 met CFA recommendations and criteria for multi-group and longitudinal invariance testing, which indicates the scale may be used to assess for differences between the groups or across time. Our overall analysis indicates the DPA SF-8 is a valid, reliable, and responsive instrument to assess patient improvement in the physically active population.

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Exploring the Psychometric Properties of the Disablement in the Physically Active Scale Short Form-8 in Adolescents

Journal of Sport Rehabilitation ◽

10.1123/jsr.2020-0173 ◽

2020 ◽

pp. 1-4

Author(s):

Mackenzie Holman ◽

Madeline P. Casanova ◽

Russell T. Baker

Keyword(s):

Psychometric Properties ◽

Short Form ◽

Psychometric Testing ◽

Scale Structure ◽

Fit Indices ◽

Adolescent Athletes ◽

Physically Active ◽

Active Population ◽

Patient Reported ◽

Fit Index

Context: Patient-reported outcomes are widely used in health care. The Disablement in the Physically Active (DPA) Scale Short Form-8 (SF-8) was recently proposed as a valid scale for the physically active population. However, further psychometric testing of the DPA SF-8 has not been completed, and scale structure has not been assessed using a sample of adolescent athletes. Objective: To assess scale structure of the DPA SF-8 in a sample of adolescent high-school athletes. Main Outcome Measure(s): Adolescent athletes (n = 289) completed the DPA SF-8. Confirmatory factor analysis (CFA) was conducted to assess the psychometric properties of the scale. Results: The CFA of the DPA SF-8 indicated that the model exceeded recommended fit indices (Comparative Fit Index = .976, Tucker–Lewis Index = .965, Root Mean Square Error of Approximation = .061, and Bollen’s Incremental Fit Index = .976). All factor loadings were significant and ranged from .62 to .86. Modification indices did not suggest that meaningful cross-loadings were present or additional specifications that could further maximize fit or parsimony. Conclusions: The CFA of the DPA SF-8 met contemporary model fit recommendations in the adolescent athlete population. The results confirmed initial findings supporting the psychometric properties of the DPA SF-8 as well as the uniqueness of the quality-of-life and physical summary factors in an adolescent population. Further research (eg, reliability, invariance between groups, minimal clinically important differences, etc) is warranted to inform scale use in clinical practice and research.

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Patient-Reported Outcome Measures in Colorectal Surgery: Construction of Core Measures Using Open-Source Research Method

Surgical Innovation ◽

10.1177/1553350621998871 ◽

2021 ◽

pp. 155335062199887

Author(s):

Alaa El-Hussuna ◽

Ines Rubio-Perez ◽

Monica Millan ◽

Gianluca Pellino ◽

Ionut Negoi ◽

...

Keyword(s):

Colorectal Surgery ◽

Outcome Measures ◽

Short Form ◽

Wide Spectrum ◽

Core Outcome Set ◽

Well Being ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Patient Reported ◽

Eortc Qlq

Purpose. The primary aim of the study was to review the existing literature about patient-reported outcome measures (PROMs) in colorectal cancer and IBD. The secondary aim was to present a road map to develop a core outcome set via opinion gathering using social media. Method. This study is the first step of a three-step project aimed at constructing simple, applicable PROMs in colorectal surgery. This article was written in a collaborative manner with authors invited both through Twitter via the #OpenSourceResearch hashtag. The 5 most used PROMs were presented and discussed as slides/images on Twitter. Inputs from a wide spectrum of participants including researchers, surgeons, physicians, nurses, patients, and patients’ organizations were collected and analyzed. The final draft was emailed to all contributors and 6 patients’ representatives for proofreading and approval. Results. Five PROM sets were identified and discussed: EORTC QLQ-CR29, IBDQ short health questionnaire, EORTC QLQ-C30, ED-Q5-5L, and Short Form-36. There were 315 tweets posted by 50 tweeters with 1458 retweets. Awareness about PROMs was generally limited. The general psycho-physical well-being score (GPP) was suggested and discussed, and then a survey was conducted in which more than 2/3 of voters agreed that GPP covers the most important aspects in PROMs. Conclusion. Despite the limitations of this exploratory study, it offered a new method to conduct clinical research with opportunity to engage patients. The general psycho-physical well-being score suggested as simple, applicable PROMs to be eventually combined procedure-specific, disease-specific, or symptom-specific PROMs if needed.

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Psychometric evaluation of the DAILY EATS questionnaire in individuals living with obesity

Journal of Patient-Reported Outcomes ◽

10.1186/s41687-020-00259-w ◽

2020 ◽

Vol 4 (1) ◽

Author(s):

John Fastenau ◽

Heather Rozjabek ◽

Shanshan Qin ◽

Lori McLeod ◽

Lauren Nelson ◽

...

Keyword(s):

Type 2 Diabetes ◽

Severe Obesity ◽

Short Form ◽

Psychometric Evaluation ◽

Health Determinants ◽

Measurement Information ◽

Related Factors ◽

Patient Global Impression ◽

Patient Reported

Abstract Background Physiological and behavioral factors including hunger, satiety, food intake, and cravings are health determinants contributing to obesity. Patient-reported outcome (PRO) measures focused on eating-related factors provide insight into the relationships between food choice and quantity, weight change, and weight-loss treatment for individuals living with obesity. The DAILY EATS is a novel 5-item, patient-reported measure evaluating key eating-related factors (Worst and Average Hunger, Appetite, Cravings, and Satiety). Methods Psychometric analyses, consistent with regulatory standards, were conducted to evaluate the DAILY EATS using data from two randomized trials that included individuals with severe obesity without diabetes (NCT03486392) and with severe obesity and type 2 diabetes (NCT03586830). Additional measures included Patient Global Impression of Status (PGIS) and Patient Global Impression of Change items, Impact of Weight on Quality of Life-Lite, Ease of Weight Management, and Patient-Reported Outcomes Measurement Information System Physical Function Short Form 8b and 10a. The reliability, validity, and responsiveness of the DAILY EATS were assessed, and a scoring algorithm and thresholds to interpret meaningful score changes were developed. Results Item-level analyses of the DAILY EATS supported computation of an Eating Drivers Index (EDI), comprising the related items Worst Hunger, Appetite, and Cravings. Internal consistency (Cronbach’s coefficient alphas ≥0.80) and test-retest reliability (coefficients > 0.7) of the EDI were robust. Construct validity correlation patterns with other PRO measures were as hypothesized, with moderate to strong significant correlations between the EDI and PGIS-Hunger (0.30 ≤ r ≤ 0.68), PGIS-Cravings (0.33 ≤ r ≤ 0.77) and PGIS-Appetite (0.52 ≤ r ≤ 0.77). Anchor- and distribution-based analyses support reductions ranging from 1.6 to 2.1 as responder thresholds for the EDI, representing meaningful within-person improvement. Conclusions The DAILY EATS individual items and the composite EDI are reliable, sensitive, and valid in evaluating the concepts of hunger, appetite, and cravings for use in individuals with severe obesity with or without type 2 diabetes.

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Patient-reported outcome measures in community-acquired pneumonia: a systematic review of application and content validity

BMJ Open Respiratory Research ◽

10.1136/bmjresp-2018-000398 ◽

2019 ◽

Vol 6 (1) ◽

pp. e000398 ◽

Cited By ~ 1

Author(s):

Melanie Lloyd ◽

Emily Callander ◽

Amalia Karahalios ◽

Lucy Desmond ◽

Harin Karunajeewa

Keyword(s):

Outcome Measures ◽

Content Validity ◽

Short Form ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Community Acquired Pneumonia ◽

Current Evidence ◽

Measurement Instruments ◽

Health Measurement ◽

Patient Reported

IntroductionPatient-reported outcome measures (PROMs) are a vital component of patient-centred care. Community-acquired pneumonia (CAP) is a significant contributor to morbidity, mortality and health service costs globally, but there is a lack of consensus regarding PROMs for this condition.MethodsWe searched MEDLINE, EMBASE and Cochrane Collaboration for studies, both interventional and observational, of adult recovery from CAP that applied at least one validated PROM instrument and were published before 31 December 2017. The full text of included studies was examined and data collected on study design, PROM instruments applied, constructs examined and the demographic characteristics of the populations measured. For all CAP-specific PROM instruments identified, content validity was assessed using the COnsensus based Standards for selection of health Measurement INstruments guidelines (COSMIN).ResultsForty-two articles met the inclusion criteria and applied a total of 17 different PROM instruments including five (30%) classified as CAP specific, six (35%) as generic and six (35%) that measured functional performance or were specific to another disease. The 36-Item Short Form Survey (SF-36) was the most commonly used instrument (15 articles). Only one of 11 (9%) patient cohorts assessed using a CAP-specific instrument had a mean age ≥70 years. The CAP-Sym and CAP-BIQ questionnaires had sufficient content validity, though the quality of evidence for all CAP-specific instruments was rated as very low to low.DiscussionPROM instruments used to measure recovery from CAP are inconsistent in constructs measured and have frequently been developed and validated in highly selective patient samples that are not fully representative of the hospitalised CAP population. The overall content validity of all available CAP-specific instruments is unclear, particularly in the context of elderly hospitalised populations. Based on current evidence, generic health instruments are likely to be of greater value for measuring recovery from CAP in this group.

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Assessment of computer adaptive testing version of the Neuro-QOL for people with multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458518810159 ◽

2018 ◽

Vol 25 (13) ◽

pp. 1791-1799 ◽

Cited By ~ 1

Author(s):

Brian C Healy ◽

Jonathan Zurawski ◽

Cindy T Gonzalez ◽

Tanuja Chitnis ◽

Howard L Weiner ◽

...

Keyword(s):

Multiple Sclerosis ◽

Outcome Measures ◽

Computerized Adaptive Testing ◽

Short Form ◽

Patient Reported Outcome Measures ◽

Adaptive Testing ◽

Patient Reported Outcome ◽

Longitudinal Change ◽

Sf 36 ◽

Patient Reported

Background: To date, the computerized adaptive testing (CAT) version of the Neuro-quality of life (QOL) has not been assessed in a large sample of people with multiple sclerosis (MS). Objective: The aim of this study was to assess the associations between the CAT version of Neuro-QOL and other clinical and patient-reported outcome measures. Methods: Subjects ( n = 364) enrolled in SysteMS completed the CAT version of the Neuro-QOL and the 36-Item Short Form Survey (SF-36) within 4 weeks of a clinical exam that included the Multiple Sclerosis Functional Composite-4 (MSFC-4). The correlations between the Neuro-QOL domains and the MSFC-4 subscores and the SF-36 scores were calculated. The changes over time in the Neuro-QOL and other measures were also examined. Results: The lower extremity functioning score of the Neuro-QOL showed the highest correlations with MSFC-4 components including Timed 25-Foot Walk, 9-Hole Peg Test, and cognitive score. The expected domains of the Neuro-QOL showed high correlations with the SF-36 subscores, and some Neuro-QOL domains were associated with many SF-36 subscores. There was limited longitudinal change on the Neuro-QOL domains over 12 months, and the change was not associated with change on other measures. Conclusion: The CAT version of the Neuro-QOL shows many of the expected associations with clinical and patient-reported outcome measures.

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Patient-reported outcomes in obsessive-compulsive disorder

Dialogues in Clinical Neuroscience ◽

10.31887/dcns.2014.16.2/msubramaniam ◽

2014 ◽

Vol 16 (2) ◽

pp. 239-254 ◽

Cited By ~ 2

Keyword(s):

Obsessive Compulsive Disorder ◽

Patient Reported Outcomes ◽

Functional Disability ◽

Psychometric Evaluation ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Future Research ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Patient Reported

The purpose of the article was to provide an overview of patient-reported outcomes (PROs) and related measures that have been examined in the context of obsessive-compulsive disorder (OCD). The current review focused on patient-reported outcome measures (PROMs) that evaluated three broad outcome domains: functioning, health-related quality of life (HRQoL), and OCD-related symptoms. The present review ultimately included a total of 155 unique articles and 22 PROMs. An examination of the PROs revealed that OCD patients tend to suffer from significant functional disability, and report lower HRQoL than controls. OCD patients report greater symptom severity than patients with other mental disorders and evidence indicates that PROMs are sensitive to change and may be even better than clinician-rated measures at predicting treatment outcomes. Nonetheless, it should be noted that the measures reviewed lacked patient input in their development. Future research on PROMs must involve patient perspectives and include rigorous psychometric evaluation of these measures.

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The effect of tibial and femoral component coronal alignment on clinical outcomes and survivorship in unicompartmental knee arthroplasty

The Bone & Joint Journal ◽

10.1302/0301-620x.103b2.bjj-2020-0959.r1 ◽

2021 ◽

Vol 103-B (2) ◽

pp. 338-346

Author(s):

Yong Zhi Khow ◽

Ming Han Lincoln Liow ◽

Merrill Lee ◽

Jerry Yongqiang Chen ◽

Ngai Nung Lo ◽

...

Keyword(s):

Femoral Component ◽

Short Form ◽

Oxford Knee Score ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Knee Score ◽

Unicompartmental Knee ◽

Unicompartmental Knee Arthroplasties ◽

Implant Survivorship ◽

Patient Reported

Aims This study aimed to identify the tibial component and femoral component coronal angles (TCCAs and FCCAs), which concomitantly are associated with the best outcomes and survivorship in a cohort of fixed-bearing, cemented, medial unicompartmental knee arthroplasties (UKAs). We also investigated the potential two-way interactions between the TCCA and FCCA. Methods Prospectively collected registry data involving 264 UKAs from a single institution were analyzed. The TCCAs and FCCAs were measured on postoperative radiographs and absolute angles were analyzed. Clinical assessment at six months, two years, and ten years was undertaken using the Knee Society Knee score (KSKS) and Knee Society Function score (KSFS), the Oxford Knee Score (OKS), the 36-Item Short-Form Health Survey questionnaire (SF-36), and range of motion (ROM). Fulfilment of expectations and satisfaction was also recorded. Implant survivorship was reviewed at a mean follow-up of 14 years (12 to 16). Multivariate regression models included covariates, TCCA, FCCA, and two-way interactions between them. Partial residual graphs were generated to identify angles associated with the best outcomes. Kaplan-Meier analysis was used to compare implant survivorship between groups. Results Significant two-way interaction effects between TCCA and FCCA were identified. Adjusted for each other and their interaction, a TCCA of between 2° and 4° and a FCCA of between 0° and 2° were found to be associated with the greatest improvements in knee scores and the probability of fulfilling expectations and satisfaction at ten years. Patients in the optimal group whose TCCA and FCCA were between 2° and 4°, and 0° and 2°, respectively, had a significant survival benefit at 15 years compared with the non-optimal group (optimal: survival = 100% vs non-optimal: survival = 92%, 95% confidence interval (CI) 88% to 96%). Conclusion Significant two-way interactions between the TCCA and FCCA demonstrate the importance of evaluating the alignment of the components concomitantly in future studies. By doing so, we found that patients who concomitantly had both a TCCA of between 2° and 4° and a FCCA of between 0° and 2° had the best patient-reported outcome measures at ten years and better survivorship at 15 years. Cite this article: Bone Joint J 2021;103-B(2):338–346.

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Feasibility of Collecting Multiple Patient-Reported Outcome Measures Alongside the Dutch Arthroplasty Register

Journal of Patient Experience ◽

10.1177/2374373519853166 ◽

2019 ◽

Vol 7 (4) ◽

pp. 484-492

Author(s):

Claire Tilbury ◽

Claudia S Leichtenberg ◽

Bart L Kaptein ◽

Lennard A Koster ◽

Suzan H M Verdegaal ◽

...

Keyword(s):

Outcome Measures ◽

Short Form ◽

Response Rates ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Participation Rates ◽

Arthroplasty Register ◽

Patient Reported ◽

Lost To Follow Up

Background: Compliance rates with patient-reported outcome measures (PROMs) collected alongside arthroplasty registries vary in the literature. We described the feasibility of a routinely collected set PROMs alongside the Dutch Arthroplasty Register. Methods: The longitudinal Leiden Orthopaedics Outcomes of OsteoArthritis Study is a multicenter (7 hospitals), observational study including patients undergoing total hip or total knee arthroplasty (THA or TKA). A set of PROMs: Short Form-12, EuroQol 5 Dimensions, Hip/Knee injury and Osteoarthritis Outcome Score, Oxford Hip/Knee Score was collected preoperatively and at 6, 12, 24 months, and every 2 years thereafter. Participation rates and response rates were recorded. Results: Between June 2012 and December 2014, 1796 THA and 1636 TKA patients were invited, of whom 1043 THA (58%; mean age 68 years [standard deviation, SD: 10]) and 970 TKA patients (59%; mean age 71 years [SD 9.5]) participated in the study. At 6 months, 35 THA/38 TKA patients were lost to follow-up. Response rates were 90% for THA (898/1000) and 89% for TKA (827/932) participants. At 1 and 2 years, 8 and 18 THA and 17 and 11 TKA patients were lost to follow-up, respectively. The response rates among those eligible were 87% (866/992) and 84% (812/972) for THA and 84% (771/917) and 83% (756/906) for TKA patients, respectively. The 2-year questionnaire was completed by 78.5% of the included THA patients and by 77.9% of the included TKA patients. Conclusions: About 60% of patients undergoing THA or TKA complete PROMs preoperatively, with more than 80% returning follow-up PROMs. To increase the participation rates, more efforts concerning the initial recruitment of patients are needed.

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Assessing the Attitudes, Awareness, and Behavioral Alterations of Patients Awaiting Total Hip Arthroplasty During the COVID-19 Crisis

Geriatric Orthopaedic Surgery & Rehabilitation ◽

10.1177/2151459320969377 ◽

2020 ◽

Vol 11 ◽

pp. 215145932096937

Author(s):

Stephen Fahy ◽

Joss Moore ◽

Michael Kelly ◽

Shane Irwin ◽

Paddy Kenny

Keyword(s):

Mental Health ◽

Short Form ◽

Hip Osteoarthritis ◽

Surgical Care ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Harris Hip Score ◽

Physical And Mental Health ◽

Patient Reported ◽

Hip Function

Background: COVID-19 has placed a huge burden on healthcare systems which has led to widespread cancellation elective surgical care. Ireland is recovering from the first wave of COVID-19 and as such the expeditious return of elective surgical care is important. This is the first study to examine the attitudes of patients to undergoing total joint arthroplasty during the COVID-19 crisis. Methods: A prospective qualitative study was undertaken in our institution during the week 13/05/2020-20/05/2020. 65 patients completed a questionnaire assessing attitudes, awareness, and behavioral changes associated with COVID-19, a Charlson Comorbidity Index, modified-Harris Hip Score, and a Short Form-12 score. Results: 86% of patients felt that they were at little to no risk of COVID-19 infection. The majority of patients were happy to proceed with surgery at the current level of COVID-19 related threat (86%). Patients with higher mHHS were more likely to postpone their operation than those with lower mHHS scores. Our cohort had low patient reported outcome measures in both mHHS and SF-12, indicating the significant burden of hip osteoarthritis on both physical and mental health. Conclusion: Patients reported a significant disease-related impairment of physical function and subsequent deterioration in mental health as a result of hip osteoarthritis. Patients with worse hip function, as measured by the mHHS are more willing to proceed with surgery than those with superior hip function. This offers a potential mechanism by which to triage patients once elective surgical pathways reopen in the coming months.

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Appraisal of Candidate Instruments for Assessment of the Physical Function Domain in Patients with Psoriatic Arthritis

The Journal of Rheumatology ◽

10.3899/jrheum.191119 ◽

2020 ◽

Vol 48 (1) ◽

pp. 58-66 ◽

Cited By ~ 1

Author(s):

Ying Ying Leung ◽

Ana-Maria Orbai ◽

Alexis Ogdie ◽

Pil Hojgaard ◽

Richard Holland ◽

...

Keyword(s):

Psoriatic Arthritis ◽

Physical Function ◽

Outcome Measures ◽

Physical Functioning ◽

Working Group ◽

Short Form ◽

Outcome Measurement ◽

Patient Reported Outcome Measures ◽

Measurement Information ◽

Patient Reported

Objective.Numerous patient-reported outcome measures (PROM) exist for the measurement of physical function for psoriatic arthritis (PsA), but only a few are validated comprehensively. The objective of this project was to prioritize PROM for measuring physical function for potential incorporation into a standardized outcome measurement set for PsA.Methods.A working group of 13 members including 2 patient research partners was formed. PROM measuring physical function in PsA were identified through a systematic literature review and recommendations by the working group. The rationale for inclusion and exclusion from the original list of existing PROM was thoroughly discussed and 2 rounds of Delphi exercises were conducted to achieve consensus.Results.Twelve PROM were reviewed and discussed. Six PROM were prioritized: Health Assessment Questionnaire (HAQ) and 4 modifications (HAQ-Disability Index, HAQ-Spondyloarthritis, modified HAQ, multidimensional HAQ), Medical Outcomes Study 36-item Short Form survey physical functioning domain, and the Patient-Reported Outcomes Measurement Information System (PROMIS) physical functioning module.Conclusion.Through discussion and Delphi exercises, we achieved consensus to prioritize 6 physical function PROM for PsA. These 6 PROM will undergo further appraisal using the Outcome Measures in Rheumatology (OMERACT) Filter 2.1.

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