scholarly journals Adaptation of the Patient Benefit Assessment Scale for Hospitalised Older Patients: Development, Reliability and Validity of the P-BAS Picture Version

2021 ◽  
Author(s):  
Maria Johanna van der Kluit ◽  
Geke J. Dijkstra ◽  
Sophia E. de Rooij
Keyword(s):  
Construct Validity ◽  
Older Patients ◽  
Assessment Scale ◽  
Benefit Assessment ◽  
Step Test ◽  
Minimal Important Change ◽  
Patient Benefit ◽  
Smallest Detectable Change ◽  
The Individual

Abstract Background: The Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP) is a tool developed to both identify the priorities of the individual patient and to measure the outcomes relevant to him/her, resulting in a Patient Benefit Index (PBI), indicating how much benefit the patient had experienced from the hospitalisation. The reliability and the validity of the P-BAS HOP appeared to be not yet satisfactory and therefore the aims of this study were to adapt the P-BAS HOP and transform it into a picture version, resulting in the P-BAS-P, and to evaluate its feasibility, reliability, validity, responsiveness and interpretability.Methods: Process of instrument development and evaluation performed among hospitalised older patients including pilot tests using Three-Step Test-Interviews (TSTI), test-retest reliability on baseline and follow-up, comparing the PBI with Intraclass Correlation Coefficient (ICC), and hypothesis testing to evaluate the construct validity. Responsiveness of individual P-BAS-P scores and the PBI with two different weighing schemes were evaluated using anchor questions. Interpretability of the PBI was evaluated with the visual anchor-based minimal important change (MIC) distribution method and computation of smallest detectable change (SDC) based on ICC.Results: Fourteen hospitalised older patients participated in TSTIs at baseline and thirteen at follow-up after discharge. After several adaptations, the P-BAS-P appeared feasible with good interviewer’s instructions. The pictures were considered relevant and helpful by the participants. Reliability was tested with 41 participants at baseline and 50 at follow-up. ICC between PBI1 and PBI2 of baseline test and retest was 0.76, respectively 0.73. At follow-up 0.86, respectively 0.85.For the construct validity, tested in 169 participants, hypotheses regarding importance of goals were confirmed. Regarding status of goals, only the follow-up status was confirmed, baseline and change were not. The responsiveness of the individual scores and PBI were weak, resulting in poor interpretability with many misclassifications. The SDC was larger than the MIC.Conclusions: The P-BAS-P appeared to be a feasible instrument, but there were methodological barriers for the evaluation of the reliability, validity, and responsiveness. We therefore recommend further research into the P-BAS-P.

scholarly journals Adaptation of the Patient Benefit Assessment Scale for Hospitalised Older Patients: development, reliability and validity of the P-BAS picture version

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Maria Johanna van der Kluit ◽  
Geke J. Dijkstra ◽  
Sophia E. de Rooij
Keyword(s):  
Construct Validity ◽  
Older Patients ◽  
Assessment Scale ◽  
Benefit Assessment ◽  
Step Test ◽  
Minimal Important Change ◽  
Patient Benefit ◽  
Smallest Detectable Change ◽  
The Individual

Abstract Background The Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP) is a tool developed to both identify the priorities of the individual patient and to measure the outcomes relevant to him/her, resulting in a Patient Benefit Index (PBI), indicating how much benefit the patient had experienced from the hospitalisation. The reliability and the validity of the P-BAS HOP appeared to be not yet satisfactory and therefore the aims of this study were to adapt the P-BAS HOP and transform it into a picture version, resulting in the P-BAS-P, and to evaluate its feasibility, reliability, validity, responsiveness and interpretability. Methods Process of instrument development and evaluation performed among hospitalised older patients including pilot tests using Three-Step Test-Interviews (TSTI), test-retest reliability on baseline and follow-up, comparing the PBI with Intraclass Correlation Coefficient (ICC), and hypothesis testing to evaluate the construct validity. Responsiveness of individual P-BAS-P scores and the PBI with two different weighing schemes were evaluated using anchor questions. Interpretability of the PBI was evaluated with the visual anchor-based minimal important change (MIC) distribution method and computation of smallest detectable change (SDC) based on ICC. Results Fourteen hospitalised older patients participated in TSTIs at baseline and 13 at follow-up after discharge. After several adaptations, the P-BAS-P appeared feasible with good interviewer’s instructions. The pictures were considered relevant and helpful by the participants. Reliability was tested with 41 participants at baseline and 50 at follow-up. ICC between PBI1 and PBI2 of baseline test and retest was 0.76, respectively 0.73. At follow-up 0.86, respectively 0.85. For the construct validity, tested in 169 participants, hypotheses regarding importance of goals were confirmed. Regarding status of goals, only the follow-up status was confirmed, baseline and change were not. The responsiveness of the individual scores and PBI were weak, resulting in poor interpretability with many misclassifications. The SDC was larger than the MIC. Conclusions The P-BAS-P appeared to be a feasible instrument, but there were methodological barriers for the evaluation of the reliability, validity, and responsiveness. We therefore recommend further research into the P-BAS-P.

scholarly journals Reliability and validity of the Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maria Johanna van der Kluit ◽  
Geke J. Dijkstra ◽  
Sophia E. de Rooij
Keyword(s):  
Construct Validity ◽  
Correlation Coefficient ◽  
Older Patients ◽  
Reliability And Validity ◽  
Weighted Kappa ◽  
Assessment Scale ◽  
Benefit Assessment ◽  
Patient Benefit ◽  
Important Benefit

Abstract Background The Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP) is a tool which is capable of both identifying the priorities of the individual patient and measuring the outcomes relevant to him/her, resulting in a Patient Benefit Index (PBI) with range 0–3, indicating how much benefit the patient had experienced from the admission. The aim of this study was to evaluate the reliability, validity, responsiveness and interpretability of the P-BAS HOP. Methods A longitudinal study among hospitalised older patients with a baseline interview during hospitalisation and a follow-up by telephone 3 months after discharge. Test-retest reliability of the baseline and follow-up questionnaire were tested. Percentage of agreement, Cohen’s kappa with quadratic weighting and maximum attainable kappa were calculated per item. The PBI was calculated for both test and retest of baseline and follow-up and compared with Intraclass Correlation Coefficient (ICC). Construct validity was tested by evaluating pre-defined hypotheses comparing the priority of goals with experienced symptoms or limitations at admission and the achievement of goals with progression or deterioration of other constructs. Responsiveness was evaluated by correlating the PBI with the anchor question ‘How much did you benefit from the admission?’. This question was also used to evaluate the interpretability of the PBI with the visual anchor-based minimal important change distribution method. Results Reliability was tested with 53 participants at baseline and 72 at follow-up. Mean weighted kappa of the baseline items was 0.38. ICC between PBI of the test and retest was 0.77. Mean weighted kappa of the follow-up items was 0.51. ICC between PBI of the test and retest was 0.62. For the construct validity, tested in 451 participants, all baseline hypotheses were confirmed. From the follow-up hypotheses, tested in 344 participants, five of seven were confirmed. The Spearman’s correlation coefficient between the PBI and the anchor question was 0.51. The optimal cut-off point was 0.7 for ‘no important benefit’ and 1.4 points for ‘important benefit’ on the PBI. Conclusions Although the concept seems promising, the reliability and validity of the P-BAS HOP appeared to be not yet satisfactory. We therefore recommend adapting the P-BAS HOP.

scholarly journals Reliability and validity of the Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP)

2020 ◽  
Author(s):  
Maria van der Kluit ◽  
Geke Dijkstra ◽  
Sophia de Rooij
Keyword(s):  
Construct Validity ◽  
Correlation Coefficient ◽  
Older Patients ◽  
Reliability And Validity ◽  
Weighted Kappa ◽  
Assessment Scale ◽  
Benefit Assessment ◽  
Patient Benefit ◽  
Important Benefit

Abstract Background: The Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP) is a tool which is capable of both identifying the priorities of the individual patient and measuring the outcomes relevant to him, resulting in a Patient Benefit Index (PBI) with range 0-3, indicating how much benefit the patient had experienced from the admission. The aim of this study was to evaluate the reliability, validity, responsiveness and interpretability of the P-BAS HOP.Methods: A longitudinal study among hospitalised older patients with a baseline interview during hospitalisation and a follow-up by telephone three months after discharge. Test-retest reliability of the baseline and follow-up questionnaire were tested. Percentage of agreement, Cohen’s kappa with quadratic weighting and maximum attainable kappa were calculated per item. The PBI was calculated for both test and retest of baseline and follow-up and compared with Intraclass Correlation Coefficient (ICC). Construct validity was tested by evaluating pre-defined hypotheses comparing the priority of goals with experienced symptoms or limitations at admission and the achievement of goals with progression or deterioration of other constructs. Responsiveness was evaluated by correlating the PBI with the anchor question ‘How much did you benefit from the admission?’. This question was also used to evaluate the interpretability of the PBI with the visual anchor-based minimal important change distribution method.Results: Reliability was tested with 53 participants at baseline and 72 at follow-up. Mean weighted kappa of the baseline items was 0.38. ICC between PBI of the test and retest was 0.77.Mean weighted kappa of the follow-up items was 0.51. ICC between PBI of the test and retest was 0.62.For the construct validity, tested in 451 participants, all baseline hypotheses were confirmed. From the follow-up hypotheses, tested in 344 participants, five of seven were confirmed. The Spearman’s correlation coefficient between the PBI and the anchor question was .51.The optimal cut-off point was 0.7 for ‘no important benefit’ and 1.4 points for ‘important benefit’ on the PBI. Conclusions: Although the concept seems promising, the reliability and validity of the P-BAS HOP appeared to be not yet satisfactory. We therefore recommend adapting the P-BAS HOP.

scholarly journals Development of a new tool for the assessment of patient-defined benefit in hospitalised older patients: the Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP)

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e038203
Author(s):  
Maria Johanna van der Kluit ◽  
Geke J Dijkstra ◽  
Barbara C van Munster ◽  
Sophia De Rooij
Keyword(s):  
Field Test ◽  
Teaching Hospital ◽  
Older Patients ◽  
Community Dwelling ◽  
Assessment Scale ◽  
Benefit Assessment ◽  
Step Test ◽  
Patient Benefit ◽  
Evaluation Questionnaire ◽  
Baseline Questionnaire

ObjectivesTo support the shift from disease-oriented towards goal-oriented care, we aimed to develop a tool which is capable both to identify priorities of an individual older hospitalised patient and to measure the outcomes relevant to him.DesignMixed-methods design with open interviews, three step test interviews (TSTIs) and a quantitative field test.SettingUniversity teaching hospital and a regional teaching hospital.ParticipantsHospitalised patients ages 70 years and older.ResultsThe Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP) consists of a baseline questionnaire and an evaluation questionnaire. Items were based on 15 qualitative interviews with hospitalised older patients. Feedback from a panel of four community-dwelling older persons resulted in some adaptations to wording and one additional item. Twenty-six hospitalised older patients participated in TSTIs with Version 1 of the baseline questionnaire, revealing indications for a good content validity and barriers in completion behaviour, global understanding and understanding of individual items, which were solved with several adaptations. Four additions were made by participants. After TSTIs with ten patients with the evaluation questionnaire, one adaptation was made. A field test with 91 hospitalised older patients revealed a small number of missing values.To enhance the feasibility, the number of items was reduced from 32 to 22, based on correlations and mean impact score. The field test was repeated with 104 other patients in a regional teaching hospital. To enhance the understanding, the tool was split into two phases. This version was tested with TSTIs with eight patients and appeared to be understandable. The final version was an interview-based tool and took about 11 min to complete.ConclusionsThe P-BAS HOP is a potentially suitable tool to identify priorities and relevant outcomes of the individual patient. Further research is needed to investigate its validity, reliability and responsiveness.

Development of the functional capacity screening tool (FCST): A brief instrument to identify functional capacity deficits in anemic cancer patients

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 8593-8593
Author(s):  
D. Cella ◽  
H. Viswanathan ◽  
R. D. Hays ◽  
T. Mendoza ◽  
K. Stein ◽  
...  
Keyword(s):  
Construct Validity ◽  
Cancer Patients ◽  
Functional Capacity ◽  
Screening Tool ◽  
Self Report ◽  
Step Test ◽  
Open Label ◽  
New Instrument ◽  
Item Scores

8593 Background: Existing fatigue measures are long and often difficult to incorporate in practice. The objective of this study was to develop a short tool (Functional Capacity Screening Tool [FCST]) to identify functional capacity deficits related to fatigue in anemic cancer patients (pts) using self-report and performance-based measures of functional capacity. Methods: Data were obtained from a multicenter, open-label, single-arm study of darbepoetin alfa therapy (3.0 μg/kg every 2 weeks) in cancer pts (n=1558) who were ≥ 18 years of age with nonmyeloid malignancies receiving cyclic chemotherapy and anemia (hemoglobin [Hb] ≤ 11 g/dL). The Modified Harvard Step Test (MHST) was used as a performance-based measure of functional capacity to assess adjusted VO2max. Pts who contributed data for the development of FCST completed the following: MHST, baseline and ≥ 1 follow-up Hb measurement, baseline and ≥ 1 follow-up Functional Assessment of Cancer Therapy-Fatigue (FACT-F), and fatigue assessed within 3 days of MHST. Items from FACT-F, Brief Fatigue Inventory (BFI), Fatigue Symptom Inventory (FSI) and Medical Outcomes Study physical functioning scale were tested for inclusion in the FCST. Individual item scores were transformed to a 100-point scale. Item selection was based on identifying best predictors of adjusted VO2max, Hb, and global FACT-F scores using linear regression and the r-square selection method. FCST scores were calculated by summating item scores and dividing by number of items. Results: Data from401 pts contributed to the development of the FCST. Eight items were identified for the FCST with a Cronbach’s coefficient alpha of 0.92. Construct validity was supported by correlations of FCST with FSI (r = 0.80, P < .0001) and BFI (r = 0.86, P < .0001). Correlations between FCST and energy (r = 0.75, P < .0001), productivity (r = 0.72, P < .0001), and Hb (r = 0.24, P < .0001) further supported construct validity. Conclusions: FCST holds promise as a short screening tool for identifying functional capacity deficits in cancer pts. This new instrument was reliable, easy to score, and completed quickly by pts, making it suitable for incorporation in clinical practice. Further validation is required in different cancer populations. [Table: see text]

scholarly journals Responsiveness and Minimal Important Change of the IKDC of Middle-Aged and Older Patients With a Meniscal Tear

2019 ◽  
Vol 47 (2) ◽  
pp. 364-371 ◽  
Author(s):  
Julia C.A. Noorduyn ◽  
Victor A. van de Graaf ◽  
Lidwine B. Mokkink ◽  
Nienke W. Willigenburg ◽  
Rudolf W. Poolman ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Older Patients ◽  
Meniscal Tear ◽  
Important Change ◽  
Minimal Important Change ◽  
Meniscal Tears ◽  
Arthroscopic Partial Meniscectomy ◽  
Patient Reported ◽  
Ikdc Score

Background: Responsiveness and the minimal important change (MIC) are important measurement properties to evaluate treatment effects and to interpret clinical trial results. The International Knee Documentation Committee (IKDC) Subjective Knee Form is a reliable and valid instrument for measuring patient-reported knee-specific symptoms, functioning, and sports activities in a population with meniscal tears. However, evidence on responsiveness is of limited methodological quality, and the MIC has not yet been established for patients with symptomatic meniscal tears. Purpose: To evaluate the responsiveness and determine the MIC of the IKDC for patients with meniscal tears. Study Design: Cohort study (design); Level of evidence 2. Methods: This study was part of the ESCAPE trial: a noninferiority multicenter randomized controlled trial comparing arthroscopic partial meniscectomy with physical therapy. Patients aged 45 to 70 years who were treated for a meniscal tear by arthroscopic partial meniscectomy or physical therapy completed the IKDC and 3 other questionnaires (RAND 36-Item Health Survey, EuroQol-5D-5L, and visual analog scales for pain) at baseline and 6-month follow-up. Responsiveness was evaluated by testing predefined hypotheses about the relation of the change in IKDC with regard to the change in the other self-reported outcomes. An external anchor question was used to distinguish patients reporting improvement versus no change in daily functioning. The MIC was determined by the optimal cutoff point in the receiver operating characteristic curve, which quantifies the IKDC score that best discriminated between patients with and without improvement in daily function. Results: Data from all 298 patients who completed baseline and 6-month follow-up questionnaires were analyzed. Responsiveness of the IKDC was confirmed in 7 of 10 predefined hypotheses about the change in IKDC score with regard to other patient-reported outcome measures. One hypothesis differed in the expected direction, while 2 hypotheses failed to meet the expected magnitude by 0.02 and 0.01 points. An MIC of 10.9 points was calculated for the IKDC of middle-aged and older patients with meniscal tears. Conclusion: This study showed that the IKDC is responsive to change among patients aged 45 to 70 years with meniscal tears, with an MIC of 10.9 points. This strengthens the value of the IKDC in quantifying treatment effects in this population.

AAC Supports for Individuals With Rett Syndrome Across the Lifespan

2015 ◽  
Vol 24 (3) ◽  
pp. 74-85
Author(s):  
Sandra M. Grether
Keyword(s):  
Rett Syndrome ◽  
Communication Skills ◽  
Preliminary Analysis ◽  
Multidisciplinary Approach ◽  
Motor Deficits ◽  
Complex Profile ◽  
Communication Behaviors ◽  
The Individual

Individuals with Rett syndrome (RS) present with a complex profile. They benefit from a multidisciplinary approach for diagnosis, treatment, and follow-up. In our clinic, the Communication Matrix © (Rowland, 1990/1996/2004) is used to collect data about the communication skills and modalities used by those with RS across the lifespan. Preliminary analysis of this data supports the expected changes in communication behaviors as the individual with RS ages and motor deficits have a greater impact.

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