Deflation-Corrected Estimators of Reliability

Underestimation of reliability is discussed from the viewpoint of deflation in estimates of reliability caused by artificial systematic technical or mechanical error in the estimates of correlation (MEC). Most traditional estimators of reliability embed product–moment correlation coefficient (PMC) in the form of item–score correlation (Rit) or principal component or factor loading (λi). PMC is known to be severely affected by several sources of deflation such as the difficulty level of the item and discrepancy of the scales of the variables of interest and, hence, the estimates by Rit and λi are always deflated in the settings related to estimating reliability. As a short-cut to deflation-corrected estimators of reliability, this article suggests a procedure where Rit and λi in the estimators of reliability are replaced by alternative estimators of correlation that are less deflated. These estimators are called deflation-corrected estimators of correlation (DCER). Several families of DCERs are proposed and their behavior is studied by using polychoric correlation coefficient, Goodman–Kruskal gamma, and Somers delta as examples of MEC-corrected coefficients of correlation.

Evaluating the key risk factors in PPP-procured mass housing projects in Nigeria: a Delphi study of industry experts

Purpose The purpose of the study is to elicit risk factors that are peculiar to public-private partnership (PPP)-procured mass housing in Nigeria from the expert perspectives in ensuring the success of the scheme thereby reducing housing deficit in the country. Design/methodology/approach The risk inherent in construction projects had been established through literature in general. The risk in PPP projects is emerging because of the recent acceptance of the procurement option by governments all over the globe. The Nigerian Government has also adopted the procurement option in bridging the housing deficit in the country. This study, therefore, conducts a Delphi survey on the probability of risk occurrence peculiar to PPP mass housing projects (MHPs) in Nigeria. Pragmatic research approach through the mixed method of both quantitative and qualitative methods was adopted for this study. The quantitative method adopts the administration of questionnaires through the Delphi survey, whereas the qualitative method used interviews with the respondents. A two-stage Delphi questionnaire was administered to construction practitioners that cut across academics, the public and the private sectors by adopting convenient sampling techniques and following the Delphi principles and procedures. A total of 63 risk factors were submitted to the expert to rank on a Likert scale of 7 and any risk factors that the mean item score (MIS) falls below the grading scale of the five-point benchmark is deemed not necessary a risk factor associated with PPP MHPs and thereby expunged from the second round of the Delphi Survey. The interview was subsequently applied to the respondents to substantiate the risk factors that are peculiar to PPP-procured mass housing in the study area. Findings The findings show that risk factors such as maintenance frequent than expected, life of facility shorter than anticipated and maintenance cost higher than expected fall below 5.0 benchmark with MIS of 4.64 and 4.55 indicating that the risk factors are not peculiar to PPP mass housing in Nigeria. Research limitations/implications The implication for practise of this research is that these risk factors provide the PPP stakeholders with the comprehensive checklists that can aid in developing PPP risk assessment guidelines in the sector though both partners should be aware of the dynamic nature of risk because new ones might be emerging. Originality/value The authors hereby declare that the research findings are a product of a thorough research conducted in the study area and have not to be submitted or published by another person or publisher and due acknowledgement was made where necessary.

Evaluation of pediatric rheumatology telehealth satisfaction during the COVID-19 pandemic

Background During the Coronavirus disease 2019 pandemic, ambulatory pediatric rheumatology healthcare rapidly transformed to a mainly telehealth model. However, pediatric patient and caregiver satisfaction with broadly deployed telehealth programs remains largely unknown. This study aimed to evaluate patient/caregiver satisfaction with telehealth and identify the factors associated with satisfaction in a generalizable sample of pediatric rheumatology patients. Methods Patients with an initial telehealth video visit with a rheumatology provider between April and June 2020 were eligible. All patients/caregivers were sent a post-visit survey to assess a modified version of the Telehealth Usability Questionnaire (TUQ) and demographic and clinical characteristics. TUQ total and sub-scale (usefulness, ease of use, effectiveness, satisfaction) scores were calculated and classified as “positive” based on responses of “agree” or “strongly agree” on a 5-point Likert scale. Results were analyzed using standard descriptive statistics and Wilcoxon signed rank testing. The association between demographic and clinical characteristics with TUQ scores was assessed using univariate linear regression. Results 597 patients/caregivers met inclusion criteria, and the survey response rate was 42% (n = 248). Juvenile idiopathic arthritis was the most common diagnosis (33.5%). The majority of patients were diagnosed greater than 6 months previously (72.6%) and were prescribed chronic medications (59.7%). The median total TUQ score was 4 (IQR: 4–5) with positive responses in 81% of items. Of the subscales, usefulness scores were lowest (median: 4, p < 0.001). Telehealth saves time traveling was the highest median item score (median = 5, IQR: 4–5). Within subscales, items that scored significantly lower included convenience, providing for needs, seeing rheumatologist as well as in person, and being an acceptable way to receive rheumatology services (all p < 0.001). There were no significant demographic or clinical features associated with TUQ scores. Conclusions Our results suggest telehealth is a promising mode of healthcare delivery for pediatric rheumatic diseases but also identifies opportunities for improvement. Innovation and research are needed to design a telehealth system that delivers high quality and safe care that improves healthcare outcomes. Since telehealth is a rapidly emerging form of pediatric rheumatology care, improved engagement and training of patients, caregivers, and providers may help improve the patient experience in the future.

Relationship between Dizziness and the Core Vestibular Projection Injury in Patients with Mild Traumatic Brain Injury

Some studies have reported that a core vestibular projection (CVP) injury is associated with dizziness following a brain injury using diffusion tensor tractography (DTT). On the other hand, there has been no DTT study on dizziness caused by a CVP injury in patients with mild traumatic brain injury (TBI). In this study, DTT was used to examine the relationship between dizziness and CVP injury in patients with mild TBI. Forty-three patients with mild TBI and twenty-nine normal subjects were recruited. The patients were classified into two groups based on the dizziness score: group A, patients with a dizziness score less than 2 on the sub-item score for dizziness in the Rivermead Post-concussion Symptoms Questionnaire; group B, patients with a dizziness score above 2. The tract volume (TV) in group B was significantly lower than group A and the control group (p < 0.05). By contrast, the TV in group A was similar to the control group (p > 0.05). Regarding the correlation, the dizziness score of all patients showed a strong negative correlation with the TV of the CVP (r = −0.711, p < 0.05). DTT revealed the CVP injury in patients with dizziness after mild TBI. In addition, the severity of dizziness of these patients was closely related to the injury severity of the CVP.

Items analysis of the Frailty Index (FI-35): Insight in the contribution of each item to the level of frailty

Background The FI-35 is a valid multidimensional Chinese frailty assessment instrument. Like other scales, functional measures rely on the information the total score provides. Our research aimed to analyze the contribution of each item. Methods Descriptive statistics were used to summarize the sample characteristics. The expected item score (EIS) was used to determine how the items contribute to the generic measure of frailty. Results This study showed that most of the EIS curves increased across the entire range of frailty levels, and most of the items discriminate relatively well over the entire frailty range. Items differentially contributed to the total frailty score and differentially discriminated between frailty levels. Conclusions Although nearly all items monotonically increased with frailty levels, there were large differences between items in their ability to differentiate between persons being either weakly, moderately or highly frail.

Housing Affordability among Civil Servants in Ekiti State, Nigeria

Housing has been acknowledged generally as a key human necessity. One of its problems may be claimed that it is not affordable for the ordinary Nigerian worker, whose earnings and wages are now strongly depressed and unable to fulfill their fundamental necessities. From the perspective of the above, this study studied the affordability of government workers in the State of Ekiti, Nigeria. Purposive method of sampling was used to sample two government agencies and parastatals. A total of One Hundred and Twenty Six (126) government officials were picked. 94 questionnaires were retrieved. The questionnaire was used to collect the information required and analysed by descriptive and medium item score statistics. The findings indicated that government employees in Ekiti State could, on average, afford to pay rental housing since most employees spend less than 30 per cent of their yearly salary on rentals, especially in the medium and high income categories. In the study, public and private engagements were proposed, leading to affordable and sustainable state housing delivery. Keywords: Housing, Civil Servant, Affordable, Rent, Ekiti State.

No impact of Asian ethnicity on EORTC QLQ-C30 scores: Group differences and differential item functioning in paroxysmal nocturnal hemoglobinuria

Background Paroxysmal nocturnal hemoglobinuria (PNH) is a rare, life-threatening terminal-complement-mediated disease resulting in intravascular hemolysis and thrombosis with significant morbidity and premature mortality. There exists no disease-specific quality-of-life (QOL) measure for PNH. Its QOL effects resemble those of hematologic cancers, which supports the use of cancer-specific QOL measures in PNH clinical trials. The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 has published norms for many European and North American countries, but not for Asian countries. We investigated differences by Asian ethnicity in scores and item function on the EORTC QLQ-C30. Methods This secondary analysis focused on two non-inferiority PNH trials (301 and 302) comparing eculizumab and ravulizumab (n = 441). Analysis of covariance examined the main effect of Asian ethnicity on baseline EORTC QLQ-C30 scores, after adjusting for propensity scores encompassing trial, demographic and clinical factors. Mixed modeling of longitudinal data compared subscale scores in Asian vs. non-Asian patients, after propensity adjustment. Differential item function (DIF) was examined using ordinal regression models at baseline and longitudinally, to predict item score from total score, ethnicity, and their interaction to test for uniform DIF (significant main effect for Asian) and non-uniform DIF (significant Asian-by-total-score interaction). Results Of the 15 baseline domains, Asian patients scored slightly better on role and emotional functioning and slightly worse on constipation and diarrhea (0.22 < Cohen’s d < 0.36). In longitudinal models, Asians reported slightly higher appetite loss, diarrhea, and financial difficulties than non-Asians (R2 increment < 0.0005). There was negligible uniform and non-uniform DIF, i.e., R2 0 to 0.018, far below Zumbo’s (1999) criterion of 0.13. On average there were larger differences from norms for Asians (mean = 0.05, sd = 0.44) than non-Asians (mean = -0.07, sd = 0.36), but the size and direction of the differences varied considerably by domain, age, and gender. Conclusion When compared to norms, Asian patients showed no systematic biases. DIF results supported this finding. We conclude that Asian ethnicity does not impact interpretation of EORTC QLQ-C30 scores.

Recommended Scoring Approach for the Pediatric Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events

Background Collecting symptom, function and adverse event (AE) data directly from children and adolescents undergoing cancer care is more comprehensive and accurate than relying solely on their caregivers or clinicians for their interpretations. We developed the Pediatric Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (Ped-PRO-CTCAE) measurement system with input from children, parents, and clinicians. Here we report how we determined the recommended Ped-PRO-CTCAE item scoring approach. Methods Scoring approaches compared were 1) at the AE attribute (frequency, severity, interference) using ordinal and dichotomous measures, 2) a weighted composite AE item score by AE attribute (0.5 - frequency; 1.0 - severity; 1.5 - interference), and 3) overall number of AEs endorsed. Associations of each AE attribute, AE item score and overall AE score with the PROMIS® Pediatric measures of anxiety, depressive symptoms, and fatigue were examined. The ability of the overall Ped-Pro-CTCAE AE score to identify patients with PROMIS symptom T-scores worse than reference population scores was assessed. Clinician preference for score information display was elicited through interviews. Results The diverse scoring approaches yielded similar outcomes, including positive correlations of the Ped-PRO-CTCAE attributes, AE item score, and the overall AEs score with the PROMIS Pediatric measures. Clinicians preferred the most granular display of scoring information (actual score reported by the child and corresponding descriptive term). Conclusions Although three scoring approaches yielded similar results, we recommend the AE attribute level of one score per Ped-Pro-CTCAE AE attribute for its simplicity of use in clinical care and research.

Are my measures comparable across groups? A unified item- and scale-score-level approach to quantifying scalar non-invariance bias

When scalar invariance does not hold, which is often the case in application scenarios, the amount of non-invariance bias may either be consequential for observed mean comparisons or not. So far, only a few attempts have been made to quantify the extent of bias due to measurement non-invariance. Building on Millsap and Olivera-Aguilar (2012), we derived a new effect size measure, called Measurement Invariance Violation Index (MIVI), from first principles. MIVI merely assumes partial scalar invariance for a set of items forming a scale and quantifies the intercept difference of one non-invariant item (at the item-score level) or several non-invariant items (at the scale-score level) as the share (i.e., proportion) of the total observed scale score difference between groups. One can inspect the cancelation effects of item bias at the scale-score level when using directional instead of absolute terms. We provide computational code and exemplify MIVI in simulated contexts.