Psychometric Validation of The Cognitive Abilities Screening Instrument Using Rasch Analysis In People With Dementia

Background: The Cognitive Abilities Screening Instrument (CASI) is one of the most commonly used cognitive screening tools to assess overall cognitive function in people with dementia. However, the unidimensionliaty of the CASI using Rasch analysis has not been evaluated in people with dementia, limiting its utility in clinical and research settings. Unidimensionality verifies whether all items of a measure reflect a single theoretical construct, which is necessary to determine whether clinicians and researchers can appropriately use the sum scores of the CASI to describe overall cognitive function. This study aimed to examine unidimensionality of the CASI using Rasch analysis and estimate Rasch person reliability in people with dementia. Methods: CASI data of people with dementia was collected from medical records of one general hospital in northern Taiwan. A total of 506 people with dementia were recruited from the Department of Neurology. Unidimensionality was confirmed through two assumptions: (1) the infit and outfit mean square (MnSq) were 0.6-1.4, and (2) residual variance of the first principal component in principal component analysis was ≤ 20%. Rasch person reliability was estimated after undimensionality was supported. Results: One item from the list-generating fluency dimension was misfitted (outfit MnSq=1.42) and was deleted. The unidimensionality of the remaining 45 items (referred to as the CASI-45) was supported with an infit and outfit MnSq (0.85-1.24 and 0.84-1.28, respectively) and low residual variance of the first principal component (12.8%). The Rasch person reliability of the CASI-45 was 0.62. Conclusion: The CASI-45 showed a unidimensional construct and had acceptable Rasch person reliability in people with dementia.

Validity and Reliability of the Persian Versions of Primary and Secondary Screening Instrument for Targeting Educational Risk Questionnaires

Background and Aim: Hearing loss in children leads to speech and language delays, low academic achievement, literacy delays, and psychosocial difficulties. Screening instrument for targeting educational risk (SIFTER) is one of the questionnaires used for evaluation of students’ performance in schools. The current study aims to develop Persian versions of primary and secondary SIFTER questionnaires and assessing their validity and reliability. Methods: The main English versions of primary and secondary SIFTER questionnaires were translated into Persian named as P-SIFTER and secondary P-SIFTER. Then, their face validities were determined based on the options of related experts. The final versions were completed by 55 teachers of 150 students (64 primary and 86 secondary school students) divided into two groups of hearing-impaired (HI) and normal-hearing (NH) students. The test- retest reliabilities were assessed in 117 students (64 primary and 53 secondary school students). Results: The results revealed that these questionnaires had high face validity. The content validity index for P-SIFTER and secondary P-SIFTER were obtained 0.94 and 0.92, respectively. The total score of P-SIFTER was 51.85 and 65.41 in HI and NH students, respectively. For the secondary P-SIFTER, it was 58.75 and 67.48, respectively. The test-retest reliability showed high correlation for NH and HI students between P-SIFTER and secondary P-SIFTER scores. The Cronbach’s alpha value for the overall score of P-SIFTER was 0.96 for both HI and NH students; for secondary P-SIFTER, the values were 0.94 and 0.93, respectively. Conclusion: The Persian versions of primary and secondary SIFTER questionnaires have acceptable validity and reliability.

Another Perspective of the Miller Forensic Assessment of Symptoms Test – Part II: A Quantitative Review

Reference [1] presented pooled data for the specificity of the M-FAST cut-off, but ignored or excluded data based on poor justifications and used questionable analytic methods. The analyses here corrected the problems associated with [1]. No moderator substantively influenced sensitivity values. Therefore, sensitivity values were pooled across all studies (k = 25) to provide an overall estimate. Overall, the average sensitivity of the M-FAST cut-off was estimated to be 0.87, 95% CI [0.80, 0.91], and 80% of true sensitivity values were estimated to range from 0.63 to 0.96. Thus, there could be methodological scenarios when the M-FAST cut-off may not operate efficiently. Average specificity values for the M-FAST cut-off were moderated by one variable: the comparison group. On average, specificity values for clinical comparison (k = 15) groups (i.e., 0.80, 95% CI [0.73, 0.85]) were lower than specificity values for non-clinical comparison (k = 11) groups (i.e., 0.96, 95% CI [0.89, 0.99]). Unlike the CIs, the estimated distributions of true specificity values for the two subgroups overlapped, which suggests there could be scenarios when these subgroups share the same true specificity value. The M-FAST was designed to be a screener to detect potential feigning of psychiatric symptoms. An examinee is never to be designating as feigning or malingering psychiatric symptoms based on only a positive M-FAST result. As a screening instrument, the results here show that the M-FAST cut-off is operating adequately overall and negate the conclusions of [1].

Bedeutung der Herzangst für den psychologischen Betreuungsbedarf und die subjektive Erwerbsprognose – Hinweise aus der stationären kardiologischen Rehabilitation

Zusammenfassung Hintergrund In der stationären kardiologischen Rehabilitation werden Patienten idealerweise nach psychosozialen Risikofaktoren gescreent und psychologisch betreut. Herzbezogene Ängste bei kardiologischen Erkrankungen können die Lebensqualität erheblich beeinträchtigen und sowohl die Prognose des Krankheitsverlaufs als auch die soziale und berufliche Teilhabe beeinflussen. Aufgrund der Diskrepanz zwischen der, in der Literatur berichteten, Prävalenz der Herzangst und dem, durch die Patienten in der Klinik Roderbirken geäußerten Bedarf an psychologischer Betreuung, vermuteten die Autoren, dass ein Teil der Patienten diesen Bedarf nicht selbständig äußert. Ziel der Studie war es, diese Patienten durch ein einfaches Screening-Instrument zu identifizieren, um ihnen eine adäquate psychologische Betreuung anzubieten und dadurch die Rehabilitationsziele, darunter den Erhalt der Erwerbsfähigkeit, zu sichern. Methode Die vorliegenden Daten wurden in einer monozentrischen Querschnittsstudie in der Rehabilitationsklinik Roderbirken, Leichlingen, NRW, erhoben. Die Patienten wurden einmalig mit einem standardisierten Fragebogen, bestehend aus dem Herzangstfragebogen, der Hospital Anxiety and Depression Scale und der Skala I des Screening-Instruments Beruf und Arbeit in der Rehabilitation befragt. Soziodemographische und klinische Daten wurden aus dem Kliniksystem ergänzt. Die Auswertung der Daten erfolgte mithilfe deskriptiv-statistischer und regressionsanalytischer Verfahren. Ein Ethikvotum liegt vor. Ergebnisse Nach Bereinigung des Datensatzes konnten 507 Patienten in die Analyse eingeschlossen werden (82,6% Männer, mittleres Alter gesamt 54,4±7,1 Jahre). Von diesen meldeten 40,0% einen Bedarf an psychologischer Betreuung an. Bei 15,7% aller Patienten lag eine Herzangst nach dem Herzangstfragebogen vor, von denen wiederum 59,0% einen Bedarf an psychologischer Betreuung anmeldeten. Es zeigte sich, dass insbesondere Patienten mit diagnostizierten psychischen Erkrankungen Betreuungsbedarf äußerten (57,6 vs. 0,7%; p<0,05). Die subjektive Erwerbsprognose war mit Herzangst und mit der Depressionssymptomatik nach Hospital Anxiety and Depression Scale assoziiert (je p<0,001), des Weiteren mit der Ausbildung und dem beruflichen Status. Diskussion Die Ergebnisse der Selbstbeurteilungsfragebögen und die Betrachtung sozioökonomischer sowie klinischer Patientencharakteristika geben Hinweise auf ein Bedarfsprofil hinsichtlich des psychologischen Betreuungsbedarfs und eine negative subjektive Erwerbsprognose. Schlussfolgerung Ein Screening mit der Hospital Anxiety and Depression Scale ist geeignet, um die Identifizierung nicht geäußerter psychologischer Betreuungsbedarfe und damit die Zielerreichung der beruflichen Reintegration in der kardiologischen Rehabilitation zu unterstützen.

Validity of a Multidimensional Psychosocial Screener Based on the ESC Cardiovascular Prevention Guidelines – Evidence from the General and Cardiovascular Patient Population

Aim. To evaluate the psychometric properties and validity of the updated version of the Dutch multidimensional European Society of Cardiology (ESC) psychosocial screening instrument in patients with heart disease and the general population. Method. 678 participants (Mage = 48.2, SD = 16.8; 46% male) of the Dutch general population and 312 cardiac patients (Mage = 65.9, SD = 9.9; 77% male) who recently received percutaneous coronary intervention completed the ESC Psychosocial screening instrument and validated questionnaires for depression (PHQ-9), anxiety (GAD-7), Type D personality (DS14), hostility (CMHS), anger (STAS-T), trauma (SRIP), and chronic work and family stress (ERI, MMQ-6). Results. Confirmatory factor analysis (CFA) confirmed that the eight screened risk factors were best measured as separate entities, rather than as broader indications of distress. Inter-instrument agreement, assessed with the intraclass coefficient (ICC) and the screening accuracy indicators (receiving operator characteristic [ROC] curves, sensitivity, specificity, and the positive and negative predictive values [PPV;NPV]) were good for most screened risk factors. PPV was low in low prevalence risk factors like anxiety and trauma. Conclusion. Overall, the current version of the ESC Psychosocial screening instrument has an acceptable performance in both populations, with a fair to excellent level of agreement with established full questionnaires. Besides a few suggestions for further refinement, the screener may be implemented in primary care and cardiological practice.

The Alcohol Use Disorders Identification Test (AUDIT) in the Russian language - a systematic review of validation efforts and application challenges

The Alcohol Use Disorders Identification Test (AUDIT) is one of the most frequently used screening instrument for hazardous and harmful use of alcohol and potential alcohol dependence in primary health care (PHC) and other settings worldwide. It has been translated into many languages and adapted and modified for use in some countries, following formal adaptation procedures and validation studies. In the Russian Federation, the AUDIT has been used in different settings and by different health professionals, including addiction specialists (narcologists). In 2017, it was included as a screening instrument in the national guidelines of routine preventive health checks at the population-level (dispanserization). However, various Russian translations of the AUDIT are known to be in use in different settings and, so far, little is known about the empirical basis and validation of the instrument in Russia—a country, which is known for its distinct drinking patterns and their detrimental impact on health. The present contribution is the summary of two systematic reviews that were carried out to inform a planned national validation study of the AUDIT in Russia.Two systematic searches were carried out to 1) identify all validation efforts of the AUDIT in Russia and to document all reported problems encountered, and 2) identify all globally existing Russian translations of the AUDIT and document their differences and any reported issues in their application. The qualitative narrative synthesis of all studies that met the inclusion criteria of the first search highlighted the absence of any large-scale rigorous validation study of the AUDIT in primary health care in Russia, while a document analysis of all of the 122 Russian translations has revealed 61 unique versions, most of which contained inconsistencies and signaled obvious application challenges of the test.The results clearly signal the need for a validation study of the Russian AUDIT.