Patient-reported outcome measures (PROM) measure attribute studies refer to studies conducted by investigators to validate the measurement attributes of PROM. The consensus-based standards for the selection of health measurement instruments (COSMIN), an international consensus standard for the selection of health measurement instruments, divides this attribute into three aspects: reliability, validity and responsiveness, and adds interpretability as an additional important feature for evaluating PROM. The purpose of this paper is to introduce the verification methods and principles of the three major measurement attributes in the COSMIN consensus, as well as the significance and direction of interpretability evaluation, and to provide international methodological experience and reference for the development of high-quality PROM psychometric attribute verification in China.
ObjectiveTo compare and evaluate the discrimination, validity, and reliability of different data envelopment analysis (DEA) models for measuring the effectiveness of models by selecting different input and output indicators of the model.MethodsData from health statistical reports and pilot program of diagnosis-related groups of tertiary hospitals in Hubei Province from 2017 to 2018 were used to analyze the discrimination, content and structure validity, and reliability of the models. Six DEA models were established by enriching the details of input and output on the basis of the input and output indicators of the conventional DEA model of hospitals.ResultsFrom the view of discrimination, the results of all models were left-skewed, the cost-efficiency model had the lowest left-skewed degree (skewness coefficient: -0.14) and was the flattest (kurtosis coefficient: -1.02). From the view of structure validity, the results of the cost-efficiency model were positively correlated with total weights, outpatient visits, and inpatient visits (r=0.328, 0.329, 0.315; P<0.05). From the perspective of content validity, the interpretation of model was more consistent with theory of production after revision of input and output indicators. From the view of reliability, the cost efficiency model had the largest correlation coefficient between the data of 2017 and 2018 (r=0.880, P<0.05).ConclusionsAfter refining the input and output indicators of the DEA model, the discrimination, validity, and reliability of the model are higher, and the results are more reasonable. Using indicators such as discrimination, validity, and reliability can measure the effectiveness of the DEA model, and then optimize the model by selecting different input and output indicators.
ObjectiveTo evaluate the reliability and validity of the Quality of Working Life Scale (QWL7-32). MethodsThe QWL7-32 scale was used to survey 487 drilling workers. The presence of chronic diseases was regarded as an effector for evaluating physical health, and the result of SCL-90 measurement was regarded as an effector for evaluating psychological health. The reliability and validity of the scale were statistically analyzed. ResultsThe results of the Pearson correlation coefficient was 0.713, the Cronbach's alpha coefficient was 0.920, and the Splithalf reliability coefficient was 0.942. The result of confirmatory factor analysis showed that the construct validity of scale was good, and the accumulative rate of 7 variances was 62.59%. The results of correlation analysis and t test showed that the validity of scale criterion was also good. In QWL7-32 scale, each dimension showed a good correlation with its relevant item but poor correlation with any other items. ConclusionThe QWL7-32 has a good reliability and validity.
ObjectivesThis study aimed to evaluate the validity and reliability of the clinical practice guidelines (CPGs) applicability evaluation tool, a preliminary revised tool, by using it to appraise specific clinical guidelines.MethodsMedical staffs were sampled from relevant departments in domestic medical institutions to use tool to evaluate the two guidelines. Spearman-Brown coefficient of odd-even split-half method and Cronbach's alpha coefficient were used to evaluate the split-half reliability and internal consistency reliability. The convergent and discriminant validity were evaluated by correlation analysis and correlation coefficient comparison hypothesis test, and the structural validity was investigated by confirmatory factor analysis based on structural equation.ResultsThe split-half reliability of the evaluation tool was 0.86, and the Cronbach's coefficient of the whole tool and each dimension were greater than 0.7 for two guidelines. The success rates of tool convergent and discriminant validity calibration were 100%. In the second-order confirmatory factor analysis model, the χ2 and df were 3.38 and 2.46, the comparative fit index (CFI) were 0.872 and 0.974, the goodness of fit index (GFI) were 0.954 and 0.983, and the adjusted goodness of fit index (AGFI) were 0.846 and 0.959 for two guidelines respectively. Both standard root mean square residual (SRMR) and root mean square error of approximation (RMSEA) were less than 0.09. Both P values of RMSEA hypothesis test were greater than 0.05.ConclusionsThe evaluation scale is a valid and reliable instrument for assessing the applicability of CPGs, which should be further evaluated in practical applications in the future.
ObjectiveThe purpose of this study was to translate the U-CEP scale into Chinese, and evaluate the reliability and validity of the Chinese version of the U-CEP, in order to provide a measurement and evaluation tool for clinical epidemiology education and research. MethodsThe U-CEP scale was translated and adapted using the Brislin translation model. A nationwide survey of clinicians was conducted using the Chinese version of the U-CEP. Item analysis, reliability analysis, and validity analysis were performed using SPSS 26.0 software. ResultsThe discriminant validity analysis showed that except for item 4, the critical value (CR) of the other twenty-four items differed significantly between high and low groups (P<0.01), with CR values ranging from 2.902 to 14.609. The ITCs of the 25 items were all positive, with 5 items having an ITC<0.15(20%), 2 items having ITC≥0.15~0.20 (8%), 6 items having ITC≥0.20~0.40 (24%) and 12 items having ITC≥0.40 (48%). In terms of reliability, the overall Cronbach’s α coefficient of the Chinese version of the U-CEP was 0.80, with Cronbach’s α coefficient ranging from 0.752 to 0.805 when deleting each item one by one. The test-retest reliability was 0.848 (P<0.001). The alternative-form reliability was 0.838 (P<0.001). In terms of validity, expert analysis showed that the content validity of the Chinese version of the U-CEP was good. The construct validity analysis showed that the cumulative contribution rate of the 25 items was 57.50%. No respondent scored full marks or zero marks, indicating that no ceiling or floor effects were found. There were statistically significant differences in the total scores among clinicians with different educational backgrounds or with or without systematic learning of relevant knowledge (P<0.05). ConclusionThe Chinese version of the U-CEP has good reliability and validity, as well as good cultural adaptability. It can effectively assess a physician's knowledge of clinical epidemiology.
ObjectiveTo formulate the Chinese version of Fear of Progression Questionnaire-Short Form/Caregiver Version (FoP-Q-SF/C) and examine the reliability and validity of the scale.MethodsA questionnaire survey of FoP-Q-SF/C was conducted among the caregivers of melanoma out-patients in West China Hospital of Sichuan University from June 2019 to March 2020. Convenient sampling method was adopted. The validity and reliability of the scale were analyzed.ResultsA total of 247 caregivers of melanoma out-patients were investigated by the FoP-Q-SF/C, and 101 valid questionnaires were finally collected. The Cronbach’s α of the FoP-Q-SF/C scale was 0.919, and the Guttman Split-Half coefficient was 0.906. Using exploratory factor analysis to extract 3 common factors, the cumulative explainable total variation was 73.964%. The model fit was as follows: chi-square/degree of freedom was 1.950, standardized root mean square residual was 0.067, goodness of fit index was 0.859, incremental fit index was 0.939, comparative fit index was 0.938, Tucker-Lewis index or non-normed fit index was 0.918, and the root-mean-square error of approximation was 0.097.ConclusionsThe FoP-Q-SF/C scale formulated in this study is divided into three dimensions, which has good reliability and validity, meanwhile, it is relatively simple and can be used to clinically screen melanoma caregivers’ FoP-Q-SF/C levels. However, the application of this scale in other diseases still needs further testing.
Objective To evaluate the reliability and validity of the Chinese version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS) in preoperative anxiety in patients with local anesthesia. Methods From May to December 2020, a convenient sampling method was used to conduct an APAIS questionnaire survey on patients undergoing percutaneous renal biopsy in the Department of Nephrology, West China Hospital, Sichuan University, and the reliability and validity of the scale were analyzed. ResultsA total of 460 questionnaires were distributed and 444 valid questionnaires were returned, with a valid response rate of 96.5%. The Cronbach α of APAIS was 0.896, the Guttman split-half reliability was 0.811, and the content validity index was 0.891. The model fit was 12.122 for the chi-square fit index/degree of freedom, 0.916 for the goodness-of-fit index, 0.902 for the value-added fit index, 0.079 for the root mean square error of approximation, and 0.946 for the comparative fit index. The APAIS anxiety subscale score was positively correlated with the 7-item Generalized Anxiety Disorder Scale score (r=0.518, P<0.001). Conclusion The APAIS has good reliability and validity for evaluating the level of preoperative anxiety in patients with local anesthesia, but the application of the scale in other conditions requires further testing.
Objective To evaluate the reliability and validity of the three-dimensional motion capture analysis system COFT-Motion® in evaluating the active range of motion of upper limbs in healthy subjects, and provide objective basis for its clinical application. Methods From January to March 2022, healthy subjects were publicly recruited for enrollment. The evaluator applied the three-dimensional motion capture analysis system COFT-Motion® and angle ruler to evaluate the active range of motion of the shoulder joint (flexion, extension, adduction, abduction) and elbow joint (flexion, extension) in healthy subjects. Pearson correlation analysis was used to evaluate validity, and intraclass correlation coefficient (ICC) was used to evaluate reliability. Results There was a positive correlation between the measurements of COFT-Motion® and the angle ruler of the active range of motion of upper limbs in healthy subjects. The Pearson correlation coefficients for active range of motion of the shoulder joint (flexion, extension, adduction, abduction) and elbow joint (flexion, extension) were 0.913, 0.964, 0.961, 0.941, 0.864, and 0.919, respectively (P<0.05). The results of using COFT-Motion® by different evaluators to evaluate the active range of motion of healthy subjects’ shoulder joints (flexion, extension, adduction, abduction) and elbow joints (flexion, extension) showed that the ICC values were 0.892, 0.942, 0.961, 0.988, 0.989, and 0.928, respectively (P<0.05). The results of repeated evaluations by the same evaluator showed that the ICC values were 0.795, 0.916, 0.900, 0.868, 0.918, and 0.911, respectively (P<0.05). Conclusion The application of the three-dimensional motion capture analysis system COFT-Motion® in healthy subjects has good validity and reliability. However, due to the limited sample size and subject of the study, further promotion and application of the system still need to be further explored.
Patient reported outcome measures (PROM) are widely used in clinical research and practice. To aid the interpretation of PROM, researchers have proposed the minimal important difference (MID), the smallest change or difference that patients perceive as important. However, the estimation methods of MID are numerous and inconsistent, which brings difficulties to selecting the optimal MID estimate to interpret PROM results. To address this issue, a research team from McMaster University in Canada has proposed an approach for selecting the optimal MID. This method includes three core steps: evaluating the credibility of MID estimates, assessing the consistency among credible MID estimates, and selecting the optimal value based on contextual factors. The credibility evaluation instrument for anchor-based MID examines five core criteria, including the data sources of PROM and anchor, the interpretability of anchor, the correlation between anchor and PROM, the precision of MID estimates, and the judgment of anchor thresholds. When there are multiple credible MID estimates, the optimal MID estimate is selected by evaluating the consistency among the estimates and considering contextual factors that affect the variability among the estimates, such as the type of intervention, follow-up time, and disease severity. In addition, the team provided recommendations to improve the reporting quality of MID studies. This article provides a detailed introduction and interpretation of these developments, aiming to enhance researchers' and clinicians' understanding and application of MID, thereby supporting clinical research and healthcare decision-making.