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Item Scores (item + score)

Distribution by Scientific Domains

Medical Sciences	84%

Selected Abstracts

Generating Dichotomous Item Scores with the Four-Parameter Beta Compound Binomial Model

JOURNAL OF EDUCATIONAL MEASUREMENT, Issue 3 2007
Patrick O. Monahan
A Monte Carlo simulation technique for generating dichotomous item scores is presented that implements (a) a psychometric model with different explicit assumptions than traditional parametric item response theory (IRT) models, and (b) item characteristic curves without restrictive assumptions concerning mathematical form. The four-parameter beta compound-binomial (4PBCB) strong true score model (with two-term approximation to the compound binomial) is used to estimate and generate the true score distribution. The nonparametric item-true score step functions are estimated by classical item difficulties conditional on proportion-correct total score. The technique performed very well in replicating inter-item correlations, item statistics (point-biserial correlation coefficients and item proportion-correct difficulties), first four moments of total score distribution, and coefficient alpha of three real data sets consisting of educational achievement test scores. The technique replicated real data (including subsamples of differing proficiency) as well as the three-parameter logistic (3PL) IRT model (and much better than the 1PL model) and is therefore a promising alternative simulation technique. This 4PBCB technique may be particularly useful as a more neutral simulation procedure for comparing methods that use different IRT models. [source]

Relationship between psychiatric symptoms and regional cerebral blood flow in patients with mild Alzheimer's disease

PSYCHOGERIATRICS, Issue 3 2008
Keisuke NAKAJIMA
Abstract Background:, Behavioral and psychological symptoms of dementia (BPSD) are frequently observed in patients with dementia and often cause serious problems. However, the cause of BPSD has not yet been elucidated. Moreover, the precise evaluation of BPSD in mild dementia has not been studied in any great detail. In the present study, we investigated the relationship between psychiatric symptoms and regional cerebral blood flow (rCBF) in patients with mild Alzheimer's disease (AD). Methods:, The present study included 47 patients (20 men and 27 women) who were diagnosed with mild AD. Mean patient age was 72.8 ± 8.2 years. Single photon emission computed tomography (SPECT) with 99mTc-ethyl cysteinate dimer (99mTc-ECD) was performed in all patients. The SPECT data were analyzed using a three-dimensional stereotactic region of interest template, which evaluated CBF in 24 segments. Psychiatric symptoms were evaluated in patients using the Brief Psychiatric Rating Scale. Each psychiatric symptom was designated as ,symptom present' in cases in which the BPRS item score was more than 3. We compared 10 segments of rCBF in symptom-present patients with those in symptom-absent patients. Results:, Motor retardation was the most common psychiatric symptom (36.2%), followed by depression (19.1%), anxiety (17.0%), emotional withdrawal (17.0%), and somatic concern (14.9%). Alzheimer's disease patients with motor retardation exhibited a tendency towards lower rCBF in seven segments (left callosomarginal, bilateral parietal, bilateral angular, and bilateral temporal). However, no specific tendency was observed in depression, anxiety, and somatic concern. Conclusions:, In the present study, we observed a tendency for decreased brain perfusion in patients with motor retardation. Further studies are necessary to confirm that this trend contributes to the appearance of psychiatric symptoms in patients with mild AD. [source]

Achieving remission with venlafaxine and fluoxetine in major depression: its relationship to anxiety symptoms

DEPRESSION AND ANXIETY, Issue 1 2002
Jonathan R.T. Davidson M.D., M.B.A.
Abstract Venlafaxine, a serotonin and norepinephrine reuptake inhibitor (SNRI), produces significantly higher remission rates in depressed patients than do the selective serotonin reuptake inhibitors (SSRIs). In this analysis of pooled data, we explored the relationship between differences in treatment efficacy, early improvement of symptoms, and severity of baseline anxiety in depressed patients treated with either venlafaxine or fluoxetine. A pooled analysis was performed on data from 1,454 outpatients with major depression from five double-blind, randomized studies comparing the 6-week efficacy of venlafaxine (542 patients) with fluoxetine (555 patients). The Hamilton rating scale for depression (HAM-D) total and item scores were analyzed at different treatment times up to 6 weeks. Venlafaxine and fluoxetine both produced statistically significant higher response and remission rates compared with placebo starting from week 2 for response and weeks 3 to 4 for remission. Venlafaxine was statistically significantly superior to fluoxetine from week 3 until week 6 in respect of response rate, and from week 2 until week 6 for remission rate. After 1 week of treatment, greater improvement in individual symptoms was observed in the depressed mood, suicide, and psychic anxiety items of the HAM-D scale for both venlafaxine- and fluoxetine-treated patients compared with placebo. Improvement in psychic anxiety was statistically significantly greater with venlafaxine than with fluoxetine. The presence of baseline psychic anxiety correlated significantly to treatment outcome when analyzing the remission rates. In depressed patients with moderate anxiety (HAM-D psychic anxiety score ,2), venlafaxine statistically significantly increased remission rates compared with placebo from week 4 until week 6, while a significant effect of fluoxetine on remission rates was observed starting at week 6. Remission rates in the severely anxious depressed patients (score >2) were statistically significantly higher with venlafaxine than placebo starting from week 3 until the end of the study period, but no difference could be observed between fluoxetine and placebo. Baseline severity of psychic anxiety had a significant impact on remission rates after treatment of patients diagnosed with depression. Venlafaxine's superior remission rates in the more severely anxious patients and its ability to improve psychic anxiety as early as week 1 compared with fluoxetine suggest that venlafaxine's early efficacy on anxiety symptoms may be the basis for its superior efficacy in depression. Depression and Anxiety 16:4,13, 2002. © 2002 Wiley-Liss, Inc. [source]

Profile of depression in adolescents with inflammatory bowel disease: Implications for treatment

INFLAMMATORY BOWEL DISEASES, Issue 1 2009
Eva Szigethy MD
Abstract Background: The purpose was to determine the utility of including neurovegetative symptoms in assessments of depression in youth with inflammatory bowel disease (IBD). Methods: Forty-one youth with IBD and concurrent depressive symptomatology were enrolled in an intervention trial and received either 9 modules of cognitive-behavioral therapy (PASCET-PI) or treatment as usual (TAU). Youth and their primary caregivers completed the Children's Depression Inventory (CDI) at pre- (T1) and posttreatment (T2). Disease severity measures and current steroid dosage were obtained at each timepoint. Change in the individual items of the CDI was compared across groups and examined in association with change in physical illness course. Results: Paired sample t -tests revealed significant changes in CDI item scores from T1 to T2 for a majority of the depressive symptoms assessed in the PASCET-PI group, but not for the TAU group. These changes did not appear to be linked to changes in disease severity and/or steroid dosage across these same timepoints. Conclusions: The inclusion of somatic items in the assessment of depression in physically ill youth is important, as these symptoms seem to respond to psychotherapeutic intervention. The present results would suggest that improvements in depressive symptomatology are not solely related to improvements in the course of IBD and that these items do reflect an important part of the profile of depressive symptoms in youth with IBD. Future research is warranted to replicate present findings and explore the generalizability of these results to other pediatric illness populations. (Inflamm Bowel Dis 2008) [source]

Reducing the length of mental health instruments through structurally incomplete designs

INTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 3 2007
Niels Smits
Abstract This paper presents structurally incomplete designs as an approach to reduce the length of mental health tests. In structurally incomplete test designs, respondents only fill out a subset of the total item set. The scores on the unadministered items are estimated using methods for missing data. As an illustration, structurally incomplete test designs recording, respectively, two thirds, one half, one third and one quarter of the complete item set were applied to item scores on the Centre of Epidemiological Studies-Depression (CES-D) scale of the respondents in the Longitudinal Aging Study Amsterdam (LASA). The resulting unobserved item scores were estimated with the missing data method Data Augmentation. The complete and reconstructed data yielded very similar total scores and depression classifications. In contrast, the diagnostic accuracy of the incomplete designs decreased as the designs had more unobserved item scores. The discussion addresses the strengths and limitations of the application of incomplete designs in mental health research. Copyright © 2007 John Wiley & Sons, Ltd. [source]

Generating Dichotomous Item Scores with the Four-Parameter Beta Compound Binomial Model

Medical students' perceptions of their educational environment: expected versus actual perceptions

MEDICAL EDUCATION, Issue 3 2007
Susan Miles
Objective, To compare Year 1 medical students' perceptions of their educational environment at the end of Year 1, with their expectations at the beginning of the year using the Dundee Ready Education Environment Measure (DREEM). Methods, Year 1 students (n = 130) at the University of East Anglia Medical School were asked to complete the DREEM during their induction week at the beginning of Year 1, thinking about the educational environment they expected to encounter (Expected DREEM), and again as part of a compulsory evaluation at the end of Year 1, thinking about the educational environment they had actually experienced (Actual DREEM). A total of 87 students (66.92% of the starting cohort) completed the DREEM on both occasions and gave permission for their data to be published. Results, The Expected DREEM score was 153 out of a maximum of 200, and the Actual DREEM score was 143. Student's expected perceptions of learning and teachers, and their expected academic self- and social self-perceptions were all more positive than their actual perceptions. There was no difference between expected and actual perceptions of atmosphere. Specific aspects of the educational environment showing dissonance were identified. In some areas students' low expectations had been matched by their actual experience. Conclusions, Medical students had started Year 1 with expectations about the educational environment that had not been met. However, areas showing dissonance received low item scores on the Actual DREEM and as such would be picked up for remediation, even without information about student expectations. [source]

Exploring the quality of dying of patients with chronic obstructive pulmonary disease in the intensive care unit: a mixed methods study

NURSING IN CRITICAL CARE, Issue 2 2009
Donna Goodridge
Abstract Rationale for the study:, Improving the quality of end-of-life (EOL) care in critical care settings is a high priority. Patients with advanced chronic obstructive pulmonary disease (COPD) are frequently admitted to and die in critical care units. To date, there has been little research examining the quality of EOL care for this unique subpopulation of critical care patients. Aims:, The aims of this study were (a) to examine critical care clinician perspectives on the quality of dying of patients with COPD and (b) to compare nurse ratings of the quality of dying and death between patients with COPD with those who died from other illnesses in critical care settings. Design and sample:, A sequential mixed method design was used. Three focus groups provided data describing the EOL care provided to patients with COPD dying in the intensive care unit (ICU). Nurses caring for patients who died in the ICU completed a previously validated, cross-sectional survey (Quality of Dying and Death) rating the quality of dying for 103 patients. Data analysis:, Thematic analysis was used to analyse the focus group data. Total and item scores for 34 patients who had died in the ICU with COPD were compared with those for 69 patients who died from other causes. Results:, Three primary themes emerged from the qualitative data are as follows: managing difficult symptoms, questioning the appropriateness of care and establishing care priorities. Ratings for the quality of dying were significantly lower for patients with COPD than for those who died from other causes on several survey items, including dyspnoea, anxiety and the belief that the patient had been kept alive too long. The qualitative data allowed for in-depth explication of the survey results. Conclusions:, Attention to the management of dyspnoea, anxiety and treatment decision-making are priority concerns when providing EOL care in the ICU to patients with COPD. [source]

Real-Time Inter-Rater Reliability of the Council of Emergency Medicine Residency Directors Standardized Direct Observation Assessment Tool

ACADEMIC EMERGENCY MEDICINE, Issue 2009
Joseph LaMantia MD
Abstract Objectives:, Developed by the Council of Emergency Medicine Residency Directors (CORD), the standardized direct observation assessment tool (SDOT) is an evaluation instrument used to assess residents' clinical skills in the emergency department (ED). In a previous study examining the inter-rater agreement of the tool, faculty scored simulated resident,patient encounters. The objective of the present study was to evaluate the inter-rater agreement of the SDOT in real-time evaluations of residents in the ED. Methods:, This was a multi-center, prospective, observational study in which faculty raters were paired to simultaneously observe and independently evaluate a resident's clinical performance using the SDOT. Data collected from eight emergency medicine (EM) residency programs produced 99 unique resident,patient encounters and reported on 26 individual behaviors related to specific core competencies, global evaluation scores for each core competency, and an overall clinical competency score. Inter-rater agreement was assessed using percentage agreement analyses with three constructs: exact agreement, liberal agreement, and binary (pass/fail) agreement. Results:, Inter-rater agreement between faculty raters varied according to category of measure used. Exact agreement ranged from poor to good, depending on the measure: the overall competency score (good), the competency score for each of the six core competencies (poor to good), and the individual item scores (fair to very good). Liberal agreement and binary agreement were excellent for the overall competency score and the competency score for each of the six core competencies and very good to excellent for the individual item scores. Conclusions:, The SDOT demonstrated excellent inter-rater agreement when analyzed with liberal agreement and when dichotomized as a pass/fail measure and fair to good agreement for most measures with exact agreement. The SDOT can be useful and reliable when evaluating residents' clinical skills in the ED, particularly as it relates to marginal performance. [source]

Freezing of Gait Questionnaire: validity and reliability of the Swedish version

ACTA NEUROLOGICA SCANDINAVICA, Issue 5 2009
M. H. Nilsson
Background,,, Patient-reported assessments of freezing of gait (FOG) in Parkinson's disease (PD), such as the FOG questionnaire (FOGQ), are needed because FOG is difficult to assess objectively. However, the measurement properties of the FOGQ have been sparsely assessed. Aim,,, To assess the measurement properties of the Swedish FOGQ, and to explore relationships between FOGQ scores and other aspects of PD. Methods,,, Thirty-seven people with PD were assessed with the FOGQ, Unified PD Rating Scale (UPDRS), Hoehn and Yahr (HY), Falls-Efficacy Scale [FES(S)], timed gait tests, and the SF-36 physical functioning (PF) scale. Results,,, Mean (SD) FOGQ item scores ranged between 1.3 and 2.1 (1.2,1.5); corrected item,total correlations ranged between 0.80 and 0.94. Reliability was 0.95. Mean (SD) and median (q1,q3) FOGQ scores were 9.6 (7.4) and 10 (2,15). Floor and ceiling effects were ,5.4%. FOGQ correlated strongest with UPDRS part II (ADL), UPDRS item 14 (freezing), and HY (rS 0.65,0.66). FOGQ scores correlated with PD duration, the Timed Up and Go test, dyskinesia, motor fluctuations, FES(S), and PF scores (rS 0.40,0.62). Fallers had higher FOGQ scores than non-fallers (median 12.5 vs 5.0). Conclusion,,, Data support the measurement properties of the Swedish FOGQ by replicating and extending previous psychometric reports. [source]

Posttraumatic stress among children in Kurdistan

ACTA PAEDIATRICA, Issue 7 2008
A Ahmad
Abstract Aim: To identify a posttraumatic stress disorder profile for the Child Behaviour Checklist. Method: Checklist item scores for 806 school-aged children in Iraqi Kurdistan (201 randomly selected from the general population, 241 orphans, 199 primary medical care visitors and 165 hospital in-patients) were analysed against the Posttraumatic Stress Symptom Scale for Children (PTSS-C) scores, estimating not only stress diagnoses, but also nonstress-related, child-specific posttraumatic symptoms. Results: Twenty checklist items, which revealed significant correlations with the stress diagnoses, formed the checklist,stress profile with acceptable reliability and validity, and significant correlation to the PTSS-C estimates. Conclusion: A child-specific stress profile for the checklist is recommended for use as a screening instrument. [source]

Reliability and validity of the General Health Questionnaire (GHQ-12) among urological patients: A Malaysian study

PSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 5 2001
Kia Fatt Quek MPHIL
Abstract This present study was undertaken to validate the English version of the General Health Questionnaire (GHQ-12) in urological patients. Validity and reliability were studied in patients with lower urinary tract symptoms (LUTS) and patients without LUTS. Reliability was evaluated using the test,retest method and internal consistency was assessed using Cronbach's alpha. Sensitivity to change was expressed as the effect size in the pre-intervention versus post-intervention score in additional patients with benign prostatic hyperplasia (BPH) who underwent transurethral resection of the prostate (TURP). Internal consistency was excellent. A high degree of internal consistency was observed for each of the 12 items with Cronbach's alpha value of 0.37,0.79, while total scores was 0.79 in the population study. Test,retest correlation coefficient for the 12 items score were highly significant. Intraclass correlation coefficient was high (0.35,0.79). It showed a high degree of sensitivity and specificity to the effects of treatment. A high degree of significant level between baseline and post-treatment scores were observed across all 12 items in the treatment cohort but not in the control group. The GHQ-12 is suitable, reliable, valid and sensitive to clinical change in urological disorders. [source]