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Response Categories (response + category)
Selected AbstractsAssessing autonomic symptoms of Parkinson's disease with the SCOPA-AUT: a new perspective from Rasch analysisEUROPEAN JOURNAL OF NEUROLOGY, Issue 2 2010M. J. Forjaz Background:, The Scale for Outcomes in Parkinson's disease (PD) for Autonomic Symptoms (SCOPA-AUT) is a specific scale to assess autonomic dysfunction in PD patients. It was developed and validated under the classic test theory approach. This study sought to test whether the SCOPA-AUT meets item response theory standards for reliability, internal construct validity, response category ordering, and differential item functioning by gender and age group. Method:, The Rasch measurement model was applied to a sample of 385 PD patients. Results:, Model fit was obtained after the response categories were rescored and item 10-Incomplete emptying deleted because of redundancy. Person separation index, a reliability measure, was 0.82. All but two items (2-Sialorrhea and 13-Nocturia) were free of gender- and age-related bias. The strict tests of unidimensionality were met, indicating the validity of the total sumscore. Scale targeting suggested the need for items representing milder autonomic symptoms. Conclusions:, Suggestions for improving the SCOPA-AUT include a shorter scale with a simpler response scheme and a combination of sexual items for men and women. The resulting SCOPA-AUT is a reliable scale, with good internal construct validity, providing Rasch transformed results on a linear metric scale. [source] Measuring inequality in self-reported health,discussion of a recently suggested approach using Finnish dataHEALTH ECONOMICS, Issue 7 2004Jorgen Lauridsen Health surveys often include a general question on self-assessed health (SAH), usually measured on an ordinal scale with three to five response categories, from ,very poor' or ,poor' to ,very good' or ,excellent'. This paper assesses the scaling of responses on the SAH question. It compares alternative procedures designed to impose cardinality on the ordinal responses. These include OLS, ordered probit and interval regression approaches. The cardinal measures of health are used to compute and decompose concentration indices for income-related inequality in health. Results are provided using Finnish data on 15D and the SAH questions. Further evidence emerges for the internal validity of a method used in a pioneering study by van Doorslaer and Jones which was based on Canadian data on the McMaster Health Utility Index Mark III (HUI) and SAH. The study validates the conclusions drawn by van Doorslaer and Jones. It confirms that the interval regression approach is superior to OLS and ordered probit regression in assessing health inequality. However, regarding the choice of scaling instrument, it is concluded that the scaling of SAH categories and, consequently, the measured degree of inequality, are sensitive to characteristics of the chosen scaling instrument. Copyright © 2003 John Wiley & Sons, Ltd. [source] Improving fatigue assessment in immune-mediated neuropathies: the modified Rasch-built fatigue severity scaleJOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 4 2009Sonja I. Van Nes Abstract Fatigue is a major disabling complaint in patients with immune-mediated neuropathies (IN). The 9-item fatigue severity scale (FSS) has been used to assess fatigue in these conditions, despite having limitations due to its classic ordinal construct. The aim was to improve fatigue assessment in IN through evaluation of the FSS using a modern clinimetric approach [Rasch unidimensional measurement model (RUMM2020)]. Included were 192 stable patients with Guillain-Barré syndrome (GBS), chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) or polyneuropathy associated with monoclonal gammopathy of undetermined significance (MGUSP). The obtained FSS data were exposed to RUMM2020 model to investigate whether this scale would meet its expectations. Also, reliability and validity studies were performed. The original FSS did not meet the Rasch model expectations, primarily based on two misfitting items, one of these also showing bias towards the factor ,walking independent.' After removing these two items and collapsing the original 7-point Likert options to 4-point response categories for the remaining items, we succeeded in constructing a 7-item Rasch-built scale that fulfilled all requirements of unidimensionality, linearity, and rating scale model. Good reliability and validity were also obtained for the modified FSS scale. In conclusion, a 7-item linearly weighted Rasch-built modified FSS is presented for more proper assessment of fatigue in future studies in patients with immune-mediated neuropathies. [source] Effects of a pseudoallergen-free diet on chronic spontaneous urticaria: a prospective trialALLERGY, Issue 1 2010M. Magerl Abstract Background:, Chronic spontaneous urticaria is a skin disorder that is difficult to manage and can last for years. ,Pseudoallergens' are substances that induce hypersensitive/intolerance reactions that are similar to true allergic reactions. They include food additives, vasoactive substances such as histamine, and some natural substances in fruits, vegetables and spices. Eliminating pseudoallergens from the diet can reduce symptom severity and improve patient quality of life. Aim:, To assess the effects of a pseudoallergen-free diet on disease activity and quality of life in patient's chronic spontaneous urticaria. Methods:, Study subjects had moderate or severe chronic spontaneous urticaria that had not responded adequately to treatment in primary care. For 3 weeks, subjects followed a pseudoallergen-free diet. They kept a clinical diary, which recorded their wheal and pruritus severity each day, to yield a clinical rating of chronic spontaneous urticaria severity (the UAS4 score). The subjects also completed the DLQI, a validated quality-of-life instrument. Use of antihistamines and glucocorticoids was minimized, recorded, and analysed. Subjects were classified into nine response categories, according to the changes in symptom severity (UAS4), quality of life (DLQI) and medication usage. Results:, From the 140 subjects, there were 20 (14%) strong responders and 19 (14%) partial responders. Additionally, there were nine (6%) subjects who made a substantial reduction in their medication without experiencing worse symptoms or quality of life. Conclusions:, Altogether the pseudoallergen-free diet is beneficial for one in three patients. The pseudoallergen-free diet is a safe, healthy and cost-free measure to identify patients with chronic spontaneous urticaria that will benefit from avoiding pseudoallergens. [source] The use of the comprehensive International Classification of Functioning, Disability and Health Core Set for low back pain in clinical practice: a reliability studyPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 3 2009Roger Hilfiker Abstract Background and Purpose.,The comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for low back pain (LBP) can be used to describe functioning and the influence of the environment of patients with LBP with a selection of 78 categories, from the ICF components ,body functions', ,body structures', ,activities and participation' and ,environmental factors'. The reliability of the qualifiers' scale of the ICF Core Set for LBP has not yet been studied.,Methods.,Reliability study was conducted in three study centres in the German-speaking part of Switzerland. In the first step, two physiotherapists independently assessed 31 patients with LBP with the original qualifier scale of the 78 ICF categories from the comprehensive ICF Core Set for LBP. After the first 31 patients, inter-rater reliability was assessed and the response options were reduced based on a Rasch analysis. The second sample (n = 30) was assessed by the physiotherapists with the modified qualifier scale and inter-rater reliability was calculated again.,Results.,The percentage agreement for the ICF categories ranged from 19% to 87%, mean 44% (nominal kappa from ,0.73 to 0.54, median 0.22; weighted kappa ,0.2 to 0.69, median 0.38) in the first round with the original qualifier scale. In the second round with the reduced response options, the percentage agreement ranged from 23% to 90%, mean 49% (nominal kappa from ,0.15 to 0.71, median 0.24; weighted kappa ,0.16 to 0.81, median 0.25). The overall percentage agreement was 44% in the first round and 49% with the reduced response categories. The overall kappa value in the first round was 0.29 and in the second round 0.32. There was a small but statistically significant improvement in the agreement.,Conclusion.,The low-to-moderate reliability found in this study requires an improved operationalization (e.g. the definition and description of each response category) and improved instructions for the ICF Core Set for LBP. Copyright © 2009 John Wiley & Sons, Ltd. [source] Fear of recurrence in long-term testicular cancer survivorsPSYCHO-ONCOLOGY, Issue 6 2009Tone Skaali Abstract Objective: To explore fear of recurrence (FoR) in long-term testicular cancer survivors (TCSs) since FoR hardly has been examined in TCSs. Methods: In a cross-sectional questionnaire study, 1336 TCSs at a mean of 11.4 years (SD 4.2) after diagnosis gave information about their medical and social situation, and completed measures on mental distress, fatigue, quality of life, coping, self-esteem and neuroticism. FoR during the last week was explored with one question, with the response categories rated on a 4-point Likert scale. Nine percent of the TCSs had a structured psychiatric interview. Results: Twenty-four percent of the TCSs reported ,quite a bit' FoR and 7% reported ,very much' FoR during the last week. The FoR question showed moderate correlations (0.22,0.51) with established psychological measures. The level of FoR was significantly positively correlated with mental distress, fatigue and neuroticism and significantly negatively correlated with quality of life, self-esteem and coping. In univariate analyses, neurotoxic side effects and somatic symptoms, but not treatment modality, were significantly associated with level of FoR. In a multivariate analysis, a medium educational level, increasing levels of traumatic cancer-related stress symptoms and of neuroticism were significantly associated with rising FoR. Among those who had a psychiatric interview, the presence of at least one current mental disorder was significantly associated with FoR. Conclusions: High levels of FoR in long-term TCSs are not uncommon. Levels of mental and somatic problems are associated with the levels of FoR. Clinical consequences of these findings for TCSs are discussed. Copyright © 2008 John Wiley & Sons, Ltd. [source] Children's Expectations of Pain, Perceptions of Analgesic Efficacy, and Experiences With Nonpharmacologic Pain Management Strategies at Home Following TonsillectomyJOURNAL FOR SPECIALISTS IN PEDIATRIC NURSING, Issue 3 2007Kimberly A. Sutters PURPOSE.,To document children's (ages 6,15 years) descriptions of their pain management at home following tonsillectomy. DESIGN AND METHODS.,Audio-taped interviews of 80 children were transcribed and coded. Data for each response category were tabulated. RESULTS.,Children reported they had more pain after surgery than expected, the pain medicine helped to take their pain away, taking the pain medicine was associated with a negative response by some children, and cold liquids/food by mouth provided pain relief. PRACTICE IMPLICATIONS.,Findings provide insight into children's perspective of pain management at home following tonsillectomy and methods for relieving their pain. [source] Comparison of gallium and PET scans at diagnosis and follow-up of pediatric patients with Hodgkin lymphomaPEDIATRIC BLOOD & CANCER, Issue 2 2008Melissa Hines-Thomas BS Abstract Background Positron emission tomography (PET) and gallium scans facilitate diagnosis and staging, evaluation of response to therapy, and monitoring for relapse in Hodgkin lymphoma (HL), but have not been compared in pediatric HL. Procedure We performed concurrent PET and gallium scans on 44 pediatric HL patients at diagnosis, early response, off chemotherapy, and off-therapy evaluations. PET and gallium scans were compared to each other and to computed tomography (CT) alone to determine whether either modality led to a change in stage or modified the results of the early response evaluation, which was used to determine the radiation dose. Results PET upstaged four patients at diagnosis (2 from stage I to II, one II to III, and one III to IV), but did not lead to a change in therapy in any of them. It changed response category in two patients at early response evaluation, leading to a change in radiation dose for 1 patient (25.5 Gy instead of 15 Gy to the spleen). Gallium did not change the stage of treatment for any patient. The negative predictive values for eventual lymphoma relapse of PET and gallium scans at off therapy were 89% and 83%, respectively; the positive predictive value of PET at off therapy is 29%. Conclusion PET appears to be superior to gallium in pediatric HL; future studies will determine the optimal timing of PET to assess early response and the utility of quantitative interpretation of the avidity of specific nodal sites. Pediatr Blood Cancer 2008;51:198,203. © 2008 Wiley-Liss, Inc. [source] The use of the comprehensive International Classification of Functioning, Disability and Health Core Set for low back pain in clinical practice: a reliability studyPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 3 2009Roger Hilfiker Abstract Background and Purpose.,The comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for low back pain (LBP) can be used to describe functioning and the influence of the environment of patients with LBP with a selection of 78 categories, from the ICF components ,body functions', ,body structures', ,activities and participation' and ,environmental factors'. The reliability of the qualifiers' scale of the ICF Core Set for LBP has not yet been studied.,Methods.,Reliability study was conducted in three study centres in the German-speaking part of Switzerland. In the first step, two physiotherapists independently assessed 31 patients with LBP with the original qualifier scale of the 78 ICF categories from the comprehensive ICF Core Set for LBP. After the first 31 patients, inter-rater reliability was assessed and the response options were reduced based on a Rasch analysis. The second sample (n = 30) was assessed by the physiotherapists with the modified qualifier scale and inter-rater reliability was calculated again.,Results.,The percentage agreement for the ICF categories ranged from 19% to 87%, mean 44% (nominal kappa from ,0.73 to 0.54, median 0.22; weighted kappa ,0.2 to 0.69, median 0.38) in the first round with the original qualifier scale. In the second round with the reduced response options, the percentage agreement ranged from 23% to 90%, mean 49% (nominal kappa from ,0.15 to 0.71, median 0.24; weighted kappa ,0.16 to 0.81, median 0.25). The overall percentage agreement was 44% in the first round and 49% with the reduced response categories. The overall kappa value in the first round was 0.29 and in the second round 0.32. There was a small but statistically significant improvement in the agreement.,Conclusion.,The low-to-moderate reliability found in this study requires an improved operationalization (e.g. the definition and description of each response category) and improved instructions for the ICF Core Set for LBP. Copyright © 2009 John Wiley & Sons, Ltd. [source] | ||||||||||