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Validation Study (validation + study)
Kinds of Validation Study Selected AbstractsShelf Life Prediction of Bread Sticks Using Oxidation Indices: A Validation StudyJOURNAL OF FOOD SCIENCE, Issue 2 2008S. Calligaris ABSTRACT:, The aim of this study was to apply the protocol for the shelf life prediction of bakery products proposed by Calligaris and others (2007a) on bread sticks. The methodology comprises 4 steps: (1) evaluation of the physical properties of fat; (2) performing the accelerated shelf life test; (3) evaluation of sensory acceptance limit and the relevant chemical index limit; (4) setting up the shelf life prediction model. The results allow validating the shelf life prediction methodology proposed. In fact, the peroxide number was found to be a representative index of the quality depletion of bread sticks during their shelf life. In addition, once again by accounting for the changes in the fat physical state, it is possible to set up a modified Arrhenius equation able to describe the temperature dependence of peroxide formation. Finally, a mathematical model to simply and quickly calculate the shelf life of bread sticks has been developed. [source] Compassion Fatigue and Psychological Distress Among Social Workers: A Validation StudyAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 1 2006Richard E. Adams PhD Few studies have focused on caring professionals and their emotional exhaustion from working with traumatized clients, referred to as compassion fatigue (CF). The present study had 2 goals: (a) to assess the psychometric properties of a CF scale, and (b) to examine the scale's predictive validity in a multivariate model. The data came from a survey of social workers living in New York City following the September 11, 2001, terrorist attacks on the World Trade Center. Factor analyses indicated that the CF scale measured multiple dimensions. After overlapping items were eliminated, the scale measured 2 key underlying dimensions,secondary trauma and job burnout. In a multivariate model, these dimensions were related to psychological distress, even after other risk factors were controlled. The authors discuss the results in light of increasing the ability of professional caregivers to meet the emotional needs of their clients within a stressful environment without experiencing CF. [source] A Validation Study of Type 2 Diabetes-related Variants of the TCF7L2, HHEX, KCNJ11, and ADIPOQ Genes in one Endogamous Ethnic Group of North IndiaANNALS OF HUMAN GENETICS, Issue 4 2010Vipin Gupta Summary The aim of this study was to validate the single nucleotide polymorphisms (SNPs) of four candidate genes (TCF7L2, HHEX, KCNJ11, and ADIPOQ) related to type 2 diabetes (T2D) in an endogamous population of north India; the Aggarwal population, having 18-clans. This endogamous population model was heavily supported by recent land mark work and we also verified the homogeneity of this population by clan-based stratification analysis. Two SNPs (rs4506565; rs7903146) in TCF7L2 were found to be significant (p-value = 0.00191; p-value = 0.00179, respectively), and odds ratios of 2.1 (dominant-model) and 2.0 (recessive-model) respectively, were obtained for this population. The TTT haplotype in the TCF7L2 gene was significantly associated with T2D. Waist-Hip ratio (WHR), systolic blood pressure (SBP), and age were significant covariates for increasing risk of T2D. Single-SNP, combined-SNPs and haplotype analysis provides clear evidence that the causal mutation is near to or within the significant haplotype (TTT) of the TCF7L2 gene. In spite of a culturally-learned sedentary lifestyle and fat-enriched dietary habits, WHR rather than body-mass-index emerged as a robust predictor of risk for T2D in this population. [source] Validation Study of Genetic Associations with Coronary Artery Disease on Chromosome 3q13-21 and Potential Effect Modification by SmokingANNALS OF HUMAN GENETICS, Issue 6 2009Benjamin D. Horne Summary The CATHGEN study reported associations of chromosome 3q13-21 genes (KALRN, MYLK, CDGAP, and GATA2) with early-onset coronary artery disease (CAD). This study attempted to independently validate those associations. Eleven single nucleotide polymorphisms (SNPs) were examined (rs10934490, rs16834817, rs6810298, rs9289231, rs12637456, rs1444768, rs1444754, rs4234218, rs2335052, rs3803, rs2713604) in patients (N = 1618) from the Intermountain Heart Collaborative Study (IHCS). Given the higher smoking prevalence in CATHGEN than IHCS (41% vs. 11% in controls, 74% vs. 29% in cases), smoking stratification and genotype-smoking interactions were evaluated. Suggestive association was found for GATA2 (rs2713604, p = 0.057, OR = 1.2). Among smokers, associations were found in CDGAP (rs10934490, p = 0.019, OR = 1.6) and KALRN (rs12637456, p = 0.011, OR = 2.0) and suggestive association was found in MYLK (rs16834871, p = 0.051, OR = 1.8, adjusting for gender). No SNP association was found among non-smokers, but smoking/SNP interactions were detected for CDGAP (rs10934491, p = 0.017) and KALRN (rs12637456, p = 0.010). Similar differences in SNP effects by smoking status were observed on re-analysis of CATHGEN. CAD associations were suggestive for GATA2 and among smokers significant post hoc associations were found in KALRN, MYLK, and CDGAP. Genetic risk conferred by some of these genes may be modified by smoking. Future CAD association studies of these and other genes should evaluate effect modification by smoking. [source] Validation study of the Victorian Birth Defects RegisterJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 9-10 2004M Riley Objective: To determine whether there has been an improvement in ascertainment of birth defects cases (,case validity') by the Victorian Birth Defects Register (BDR) since an earlier study (conducted in 1993), to ascertain the accuracy of registered data (,item validity') and to investigate another possible source of notification. Methods: The medical records were reviewed of 500 children born after 1 January 1993 who were consecutively admitted after 1 January 1999 to two paediatric teaching hospitals in Victoria. In addition, records of 200 children referred to a clinical genetics service were reviewed for children born after 1 January 1993 and who were seen in two periods: 2 months after 1 January 2001 and 2 months after 1 January 2002. The records from the hospitals and clinical genetics service were reviewed separately to determine whether children recorded as having a birth defect had previously been notified to the BDR. Results: Twenty percent of the hospital records related to a child with a birth defect, as did 70% of the clinical genetics service records. Overall case validity for birth defect cases from the hospitals was 88%. There was 100% ascertainment for three of five categories. Sixty per cent of birth defects cases from the clinical genetics service had been notified to the BDR. When all diagnoses in matched cases were considered, item validity was 54%, however, if only primary diagnoses were included then 92% of cases had the same diagnosis. Conclusions: Overall case validity from the two paediatric teaching hospitals has significantly improved since our previous study. The addition of an extra data source from a clinical genetics service would identify new cases, particularly genetic disorders and developmental delay, as well as adding new diagnoses to existing ones. This study has highlighted the need to improve item validity, perhaps through routine education for all coders and notifiers on the inclusion and exclusion of specific associated conditions when notifying major birth defects. [source] Validation study of the prediction system for clinical response of M-VAC neoadjuvant chemotherapyCANCER SCIENCE, Issue 1 2007Ryo Takata To predict the efficacy of the M-VAC neoadjuvant chemotherapy for invasive bladder cancers, we previously established the method to calculate the prediction score on the basis of expression profiles of 14 predictive genes. This scoring system had clearly distinguished the responder group from the non-responder group. To further validate the clinical significance of the system, we applied it to 22 additional cases of bladder cancer patients and found that the scoring system correctly predicted clinical response for 19 of the 22 test cases. The group of patients with positive predictive scores had significantly longer survival than that with negative scores. When we compared our results with a previous report describing the prognosis of the patients with cystectomy alone, the results imply that patients with positive scores are likely to benefit from M-VAC neoadjuvant chemotherapy, but that the chemotherapy would shorten the lives of patients with negative scores. We are confident that our prediction system to M-VAC therapy should provide opportunities for achieving better prognosis and improving the quality of life of patients. Taken together, our data suggest that the goal of ,personalized medicine', prescribing the appropriate treatment regimen for each patient, may be achievable by selecting specific sets of genes for their predictive values according to the approach shown here. (Cancer Sci 2007; 98: 113,117) [source] Criminal cognitions and personality: what does the PICTS really measure?CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 3 2000Dr Vincent Egan Introduction The Psychological Inventory of Criminal Thinking Styles (PICTS) is a measure of the criminal cognitions and thinking styles that maintain offending. The scale comprises 8 a priori thinking styles and two validation scales, the validation scales having been found to be unreliable. Owing to the large amount of apparently shared variance in the original validation study, this data matrix needs re-analysis. Results from the PICTS were examined in relation to general measures of individual differences, in order to link the PICTS to the broader literature on the characteristics of offenders. Method The original PICTS data-matrix was re-analysed using a more parsimonious method of analysis. The PICYS was also given to 54 detained, mentally disordered offenders along with the NEO-Five Factor Inventory, the Sensation-Seeking Scale (SSS), the Attention Deficit Scales for Adults (ADSA) and, as a measure of general intelligence, the Standard Progressive Matrices. Results Principal components analysis suggested that the PICTS really comprised two factors: a lack of thoughtfulness (i.e. lack of attention to one's experience), and wilful hostility, with the first factor being most well defined. Intelligence was not associated with any factor of criminal thinking style. High scores on the ADSA and Disinhibition and Boredom Susceptibility subscales of the SSS were associated with much greater endorsement of criminal sentiments; high Neuroticism, low Extroversion, and low Agreeableness were slightly lower correlates. Discussion The issues involved in criminogenic cognitions need clarification and to be linked to the broader literature on cognitive distortions and personality. Interventions targeted at dismantling impulsive destructive behaviour, whether it be thoughtlessness or wilful hostility, may be effected by increasing thinking skills, so breaking down the cognitions that maintain criminal behaviour. Copyright © 2000 Whurr Publishers Ltd. [source] Preparation of thyroid FNA material for routine cytology and BRAF testing: A validation studyDIAGNOSTIC CYTOPATHOLOGY, Issue 3 2010Giancarlo Troncone M.D., Ph.D. Abstract V600E BRAF mutation is emerging as an independent marker of papillary thyroid carcinoma aggressive behavior. Papillary thyroid carcinomas harboring this mutation should be extensively resected. However, this requires an unquestionable cytological diagnosis of malignancy. Thus, cytological specimens should be properly handled to provide both morphological and molecular information. Here, we assessed whether our method of preparation of fine-needle aspiration material is suitable for both tests. A series of 128, routinely performed, fine-needle aspirations was analyzed. Each nodule was punctured three times. A representative Diff-Quik smear prepared from the first two passages was evaluated onsite. When microscopy was diagnostic (n = 44), the third needle pass was dedicated to harvest material for BRAF testing; in the remaining cases (n = 84), additional direct smears for cytology were prepared and the remaining material in the needle plus the needle rinsing was collected for BRAF testing. Cellularity was adequate in 126/128 (98%) cases. Cytological diagnoses were inadequate (2%), benign (85%), follicular lesion of undetermined significance (5%), follicular neoplasms (2%), suspicious for malignancy (2%), and malignant (4%). Higher average of extracted DNA concentration was observed in the dedicated pass group (25.9 vs 7.95 ng/,l). However, the rate of successful exon 15 BRAF amplification was similar with (43/44; 97.7%) or without (79/84; 94%) the dedicated pass. Thus, our protocol is suitable for both tests. Whenever necessary BRAF testing may also be performed on the residual samples of thyroid nodules, without interfering with routine cytology. Diagn. Cytopathol. 2010. © 2009 Wiley-Liss, Inc. [source] Interobserver agreement in endoscopic evaluation of reflux esophagitis using a modified Los Angeles classification incorporating grades N and M: A validation study in a cohort of Japanese endoscopistsDISEASES OF THE ESOPHAGUS, Issue 4 2008H. Miwa SUMMARY., The Los Angeles classification system is the most widely employed criteria associated with the greatest interobserver agreement among endoscopists. In Japan, the Los Angeles classification system has been modified (modified LA system) to include minimal changes as a distinct grade of reflux esophagitis, rather than as auxiliary findings. This adds a further grading M defined as minimal changes to the mucosa, such as erythema and/or whitish turbidity. The modified LA system has come to be used widely in Japan. However, there have been few reports to date that have evaluated the interobserver agreement in diagnosis when using the modified LA classification system incorporating these minimal changes as an additional grade. A total of 100 endoscopists from university hospitals and community hospitals, as well as private practices in the Osaka-Kobe area participated in the study. A total of 30 video clips of 30,40 seconds duration, mostly showing the esophagocardiac junction, were created and shown to 100 endoscopists using a video projector. The participating endoscopists completed a questionnaire regarding their clinical experience and rated the reflux esophagitis as shown in the video clips using the modified LA classification system. Agreement was assessed employing kappa (,) statistics for multiple raters. The , -value for all 91 endoscopists was 0.094, with a standard error of 0.002, indicating poor interobserver agreement. The endoscopists showed the best agreement on diagnosing grade A esophagitis (0.167), and the poorest agreement when diagnosing grade M esophagitis (0.033). The , -values for the diagnoses of grades N, M, and A esophagitis on identical video pairs were 0.275,0.315, with a standard error of 0.083,0.091, indicating fair intraobserver reproducibility among the endoscopists. The study results consistently indicate poor agreement regarding diagnoses as well as fair reproducibility of these diagnoses by endoscopists using the modified LA classification system, regardless of age, type of practice, past endoscopic experience, or current workload. However, grade M reflux esophagitis may not necessarily be irrelevant, as it may suggest an early form of reflux disease or an entirely new form of reflux esophagitis. Further research is required to elucidate the pathophysiological basis of minimal change esophagitis. [source] Intra- and interlaboratory calibration of the DR CALUX® bioassay for the analysis of dioxins and dioxin-like chemicals in sedimentsENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 12 2004Harrie T. Besselink Abstract In the Fourth National Policy Document on Water Management in the Netherlands [1], it is defined that in 2003, in addition to the assessment of chemical substances, special guidelines for the assessment of dredged material should be recorded. The assessment of dredged material is based on integrated chemical and biological effect measurements. Among others, the DR CALUX® (dioxin responsive,chemically activated luciferase expression) bioassay has tentatively been recommended for inclusion in the dredged material assessment. To ensure the reliability of this bioassay, an intra- and interlaboratory validation study, or ring test, was performed, organized by the Dutch National Institute for Coastal and Marine Management (RIKZ) in cooperation with BioDetection Systems BV (BDS). The intralaboratory repeatability and reproducibility and the limit of detection (LOD) and quantification (LOQ) of the DR CALUX bioassay were determined by analyzing sediment extracts and dimethyl sulfoxide (DMSO) blanks. The highest observed repeatability was found to be 24.1%, whereas the highest observed reproducibility was calculated to be 19.9%. Based on the obtained results, the LOD and LOQ to be applied for the bioassay are 0.3 and 1.0 pM, respectively. The interlaboratory calibration study was divided into three phases, starting with analyzing pure chemicals. During the second phase, sediment extracts were analyzed, whereas in the third phase, whole sediments had to be extracted, cleaned, and analyzed. The average interlaboratory repeatability increased from 14.6% for the analysis of pure compound to 26.1% for the analysis of whole matrix. A similar increase in reproducibility with increasing complexity of handlings was observed with the interlaboratory reproducibility of 6.5% for pure compound and 27.9% for whole matrix. The results of this study are intended as a starting point for implementing the integrated chemical,biological assessment strategy and for systematic monitoring of dredged materials and related materials in the coming years. [source] A field validation of two sediment-amphipod toxicity testsENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 7 2002Steven P. Perraro Abstract A field validation study of two sediment-amphipod toxicity tests was conducted using sediment samples collected subtidally in the vicinity of a polycyclic aromatic hydrocarbon (PAH)-contaminated Superfund site in Elliott Bay (WA, USA). Sediment samples were collected at 30 stations with a 0.1 m2 grab from which subsamples were taken for sediment toxicity testing and geochemical and macrofaunal analyses. Standard 10-d sediment-amphipod toxicity tests were conducted with Rhepoxynius abronius and Leptocheirus plumulosus. Sediments were analyzed for 33 PAHs, pentachlorophenol, polychlorinated biphenyls, acid-volatile sulfide, simultaneously extracted metals (Cd, Cu, Zn, Pb, Ni), total organic carbon, and grain size. Sediment temperature, oxygen-reduction potential, water depth, and interstitial water salinity were also measured. Polycyclic aromatic hydrocarbons, quantified as total PAH toxic units (TUPAH), were confirmed to be an important common causal agent of the changes in the two toxicity test (% survival R. abronius, % survival L. plumulosus) and five macrofaunal community (number of species, S; numerical abundance, A; total biomass, B; Swartz's dominance index, SDI; Brillouin's index, H) endpoints. Two other macrofaunal community metrics (the complement of Simpson's index, 1 , SI, and McIntosh's index, MI) were less sensitive to TUPAH than the two toxicity test endpoints. The sensitivities of R. abronius and L. plumulosus to TUPAH were statistically indistinguishable. Field validations were conducted by testing the association between or among each toxicity test endpoint, each of seven macrofaunal community metrics (S, A, B, SDI, H, 1 , SI, MI), and TUPAH by (1) Spearman's coefficient of rank correlation, (2) Kendall's coefficient of concordance, (3) G tests of independence, and (4) regression analysis. Some field validations based on multivariable tests of association (e.g., points 2 and 3) among toxicity test, field, and stressor endpoints produced false positive results. Both toxicity test endpoints were validated as indicators of changes in S, A, SDI, and H by all the methods tested. The resolution power of the relationships between the laboratory toxicity test and macrofaunal field endpoints was low (, three classes) but sufficient to discriminate ecologically important effects. We conclude that standard sediment-amphipod toxicity tests are ecologically relevant and that, under the proper conditions, their results can be used for lab-to-field extrapolation. [source] Adapted Finnish Migraine-Specific Questionnaire for family studies (FMSQFS): a validation study in two languagesEUROPEAN JOURNAL OF NEUROLOGY, Issue 10 2008M. F. Facheris Background and purpose:, The hypothesis of a genetic component in the etiology of migraine is getting a foothold. However, to explore genetic associations, precision in clinical phenotypization is crucial. For this reason, migraine-specific questionnaires, well discriminating between primary headaches, are required when large numbers of individuals need to be assessed. Methods:, We adapted and translated in two languages, German and Italian, the Finnish Migraine-Specific Questionnaire for use in family studies. Results and conclusions:, This adaptation proved to be reliable when differentiating from primary headaches, and to be in very good agreement with the standard for comparison. However, discriminating between migraine with and without aura still relays on a specialist evaluation. This article describes the validation of this questionnaire. [source] Neuroticism and responses to social comparison among cancer patientsEUROPEAN JOURNAL OF PERSONALITY, Issue 6 2009Abraham P. Buunk Abstract The present study examined how the effects of three audiotapes containing different types of social comparison information on the mood of cancer patients depended on the level of neuroticism. On the procedural tape, a man and woman discussed the process of radiation therapy, on the emotion tape, they focussed on emotional reactions to their illness and treatment, while on the coping tape they focussed on the way they had been coping. A validation study among 115 students showed that the tapes were perceived as they were intended. The main study was conducted among 226 patients who were about to undergo radiation therapy. Compared to patients in the control group, as patients were higher in neuroticism, they reported less negative mood after listening to the procedural and the coping tape. Furthermore, as patients were higher in neuroticism, they reported less negative mood after listening to the coping tape than to the emotion tape. Copyright © 2009 John Wiley & Sons, Ltd. [source] Assessment of a HER2 scoring system for gastric cancer: results from a validation studyHISTOPATHOLOGY, Issue 7 2008M Hofmann Aims:, Human epidermal growth factor receptor 2 (HER2) overexpression/amplification is implicated in the development of various solid tumour types. Validated methods and scoring systems for evaluating HER2 status exist in breast cancer, but not in gastric cancer. The aim was to establish a HER2 scoring system for gastric cancer to identify suitable patients for enrolment in a trial of trastuzumab (Herceptin®) in advanced metastatic gastric cancer. Methods and results:, Formalin-fixed paraffin-embedded gastric cancer samples were tested for HER2 status using the fluorescence in situ hybridization (FISH) pharmDxÔ kit (Dako Denmark A/S). Immunohistochemistry (IHC) was performed using the HercepTestÔ (Dako). Concordance between FISH and IHC was 93.5% in 168 evaluable samples. Eleven samples were scored as FISH+ but IHC, or equivocal. Conclusions:, IHC/FISH discrepancies were attributed to basolateral membranous immunoreactivity of glandular cells resulting in incomplete membranous reactivity and/or a higher rate of tumour heterogeneity in gastric cancer compared with breast cancer. With modifications to the IHC scoring system, the HercepTestÔ is considered valid for the identification of HER2+ gastric tumours for this clinical trial. Correlation of HER2 scores with clinical outcomes will be needed to determine which patients might benefit from trastuzumab therapy. [source] fMRI analysis for motor paradigms using EMG-based designs: A validation studyHUMAN BRAIN MAPPING, Issue 11 2007Anne-Fleur van Rootselaar Abstract The goal of the present validation study is to show that continuous surface EMG recorded simultaneously with 3T fMRI can be used to identify local brain activity related to (1) motor tasks, and to (2) muscle activity independently of a specific motor task, i.e. spontaneous (abnormal) movements. Five healthy participants performed a motor task, consisting of posture (low EMG power), and slow (medium EMG power) and fast (high EMG power) wrist flexion,extension movements. Brain activation maps derived from a conventional block design analysis (block-only design) were compared with brain activation maps derived using EMG-based regressors: (1) using the continuous EMG power as a single regressor of interest (EMG-only design) to relate motor performance and brain activity, and (2) using EMG power variability as an additional regressor in the fMRI block design analysis to relate movement variability and brain activity (mathematically) independent of the motor task. The agreement between the identified brain areas for the block-only design and the EMG-only design was excellent for all participants. Additionally, we showed that EMG power variability correlated well with activity in brain areas known to be involved in movement modulation. These innovative EMG-fMRI analysis techniques will allow the application of novel motor paradigms. This is an important step forward in the study of both the normally functioning motor system and the pathophysiological mechanisms in movement disorders. Hum Brain Mapp, 2007. © 2007 Wiley-Liss, Inc. [source] A Multimethod Multitrait Validity Assessment of Self-Construal in Japan, Korea, and the United StatesHUMAN COMMUNICATION RESEARCH, Issue 1 2005Mary J. Bresnahan A large number of previous studies have used self-construal to predict communication outcomes. Recent evidence, however, suggests that validity problems may exist in self-construal measurement. The current study conducted a multimethod multitrait (Campbell & Fiske, 1959) validation study of self-construal measures with data (total N= 578) collected in Korea (N= 200), Japan (N= 212), and the U.S. (N= 166). The data showed that the Singelis (1994) Self-Construal Scale, the Cross, Bacon, and Morris (2000) Relational Interdependent Self-Construal Scale (RISC), and the Kuhn and McPartland (1954) Twenty Statements Test (TST) lacked convergent and discriminant validity, both pan-culturally and within each of the three countries included in the study. Scores on the TST were not significantly related to scores on the self-construal scales, and the various self-construal measures correlated more highly with measures of communication directness than with alternative measures of the same type of self-construal. Substantial method effects were also observed. The results were tested for both 2- and 3-dimensional models of self-construal and for refined scales and scales with all items retained. The results of all analyses were inconsistent with the claim that self-construal measures are construct valid. [source] The Ages & Stages Questionnaire: Social,Emotional: A validation study of a mother-report questionnaire on a clinical mother,infant sample,INFANT MENTAL HEALTH JOURNAL, Issue 4 2010Björn Salomonsson Mother-report questionnaires of infant socioemotional functioning are increasingly used to screen for clinical referral to infant mental health services. The validity of the Ages & Stages Questionnaire: Social Emotional (ASQ:SE; J. Squires, D. Bricker, K. Heo, & E. Twombly, 2002) was investigated in a sample of help-seeking mothers with young infants. It was compared with independent observer-rated dyadic interactions, and the quality of dyadic relationships was rated by expert clinicians. The ASQ:SE ratings also were compared with questionnaires on maternal psychological stress and distress. The ASQ:SE did not correlate significantly with either external ratings of dyadic interaction or clinically assessed relationship qualities, though the latter two were strongly associated with each other. In contrast, ASQ:SE scores were associated with questionnaires relating to maternal psychological distress. This was especially true for mothers classified as depressed. Furthermore, reports on the ASQ:SE were strongly predicted by maternal stress. The study points to some problems with the concurrent validity of the ASQ:SE in clinical samples. It also demonstrates a close link between mothers' psychological distress and their ratings of infant social and emotional functioning. Further research should investigate the extent to which the ASQ:SE specifically measures infant functioning or maternal distress, and how it functions in clinical versus nonclinical samples. Los cuestionarios en que las madres reportan el funcionamiento socio-emocional del infante se están usando más para determinar la necesidad de referir a los servicios de salud mental infantil. Se investigó la validez del Cuestionario de Edades y Niveles: Socio-emocional (ASQ:SE) en un grupo muestra de madres con infantes pequeños las cuales buscaban ayuda. Al grupo se le comparó con las interacciones de las díadas evaluadas por un observador independiente, y con la calidad de las relaciones de las díadas evaluadas por clínicos expertos. Los puntajes del ASQ:SE también fueron comparados con cuestionarios sobre el estrés y la ansiedad maternales sicológicas. Resultados: el ASQ:SE no se correlacionó significativamente ni con los puntajes externos de la interacción de la díada ni con las cualidades de la relación evaluadas clínicamente, aunque ambas fueron asociadas fuertemente una con la otra. En contraste, los puntajes de ASQ:SE fueron asociados con cuestionarios que se referían a la ansiedad mental psicológica maternal. Esto resultó verdadero sobretodo en los casos de madres clasificadas como depresivas. Es más, el estrés maternal predijo fuertemente los reportes sobre el ASQ:SE. Este estudio apunta hacia ciertos problemas con la validez concurrente del ASQ:SE en muestras clínicas. El mismo demuestra una conexión cercana entre la ansiedad mental psicológica maternal y los puntajes que las madres les dan al funcionamiento social y emocional del infante. La investigación futura debe enfocarse en hasta qué punto el ASQ:SE mide específicamente el funcionamiento del infante o la ansiedad mental de la madre, y cómo el mismo funciona en muestras clínicas versus aquellas que no lo son. Les questionnaires "rapport de la mère" de fonctionnement social et émotionnel du nourrison sont de plus en plus utilisés pour tester les enfants afin de les envoyer consulter en services de santé mentale du nourrisson. La validité du questionnaire "âge et étapes: social et émotionnel" (en anglais Ages and Stages Questionnaire: Social et Emotionnel, abrégé ASQ:SE en anglais) a été examinée chez un échantillon de mères de jeunes bébés cherchant de l'aide. Elle a été comparée à des interactions dyadiques évaluées par un observateur indépendant, la qualité des relations dyadiques étant évaluée par des cliniciens experts. Les évaluations ASQ:SE ont aussi été comparées aux questionnaires sur la détresse et le stress psychologique maternel. Résultats: Le questionnaire ASQ:SE n'a pas été fortement mis en corrélation avec soit les évaluations externes d'interaction dyadique soit les qualités de la relation évaluées cliniquement, bien que ces deux dernières aient été fortement liées les unes aux autres. Par contre, les scores ASQ:SE étaient liés aux questionnaires qui portaient sur la détresse psychologique maternelle. Ceci s'est surtout avéré vrai pour les mères classifiées comme déprimées. De plus, les rapports sur le ASQ:SE étaient frotement prédits par le stress maternel. Cette étude met en lumière certains problèmes avec la validité simultanée du questionnaire ASQ:SE dans les échantillons cliniques. Elle démontre aussi un lien étroit entre la détresse psychologique des mères et leurs évaluations du fonctionnement social et émotionnel du nourrisson. Des recherches plus approfondies devraient porter sur la mesure dans laquelle le questionnaire ASQ:SE mesure spécifiquement le fonctionnement du nourrisson ou la détresse maternelle, et comment il fonctionne dans des échantillons cliniques par rapport à non-cliniques. Fragebögen der sozial-emotionalen Funktionsweisen, die auf Elternurteilen beruhen, werden zunehmend zur Klärung der Frage eingesetzt, ob eine ärztliche Überweisung im Rahmen von psychischer Gesundheit im Kleinkindalter induziert ist. Die Gültigkeit des Fragebogens zum Alter und zu den Entwicklungsstufen "Sozial Emotional" (ASQ: SE) wurde von einer Gruppe Hilfe-suchender Mütter mit Kleinkindern entwickelt. Die Fragebögen wurden von unabhängigern Beobachter innerhalb dyadischer Interaktionen validiert. Zusätzlich überprüften erfahrene Kliniker die Qualität der dyadischen Beziehungen. Die Bewertungen mittels ASQ: SE wurden darüber hinaus mit Fragebogen zu mütterlichen psychologischem Stress und Ängste verglichen. Ergebnisse: Die ASQ: SE zeigte keine signifikant Korrelation mit den externen Ergebnissen der dyadischen Interaktion oder den klinisch beurteilten Beziehungsqualitäten, obwohl die beiden letzteren trotzdem in Zusammenhang standen. Im Gegensatz dazu zeigten die Ergebnisse des ASQ: SE einen Zusammenhang mit den Fragebögen zur mütterlichen psychischen Belastung. Dies galt vor allem für Mütter die als depressiv eingestuft wurden. Außerdem machten die Ergebnisse des ASQ: SE eindeutige Vorhersagen was den mütterlicher Stress anbelangt. Die Studie weist auf einige Probleme der übereinstimmenden Gültigkeit des ASQ: SE in klinischen Stichproben hin. Es zeigt aber auch eine enge Verbindung zwischen mütterlicher psychischer Belastung und ihren Bewertungen der sozialen und emotionalen Funktionsfähigkeit ihrer Säuglinge hin. Weitere Forschung sollte untersuchen, inwieweit der ASQ: SE gezielt Maßnahmen zur Steigerung der Funktionalität von Säuglingen oder mütterliche Not misst und in wie weit der Fragebogen im klinischen bzw. nicht-klinischen Setting Gültigkeit behält. [source] Dementia Care Mapping (DCM): initial validation of DCM 8 in UK field trialsINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 11 2006Dawn J. Brooker Abstract Objectives This paper describes DCM 8 and reports on the initial validation study of DCM 8. Methods Between 2001,2003, a series of international expert working groups were established to examine various aspects of DCM with the intention of revising and refining it. During 2004,2005 the revised tool (DCM 8) was piloted in seven service settings in the UK and validated against DCM 7th edition. Results At a group score level, WIB scores and spread of Behavioural Category Codes were very similar, suggesting that group scores are comparable between DCM 7 and 8. Interviews with mappers and focus groups with staff teams suggested that DCM 8 was preferable to DCM 7th edition because of the clarification and simplification of codes; the addition of new codes relevant to person-centred care; and the replacement of Positive Events with a more structured recording of Personal Enhancers. Conclusions DCM 8 appears comparable with DCM 7th edition in terms of data produced and is well received by mappers and dementia care staff. Copyright © 2006 John Wiley & Sons, Ltd. [source] Depression in dementia: a comparative and validation study of four brief scales in the elderly ChineseINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 5 2004Chee Kum Lam Abstract Aim The study aimed to determine: (i) the diagnostic accuracy of four brief depression scales, the Geriatric Depression Scale (GDS), Even Briefer Assessment Scale for Depression (EBAS DEP), Single Question and Cornell Scale for Depression in Dementia (Cornell) in an elderly Chinese population with varying dementia severity; and (ii) which scale had the best diagnostic performance. Method All four scales were administered to 88 elderly outpatients with dementia: 66 without and 22 with depression. Receiver Operating Characteristic (ROC) analysis was used to establish the optimal cut-off scores of the GDS, EBAS DEP and Cornell scales. The patients' dementia-severity was dichotomously categorized into mild and moderate-severe dementia, and the above analysis was repeated in both these groups to look at changes in the scales' diagnostic performance as dementia advances. Results The best diagnostic scale for detecting depression in dementia was the Cornell scale. Its optimal cut-off score was 6/7 (sensitivity 91.7%, specificity 80.0%) in the mild dementia group and 12/13 (sensitivity 70.0%, specificity 87.0%) in the more advanced dementia group. The optimal cut-off scores of the GDS and EBAS DEP also shifted to higher values when moving from the mild to the more advanced dementia groups, indicating the increasing difficulty on all these scales to detect depression with worsening cognitive impairment. The Single Question, however, was more robust with much less changes in its diagnostic parameters in both dementia cohorts: sensitivity 58.3%, specificity 90.0% for mild dementia, and 60.0 and 84.8%, respectively, for more advanced dementia. Conclusion An efficient strategy to diagnose depression in dementia amongst elderly Chinese patients is to administer the Single Question followed by, when necessary, the Cornell scale. Copyright © 2004 John Wiley & Sons, Ltd. [source] Behavioral profile of Alzheimer's disease in Chinese elderly , a validation study of the Chinese version of the Alzheimer's disease behavioral pathology rating scaleINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 4 2001Linda C. W. Lam Abstract Objectives This study aims to examine the psychometric properties of the Chinese version of the Alzheimer's disease behavioral pathology rating scale (CBehave-AD) and the behavioral profile of Chinese patients with AD. Methods Seventy-one subjects with NINCDS-ADRDA diagnosis of probable and possible AD were assessed for validation of the CBehave-AD. A behavioral symptom frequency checklist, the Chinese version of the Blessed Roth dementia scale (CDS) and the Cantonese version of the Mini-Mental State Examination (CMMSE) were used for comparison. An extended sample of 120 AD patients was then evaluated with the CBehave-AD. Results High correlations between the CBehave-AD and checklist scores were found (paranoid and delusional ideation, hallucinations, activity disturbances, aggressiveness and diurnal rhythm disturbances). The scale also demonstrated satisfactory inter-rater and test-retest reliabilities. The mean (SD) CMMSE score of the 120 patients was 9.4 (7.1). Among them, 32% have delusions, 15% had hallucinations, 54% had activity disturbances, 61% had aggressive behavior, 44% had sleep disturbance, 24% had affective disturbances, 19% had anxiety and phobias. Delusional ideation was significantly associated with hallucinations, aggressiveness, and affective disturbances. Diurnal rhythm disturbances were associated with activity disturbances and aggressiveness. CBehave-AD total scores were not significantly correlated with severity of AD, but individual symptom categories showed different pattern of correlation. Delusions, hallucinations, anxiety and phobias were significantly correlated with dementia staging. Conclusion The findings suggest that the CBehave-AD is a valid assessment tool for behavioral disturbances in patients with AD. Variable associations between different symptom categories and dementia staging suggest a need for further exploration of the complex interactions between behavioral and cognitive disturbances in dementia. Copyright © 2001 John Wiley & Sons, Ltd. [source] A validation study of the Cross-Cultural Adaptability InventoryINTERNATIONAL JOURNAL OF TRAINING AND DEVELOPMENT, Issue 2 2010Nhung T. Nguyen Despite the claims made about the effectiveness of cross-cultural training programs, few studies have examined the reliability and validity of the instruments used in these training programs. In this study, the authors examined the factor structure of the Cross-Cultural Adaptability Inventory (CCAI) via a confirmatory factor analytic approach. A series of confirmatory factor analytic models was tested and applied at the item level to both the CCAI and Goldberg's Big Five Inventory. A confirmatory factor analysis (CFA) model in which a method factor was estimated fits the data significantly better than a model without such a method effect. Further, the method factor suppressed substantive relationships such that the two CCAI factors of Emotional Resilience and Personal Autonomy became significant correlates with self-reported number of international job assignments after accounting for method variance. Implications for research and practice are discussed. [source] Characteristics of and interventions for fever in JapanINTERNATIONAL NURSING REVIEW, Issue 4 2004Y. Ikematsu rn Abstract Purpose:, As part of a larger multinational validation study of the International Classification for Nursing Practice (ICNP®) alpha version, a survey was conducted in Japan to determine characteristics of ,fever' and interventions to treat febrile patients. Sample:, Three hundred and fifty-six acute and critical care Japanese nurses participated in this study. Method:, The major and minor characteristics of ,fever' perceived by Japanese nurses and interventions used by the nurses in managing febrile patients were identified using the Diagnostic Content Validity (DCV) model. Results:, Two characteristics, ,increased body temperature' and ,chills' were selected as major characteristics from the standardized list of the ICNP® alpha version validation study. Nine characteristics among the standardized list of characteristics were rated as minor characteristics, and six of the ICNP® characteristics were rejected. ,Shivering' and ,infectious lab data' were added with a level of representativeness similar to a major characteristic by nine of the nurses. A variety of interventions to treat fever were reported. The most frequently reported intervention was cooling, followed by warming and medication. Nine dimensions were derived from all reported interventions. Discussion:, As well as perceived characteristics of fever, these interventions may have aspects unique to Japanese nursing practice and to the acute and critical care settings. These results can be compared to those of other populations in future studies. [source] Insomnia Severity Index: psychometric properties with Chinese community-dwelling older peopleJOURNAL OF ADVANCED NURSING, Issue 10 2010Doris S.F. Yu yu d.s.f. (2010) Insomnia Severity Index: psychometric properties with Chinese community-dwelling older people. Journal of Advanced Nursing,66(10), 2350,2359. Abstract Aim., This paper is a report of a study to evaluate the psychometric properties of the Chinese version of the Insomnia Severity Index. Background., Despite the high prevalence of insomnia in older people and its detrimental impact on well-being and healthcare costs, this problem is almost always undetected and consequently under-treated. The Insomnia Severity Index is psychometrically sound in measuring perceived insomnia severity. However, it has had very limited application in non-White populations. Methods., An instrument validation study was carried out between October 2008 and April 2009. The Insomnia Severity Index was translated into Chinese using Brislin's model and administered to a convenience sample of 585 older Chinese people recruited from three community centres for elders. Other instruments were also administered, including the Chinese version of the Pittsburgh Sleep Quality Index and the Geriatric Depression Scale. Results., Cronbach's alpha of the Chinese version of the Insomnia Severity Index was 0·81, with item-to-total correlations in the range of 0·34,0·67. Construct validity was supported by its moderate relationship with the Chinese Pittsburgh Sleep Quality Index and sleep efficiency. The Chinese version of the Insomnia Severity Index also indicated more severe level of insomnia in older people who reported depressed mood on the Geriatric Depression Scale. Discriminant validity was supported as the Chinese version of the Insomnia Severity Index could discriminate poorer sleepers from normal sleepers. Exploratory factor analysis identified a two-factor structure for the Chinese version of the Insomnia Severity Index in measuring the severity and impacts of insomnia on the Chinese older people. Conclusion., The Chinese version of the Insomnia Severity Index is a culturally-relevant and psychometrically-sound instrument for assessing severity and impact of insomnia in Chinese community-dwelling older people. Nurses can use this tool to assess older people's perceptions of insomnia. [source] Estimating Cardiorespiratory Fitness in Well-Functioning Older Adults: Treadmill Validation of the Long Distance Corridor WalkJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2006Eleanor M. Simonsick PhD Objectives: To determine criterion validity of the 400-m walk component of the Long Distance Corridor Walk (LDCW) and develop equations for estimating peak oxygen consumption (VO2) from 400-m time and factors intrinsic to test performance (e.g., heart rate (HR) and systolic blood pressure (SBP) response) in older adults. Design: Cross-sectional validation study. Setting: Gerontology Research Center, National Institute on Aging, Baltimore, Maryland. Participants: Healthy volunteers (56 men and 46 women) aged 60 to 91 participating in the Baltimore Longitudinal Study of Aging between August 1999 and July 2000. Measurements: The LDCW, consisting of a 2-minute walk followed immediately by a 400-m walk "done as quickly as possible" over a 20-m course was administered the day after maximal treadmill testing. HR and SBP were measured before testing and at the end of the 400-m walk. Weight, height, activity level, perceived effort, and stride length were also acquired. Results: Peak VO2 ranged from 12.2 to 31.1 mL oxygen/kg per minute, and 400-m time ranged from 2 minutes 52 seconds to 6 minutes 18 seconds. Correlation between 400-m time and peak VO2 was ,0.79. The estimating equation from linear regression included 400-m time (partial coefficient of determination (R2)=0.625), long versus short stride (partial R2=0.090), ending SBP (partial R2=0.019), and a correction factor for fast 400-m time (<240 seconds; partial R2=0.020) and explained 75.5% of the variance in peak VO2 (correlation coefficient=0.87). Conclusion: A 400-m walk performed as part of the LDCW provides a valid estimate of peak VO2 in older adults. Incorporating low-cost, safe assessments of fitness in clinical and research settings can identify early evidence of physical decline and individuals who may benefit from therapeutic interventions. [source] A Chart-Based Method for Identification of Delirium: Validation Compared with Interviewer Ratings Using the Confusion Assessment MethodJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2005Sharon K. Inouye MD Objectives: To validate a chart-based method for identification of delirium and compare it with direct interviewer assessment using the Confusion Assessment Method (CAM). Design: Prospective validation study. Setting: Teaching hospital. Participants: Nine hundred nineteen older hospitalized patients. Measurements: A chart-based instrument for identification of delirium was created and compared with the reference standard interviewer ratings, which used direct cognitive assessment to complete the CAM for delirium. Trained nurse chart abstractors were blinded to all interview data, including cognitive and CAM ratings. Factors influencing the correct identification of delirium in the chart were examined. Results: Delirium was present in 115 (12.5%) patients according to the CAM. Sensitivity of the chart-based instrument was 74%, specificity was 83%, and likelihood ratio for a positive result was 4.4. Overall agreement between chart and interviewer ratings was 82%, kappa=0.41. By contrast, using International Classification of Diseases, Ninth Revision, Clinical Modification, administrative codes, the sensitivity for delirium was 3%, and specificity was 99%. Independent factors associated with incorrect chart identification of delirium were dementia, severe illness, and high baseline delirium risk. With all three factors present, the chart instrument was three times more likely to identify patients incorrectly than with none of the factors present. Conclusion: A chart-based instrument for delirium, which should be useful for patient safety and quality-improvement programs in older persons, was validated. Because of potential misclassification, the chart-based instrument is not recommended for individual patient care or diagnostic purposes. [source] X-Cell: a novel indexing algorithm for routine tasks and difficult casesJOURNAL OF APPLIED CRYSTALLOGRAPHY, Issue 2 2003Marcus A. Neumann X-Cell is a novel indexing algorithm that makes explicit use of systematic absences to search for possible indexing solutions from cells with low numbers of calculated reflections to cells with high numbers of reflections. Space groups with the same pattern of systematic absences are grouped together in powder extinction classes, and for a given peak number range an independent search is carried out in each powder extinction class. The method has the advantage that the correct cell is likely to be found before the rapid increase of possible solutions slows down the search significantly. A successive dichotomy approach is used to establish a complete list of all possible indexing solutions. The dichotomy procedure is combined with a search for the zero-point shift of the diffraction pattern, and impurity peaks can be dealt with by allowing for a user-defined portion of unindexed reflections. To rank indexing solutions with varying numbers of unindexed reflections, a new figure of merit is introduced that takes into account the highest level of agreement typically obtained for completely incorrect unit cells. The indexing of long and flat unit cells is facilitated by the possibility to search for rows or zones in reciprocal space first and then to use the lattice parameters of the dominant row or zone in the unit-cell search. The main advantages of X-Cell are robustness and completeness, as demonstrated by a validation study on a variety of compounds. The dominant phase of phase mixtures can be indexed in the presence of up to 50% of impurity peaks if high-quality synchrotron data are available. [source] Popliteal lymph node assay: facts and perspectivesJOURNAL OF APPLIED TOXICOLOGY, Issue 6 2005Guillaume Ravel Abstract The popliteal lymph node assay (PLNA) derives from the hypothesis that some supposedly immunemediated adverse effects induced by certain pharmaceuticals involve a mechanism resembling a graft-versus-host reaction. The injection of many but not all of these compounds into the footpad of mice or rats produces an increase in the weight and/or cellularity of the popliteal lymph node in the treated limb (direct PLNA). Some of the compounds known to cause these adverse effects in humans, however, failed to induce a positive PLNA response, leading to refinements of the technique to include pretreatment with enzyme inducers, depletion of CD4+ T cells or additional endpoints such as histological examination, lymphocyte subset analysis and cytokine fingerprinting. Alternative approaches have been used to improve further the predictability of the assay. In the secondary PLNA, the test compound is injected twice in order to illicit a greater secondary response, thus suggesting a memory-specific T cell response. In the adoptive PLNA, popliteal lymph node cells from treated mice are injected into the footpad of naive mice; a marked response to a subsequent footpad challenge demonstrates the involvement of T cells. Finally, the reporter antigens TNP-Ficoll and TNP-ovalbumin are used to differentiate compounds that induce responses involving neo-antigen help or co-stimulatory signals (modified PLNA). The PLNA is increasingly considered as a tool for detection of the potential to induce both sensitization and autoimmune reactions. A major current limitation is validation. A small inter-laboratory validation study of the direct PLNA found consistent results. No such study has been performed using an alternative protocol. Other issues include selection of the optimal protocol for an improved prediction of sensitization vs autoimmunity, and the elimination of false-positive responses due to primary irritation. Finally, a better understanding of underlying mechanisms is essential to determine the most relevant endpoints. The confusion resulting from use of the PLNA to predict autoimmune-like reactions as well as sensitization should be clarified. Interestingly, most drugs that were positive in the direct PLNA are also known to cause drug hypersensitivity syndrome in treated patients. This observation is expected to open new avenues of research. Copyright © 2005 John Wiley & Sons, Ltd. [source] Imputation of 10-year osteoporotic fracture rates from hip fractures: A clinical validation studyJOURNAL OF BONE AND MINERAL RESEARCH, Issue 2 2010William D Leslie Abstract The World Health Organization (WHO) fracture risk assessment system (FRAX) allows for calibration from country-specific fracture data. The objective of this study was to evaluate the method for imputation of osteoporotic fracture rates from hip fractures alone. A total of 38,784 women aged 47.5 years or older at the time of baseline femoral neck bone mineral density (BMD) measurement were identified in a database containing all clinical dual energy X-ray absorptiometry (DXA) results for the Province of Manitoba, Canada. Health service records were assessed for the presence of nontrauma osteoporotic fracture codes after BMD testing (431 hip, 787 forearm, 336 clinical vertebral, and 431 humerus fractures). Ten-year hip and osteoporotic fracture rates were estimated by the Kaplan-Meier method. The population was stratified by age (50 to 90 years, 5-year width strata) and again by femoral neck T -scores (,4.0 to 0.0, 0.5 SD width strata). Within each stratum, the ratio of hip to osteoporotic fractures was calculated and compared with the predicted ratio from FRAX. Increasing age was associated with greater predicted hip-to-osteoporotic ratios (youngest 0.07 versua oldest 0.41) and observed ratios (youngest 0.10 versus oldest 0.48). Lower T -scores were associated with greater predicted (highest 0.04 versus lowest 0.71) and observed ratios (highest 0.06 versus lowest 0.44). There was a strong positive correlation between predicted and observed ratios (Spearman r,=,0.90,0.97, p,<,.001). For 14 of the 18 strata, the predicted ratio was within the observed 95% confidence interval (CI). Since collection of population-based hip fracture data is considerably easier than collection of non,hip fracture data, this study supports the current emphasis on using hip fractures as the preferred site for FRAX model calibration. © 2010 American Society for Bone and Mineral Research [source] Comparison of immunoradiometric assays for determination of thyroglobulin: a validation studyJOURNAL OF CLINICAL LABORATORY ANALYSIS, Issue 3 2007L.A. Tortajada-Genaro Abstract In this study we compared and validated commercial immunoradiometric assays (IRMA) to determine thyroglobulin (Tg) levels in serum. From a set of 440 samples, 68 were selected to calculate the validation parameters and the clinical performance of the assays. The commercial kits evaluated were the Tg-CTK (DiaSorin), IRMAZenco Tg (ZenTech), and SELco-Tg (Medipan). We found that 21% of the collected samples were in the critical range of concentration. Detection limits were calculated as being below 3,µg/L. Intra- and inter-reproducibility were lower than 3.1% and 9.2%, respectively. Dilution and recovery studies provided quantitative determinations. Correlation regression coefficients from the results of the methods were obtained. The determined concentrations were compared with the clinical evidence of disease. Variation in the 125-iodine-labeled antibody concentration and control charts showed the robustness of the methods. Analysis time and the simplicity of the methods were also evaluated. Reliable Tg determination is important for monitoring patients with differentiated thyroid cancer (DTC), controlling other thyroid diseases, and assessing the quality of imaging techniques. A strategy for verification and comparison based on analytical parameters and clinical performance is proposed. J. Clin. Lab. Anal. 21:147,153, 2007. © 2007 Wiley-Liss, Inc. [source] Measuring physiotherapists' guideline adherence by means of clinical vignettes: a validation studyJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 5 2006Geert M.J. Rutten MPH Abstract Rationale, aims and objectives, To assess the criterion validity of paper-and-pencil vignettes to assess guideline adherence by physiotherapists in the Netherlands. The evidence-based physiotherapy practice guideline for low back pain was used as an example. Methods, Four vignettes were constructed and pre-tested. Three vignettes were found to represent an adequate case-mix. They described one patient with specific low back pain, one with non-specific low back pain and a normal recovery process and one with non-specific low back pain and a delay in the recovery process. Invited to participate were 113 primary care physiotherapists who had joined an randomized controlled trial study 8 months before, in which guideline adherence had been measured by means of semi-structured treatment recording forms. The criterion validity was determined with Spearman's rs, using Cohen's classification for the behavioural sciences to categorize its effect size. Results, Of the 72 physiotherapists who agreed to participate, 39 completed the questions on the vignettes. In the end, both adherence measures were available for 34 participants, providing 102 vignettes and 268 recording forms. Mean guideline adherence scores were 57% (SD = 17) when measured by vignettes and 74% (SD = 15) when measured by recording forms. Spearman's rs was 0.31 (P = 0.036), which, according to Cohen's classification, is a medium effect size. Conclusion, Vignettes are of acceptable validity, and are an inexpensive and manageable instrument to measure guideline adherence among large groups of physiotherapists. Further validation studies could benefit from the use of standardized patients as a gold standard, a more diverse case mix to better reflect real physiotherapy practice, and the inclusion of longitudinal vignettes that cover the patients' course of treatment. [source] | |||||||||||||||||||||||||