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PubMed2004

[Symptom Checklist SCL-27].

The Symptom-Checklist-27 (SCL-27) forms a modification of the widely used Symptom-Checklist-90-R, with the latter demonstrating considerable shortcomings in psychometric properties. The SCL-27 is designed to screen for psychiatric symptoms in patients presenting somatic complaints. It contains the six subscales depressive, dysthymic, vegetative, agoraphobic, sociophobic symptoms and symptoms of mistrust. Additionally, a global severity index (GSI-27), similar to the GSI in the SCL-90-R is available. The subscales are short, the number of items varies between four and six. Psychometric properties and reference values based on a representative German sample of more than 2000 subjects are presented for the various subscales. All subscales show sufficient internal consistency with Cronbach's alpha > or = 0.70 and for the GSI-27 alpha is = 0.93. The correlation between GSI-27 and GSI is r = 0.93. Sex-specific cut-offs are presented to identify those patients, who need further examination.

Adolescent↗
PubMed2003

Indication for genetic testing: a checklist for Rett syndrome.

OBJECTIVE: We reevaluated 49 girls with either Rett syndrome (RTT) or features of RTT who had negative test results for mutations in the MECP2 gene and compared them with 49 girls who had positive test results. The girls with MECP2-positive results included 2 girls with forme fruste and 2 with congenital RTT. Study design Based on the original diagnostic criteria for RTT, we developed a 10-item checklist with a score ranging from 0 to 12. RESULTS: If only girls with a score of 8 or more had been tested, 46% of the girls without mutations would have been excluded from testing without missing a single girl with MECP2-positive results. CONCLUSIONS: This checklist provides a simple aid for deciding whether or not a genetic test for RTT should be performed with only a minimal risk of missing girls with MECP2-positive results.

Child↗
PubMed1983

Factor structure and norms for the Revised Behavior Problem Checklist in New Zealand children.

The Revised Behavior Problem Checklist (RBPC) is a recent expansion of the widely used Behavior Problem Checklist. This study attempted to replicate the factor structure of the RBPC, originally developed for U.S.A. children, and to establish norms for its use with New Zealand children. Two groups of children, aged five to 13 years, were rated on the scale by their parents. One was a clinic sample and comprised 266 patients attending two psychiatric clinics. The second was a random community sample of 267 children, from four census tracts in Auckland, selected to cover a range of socioeconomic strata representative of New Zealand. Factor analysis of the clinic data resulted in a factor structure similar to that found in American children. Only two of the six factors (Socialised Aggression and Psychotic Behaviour) differed to any degree. Using ratings from the community sample, norms were developed for screening and diagnostic purposes.

Adolescent↗
PubMed2003

A feasibility study comparing checklists and global rating forms to assess resident performance in clinical skills.

This study evaluated the feasibility of two different scoring forms for assessing the clinical performance of residents in anaesthesiology. One of the forms had a checklist format including task-specific items and the other was a global rating form with general dimensions of competence including 'clinical skills', 'communication skills' and 'knowledge'. Thirty-two clinicians representing 25 (83%) of the 30 training hospitals in the country participated in the study. The clinicians were randomized into two groups, each of which used one of the scoring formats to assess a resident's performance in four simulated clinical scenarios on videotape. Clinicians' opinions about the appropriateness of the scoring forms were rated on a scale of 1-5. The checklist format was rated significantly higher compared with the global rating form (mean 4.6, 0.5 vs. mean 3.5, 1.4, p < 0.001). The inter-rater agreement regarding pass/fail decisions was poor irrespective of the scoring form used. This was explained by clinicians' leniency as assessors rather than by lack of vigilance in the observations or disagreements on standards for good performance.

Anesthesiology↗
PubMed2003

Psychiatric staff members' emotional reactions toward patients. A psychometric evaluation of an extended version of the Feeling Word Checklist (FWC-58).

The study evaluated the psychometric properties of an extended version of the Feeling Word Checklist (FWC-58), which measure the therapists' emotional reactions toward patients. Doctors, psychologists, nurses and aides from 23 wards in seven widely different psychiatric departments completed a total of 3012 forms. The original Feeling Word Checklist (Whyte CR, Constantopoulos C, Bevans HG. Br J Med Psychol 1982;55:187-201) was expanded with 28 feeling words covering more feelings of being invaded, idealized, devalued and of being secure. The rating scale was changed from a two-point (yes/no) scale to a five-point scale ranging from not at all (=0) to very much (=4). The factor analysis revealed ten factors with an eigenvalue equal or greater than 1.0. The two first factors were clearly the strongest but a two-factor solution did not satisfactorily reflect the data. The scree test indicated four to seven factors. We chose a seven-factor solution, as this seemed clinically most meaningful. Based on the factors we developed seven indices which were named: Important, Rejected, Confident, Bored, On guard, Overwhelmed and Inadequate. The subscales had satisfactory internal consistency and described meaningful emotional profiles of the different psychiatric wards and the individual patients. The seven subscales seem well worth to use in further research and in a clinical context.

Attitude of Health Personnel↗
PubMed2006

Brief checklists for assessing violence risk among patients discharged from acute psychiatric facilities: a preliminary study.

Violence risk assessment instruments are increasingly being used. Their use has, however, mostly been confined to forensic psychiatry for assessing the risk among perpetrators to repeat violent acts. In general psychiatry, very few studies of violence risk among discharged persons from acute inpatient units have been conducted. The available instruments are extensive and time consuming. This study aimed at the construction of a brief checklist. A 33-item scale, the PS (Preliminary Scheme), strongly influenced by the established HCR-20 (Historical, Clinical and Risk Management Assessment Scheme) was developed to undergo logistic regression analysis and possible item reduction. One hundred and ten patients from an acute inpatient unit, scored with PS at discharge, were monitored for violent episodes throughout the following year. Risk assessments and violence registrations were then compared. Of the 110 patients, 29 (26%) had acted violently during the follow-up, with the PS showing a definite association with post-discharge violence. Receiver operating characteristics (ROC) for the instrument yielded an area under the curve (AUC) of 0.71 (P<0.01). Regression analysis indicated that the number of PS items could be strongly reduced without losing predictive validity. Even a four-item checklist showed a higher AUC (0.77) than the PS did with all 33 items. The four items were: 1) Previous violence, 2) Substance use problems, 3) Lack of empathy and 4) Stress. The development of a brief risk assessment instrument with good predictive properties seems possible. Further clinical trials are planned. Ethical aspects of violence prediction must always be considered.

Acute Disease↗
PubMedDate not supplied

Children's Communication Checklist (CCC) scores in 11-year-old children with communication impairments.

BACKGROUND: The pragmatic skills of children with communication disorders and their assessment are currently an issue for speech and language therapy and educational placement. AIMS: To explore whether different subgroups of children with communication disorders score differently on the Children's Communication Checklist (CCC) and to study how they compare with published normative data. METHODS & PROCEDURES: A sample of 161 eleven-year-old children with a history of communication disorders was assessed using the CCC. The main use of this questionnaire was to establish whether pragmatic impairments were part of a child's communication difficulty. Although the checklist was originally designed for research purposes, normative data for this scale have been recently published as well as group data from a number of different clinical groups. Whilst the present CCC data have been previously reported descriptively for a wider sample, they have not been examined in terms of subgroups or compared directly with normative information and similarly diagnosed individuals from other studies. OUTCOMES & RESULTS: Of the children assessed, 52 (33%) scored in the normal range (within 1 SD) on the pragmatic scale, 40 (26%) fell between 1 and 2 SD below the normative mean, and 64 (41%) scored below 2 SD of the mean of typically developing children (aged 6-16 years). Thus, the majority (67%) scored out of the normal range for pragmatic skill at 11 years of age. The cohort was separated into four diagnostic subcategories: those with a definite diagnosis of autistic spectrum disorder (n=15); those with typical specific language impairment (n=82); generally impaired (n=37); and those with a clinical history of primary pragmatic language impairment (independent of CCC score, n=27). CONCLUSIONS: Findings show that those generally impaired and with specific language impairment were less impaired than the other groups on the CCC pragmatic scale. There was a significant trend for those with autistic spectrum disorders to score lowest through pragmatic language impairment, generally impairment to specific language impairment. It is argued that a cut-off of 140 may prove more useful at this age than the 132 level previously published for 8 year olds. Results suggest that the CCC can be used as a clinical tool, but in conjunction with other reliable measures.

Autistic Disorder↗
PubMed1998

Risk-factor assessment for falls: from a written checklist to the penless clinic.

OBJECTIVE: to audit risk-factor identification of fallers before and after an education programme and the insertion of a written checklist in medical notes. Risk-factor identification in a dedicated, computerized falls clinic was then examined. METHODS: documentation of risk factors for falls was studied on wards and a self-auditing 'penless' clinic for fallers subsequently set up to generate reports for medical notes and letters for general practitioners. RESULTS: risk-factor identification improved after the insertion of the checklist but remained relatively poor. A dedicated clinic allowed almost complete identification of risk factors. Of the first 112 patients (median age 82) seen in the clinic, 75 (67%) were housebound. Remediable risk factors--e.g. inappropriate medication (67%), unsatisfactory footwear (59%) and postural hypotension (17%)--were found in most. Thirty-three patients (29%) had difficulty with alarm raising. CONCLUSION: ward-based intervention showed limited capacity to identify risk factors for falls: a dedicated clinic was more successful. The use of a portable computer with a programme to screen fallers for risk factors is worthy of consideration.

Accidental Falls↗
PubMed2004

High-fidelity patient simulation: validation of performance checklists.

BACKGROUND: Standardized scenarios can be used for performance assessments geared to the level of the learner. The purpose of this study was to validate checklists used for the assessments of medical students' performance using high-fidelity patient simulation. METHODS: Our undergraduate committee designed 10 scenarios based on curriculum objectives. Fifteen faculty members with undergraduate educational experience identified items considered appropriate for medical students' performance level and identified items that, if omitted, would negatively affect grades. Items endorsed by less than 20% of faculty were omitted. For remaining items, weighting was calculated according to faculty responses. Students managed at least one scenario during which their performance was videotaped. Two raters independently completed the checklists for three consecutive sessions to determine inter-rater reliability. Validity was determined using Cronbach's alpha with an alpha>or=0.6 and <or=0.9 considered acceptable internal consistency. Item analysis was performed by recalculating Cronbach's alpha with each item deleted to determine if that item contributed to a low internal consistency. RESULTS: 135 students participated in the study. Inter-rater reliability of the two raters determined on the third session was 0.97 and therefore one rater completed the remaining performance assessments. Cronbach's alpha for the 10 scenarios ranged from 0.16 to 0.93 with two scenarios demonstrating acceptable internal consistency with all items. Three scenarios demonstrated acceptable internal consistency with one item deleted. CONCLUSIONS: Five scenarios developed for this study were shown to be valid when using the faculty criteria for expected performance level.

Algorithms↗
PubMed1990

Assessment of injury risk in young children: a preliminary study of the injury behavior checklist.

There is a need for practical and cost-effective measures of the behavioral characteristics that predict subsequent injury in children. Previous research has focused on the predictive power of child problem behavior (e.g., hyperactivity, aggression, noncompliance) and has found reliable, but relatively weak associations with injury frequency. In an effort to improve upon this level of prediction using child behavioral measures, a care-giver report checklist of specific "risky" behaviors was developed for toddlers and preschoolers, called the Injury Behavior Checklist (IBC). A preliminary test of the reliability and validity of this instrument was undertaken in a sample of middle-class families (N = 253). Results indicated that the IBC has acceptable reliability (internal consistency = .87; 1-month test-retest correlation = .81) and is able to significantly discriminate children with two or more injuries from those with one or none (p less than .001). Multiple regression analyses indicated that the IBC was a better predictor of injury than parent-reported levels of child problem behavior using the Conners Parent Rating Scale.

Accident Proneness↗
PubMed2005

Screening for preschool posttraumatic stress disorder with the Child Behavior Checklist.

OBJECTIVE: To examine the psychometric properties and utility of a Child Behavior Checklist-Posttraumatic Stress Disorder (CBCL-PTSD) Scale to screen for posttraumatic stress disorder (PTSD) in traumatized preschool children. METHOD: Data for this study were drawn from a study of young child trauma and consisted of 62 traumatized children, 23 months through 6 years of age. The children's mothers were interviewed about PTSD symptoms and then completed the Child Behavior Checklist (CBCL). RESULTS: The modified CBCL-PTSD correlated highly with the number of PTSD symptoms from the interview (r = 0.66). The CBCL-PTSD scale predicted PTSD symptoms above and beyond the internalizing and externalizing scales of the CBCL. A cutoff score of nine on this scale possessed the best sensitivity and specificity in classifying those traumatized children who met diagnostic criteria for PTSD. CONCLUSION: The modified CBCL-PTSD scale could be a useful cost-effective tool to screen for PTSD in traumatized, preschool-age children.

Child↗
PubMed2003

Making sense of symptom checklists: a latent class approach to the first 9 years of the British Household Panel Survey.

BACKGROUND: In health inequalities research there is a growing impetus to examine the development of inequalities in health over time. However, many of the sources of longitudinal data in Britain are not designed specifically for health research. Typically, health status is assessed by self-reported problems and the use of symptom checklists. METHODS: The British Household Panel Survey (BHPS) is an annual survey of approximately 5500 private households containing 9000 men and women, which began in 1991. Each year, the BHPS contains a checklist of 13 health problems and symptoms. The findings presented here are based on adult participants aged 16 years and over in 1991. Using eight waves of data from the BHPS, we use latent class analysis (LCA) to model latent health status from a set of observed binary variables. Individuals are assigned to a latent health class on the basis of LCA estimated probabilities of class membership given their response patterns and the estimated unconditional class frequencies. The predictive value of latent health class membership is assessed for self-reported health status and functioning, health and welfare service use, and mortality 1 year later. RESULTS: The LCA supported a suitable four-class model of health status representing good health, psychosomatic health problems, physical health problems and comorbid health problems. Members of the good latent health class were predicted to have better self-reported health and functioning, less health and welfare service use, and lower risk of mortality 1 year later than members of the three problem health classes. Those with comorbid health problems were predicted to have particularly poor outcomes. CONCLUSIONS: A latent class approach to modelling self-reported health problems and symptoms has allowed for both quantitative and qualitative dimensions of health status to be captured. This may motivate better informed models of health by users of general population surveys.

Chi-Square Distribution↗
PubMed2003

Objectivity in objective structured clinical examinations: checklists are no substitute for examiner commitment.

PURPOSE: This study explored factors that contribute to objectivity in objective structured clinical examinations (OSCEs). The authors quantified the effect of examiners on interrater reliability and separated this effect from that of station construction, determined the effect of objectification on station reliability and validity, and explored examiner factors that may contribute to interrater reliability. METHOD: Data came from examiners' mark sheets from four annual OSCEs (1997-2000). The OSCEs were conducted identically and simultaneously at three sites, within the University of Otago medical school in New Zealand, with two examiners at each station. The contribution to interrater correlations of station construction and mark sheet compared with examiners' contribution was partitioned out using a random-effects analysis of variance. For one OSCE, a multiple linear regression was used to determine the independent contributions to interrater reliability of the number of checklist items per mark sheet, examiner experience, and examiner involvement in station construction. RESULTS: Station construction and mark sheets contributed 10.1% and examiners contributed 89.9% to the variation in interrater reliability. Following multivariate analysis, the number of items per mark sheet was negatively associated, and examiner involvement in station construction was positively associated, with interrater reliability. Examiner experience in examining or in clinical medicine was not associated with interrater reliability. There was a negative, but nonsignificant, correlation between number of items per mark sheet and that station's correlation with the aggregate OSCE mark. CONCLUSIONS: The contribution of objective mark sheets to objectivity is relatively minor compared with examiners' contribution. Increasing the number of checklist items per mark sheet decreased both reliability and validity. Achieving objectivity requires diligent examiners who are involved in the whole assessment.

Analysis of Variance↗
PubMed2002

Radioactive drug research program audit checklist.

Many institutions conduct human research studies that involve the administration of radiopharmaceuticals. The Radiation Safety Officer (RSO) may be the person responsible for ensuring that such studies are performed safely and in compliance with applicable regulations. Sometimes, RSOs assigned this responsibility lack the knowledge and experience necessary to oversee such research activities. In an effort to assist RSOs unfamiliar with radioactive drug research regulations to establish an effective compliance program in this field, the authors developed a comprehensive audit checklist. Periodic use of this checklist may be effective in ensuring compliance with applicable regulations.

Drug and Narcotic Control↗
PubMed1991

The Child Behavior Checklist nonclinical standardization samples: should they be utilized as norms?

The Child Behavior Checklist (CBCL) is an extensively standardized parent-completed checklist of competencies and behavior problems of children and adolescents. Clinicians and researchers frequently assume that the published scale scores for the CBCL nonclinical sample are stable even across demographically heterogeneous populations. The present study, a school-based postal questionnaire survey, was designed to compare the CBCL nonclinical sample with a different community sample collected in the U.S. The parents of 530 children, 6 to 10 years of age (73% of the eligible sample), attending one public school system in northern New Jersey were recruited. Mean total behavior problem scores for both sexes in the school sample were dramatically higher than the CBCL nonclinical sample even after removing clinically referred cases from the analyses. Additionally, in contrast to the manual, marked race/ethnicity effects were found in the male subsample. These results, in conjunction with those from other studies, raise serious questions about the common practice of using the CBCL norms as a yardstick for sample comparisons.

Child↗
PubMed1991

The use of a computer-assisted interview to administer the Child Behavior Checklist in a child psychiatry service.

This study describes the use of a computer-assisted interview to administer the Child Behavior Checklist to the parents of children referred to a child psychiatry service. The scores from the computer-assisted interview varied little from the scores obtained using the standard written checklist. Information collected by means of computer-assisted interviews with parents and children has the potential to facilitate the diagnostic assessment of individual children with emotional and behavioral problems, to provide a more comprehensive description of the work of child psychiatry services, and to encourage new clinical research by mental health professionals working in child psychiatry services.

Adolescent↗
PubMed2002

Screening young people for autism with the developmental behavior checklist.

OBJECTIVE: To determine whether a subset of items from the Developmental Behavior Checklist (DBC) could be selected to construct a reliable autism screening tool. METHOD: A 29-item scale-the Developmental Behavior Checklist-Autism Screening Algorithm (DBC-ASA)-was developed by using items from the DBC and evaluated in a sample comprising 180 children who met criteria for autism and 180 controls matched for age, sex, and IQ range. RESULTS: This study found that the DBC-ASA has good validity in discriminating young people (4-18 years) with autism and IQ ranging from normal to severe intellectual disability from others using a cutoff score of 17. CONCLUSION: The DBC-ASA is an effective autism screening questionnaire for at-risk young people, including those with intellectual disability.

Adolescent↗
PubMed2006

Early screening for autism spectrum disorders: update on the modified checklist for autism in toddlers and other measures.

Early intervention for autism spectrum disorders necessitates early detection. This need has led to widespread agreement across disciplines that screening is critical in very young children. Two screening issues are highlighted in this review. Level of screening refers to the type of sample: Level I is defined as an unselected sample, and Level II consists of selected children already identified as being at risk for a developmental disorder. Breadth or scope of screening refers to the range of difficulties the screening tool attempts to identify: broad screening instruments identify multiple range of developmental difficulties, whereas disorder-specific tools focus on a single disorder or class of disorders. Broad developmental instruments reviewed include the Parents' Evaluation of Developmental Status and the Ages and Stages Questionnaires; autism-specific tools reviewed include the Checklist for Autism in Toddlers, the Modified Checklist for Autism in Toddlers (M-CHAT), the Pervasive Developmental Disorders Screening Test, Second Edition, and the Screening Tool for Autism in Two-year-olds. The development of the M-CHAT, a Level I and Level II screening instrument, is described, and current research and clinical use of the M-CHAT are reviewed, including description of the structured follow-up interview which reduces the false-positive rate of the parent-report M-CHAT.

Autistic Disorder↗