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PubMed2026

Reliability, Device Agreement and Validity of Load-Velocity Profiles: A Systematic Review with Meta-analysis.

BACKGROUND: For a valid one-repetition maximum (1RM) prediction via load-velocity (LV) relationships, high reliability and accuracy must be assumed. OBJECTIVE: Since individual study results indicate ambivalent prediction, this systematic review and meta-analysis was designed to provide a updated and comprehensive overview, extending knowledge about the validity and reliability of commercially available velocity sensors in Part I and the validity and reliability of velocity-based 1RM prediction models in Part II. METHODS: A systematic literature search was conducted in PubMed/MEDLINE, Web of Science, and Scopus. Validity and/or reliability studies or velocity-based 1RM prediction evaluations were included. Methodological quality was assessed using adapted COSMIN. The analysis was performed for intraclass correlation coefficient (ICC), Lin's concordance correlation coefficient (CCC), and Pearson's correlation coefficient (r). The review was preregistered in PROSPERO (CRD42025634595). RESULTS: Sixty-three studies were included for sensor validity and reliability and 38 for 1RM prediction models. Part I: Velocity sensors demonstrated good-to-excellent pooled validity and device agreement (ICC = 0.91-0.92 [0.83-0.97]; k = 55 and 439, respectively); intra- and inter-day reliability were classified as good to excellent with ICC = 0.90-0.91 [0.85-0.95] (k = 228 and 608, respectively), with sensor technology moderating the results. However, substantial heterogeneity and wide ranges of study-level estimates indicated considerable variability across moderators, linear position transducer (LPT) generally showing more consistent performance than inertial measurement units (IMU). Part II: Velocity-based 1RM prediction showed ICCs = 0.90 [0.83-0.94] (k = 124) and ICC = 0.91 [0.72-0.98] (k = 9); for reliability and validity, respectively. DISCUSSION: Commercial velocity sensors generally provide high relative validity and reliability. Results varied depending on exercise complexity, intensity, sensor technology, and modeling approach. While velocity-based 1RM prediction demonstrated high average validity, large heterogeneity in lower body exercises significantly biased the results. Furthermore, the dearth of measurement error and agreement analyses prohibits final conclusions. CONCLUSION: Therefore, velocity-based monitoring and 1RM prediction require cautious interpretation, as sensor- and exercise-specific evidence remains limited.

Load–velocity relationship↗
PubMed2006

Family-centred services in The Netherlands: validating a self-report measure for paediatric service providers.

OBJECTIVE: To validate the Dutch translation of the Canadian Measure of Processes of Care for Service Providers questionnaire (MPOC-SP) for use in paediatric rehabilitation settings in the Netherlands. DESIGN: The construct validity, content validity, face validity, and reliability of the Dutch MPOC-SP were determined. SUBJECTS: The 163 service providers that participated in the validation study represented seven children's rehabilitation centres and affiliated schools in the Netherlands (overall response rate 55.6%). In this sample 19 disciplines were represented. MAIN MEASURES: The MPOC-SP consists of 27 items (assessing four domains) and was designed to examine how service providers think about the quality of care they provide and to assess the extent to which these services are family centred. Fifty-three service providers filled out an additional face validity questionnaire. RESULTS: All items correlated best and significantly with their own scale score (r(s) 0.48-0.82, P<0.001). The Pearson's correlation coefficients were all significant and confirmed that the four scales measure different aspects of a same construct, namely family-centred service. The content validity and the face validity of the Dutch MPOC-SP were good, indicating the questionnaire measures relevant aspects of family-centred service delivery in paediatric rehabilitation settings in the Netherlands. The test-retest analyses (intraclass correlation coefficient (ICC) 0.83-0.89) and the internal consistency analyses (alpha 0.65-0.84) showed that the Dutch MPOC-SP is a reliable tool. CONCLUSIONS: The Dutch MPOC-SP is a reliable and valid instrument to measure the family-centredness of service delivery.

Child↗
PubMed2004

Utility of pedometers for assessing physical activity: construct validity.

Valid assessment of physical activity is necessary to fully understand this important health-related behaviour for research, surveillance, intervention and evaluation purposes. This article is the second in a companion set exploring the validity of pedometer-assessed physical activity. The previous article published in Sports Medicine dealt with convergent validity (i.e. the extent to which an instrument's output is associated with that of other instruments intended to measure the same exposure of interest). The present focus is on construct validity. Construct validity is the extent to which the measurement corresponds with other measures of theoretically-related parameters. Construct validity is typically evaluated by correlational analysis, that is, the magnitude of concordance between two measures (e.g. pedometer-determined steps/day and a theoretically-related parameter such as age, anthropometric measures and fitness). A systematic literature review produced 29 articles published since > or =1980 directly relevant to construct validity of pedometers in relation to age, anthropometric measures and fitness. Reported correlations were combined and a median r-value was computed. Overall, there was a weak inverse relationship (median r = -0.21) between age and pedometer-determined physical activity. A weak inverse relationship was also apparent with both body mass index and percentage overweight (median r = -0.27 and r = -0.22, respectively). Positive relationships regarding indicators of fitness ranged from weak to moderate depending on the fitness measure utilised: 6-minute walk test (median r = 0.69), timed treadmill test (median r = 0.41) and estimated maximum oxygen uptake (median r = 0.22). Studies are warranted to assess the relationship of pedometer-determined physical activity with other important health-related outcomes including blood pressure and physiological parameters such as blood glucose and lipid profiles. The aggregated evidence of convergent validity (presented in the previous companion article) and construct validity herein provides support for considering simple and inexpensive pedometers in both research and practice.

Adolescent↗
PubMed2001

[Indicators of early Alzheimer dementia in family practice. Development and validation of the Observation List of Early Symptoms of Dementia (OLD)].

UNLABELLED: Aim of the study was the development and validation of a short observation list of possible early signs of dementia (OLD) for use in general practice. A stepwise development was carried out using reviews of publications and expert consensus. Experimental observations were carried out by 22 general practitioners in 19 Dutch practices. A field study (with interviews and family forms) was conducted out afterwards, to evaluate reliability and validity. Data reduction techniques were used to construct a short version. The first two patients seen on 15 working days (N = 470) were observed. INCLUSION CRITERIA: age > 75, without a known diagnosis of dementia. Exclusion: psychiatric treatment, severe depression, acute illness with confusion. The patients were divided into three groups with no, intermediate, and the most signs (total of interviewed patients n = 60; family forms n = 39). Cronbach's alpha and factor-analysis were used to evaluate the reliability. The Cognitive Screening Test (CST), the Word Learning Test (WLT; total and retention), the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), the Groningen Activities Restriction Scale (GARS), and an IADL scale were used to evaluate convergent validity. The Geriatric Depression Scale (GDS) was used to evaluate discriminant validity. Construct validity was evaluated using PRINCALS. Incremental validity was evaluated using the intuitive opinion of the GP (McNemar test). The reliability in the total group was 0.88, the first factor explained 42.5% of the variance. Convergent validity (2-side ANOVA) results: CST (p = 0.00), WLT-total (p = 0.001), WLT retention (p = 0.00), IQCODE (p = 0.09). No statistically significant differences were found for GARS and IADL. The GDS (p = 0.30) showed no difference. The first factor of PRINCALS explained 48% of the variance. The OLD added to the GP opinion (McNemar p = 0.00). Reliability of the short version (12 items) was 0.89 (interviewed group), and 0.86 (total group). The conclusion is that the OLD is a valid and reliable method to detect early signs of dementia in general practice. (Partly adapted from: Hopman-Rock M, Tak ECPM, Staats PGM. Development and validation of the Observation List for early signs of Dementia (OLD). Int J Geriatr Psychiatry 2001 (in press)).

Aged↗
PubMed2003

Methodological aspects of the evaluation of postoperative cancer surveillance. Part I: Validity.

This contribution deals with problems of determining the validity and efficacy of diagnostic procedures used in postoperative cancer surveillance. While there is a large number of follow-up studies attempting to estimate sensitivity, specificity, or the predictive values of follow-up tests, the methodological aspects of validation are rarely addressed adequately in these publications, and the estimations of validity are often not well-founded. In the first part of this paper we analyze aspects of validity and validation studies. In particular, the following problems are addressed: a) Validity depends on the context; in particular, it depends on the characteristics of the population, the embedding of the test in a diagnostic strategy, the uncertainty of the test itself, the gold standard, and the criterion for positive test results. b) Global, time-independent measures of validity are hardly adequate. In particular, any attempt to incorporate a positive lead-time in the definition of the sensitivity is incompatible with an exhaustive classification matrix and with a meaningful definition of predictive values. c) Published estimations of sensitivity mostly suffer from numerous biases. First, there is work-up bias, which arises if positive and negative test-results are verified in a different way (in fact, this implies the use of two different gold standards). Next, test-review bias may occur unless the determination of the test result and the gold standard are mutually blinded. Finally, in quantitative tests, like tumor markers, there is a risk of resubstitution bias if the sample used for defining the cutoff level is identical to the validation sample. Several practical recommendations are given for designing validation studies. In the second part, problems of the efficacy of follow-up programs in regard to patient survival are discussed. Five necessary conditions must be satisfied in order to make such an effect possible. Taking these aspects into account, it can be shown that the usual arguments advanced in favor of diagnostic monitoring are not stringent. As for the design of studies on the efficacy of cancer surveillance, non-randomized studies are inconclusive given that they suffer from a variety of specific biases. It can be shown that the demand, often found in recent publications, that comparative studies of more versus less intensive monitoring be designed so as to permit the detection of a survival advantage in the subgroup of patients who relapse, is unjustified. In the final sections, an overview over published randomized studies and meta-analyses on the efficacy of postoperative monitoring of breast and colorectal cancer is given.

Follow-Up Studies↗
PubMedDate not supplied

[Multidimensional assessment of coping: validation of the Brief COPE among French population].

This Article aims to introduce the translation and the validation of a multidimensional measure of coping strategies: the Brief COPE, in a French population. The coping concept comes from psychological studies that were conducted on stress. In the conceptual analysis of stress by Lazarus and Folkman, coping works with two cognitive appraisals performed by the person concerning the perception of a threatening situation and his or her available resources to deal with it. Coping is defined as "cognitive and behavioural efforts to master, reduce, or tolerate the internal and/or external demands that are created by the stressful transaction". The Brief COPE is the abridged version of the COPE inventory and presents fourteen scales all assessing different coping dimensions: 1) active coping, 2) planning, 3) using instrumental support, 4) using emotional support, 5) venting, 6) behavioural disengagement, 7) self-distraction, 8) self-blame, 9) positive reframing, 10) humor, 11) denial, 12) acceptance, 13) religion, and 14) substance use. Each scale contains two items (28 altogether). This inventory has the advantage of being built from acknowledged theoretical models (Lazarus' transactional model of stress, 1984; behavioral self-regulation model, Carver and Scheier, 1981, 1998). It can be used to assess trait coping (the usual way people cope with stress in everyday life) and state coping (the particular way people cope with a specific stressful situation). As is the COPE inventory, the Brief COPE is a measure used for many health-relevant studies: drugs addiction, ageing, breast cancer, depression, AIDS. Both measures are widely used in Anglophone countries and translated in many Languages. Today, the COPE inventory has been validated among Estonian, Croatian, Chinese, and Italian populations and the Brief COPE is also validated among Spanish people. Thus, the worldwide use of this coping inventory should allow a broad comparison of medical and psychological research for coping strategies regarding every kind of pathologies. Thus, we were led to present the translation and the validation of this measure in a French population. Two studies are presented in this Article: the first one describes the validation of the inventory in a dispositional format (trait coping) and the second one the validation of the inventory in a situational format (state coping). The French version of Brief COPE, which was used for both studies, was back-translated and analysed by the Brief COPE Author: Charles S. Carver. For study 1, 834 first Year university students answered the Brief COPE in its dispositional format. To study the factor structure of the Brief COPE, we used structural equation modeling and the LISREL software. Results show that the expected theoretical structure and the observed one fit adequately (c2=606, p<0,05, RMSEA=0,04, GFI>0,95, AGFI>0,92, RMR<0,03). In order to study convergent and discriminant validity of Brief COPE, self-esteem (SEI, Rosenberg, 1979), perceived stress (PSS, Cohen et al., 1983), and psychological distress (GHQ-12, Goldberg, 1972) measures were used. Results show that functional coping strategies (eg, active coping) are linked to good self-esteem, to lower perceived stress, and to lower psychological distress, whereas less functional strategies (eg, denial or self-blame) are widely linked to poor self-esteem, to a high perceived stress, and to psychological distress. Study 1 shows also several significant gender differences. Study 2 describes the Brief COPE validation in its situational format. 178 additional students answered this version. The method that was used is the same the one developed by Lazarus and his colleagues for the WCC validation. Participants were asked to recall and think about the most stressful event they had experienced during the past two Months. They were also to give an account of how much that situation mattered to them. They had to evaluate their capacity to control the situation and indicated whether they felt the situation was amenable to change. The study includes only peoples only people who labeled an event as "important" or "very important". Here again LISREL was used to study the factor structure of the Brief COPE. The results emphasise - as in study 1 - that the expected theoretical structure and the observed one fit adequately (c2=391, p<0,05, RMSEA<0,05, GFI=0,87, AGFI=0,80, RMR<0,06). Differences among means showed how the perceived control of the situation and how the perception of its favourable evolution influenced the coping strategies used (eg, humour or denial). Results in both studies indicate good psychometric properties for the Brief COPE in its French version, whatever the format (ie, dispositional or situational). Thus French searchers have a relevant tool on hand to measure as accurately as possible the coping strategies someone used in everyday life (strategies interfering on health, on a long scale), or in distressful situations (eg, serious illness, traumas). The fact that this easy-to-use coping measure is worldwide spread among medical and psychological studies allows a better broadcast and comparison of results whatever the pathology.

Adaptation, Psychological↗
PubMed1994

The validation of analytical methods for drug substances and drug products in UK pharmaceutical laboratories.

Results of a survey on method validation of analytical procedures used in the testing of drug substances and finished products, of most major research based pharmaceutical companies with laboratories in the UK, are presented. The results indicate that although method validation shows an essential similarity in different laboratories (in particular, chromatographic assay methods are validated in a similar manner in most laboratories), there is much diversity in the detailed application of validation parameters. Testing procedures for drug substances are broadly similar to finished products. Many laboratories validate methods at clinical trial stage to the same extent and detail as at the marketing authorization application (MAA)/new drug application (NDA) submission stage, however, only a small minority of laboratories apply the same criteria to methodology at pre-clinical trial stage. Extensive details of method validation parameters are included in the summary tables of this survey, together with details of the median response given for the validation of the most extensively applied methods. These median response details could be useful in suggesting a harmonized approach to method validation as applied by UK pharmaceutical laboratories. These guidelines would extend beyond the recommendations made to date by regulatory authorities and pharmacopoeias in that minimum requirements for each method validation parameter, e.g. number of replicates, range and tolerance, could be harmonized, both between laboratories and also in Product Licence submissions.

Chromatography, High Pressure Liquid↗
PubMed1993

The validity of health assessments: resolving some recent differences.

The purpose of this paper is to examine what is meant by a valid measure of health. Guyatt, Kirshner and Jaeschke propose that health tests should be designed so as to have one of several kinds of validity: "longitudinal construct validity" for those which are used for longitudinal research designs, and "cross-sectional construct validity" for those which are used for cross-sectional designs. Williams and Naylor argue that this approach to test classification and validation confuses what a test purports to measure with the purpose for which it is used, and that some tests have multiple uses. A review of the meanings of validity in the psychological test literature shows that both sets of authors use the term validity in an idiosyncratic way. Although the use of a test (evaluated by content validity) should not be conflated with whether the test actually measures a specified construct (evaluated by construct validity), if health is actually made up of several constructs (as suggested in Hyland's interactional model) then there may be an association between types of construct and types of purpose. Evidence is reviewed that people make several, independent judgements about their health: cognitive perceptions of health problems are likely to be more sensitive to change in a longitudinal research design, whereas emotional evaluations of health provide less bias in cross-sectional designs. Thus, a classification of health measures in terms of the purpose of the test may parallel a classification in terms of what tests purport to measure.

Health↗
PubMed2006

Results of diagnostic accuracy studies are not always validated.

BACKGROUND AND OBJECTIVE: Internal validation of a diagnostic test estimates the degree of random error, using the original data of a diagnostic accuracy study. External validation requires a new study in an independent but similar population. Here we describe whether diagnostic research is validated, which technique is used, and to what extent the validation study results differ from the original. STUDY DESIGN AND SETTING: All original diagnostic accuracy studies published in 1993 in a predefined set of journals were selected. Validation of these studies was assessed in the original article and in articles published within a period of 10 years, through a literature search and contacting the authors. RESULTS: None of the original studies reported any form of validation. Validation studies published later could be identified for 7 of the 11 original studies. Test characteristics were difficult to compare. Despite what was generally believed, not every validation study showed results inferior to the original. We found more studies that evaluated the test in a different population than in a similar one. CONCLUSION: Not every diagnostic accuracy study is validated. Diagnostic tests are more often repeated in different populations.

Databases, Bibliographic↗
PubMed2005

Validation of immunoassays used to assess immunogenicity to therapeutic monoclonal antibodies.

Immunogenicity has always been an important consideration in the evaluation of pharmaceutical protein biologics. In this article, method validation parameters relevant to enzyme immunoassays are described for assays applied to the analysis of anti-drug antibodies, with special considerations for immunogenicity to therapeutic monoclonal antibodies. Common strategies for experimental investigation of various validation parameters are proposed. In addition, a novel, yet simple, approach is proposed to categorize the validation effort into two mutually interdependent phases, based on the characterization of validation parameters as "system descriptive" or "system controlled". System descriptive parameters are those that must be characterized but need not have pre-specified acceptance criteria for assay validation. In contrast, system-controlled parameters should be understood early in assay development, and optimized and confirmed using a priori acceptance criteria in validation to assure sufficient control over them during routine bioanalysis. This approach not only streamlines the validation process but also eliminates unnecessary redundancies. This validation method can be achieved with proper scientific rigor and remain within the realm of GLP compliance. The authors hope that other research groups would engage in discussions on validation of anti-drug antibody assays in order to establish a consistent approach across the industry and academia.

Animals↗
PubMed1999

Using wound care algorithms: a content validation study.

PURPOSE: Valid and reliable heuristic devices facilitating optimal wound care are lacking. The objectives of this study were to establish content validation data for a set of wound care algorithms, to identify their associated strengths and weaknesses, and to gain insight into the wound care decision-making process. METHODS: Forty-four registered nurse wound care experts were surveyed and interviewed at national and regional educational meetings. Using a cross-sectional study design and an 83-item, 4-point Likert-type scale, this purposive sample was asked to quantify the degree of validity of the algorithms' decisions and components. Participants' comments were tape-recorded, transcribed, and themes were derived. RESULTS: On a scale of 1 to 4, the mean score of the entire instrument was 3.47 (SD +/- 0.87), the instrument's Content Validity Index was 0.86, and the individual Content Validity Index of 34 of 44 participants was > 0.8. Item scores were lower for those related to packing deep wounds (P < .001). No other significant differences were observed. Qualitative data analysis revealed themes of difficulty associated with wound assessment and care issues, that is, the absence of valid and reliable definitions. CONCLUSION: The wound care algorithms studied proved valid. However, the lack of valid and reliable wound assessment and care definitions hinders optimal use of these instruments. Further research documenting their clinical use is warranted. Research-based practice recommendations should direct the development of future valid and reliable algorithms designed to help nurses provide optimal wound care.

Adult↗
PubMed2000

Item selection counts: a comparison of empirical key and rational scale validities in theory-based and non-theory-based item pools.

Little explicit attention has been given to the impact of item pools on the validities and cross-validities of different background data scoring approaches. This study tests the idea that pools of items theoretically related to the performance of interest will outperform pools of items with no hypothesized relationship with the criterion. Validities and cross-validities of rational scales and empirical keys created from theory- and non-theory-based item pools were compared for 3 criteria. When size of the item pools was held constant, theory-based empirical keys (correlational and vertical percent) and rational scales showed larger validities and cross-validities than non-theory-based empirical keys (correlational and vertical percent) and showed minimal shrinkage in cross-validities. Even when item pool for the non-theory-based keys was expanded to include all items in the instrument, the theory-based keys showed comparable or slightly better validities and cross-validities for 2 of the 3 criteria, including college GPA, which was separated from the predictors by 4 years.

Cross-Sectional Studies↗
PubMed2000

Large-sample confidence intervals for validity and reliability coefficients.

Large-sample confidence intervals (CI) for reliability, validity, and unattenuated validity are presented. The CI for unattenuated validity is based on the Bonferroni inequality, which relies on one CI for test-retest reliability and one for validity. Covered are four reliability-validity situations: (a) both estimates were from random samples; (b) reliability was from a random sample but validity was from a selected sample; (c) validity was from a random sample but reliability was from a selected sample; and (d) both estimates were from selected samples. All CIs were evaluated by using a simulation. CIs on reliability, validity, or unattenuated validity are accurate as long as selection ratio is at least 20% and selected sample size is 100 or larger. When selection ratio is less than 20%, estimators tend to underestimate their parameters.

Confidence Intervals↗
PubMed2004

Validity threats: overcoming interference with proposed interpretations of assessment data.

CONTEXT: Factors that interfere with the ability to interpret assessment scores or ratings in the proposed manner threaten validity. To be interpreted in a meaningful manner, all assessments in medical education require sound, scientific evidence of validity. PURPOSE: The purpose of this essay is to discuss 2 major threats to validity: construct under-representation (CU) and construct-irrelevant variance (CIV). Examples of each type of threat for written, performance and clinical performance examinations are provided. DISCUSSION: The CU threat to validity refers to undersampling the content domain. Using too few items, cases or clinical performance observations to adequately generalise to the domain represents CU. Variables that systematically (rather than randomly) interfere with the ability to meaningfully interpret scores or ratings represent CIV. Issues such as flawed test items written at inappropriate reading levels or statistically biased questions represent CIV in written tests. For performance examinations, such as standardised patient examinations, flawed cases or cases that are too difficult for student ability contribute CIV to the assessment. For clinical performance data, systematic rater error, such as halo or central tendency error, represents CIV. The term face validity is rejected as representative of any type of legitimate validity evidence, although the fact that the appearance of the assessment may be an important characteristic other than validity is acknowledged. CONCLUSIONS: There are multiple threats to validity in all types of assessment in medical education. Methods to eliminate or control validity threats are suggested.

Bias↗
PubMed2000

Are chiropractic tests for the lumbo-pelvic spine reliable and valid? A systematic critical literature review.

OBJECTIVE: To systematically review the peer-reviewed literature about the reliability and validity of chiropractic tests used to determine the need for spinal manipulative therapy of the lumbo-pelvic spine, taking into account the quality of the studies. DATA SOURCES: The CHIROLARS database was searched for the years 1976 to 1995 with the following index terms: "chiropractic tests," "chiropractic adjusting technique," "motion palpation," "movement palpation," "leg length," "applied kinesiology," and "sacrooccipital technique." In addition, a manual search was performed at the libraries of the Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark, and the Anglo-European College of Chiropractic, Bournemouth, United Kingdom. STUDY SELECTION: Studies pertaining to intraexaminer reliability, interexaminer reliability, and/or validity of chiropractic evaluation of the lumbo-pelvic spine were included. DATA EXTRACTION: Data quality were assessed independently by the two reviewers, with a quality score based on predefined methodologic criteria. Results of the studies were then evaluated in relation to quality. DATA SYNTHESIS: None of the tests studied had been sufficiently evaluated in relation to reliability and validity. Only tests for palpation for pain had consistently acceptable results. Motion palpation of the lumbar spine might be valid but showed poor reliability, whereas motion palpation of the sacroiliac joints seemed to be slightly reliable but was not shown to be valid. Measures of leg-length inequality seemed to correlate with radiographic measurements but consensus on method and interpretation is lacking. For the sacrooccipital technique, some evidence favors the validity of the arm-fossa test but the rest of the test regimen remains poorly documented. Documentation of applied kinesiology was not available. Palpation for muscle tension, palpation for misalignment, and visual inspection were either undocumented, unreliable, or not valid. CONCLUSION: The detection of the manipulative lesion in the lumbo-pelvic spine depends on valid and reliable tests. Because such tests have not been established, the presence of the manipulative lesion remains hypothetical. Great effort is needed to develop, establish, and enforce valid and reliable test procedures.

Chiropractic↗
PubMed1997

Development of a scientifically valid coordinated care path.

OBJECTIVE: The goal of this study was to develop a method to scientifically create and validate a coordinated care path for use within any hospital setting. BACKGROUND: In an attempt to reduce the costs associated with high-volume and high-risk diagnosis, attention was focused on reducing patients' length of stay in the hospital. A method to reduce length of stay uses a coordinated care path. A path is a guideline used to manage the clinical care of selected patients. The literature is relatively silent regarding studies that have scientifically validated the use of these paths. METHODS: This project used a content validity method to validate the care path. Using current research findings, best practice standards both locally and nationally, a transdisciplinary team developed practice guidelines that included sequencing, timing of interventions, and expected patient outcomes. The path was rated by local and national experts using a four-point rating scale. Using Lynn's proportion of experts table computations, the validity of the path and each of its components was determined. RESULTS: Of 161 items on the care path, 10 were not validated. The experts validated the instrument as a whole. Of the 161 items, 151 were validated. This is an instrument validation rate of 0.94. No additional changes or modifications to the path were suggested by the experts. The transdisciplinary team addressed the nonvalidated items. This method can be used to develop other coordinated paths for other diagnostic groups.

Critical Pathways↗
PubMed2001

Commentary on the American Medical Association guides' lumbar impairment validity checks.

STUDY DESIGN: The American Medical Association's (AMA) Guides to the Evaluation of Permanent Impairment range of motion-based (ROM) lumbar impairment model validity checks were reviewed. Published literature of lumbar ROM (LROM) testing also was reviewed for application of the AMA validity checking protocols. OBJECTIVE: The utility and feasibility of use of the AMA Guides' ROM lumbar impairment ratings were examined. SUMMARY OF BACKGROUND DATA: Although they appear to be essential components of the ROM model, few published studies report use of these validity checks. Of at least 22 reviewed studies of LROM testing, only six studies included at least three measurements (the bare minimum) of LROM. Furthermore, only two (9.1%) reported performance of the LROM validity check. Only one, however, reported the results. METHODS: English language journals were searched on Medline using "region, lumbar," "range of motion," "validity of results," "observer variation," and "low back pain" as title and subject search terms. The study methodologies approximating the AMA Guides' specifications were included in the analysis. RESULTS: Under normal conditions of ROM measurement, 33% of three consecutive lumbar flexion and 27% of three consecutive lumbar extension measurements failed the LROM validity check. In addition, across three different experimental sessions (each with more than three consecutive LROM measurements taken) only 15 participants (33%) had valid flexion scores and only 24 participants (53%) had valid extension scores across all three sessions. CONCLUSION: Technical complications inherent in the ROM-based impairment-rating model render the validity checks difficult to perform satisfactorily and thus rarely used.

American Medical Association↗
PubMed2004

The inflammatory bowel disease questionnaire: a review of its national validation studies.

Health-related quality of life (HRQoL) is an important measure of illness perception on the part of the patient. The Inflammatory Bowel Disease Questionnaire (IBDQ) is a widely used questionnaire for HRQoL assessment in patients with inflammatory bowel diseases (IBDs). This questionnaire has been adapted and validated into several languages and cultural milieus. The aim of this study is to review the methods used by several adaptation studies for assessing the validity and reliability of the adapted IBDQ. A search was made of the Medline database for relevant articles since 1989. Standard validation criteria were used for including studies for further evaluation. The following aspects of the validation procedure were examined: translation, construct validity, reliability, sensitivity to change, and used statistical methods. Nine validation studies of the IBDQ, in England and in non English-speaking countries (Holland, Spain, Korea, Sweden, Greece, and China) were selected. All studies concluded that the adapted instrument was valid and reliable. Only few modifications were proposed. Two studies recommended the split of the four dimensions of the original questionnaire in five. Assessing HRQoL in patients with IBD is an ever-increasing practice, especially in clinical trials. IBDQ was proven to be valid and reliable in several cultural and linguistic milieus when appropriate validation procedures were applied.

Health Status↗