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PubMedDate not supplied

The ECVAM international validation study on in vitro embryotoxicity tests: results of the definitive phase and evaluation of prediction models. European Centre for the Validation of Alternative Methods.

From 1996 to 2000, ZEBET (Centre for Documentation and Evaluation of Alternative Methods to Animal Experiments at the BgVV, Berlin, Germany) coordinated the European Centre for the Validation of Alternative Methods (ECVAM) prevalidation and validation study on three embryotoxicity tests: a) a test employing embryonic stem cell lines (EST); b) the micromass (MM) test; and c) the postimplantation rat whole-embryo culture assay (WEC test). The main objectives of the study were to assess the performance of these three in vitro tests in discriminating between non- embryotoxic, weakly embryotoxic and strongly embryotoxic compounds. Phase I of the study (1997) was designed as a prevalidation phase, for test protocol optimisation, and for the establishment of a comprehensive database of in vivo and in vitro data on embryotoxic compounds. Phase II (1998-2000) involved a formal validation trial, conducted under blind conditions on 20 test compounds selected from the database, which were coded and distributed to the participating laboratories. In the preliminary phase of the validation study, six chemicals out of the 20, which showed embryotoxic potential, were tested. These results were used to define new biostatistically based prediction models (PMs) for the MM and WEC tests, and to evaluate those developed previously for the EST. As a next step, the PMs were evaluated by using the results for the remaining 14 chemicals of the definitive phase of the validation study. The three in vitro embryotoxicity tests proved to be applicable to testing a diverse group of chemicals with different embryotoxic potentials (non-embryotoxic, weakly embryotoxic, and strongly embryotoxic). The reproducibility of the three in vitro embryotoxicity tests were acceptable according to the acceptance criteria defined by the Management Team. The concordances between the embryotoxic potentials derived from the in vitro data and from the in vivo data were good for the EST and the WEC (PM2) test, and sufficient for the MM test and the WEC (PM1) tests according to the performance criteria defined by the Management Team before the formal validation study. When applying the PM of the EST to the in vitro data obtained in the definitive phase of the formal validation study, chemicals were classified correctly in 78% of the experiments. For the MM and the WEC tests, the PMs provided 70% and 80% (PM2) correct classifications, respectively. And, very importantly, an excellent predictivity (100%, except for PM1 of the WEC test, with 79%, considered as good) was obtained with strong embryotoxic chemicals in each of the three in vitro tests.

3T3 Cells↗
PubMed1999

[Development of prediction models for three in vitro embryotoxicity tests which are evaluated in an ECVAM validation study]

In 1997 ZEBET started the co-ordination of a study funded by the European Centre for the Validation of Alternative Methods (ECVAM) with the aim of pre-validation and validation of three in vitro embryotoxicity tests. These tests employ the cultivation of post-implantation whole rat embryos (WEC test), cultures of primary limb bud cells of rat embryos (micromass test, MM-Test), and cultures of a pluripotent mouse embryonic stem cell line (embryonic stem cell test, EST). In the current Validation Study each of the tests is evaluated in four laboratories under blind conditions. In an initial phase of the validation study six out of 20 test chemicals comprising different embryotoxic potential (non, weak and strong embryotoxic) were tested. The results were used to improve the prediction models (PM) for the WEC test and the MM-Test in order to identify the embryotoxic potential of test chemicals. In addition, the existing PM for the EST was evaluated using the results from testing of the initial six chemicals. The PM for the EST was developed using the results of a previous pre-validation study (Scholz et al.,1999), in which 94% of the learning sample were classified correctly. Applying this PM to the results of the initial phase of the current validation study, 80% of the experiments were classified correctly according to the embryotoxic potential of the tested chemicals in vivo. Applying the PM for the MM-Test and the WEC test that were developed during the current validation study in both tests, 79% correct classifications were achieved. Since the PM of the WEC-Test took into account only parameters of growth and development, but not cytotoxicity data, a second PM (PM2) for the WEC was developed that was improved by incorporating cytotoxicity data of the differentiated mouse fibroblast cell line 3T3 derived from the EST. This approach, which has previously never been used as an adjunct to the WEC test, resulted in an increase of correct classifications to 96%.

Journal Article↗
PubMed1997

Validation study of a computerized version of the Western Ontario and McMaster Universities VA3.0 Osteoarthritis Index.

OBJECTIVE: To study the validity and feasibility of a computerized version of the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index. METHODS: Thirty patients with osteoarthritis (OA) of the knee completed both a paper and a computerized version of WOMAC in random order. The visual analog scaled version of WOMAC, VA3.0, was used. We studied criterion validity by comparing the paper and computerized versions. RESULTS: All patients completed the computerized version without undue difficulty. Criterion validity, based on aggregated subscale scores, was excellent: Pain, ICC = 0.89, Stiffness, ICC = 0.87, Physical Function, ICC = 0.95. CONCLUSION: The computerized version of WOMAC VA3.0 is a valid alternative to the paper version.

Aged↗
PubMed2003

Sentinel node biopsy in breast cancer: validation study and comparison of blue dye alone with triple modality localization.

BACKGROUND: Sentinel node biopsy (SNB) for breast cancer patients is a new technique with the potential to provide an accurate staging of the axillary nodal status while avoiding the morbidity of an axillary dissection. The objective of the present study is to validate the use of sentinel node biopsy in a New Zealand hospital and to compare the ability of patent blue dye (PB) alone with triple modality (TM) (preoperative lymphoscintigraphy, intraoperative gamma probe and intraoperative blue dye) to identify the sentinel node. METHODS: A total of 104 patients who had a palpable breast lump that was confirmed to be malignant by radiology and cytology and a clinical diagnosis of stage I or stage II breast cancer, were enrolled for SNB and randomly assigned to triple modality or blue dye alone for the localization of the sentinel node. Axillary dissection was performed after the sentinel node(s) had been removed. RESULTS: There were 63 patients in the PB group and 41 patients in the TM group. Both groups are comparable, with a similar mean age and primary tumour size. A sentinel node was identified in 57 (90%) of the PB group patients and 40 (98%) of the TM group patients. Of these 23 (37%) of the PB group and 23 (56%) in the TM group had axillary nodes positive for malignancy. There was one false negative SNB in the PB group and two false negative results in the TM group. Therefore, the PB group had an accuracy of 98% and a sensitivity of 96% compared to an accuracy of 95% and a sensitivity of 91% for the TM group. CONCLUSION: The results of the present study validate the use of SNB in suitable breast cancer patients. Identification and the accuracy of the sentinel node localization were similar between the two groups. Therefore, in hospital centres without adequate access to a nuclear medical facility, it would be feasible to conduct SNB using blue dye alone.

Antimony↗
PubMed2005

Inter-laboratory validation study of five commercial ELISA test kits for the determination of peanut proteins in biscuits and dark chocolate.

The results of an inter-laboratory study with five commercially available peanut ELISA test kits to detect and quantify peanut residues in two food matrices (biscuit and dark chocolate) at four different concentrations (0-10 mg peanut kg(-1) matrix corresponding to about 0-2.5 mg peanut protein kg(-1) matrix) are reported. In general the five ELISA test kits evaluated could detect peanut protein in the two food matrices. In three cases, the study challenged the test kits beyond their intended use for quantification below the manufacturers' defined cut-off limits. Generally, all five ELISA test kits performed well in the concentration range 5-10 mg kg(-1) rather than in the low concentration range (2.0 or 2.5 mg kg(-1)). The variation in the found recoveries of peanut between the different test kits had a spread of 44-191% across all concentrations. The quantification characteristics between test kits differed significantly at the very low mg kg(-1) level. Two test kits performed well even at concentrations below 5 mg kg(-1) with reproducibilities of 27-36% for biscuits and 45-57% for chocolate.

Arachis↗
PubMed2006

Validation study of fractional exhaled nitric oxide measurements using a handheld monitoring device.

We tested reproducibility of exhaled nitric oxide (FE(NO)) and inter-operator handling when measured with a handheld device, NIOX MINO. We enrolled 20 volunteers using a priori goals of acceptable reproducibility to be mean within-subject standard deviation less than 3 parts per billion (ppb) for FE(NO) measurements less than 30 ppb, and mean coefficient of variation less than 10% for FE(NO) measurements more than 30 ppb. Seventeen subjects with measurements less than 30 ppb displayed a mean standard deviation of 1.15, and 3 subjects with FE(NO) more than 30 ppb had a mean coefficient of variation of 2.4%. We conclude that NIOX MINO demonstrates excellent reproducibility for all ranges of FE(NO).

Adolescent↗
PubMed2001

On the relationship between the efficiency and the quality of the consultation. A validity study.

OBJECTIVES: The aim of this study was to determine how the medical performance of physicians during consultations is related to doctor-patient communication and satisfaction of patients, taking into account the actual length of the consultations. In addition, we studied the validity of the 'efficiency-per-time score' as a measure of competence. METHODS: General practice trainees participated in a test situation in which they were confronted with six consultations with standardized (simulated) patients (SPs). All consultations were videotaped and evaluated by multiple observers, using national guidelines on medical content and on communication. The SPs scored satisfaction with the consultation using a satisfaction checklist. Forty GP-trainees were invited, of whom 34 participated. The main outcome measures were the number of obligatory actions undertaken by the GP-trainees, total number of actions undertaken, consultation time, efficiency-per-time score, patient satisfaction and quality of communication score, and the Pearson correlations between these measures. RESULTS: There was a negative correlation between the 'efficiency-per-time score' of the GP-trainees and the satisfaction of the SPs in five of the six consultations [Pearson r from -0.29 (P < 0.05) to -0.58 (P < 0.001)] and between the 'efficiency-per-time score' and the quality of the communication in three of the six consultations [Pearson r from -0.34 (P <.05) to -0.51 (P < 0.001)]. CONCLUSIONS: Short consultations with high technical medical efficiency seem to be related to bad communication and dissatisfied patients, thus questioning the validity of the 'efficiency-per-time score' as a measure of competence.

Belgium↗
PubMed2004

Multicenter validation study of the %CDT TIA kit in alcohol abuse and alcohol dependence.

BACKGROUND: Carbohydrate-deficient transferrin (CDT) and gamma-glutamyl transferase (GGT) are used as biomarkers of alcohol misuse. The aim of this study was to evaluate, in terms of sensitivity and specificity, the performance of the new Bio-Rad %CDT TIA kit and GGT assay for identifying alcohol abuse and alcohol dependence (according to the DSM-IV criteria). METHODS: An open multicenter study (30 centers) over 3 months, including patient groups of "abusers," "dependents," and controls, was conducted in France. RESULTS: In alcohol abuse, the sensitivity of GGT was 0.56, and that of CDT was 0.80; in alcohol dependence, the sensitivity of GGT was 0.86, and that of CDT was 0.91. The specificity of GGT was 0.77, and that of CDT was 0.83. The association of GGT with CDT increased sensitivity for alcohol abuse to 0.90 and for alcohol dependence to 0.99, but it appreciably decreased specificity (0.63). CONCLUSIONS: %CDT is the better screening marker for alcohol abuse and dependence, but GGT is still a useful marker for the detection of alcohol dependence. As an assay method, the second-generation Bio-Rad %CDT immunoassay can be recommended for routine CDT measurement.

Adult↗
PubMed2006

The short-form Buss-Perry Aggression Questionnaire (BPAQ-SF): a validation study with federal offenders.

The 12-item short form of the Buss-Perry Aggression Questionnaire (BPAQ-SF) was originally developed by Bryant and Smith (2001) and modified and confirmed using confirmatory factor analysis with mentally ill offenders by Diamond, Wang, and Buffington-Vollum (2005). In the current study, construct validity of the BPAQ-SF was assessed with a sample of 1,181 male and 435 female general population federal offenders. Confirmatory factor analysis supported the four-factor structure. Tests confirmed factorial invariance across gender for all loadings and covariances. Reliabilities were found to be adequate and comparable to those found in the studies cited above. Concurrent validity was supported by high correlations between the subscales of the BPAQ-SF and several relevant subscales on the Personality Assessment Inventory (PAI). In addition, those offenders with prior history of violence, head injuries, childhood abuse, residential treatment, custody, or foster care as a child had higher scores on the BPAQ subscales.

Aggression↗
PubMed2001

Efficient regression calibration for logistic regression in main study/internal validation study designs with an imperfect reference instrument.

An extension to the version of the regression calibration estimator proposed by Rosner et al. for logistic and other generalized linear regression models is given for main study/internal validation study designs. This estimator combines the information about the parameter of interest contained in the internal validation study with Rosner et al.'s regression calibration estimate, using a generalized inverse-variance weighted average. It is shown that the validation study selection model can be ignored as long as this model is jointly independent of the outcome and the incompletely observed covariates, conditional, at most, upon the surrogates and other completely observed covariates. In an extensive simulation study designed to follow a complex, multivariate setting in nutritional epidemiology, it is shown that with validation study sizes of 340 or more, this estimator appears to be asymptotically optimal in the sense that it is nearly unbiased and nearly as efficient as a properly specified maximum likelihood estimator. A modification to the regression calibration variance estimator which replaces the standard uncorrected logistic regression coefficient variance with the sandwich estimator to account for the possible misspecification of the logistic regression fit to the surrogate covariates in the main study, was also studied in this same simulation experiment. In this study, the alternative variance formula yielded results virtually identical to the original formula. A version of the proposed estimator is also derived for the case where the reference instrument, available only in the validation study, is imperfect but unbiased at the individual level and contains error that is uncorrelated with other covariates and with error in the surrogate instrument. Replicate measures are obtained in a subset of study participants. In this case it is shown that the validation study selection model can be ignored when sampling into the validation study depends, at most, only upon perfectly measured covariates. Two data sets, a study of fever in relation to occupational exposure to antineoplastics among hospital pharmacists and a study of breast cancer incidence in relation to dietary intakes of alcohol and vitamin A, adjusted for total energy intake, from the Nurses' Health Study, were analysed using these new methods. In these data, because the validation studies contained less than 200 observations and the events of interest were relatively rare, as is typical, the potential improvements offered by this new estimator were not apparent.

Adult↗
PubMed1986

Simultaneous determination of local cerebral glucose utilization and blood flow by carbon-14 double-label autoradiography: method of procedure and validation studies in the rat.

Validation studies were undertaken to establish a computer-assisted double-label autoradiographic strategy employing [14C]2-deoxyglucose ([14C]2DG) and [14C]iodoantipyrine ([14C]IAP) to measure local CMRglu (LCMRglu) and CBF (LCBF). An organic solvent was used to extract the majority of IAP between first and second film exposures. In contrast to previously published data, all solvents tested produced partial losses of 2DG from tissue, and all allowed 2-6% of IAP to persist even after 5-day washes. Technical-grade chloroform permitted equal retention of unmetabolized and metabolized 2DG. A linear model was established, which was insensitive to the changes in tissue self-absorption that were shown to occur with chloroform extraction. Propagated error in computing tissue [14C]2DG and [14C]IAP was reduced by maximizing IAP extraction (by longer solvent wash times) and by administering 2.5 times as much IAP as 2DG. Fractional 2DG retention was measured in single-label 2DG sections placed on the films, and fractional IAP retention was evaluated by an optimization procedure. With this strategy, double-label values for LCMRglu and LCBF in anesthetized rats agreed with values obtained in matched single-label series to within 5%. The coefficients of variation for the double- and single-label LCMRglu data were virtually identical, whereas the coefficient of variation for double-label LCBF was 1.8 times that of single-label LCBF. The double-label strategy permitted pixel-by-pixel measurement and video display of the LCMRglu/LCBF ratio; the mean value among structures was 0.472 mumol/ml. With proper attention to methodological detail, this double-label strategy shows great promise for routine laboratory application.

Animals↗
PubMedDate not supplied

Predicting NCLEX success with the HESI Exit Exam: Fourth annual validity study.

The fourth annual validity study of the Health Education Systems, Inc. (HESI) Exit Exam was designed to examine not only the accuracy of the examination in predicting NCLEX success but also the degree of risk for failure of the licensure examination associated with specific scoring intervals. A descriptive comparative design was used to examine the data provided by schools of nursing regarding students' NCLEX outcomes in the 1999-2000 academic year. As in the 3 previous studies, the examination was found to be a highly accurate predictor of NCLEX success (98.46%). Each scoring interval was significantly different from each of the other scoring intervals (P = .001). In fact, for the combined group of registered nurse and practical nurse students, the percentage of students who failed the NCLEX more than doubled with each successively lower scoring interval. These findings provide the information faculties needed to make evidence-based decisions regarding students' risks for NCLEX failure. Additionally, frequency data were obtained from this survey regarding the use of the examination as a benchmark for progression and remediation, and these findings may also be useful to faculties that are considering establishing such programs.

Journal Article↗
PubMed2005

Arthroscopic assessment of cartilage repair: a validation study of 2 scoring systems.

PURPOSE: This study tested the validity and reliability of the International Cartilage Repair Society (ICRS) cartilage repair assessment and the Oswestry Arthroscopy Score (OAS), which have been designed to assess repair of articular cartilage. TYPE OF STUDY: Prospective validation study of arthroscopic cartilage repair scores. METHODS: Arthroscopic videos were assessed by a panel of orthopaedic surgeons specializing in cartilage repair. Scoring was repeated after a 2-month interval. Scorers also answered a questionnaire to assess the face and content validity of the scoring systems. Validity of the 2 systems was compared and reliability and repeatability were measured. Pearson's correlation coefficient was used to measure equivalence reliability. The interclass correlation coefficient (ICC) was used to assess the repeatability and inter-rater reliability of each score, and internal consistency was assessed with Cronbach's alpha. RESULTS: Face and content validity are acceptable for both scores. There is good agreement (equivalence reliability) between the scores (Pearson's correlation coefficient, r = .88; P < .001). Stability (interobserver reliability) and repeatability (test-retest reliability) are satisfactory for both scores with an ICC >0.7 for each score. Cronbach's alpha was 0.91 for ICRS and 0.82 for OAS, indicating better internal consistency for the ICRS score. CONCLUSIONS: The ICRS and OAS arthroscopic scores have been validated for the assessment of cartilage repair and both have been found to be statistically reliable and repeatable. The ICRS score does not allow for graft hypertrophy and may overscore in this situation, whereas the OAS includes assessment of graft stiffness. Both scores show satisfactory stability and repeatability. Internal consistency is adequate for both scores, although it is higher for the ICRS score. Both the ICRS and OAS arthroscopic scores are effective tools in the evaluation of cartilage repair. LEVEL OF EVIDENCE: Level III, diagnostic study of nonconsecutive patients (no consistently applied reference gold standard).

Arthroscopy↗
PubMedDate not supplied

Virus validation studies of immunoglobulin preparations.

OBJECTIVE: A validation study of the viral safety of a new polyvalent intravenous immunoglobulin (OCTAGAM) according to EU-guideline III/8115/89-EN and the requirements of the Federal Agency for Sera and Vaccines in Germany was undertaken in May 1994. The following processing steps were analyzed: Cohn-Oncley fractionation, solvent/detergent (SD) treatment, pH 4 exposure, storage of the final product at low pH and immune neutralisation. METHODS: The following virus reduction factors were obtained: Cohn-Oncley fractionation: HIV-1 > 5.50; sindbis virus > 6.36; pseudorabies virus > 7.28; coxsackievirus-B6 2.70; poliovirus-1 > 3.80; SV40 > 5.51. Solvent/Detergent treatment: HIV-1 > 6.03; sindbis virus > 7.80; pseudorabies virus > 8.38. pH 4 exposure: HIV-1 > 8.60; sindbis virus > 8.94; pseudorabies virus > 5.95; coxsackievirus-B6 2.72; SV40 1.15. Immune neutralisation: coxsackievirus-B6 > 4.98, polio-virus-1 > 5.14, HAV > 3.44, HSV-1 > 5.92. The following virus reduction factors were calculated for the final product: HIV-1 > 20.13; sindbis virus > 23.10; pseudorabies virus > 21.61; coxsackievirus-B6 > 10.4; poliovirus-1: > 8.94; HAV > 3.44; SV40 > 6.66. CONCLUSION: The results of our validation studies demonstrated that in addition to Cohn fractionation and immune neutralization, the two additional steps of solvent/detergent treatment and pH 4 exposure, mainly contribute to the safety of OCTAGAM with respect to both enveloped and non-enveloped viruses.

Biological Products↗
PubMedDate not supplied

Maintaining study validity in a changing clinical environment.

BACKGROUND: Nurse scientists who conduct intervention research in a variety of clinical settings find themselves facing numerous challenges posed by today's changing and sometimes complex health care environment. Maintaining study validity thus becomes a major focus of interventional research, but existing literature does not fully address challenges to study validity nor offer potential solutions. OBJECTIVES: The purposes of this paper are to 1) discuss methodologic challenges to maintaining study validity of intervention research that is conducted in a changing clinical environment, and 2) share strategies for maximizing study validity. METHODS: A recently completed intervention study is used as an example to discuss two specific areas that affected study validity, provide examples of selected threats to validity, and outline strategies used to minimize these threats. RESULTS: Careful definition of goals, thoughtful decision making, and implementation of specific strategies to maintain study validity helped increased the rigor of the research. CONCLUSIONS: Investigators conducting intervention research in changing clinical settings can reduce threats to study validity and increase design rigor by considering clinical realities (e.g., clinician-researcher role conflict) when making methodologic decisions, becoming familiar with the setting, and involving clinicians in the research.

Decision Making↗
PubMedDate not supplied

[French validation study of the levels of emotional awareness scale].

According to a thesis based on the idea of an influence of cognitions in the structuring of internal reality, emotional awareness, ie the capacity of representing your own emotional experience and that of others, is a cognitive process that goes into maturation. Defining this concept, Lane and Schwartz present a cognitivo-developmental model in five stages of the processes of symbolization, accounting for the differences in levels of emotional awareness observed in individuals. The organization of these cognitive processes would thus be structured in well differentiated stages, in which the development of the emotions would be inseparable from the development of ego and of the relation to others. These authors focus on the capacity of representing in a conscious way the emotional experience and consider that verbal representations used to describe the contents of what is experience constitute a good reflection of the organization structural of the emotional awareness. Therefore, they worked out an instrument of evaluation: the Levels of Emotional Awareness Scale (LEAS), which measures the capacity to describe your own emotional experience and the one you allow to others, in an emotional situation. The system of quotation of this scale is based on the analysis of the verbal contents of the provided answers, in direct reference to the authors' theory of the levels of differentiation and integration of the emotional experience. It is therefore an empirical measurement which is centered specifically on the structural organization of the emotional experience. The various studies of validation of this instrument show that it presents solid metrological properties. This work presents the validation of the French version of Lane and Schwartz's LEAS. Validity and fidelity were studied in a group of 121 healthy subjects. This setting is part of a larger clinical evaluation, also including a collection of socio-demographic and clinical data, and other instruments of self-evaluation (Beck Depression Inventory, BDI, Hospital Anxiety and Depression Scale, HAD, and Toronto Alexithymia Scale, TAS). The face validity appears correct: the questionnaire was well accepted and seemed easy to complete. A principal components analysis of the correlation matrix of the set of items was used as the method of extraction of the various factors and made it possible to confirm the unidimensionality of the instrument. The number of factors to be retained was given according to Kaiser and Cattell criteria. The internal consistency was evaluated through computation of the Cronbach coefficient, whose value is 0.75 for the scale's global score. The confidence interval of the margin of error of LEAS scores was also measured; for the global score it is IC=[m 6.1]. The measure given by this rating scale may therefore be considered sufficiently accurate, since this interval is weak. A study of the frequency of quotation of each item of the instrument was carried out, in order to check the homogeneity and the uniformity of quotations, as well as a diagram of distribution of the score, showing that it follows a law which is close to a normal law. The concurrent validity could only be studied via the similar concept of alexithymia, measured with the TAS, for there is not other instrument validated in French evaluating the levels of emotional awareness, and these two instruments seem to measure different notions, because none of the correlations between the scores of these two questionnaires are significant. Concerning discriminant validity, the Pearson correlation coefficients between the global score for the LEAS, the BDI score and the HAD sub-scores for depression and anxiety were measured; it is clear that the level of emotional awareness is independent from negative affects. Furthermore, the study of the reliability made it possible to highlight excellent intra-class correlation coefficients (r=0.993). The French version of the Levels of Emotional Awareness Scale thus appears to be valid and accurate and should allow the study of levels of emotional awareness on psychopathology. It is about an easily acceptable and simple questionnaire of use in varied clinical circumstances.

Adolescent↗
PubMed2005

A new selection system to recruit general practice registrars: preliminary findings from a validation study.

OBJECTIVE: To design and validate a new competency based selection system to recruit general practice registrars, comprising a competency based application form, referees' reports, and an assessment centre. DESIGN: Longitudinal predictive validity study and a matched case comparison. SETTING: South Yorkshire and East Midlands region, United Kingdom, comprising three deaneries. PARTICIPANTS: 46 of 167 doctors were followed up in training after three months in practice, and 20 general practice trainers were selected by using traditional recruitment methods. MAIN OUTCOME MEASURES: Trainer ratings of trainee performance in practice on targeted competencies. RESULTS: Performance ratings of targeted competencies at the assessment centre predicted trainer ratings of performance in the job. Furthermore, those trainees recruited through the new competency based process performed significantly better in the job than those recruited through traditional recruitment processes. CONCLUSION: A new competency based selection process using assessment centres improves the validity of selection of general practice registrars compared with traditional selection techniques.

Adult↗
PubMed2006

The Geriatric Depression Scale and the Cornell Scale for Depression in Dementia. A validity study.

The study is a validation study of two psychogeriatric depression rating scales, The Geriatric Depression Scale (GDS) and the Cornell Scale for Depression in Dementia (CSDD). The sensitivity and specificity, and the convergent and criterion validity of the two scales as well as the inter-rater reliability of the CSDD are reported. Two independent clinicians using the ICD-10 for depression and dementia, the Clinical Global Impression (CGI), the Hamilton Depression rating scale 17-items and the Mini-Mental-State Examination (MMSE), interviewed each patient or control subject. One hundred forty-five persons of 65 years or more of age were included, 73 were depressed only, 36 depressed and demented; 36 persons were control subjects, 11 of these were demented. The inter-rater reliabilities were high or very high equalling perfect correlation. There was very high convergent validity between the screening tools and the severity scales; the shorter versions of the GDS (15-, 10- or four-item version) had lower though still almost perfect correlations. The criterion validity in the total population showed the CSDD as the better scale with sensitivity and specificity of 93% and 97% with a cut-off value of > or =6. The GDS versions had sensitivities and specificities ranging from 82% to 90% and 75% to 94% respectively with cut-off values > or =9, 4, 3 and 1. The CSDD retained its validity and specificity as a screening tool for depression in a population of demented, while the GDS versions all diminished in validity. The GDS and the CSDD are both valid screening tools for depression in the elderly; however, the CSDD alone seems to be equally valid in populations of demented and non-demented.

Aged↗