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PubMed2000

Validation of the Warwick Child Health and Morbidity profile in routine child health surveillance.

OBJECTIVE: To further validate a simple instrument for the measurement of parent-reported health and morbidity in infancy and childhood when used in routine child health surveillance as part of a whole year birth cohort study. Setting The socially and ethnically diverse city of Coventry. METHODS: Health visitors administered the Warwick Child Health and Morbidity profile (WCHMP), incorporated into the Parent Held Record (PHR), to the parents of infants born in 1996 and enrolled in the Coventry Cohort study as part of routine child health surveillance at 8 weeks and 8 months. Criterion validity was estimated for Hospital admission status and immunization status against health records and validity against medically plausible constructs was tested by comparing responses between domains and between the two data collection points for the whole cohort. RESULTS: Criterion validity for parental reporting of immunization status (Kappa 0.824 [95% CIs, 0.708, 0.940]) and hospital admission (Weighted Kappa 0.987 [95% CIs, 0.977, 0.997]) were high. There was a high level of concordance between parental responses to related domains and the medically plausible constructs. The proportion of parents reporting chronic illness, acute significant illness, chronic illness and accidents increased as expected between 8 weeks and 8 months. As expected, adverse outcomes at 8 weeks were associated with an increased risk of the same outcomes at 8 months. CONCLUSIONS: The WCHMP is a simple measure of parent-reported health and illness which was shown to be reliable and valid with low inter-observer variation on initial field-testing. Further validation of the WCHMP, incorporated into the PHR, in a routine child health surveillance programme demonstrates its suitability for use in infancy to collect cross-sectional and longitudinal health and morbidity data for research and service planning purposes.

Child Health Services↗

PubMed1993

The conceptual validity of a taxonomy of nursing interventions.

The purpose of this paper is to report validity evidence for the nursing intervention taxonomy developed as part of the Nursing Intervention Lexicon and Taxonomy (NILT) Study. Using eclectic classification methods of library science, cognitive science, nursing science and computational linguistics, a taxonomy of nursing interventions consisting of seven categories was developed. These categories which incorporate care as a central concept are described and defined, and prototypical examples of each category are presented. Brinberg & McGrath's validity schema provides the framework within which evidence for validity as value, validity as correspondence and validity as generalizability were examined. Comparison of the NILT categories with previously published categorizations of nursing functions and interventions provides strong support for the validity of this classification. Additionally, comparison of the NILT categories with two internationally derived categorizations of nursing functions supports the robustness or generalizability of the NILT classification.

Job Description↗

PubMed2000

Validation of a new method for patient classification, the Oulu Patient Classification.

At Vasa Central Hospital in Western Finland a further development of the Oulu Patient Classification (OPC) has been made by the development of weight coefficients and by estimating the nursing care intensity per nurse. The daily level of nursing care intensity of a ward is expressed by the number of nursing care intensity points per nurse. This article presents results from a validity test of the OPC at Vasa Central Hospital. The test was carried out by comparing the daily patient classifications by means of the OPC against measurements made by means of a new measuring instrument, the 'Professional Assessment of Optimal Nursing Care Intensity Level' (PAONCIL) developed at the Vasa Central Hospital. The study was implemented in eight wards during a period of 3 months. The data material consisted of two parts, the daily patient classifications based on the OPC (n = 19 324) and the measurements by means of the PAONCIL forms (n = 8458). Simple and multiple linear regression analyses were used as statistical methods in quantifying the linear relationship between the two interval-scaled variables. In the test of concurrent validity the coefficient of determination was 0.366, i.e. the association between these two indicators is fairly strong (36.6%). The testing of construct validity showed that the construct validity of the indicator hardly deteriorates as a result of the patients being placed in separate nursing care intensity categories. There was a clear correlation between the scores allotted by the indicator to the six different sub-areas of nursing care. When examining the construct validity of the OPC, no factors with independent explanatory power in predicting PAONCIL values were discovered other than those of the OPC. The OPC proved on the basis of this research material and these statistical methods to possess fairly adequate validity, and thus there is a good basis for further research and a development of nursing care.

Analysis of Variance↗

PubMed1999

Assessment of general practitioners by video observation of communicative and medical performance in daily practice: issues of validity, reliability and feasibility.

OBJECTIVES: To develop a video assessment method for General Practitioners (GPs) by analysing issues of validity, reliability and feasibility of observation of videotaped regular consultations. DESIGN: In a cross-sectional study consultations of 93 GPs were video recorded in the practice during 1 week. The GPs registered consultation and patient data in a logbook; 16 consultations per GP were selected using preset criteria. The quality of communicative and medical performance of these consultations was assessed by GP observers with a validated instrument. The validity of the procedure was evaluated by checking the content of each GP's sample using specific sample criteria. Selection bias was estimated by multiple regression analysis, with sample characteristics as independent variables and scores on communication and medical performance as dependent variables. The influence of observation on GPs and patients was assessed by a questionnaire. Generalizability theory was used to estimate reliability. Feasibility was assessed by conducting a questionnaire, by keeping accounts, and by checking the technical quality of the videotaped consultations. SETTING: Universities of Nijmegen and Maastricht, The Netherlands. SUBJECTS: General Practitioners (GPs). RESULTS: The domain of general practice was well covered in the samples; content validity was satisfactory. With regard to the sample characteristics, only the total duration of consultations appeared to correlate significantly with both the score on communication and the score on medical performance. A majority (71%) of GPs reported not being influenced by the observation, except in the first cases, and recognizing their usual daily performance in the videotaped consultations. An acceptable level of reliability was reached after 2.5 hours of observation, i.e. 12 cases by a single observer. The method was well accepted by both GPs and patients. The costs were pound250 per GP. CONCLUSIONS: Video assessment of GPs in daily practice according to the procedures described is a valid and reliable method, one which is useful for education and quality improvement. There is a trade-off between feasibility on one hand and validity, reliability and credibility on the other hand. Compared to investments in observation methods in standardized settings, the costs of video observation of GPs' actual performance are acceptable.

Clinical Competence↗

PubMed2003

Reliability and validity of the direct observation clinical encounter examination (DOCEE).

CONTEXT: The College of Medicine and Medical Sciences at the Arabian Gulf University, Bahrain, replaced the traditional long case/short case clinical examination on the final MD examination with a direct observation clinical encounter examination (DOCEE). Each student encountered four real patients. Two pairs of examiners from different disciplines observed the students taking history and conducting physical examinations and jointly assessed their clinical competence. OBJECTIVES: To determine the reliability and validity of the DOCEE by investigating whether examiners agree when scoring, ranking and classifying students; to determine the number of cases and examiners necessary to produce a reliable examination, and to establish whether the examination has content and concurrent validity. SUBJECTS: Fifty-six final year medical students and 22 examiners (in pairs) participated in the DOCEE in 2001. METHODS: Generalisability theory, intraclass correlation, Pearson correlation and kappa were used to study reliability and agreement between the examiners. Case content and Pearson correlation between DOCEE and other examination components were used to study validity. RESULTS: Cronbach's alpha for DOCEE was 0.85. The intraclass and Pearson correlation of scores given by specialists and non-specialists ranged from 0.82 to 0.93. Kappa scores ranged from 0.56 to 1.00. The overall intraclass correlation of students' scores was 0.86. The generalisability coefficient with four cases and two raters was 0.84. Decision studies showed that increasing the cases from one to four improved reliability to above 0.8. However, increasing the number of raters had little impact on reliability. The use of a pre-examination blueprint for selecting the cases improved the content validity. The disattenuated Pearson correlations between DOCEE and other performance measures as a measure of concurrent validity ranged from 0.67 to 0.79. CONCLUSIONS: The DOCEE was shown to have good reliability and interrater agreement between two independent specialist and non-specialist examiners on the scoring, ranking and pass/fail classification of student performance. It has adequate content and concurrent validity and provides unique information about students' clinical competence.

Bahrain↗

PubMed2003

Methodological index for non-randomized studies (minors): development and validation of a new instrument.

BACKGROUND: Because of specific methodological difficulties in conducting randomized trials, surgical research remains dependent predominantly on observational or non-randomized studies. Few validated instruments are available to determine the methodological quality of such studies either from the reader's perspective or for the purpose of meta-analysis. The aim of the present study was to develop and validate such an instrument. METHODS: After an initial conceptualization phase of a methodological index for non-randomized studies (MINORS), a list of 12 potential items was sent to 100 experts from different surgical specialties for evaluation and was also assessed by 10 clinical methodologists. Subsequent testing involved the assessment of inter-reviewer agreement, test-retest reliability at 2 months, internal consistency reliability and external validity. RESULTS: The final version of MINORS contained 12 items, the first eight being specifically for non-comparative studies. Reliability was established on the basis of good inter-reviewer agreement, high test-retest reliability by the kappa-coefficient and good internal consistency by a high Cronbach's alpha-coefficient. External validity was established in terms of the ability of MINORS to identify excellent trials. CONCLUSIONS: MINORS is a valid instrument designed to assess the methodological quality of non-randomized surgical studies, whether comparative or non-comparative. The next step will be to determine its external validity when used in a large number of studies and to compare it with other existing instruments.

Clinical Trials as Topic↗

PubMed1998

Development and validation of an audit instrument: the Prostate Outcomes Questionnaire.

OBJECTIVE: To develop a short, patient-based questionnaire for auditing the outcomes of treatment for benign prostatic hyperplasia (BPH) and to evaluate the acceptability, reliability and validity of the measure. PATIENTS AND METHODS: Data from a long research questionnaire used in the Oxford/North West Thames Prostatectomy Study were analysed to identify the subset of items which contained the most scientifically sound indicators of outcome. Items were selected on the basis of standard psychometric analyses to develop a short questionnaire, the Prostate Outcomes Questionnaire (POQ), a 27-item instrument covering urinary symptoms, complications after surgery, quality of life and patient satisfaction with outcome. The POQ was field tested for acceptability, reliability and validity in a postal survey of 125 men undergoing transurethral resection of the prostate for BPH from seven hospitals in south-east England. RESULTS: The POQ was highly acceptable to patients, as indicated by a 95% response rate, the absence of 'floor' and 'ceiling' effects and a low proportion of missing data. It showed excellent internal consistency reliability (Cronbach's alpha of 0.82-0.93 for the five summary scales and a mean item-total correlation of 0.56) and test-retest reliability (test-retest correlations for items were 0.40-1.00, with a mean test-retest correlation of 0.85, and for summary scales of 0.91-0.95). Construct validity was confirmed by: high intercorrelations between the five summary scales and the total score (0.88-0.95), with a pattern of intercorrelations among specific subscales that showed item-convergent and discriminant validity; higher scores for patients who reported an improvement after surgery than in those who were not improved (P < 0.001); the expected gradient of scores for patients reporting different levels of symptom distress (P < 0.001); high correlations with the longer parent questionnaire (0.75-0.88); and low to moderate correlations with the Nottingham Health Profile and Activities of Daily Living scores (0.15-0.67), with the pattern of correlations providing evidence of scale convergent and discriminant validity. Correlations with age and social class were low, suggesting that responses were not biased by sociodemographic factors. CONCLUSION: The POQ is a practical and scientifically sound patient-based measure of outcome after treatment for BPH which can be used for routine audit. It takes < 5 min to complete, is feasible for routine monitoring of large numbers of patients by postal survey, and is accompanied by a Users' Manual which provides practical help in conducting a local patient survey, and a computer program for scoring data. Most importantly, the POQ has been shown scientifically to perform well, having met standard psychometric criteria for reliability and validity.

Aged↗

PubMed2000

The stroke impairment assessment set: its internal consistency and predictive validity.

OBJECTIVE: To study the scale quality and predictive validity of the Stroke Impairment Assessment Set (SIAS) developed for stroke outcome research. DESIGN: Rasch analysis of the SIAS; stepwise multiple regression analysis to predict discharge functional independence measure (FIM) raw scores from demographic data, the SIAS scores, and the admission FIM scores; cross-validation of the prediction rule. SETTING: Tertiary rehabilitation center in Japan. PATIENTS: One hundred ninety stroke inpatients for the study of the scale quality and the predictive validity; a second sample of 116 stroke inpatients for the cross-validation study. MAIN OUTCOME MEASURES: Mean square fit statistics to study the degree of fit to the unidimensional model; logits to express item difficulties; discharge FIM scores for the study of predictive validity. RESULTS: The degree of misfit was acceptable except for the shoulder range of motion (ROM), pain, visuospatial function, and speech items; and the SIAS items could be arranged on a common unidimensional scale. The difficulty patterns were identical at admission and at discharge except for the deep tendon reflexes, ROM, and pain items. They were also similar for the right- and left-sided brain lesion groups except for the speech and visuospatial items. For the prediction of the discharge FIM scores, the independent variables selected were age, the SIAS total scores, and the admission FIM scores; and the adjusted R2 was .64 (p < .0001). Stability of the predictive equation was confirmed in the cross-validation sample (R2 = .68, p < .001). CONCLUSIONS: The unidimensionality of the SIAS was confirmed, and the SIAS total scores proved useful for stroke outcome prediction.

Adult↗

PubMed2001

Measuring leg-length discrepancy by the "iliac crest palpation and book correction" method: reliability and validity.

OBJECTIVE: To determine the reliability and validity of a clinical measurement of leg-length discrepancy (LLD), by using the iliac crest palpation and book correction (ICPBC) method. DESIGN: Intra- and interrater reliability and validity determinations. SETTING: Rehabilitation center. PARTICIPANTS: Thirty-four healthy subjects, none of whom had an apparent LLD, as determined by iliac crest palpation. INTERVENTIONS: We induced a simulated LLD (7-53 mm) for each subject. To measure the LLD, the examiner performed the ICPBC method by palpating the iliac crests and correcting identified differences with a book opened to the required number of pages. The thickness of the book correction was measured. MAIN OUTCOME MEASURES: Reliability LLD measurement (n = 20), by using the ICPBC method to measure the LLD; construct validity (n = 34), comparing ICPBC measurement with the extent of the induced LLD; and concurrent validity (n = 14), the difference in heights of the superior aspect of the femoral heads from standing radiographs. RESULTS: The intraclass correlation coefficients (ICCs) for the intrarater and interrater reliabilities were.98 and.91, respectively. The ICCs for the construct and concurrent validities were.62 and.76, respectively. The ICPBC method underestimated the induced LLD by a mean difference +/- standard deviation of 3.8 +/- 10.3mm (p =.055) and the radiologic measure by 5.1 +/- 8.6 mm (p =.043). CONCLUSIONS: The ICPBC technique for measuring LLD is highly reliable and moderately valid. When there is no history of pelvic deformity and the iliac crests can be readily palpated, we recommend using iliac crest palpation to detect LLD, and the book correction to quantify it.

Adult↗

PubMed2002

French translation and validation of 3 functional disability scales for neck pain.

OBJECTIVE: To translate and assess the reliability and the construct validity of 3 functional disability scales for neck pain. DESIGN: Reliability and validity study. SETTING: Tertiary care teaching hospital and outpatient clinic. PARTICIPANTS: One hundred one patients (mean age, 49 y). INTERVENTION: French translations were obtained by using the "translation-backward translation" method. Adaptations were made after a pilot study. MAIN OUTCOME MEASURES: Impairment outcome measures (visual analog scale [VAS] pain, neck range of motion, morning stiffness, score of neck sensitivity, radiologic score of Kellgren) and patients' perceived handicap (VAS) were recorded at the baseline visit. Three functional disability scales (Neck Disability Index [NDI], Neck Pain and Disability Scale [NPDS], Northwick Park Neck Pain Questionnaire [NPQ]) were recorded twice, at baseline visit and 24 hours later. Reliability was assessed by using the intraclass correlation coefficient (ICC) and the Bland and Altman method. Construct (convergent and divergent) validity was investigated by using the Spearman rank correlation coefficient and a factor analysis was performed. RESULTS: Test-retest was excellent for the NPDS and NDI (ICC =.91,.93, respectively) and good for the NPQ (ICC =.84). The Bland and Altman method showed no systematic trend. Expected convergent and divergent validity were observed only for the NPDS; 3 main factors were extracted by factor analysis and explained 78% of the cumulative variance. CONCLUSION: The 3 translated scales are valid, but the NPDS seems to have the best construct validity.

Adult↗

PubMed2002

Clinimetric properties of the AUSCAN Osteoarthritis Hand Index: an evaluation of reliability, validity and responsiveness.

OBJECTIVE: To assess the reliability, validity and responsiveness of the Australian/Canadian (AUSCAN) Osteoarthritis Hand Index in both Likert (LK) and Visual Analogue (VA)-scaled formats. METHODS: Two separate studies were conducted; the first addressing reliability and validity issues and the second addressing index responsiveness. In a group of 50 patients with osteoarthritis (OA) of the hand, test-retest reliability was assessed at a 1-week interval and internal consistency from single administrations of the Index. Construct validity was evaluated against several other outcome measures including the Functional Index for Hand Osteoarthritis (FIHOA), separate patient and physician global assessments, Doyle Index, grip strength, pinch grip, and Health Assessment Questionnaire. A 6-week washout retreatment design was used in a group of 44 OA hand patients to assess index responsiveness and comparative responsiveness against the FIHOA. RESULTS: Reliability and construct validity coefficients confirm the reliability and construct validity of both the AUSCAN LK3.0 and AUSCAN VA3.0 Indices. The washout retreatment study establishes index responsiveness and suggests that the AUSCAN LK3.0 and AUSCAN VA3.0 Indices may be more responsive than the FIHOA. CONCLUSIONS: The patient self-completed AUSCAN LK3.0 and AUSCAN VA3.0 Indices are reliable, valid and responsive and can be recommended as primary outcome measures for future hand OA clinical trials.

Adult↗

PubMed2002

A psychophysiological causal model of pain report validity.

The validity of the pain report is vitally important but difficult to assess because pain is a personal experience. Human laboratory research affords an opportunity to investigate validity because one can measure the consistency and sensitivity of pain ratings produced in response to known stimuli. This article presents 2 levels of evidence characterizing the validity of the pain report measure. The within-subject agreement of pain report with known stimulus variation quantifies the criterion validity, or accuracy, of the measure. Causal modeling defines a second, between-subject, level of construct validity by suggesting a psychophysiological mechanism determining the observed individual variation in accuracy. We analyzed pain rating data obtained in a laboratory study where 100 subjects (56 men and 44 women) experienced varied levels of painful fingertip electrical stimulation, delivered in random order across 144 trials. Unknown to the subjects, there were only 3 stimulus intensities. Accuracy, defined operationally as the proportion of variance in pain report explained by stimulus level, ranged from 0.07 to 0.91 with a median of 0.64. Hypothesized determinants of accuracy comprised current intensity, event-related late near field evoked potentials, skin conductance response, heart rate, and pupil diameter change. We limited the evoked potential measures to the amplitude of the negative peak at 150 msec (N150amp) and combined the latter 3 measures to form a single index of overall sympathetic nervous system arousal (Arousal). Although men chose higher stimulus levels for the experiment and had higher Arousal than did women, their mean pain reports and their Accuracy did not differ from those of female subjects. We constructed a sequence of path analysis models designed to clarify the causal contributions of current intensity, N150amp, and Arousal, and to determine whether these relationships differ in men and women. The final model revealed a direct causal chain. Stimulus current determined the amplitude of N150amp (possibly an indicator of attention). N150amp in turn determined Arousal, and Arousal emerged as the sole determinant of the Accuracy of the pain report. In addition, this latter effect differed across the sexes. Men who experienced higher levels of Arousal gave more accurate pain reports than those who had lower levels, but women who had higher levels of Arousal gave less accurate pain reports than those with lower levels. Thus construct validation emerged, not from direct stimulus-response correlation, but from the elucidation of a causal chain that related stimulus to response.

Journal Article↗

PubMed2003

The validity and reliability of pain measures in adults with cancer.

To be most useful, clinical trials of cancer pain treatments should use pain measures that are both reliable and valid. A great variety of measures are now available that may be used to assess cancer pain. However, there are not yet any clear guidelines for selecting one or more measures over the others. The purpose of this article is to summarize the evidence concerning the validity and reliability of cancer pain measures. One hundred sixty-four articles were identified that provided psychometric data of pain measures among patients with cancer. The results indicate that commonly used single-item ratings of pain intensity are all valid and adequately reliable as measures of pain intensity, although some scales appear to be easier for patients with cancer to understand and to use than others. Multiple-item measures of pain intensity are reliable, but evidence concerning their validity is lacking. There is a paucity of research examining the psychometric properties of measures of cancer pain interference, pain relief, pain site, the temporal aspects of pain, and pain quality. This lack of evidence limits the conclusions that may be drawn concerning the reliability and validity of these other pain measures. Composite measures that combine ratings of pain intensity and pain interference into a single score appear to be both valid and reliable for describing patient populations, although their usefulness in clinical trials may be limited because they can obscure the contributions of intensity and interference to the total score. Proxy measures of cancer pain (pain ratings made by someone other than the patient) may be useful when patients are not able to provide pain ratings, but they should not be used as replacements for patient ratings when patient self-report measures are available. The discussion includes specific recommendations for selecting from among the available pain measures, as well as recommendations for future research into the assessment of cancer pain.

Adolescent↗

PubMed2002

Development and validation of a health-related quality-of-life questionnaire in patients with yellow jacket allergy.

BACKGROUND: The effects of an anaphylactic reaction after a yellow jacket sting on health-related quality of life (HRQL) have not been studied and are thus unknown. OBJECTIVE: Development of a disease-specific instrument to measure HRQL in patients with yellow jacket allergy and validation of this instrument both cross-sectionally and longitudinally. METHODS: Quality-of-life items were generated from patient interviews. Items with the highest impact were considered and correlated cross-sectionally with an independent measure (consisting of 2 questions in which patients were asked what they expected would happen if they were stung again, "Expectation of Outcome" questionnaire). Cross-sectional and longitudinal validation was achieved by administering this instrument to 69 Dutch patients. The questionnaire was also administered to 50 patients with yellow jacket allergy in Baltimore, Maryland, to establish cross-sectional validity of the English version. RESULTS: The survey showed that patients experienced impairment in quality of life especially because of emotional distress. The resultant questionnaire has 14 items. The cross-sectional validation yielded a correlation coefficient of 0.69 for the Dutch version and 0.56 for the English version. The longitudinal validation yielded a correlation coefficient of 0.71. The responsiveness of this instrument was demonstrated by the questionnaire's ability to detect changes over time. It may be completed in approximately 10 minutes by patients without assistance. CONCLUSION: Patients with yellow jacket allergy experience impairment in quality of life especially because of emotional distress. It has been possible to develop and validate a questionnaire (the Vespid Allergy Quality of Life Questionnaire) by which the HRQL of these patients can be measured. The instrument may be administered rapidly and is easy to use.

Adult↗

PubMed2000

Translation and validation of the Oxford-12 item knee score for use in Sweden.

The Oxford-12 Item Knee Score is a recently developed and validated patient-completed outcome measure designed specifically for use with knee arthroplasty in the United Kingdom. We have translated this questionnaire into Swedish and tested the validity and reliability of the translated version in a cross-sectional study by a postal survey to 1,200 randomly selected patients from the Swedish Knee Arthroplasty Register. Swedish versions of the WOMAC, Nottingham Health Profile, SF-36, SF-12, and the Sickness Impact Profile were employed in the validation process. We also tested feasibility and patient-burden parameters. The translated version appeared to be linguistically and culturally equivalent to the original version with good validity and reliability. Indirect measures of responsiveness indicated that it is at least as responsive to relevant knee arthroplasty patient states as the previously validated Swedish version of the WOMAC. Application of the translated questionnaire to this population is feasible with minimal imposed patient-burden. The Swedish translation of the Oxford-12 Item Knee Score is a valid and reliable tool for outcome studies on knee arthroplasty patients.

Aged↗

PubMed2000

Validity and reliability of Swedish WOMAC osteoarthritis index: a self-administered disease-specific questionnaire (WOMAC) versus generic instruments (SF-36 and NHP).

We assessed whether a disease-specific, self-administered questionnaire could replace a generic instrument as an outcome tool after total hip replacement, and tested the validity and reliability of the Swedish WOMAC osteoarthritis index. 58 patients operated on with total hip arthroplasty 2-10 years ago were randomized to the study. All patients were asked to answer one disease-specific questionnaire (WOMAC osteoarthritis index) and two generic instruments (NUP and SF-36) in the same week. The procedure was repeated after 4 weeks. We tested content validity, construct validity, criterion validity, test-retest reliability and internal consistency reliability according to total score, domains and items. We found that both the generic instruments (NHP and SF-36) and the disease-specific test (WOMAC) had a high validity, i.e., measuring what they were supposed to measure (high validity). The questionnaires were also reproducible over time (high reliability). We suggest the Swedish WOMAC to be used after total hip arthroplasty in future studies.

Aged↗

PubMed2003

Reliability and validity of the Dutch version of QUEST 2.0 with users of various types of assistive devices.

PURPOSE: In this paper, the Dutch version of the Quebec User Evaluation of Satisfaction with assistive Technology (D-QUEST) is validated in users of a large variety of assistive devices (n=2002). METHOD: D-QUEST consists of a written questionnaire. The respondent rates his or her satisfaction with respect to 12 aspects on a five-point scale. Users of 10 different types of assistive devices participated. Analyses were performed for each type of assistive device. Reliability is tested by analysing internal consistency. Content validity is tested by analysing applicability of the 12 aspects. The non-applicability option for answering questions is studied. Construct validity is tested by analysing correlations with problem solving and with general satisfaction. RESULTS: Reliability proves to be good for all types of assistive devices. Including the non-applicability option improves the feasibility of the instrument without affecting content validity. Correlations between D-QUEST scores on the one hand and problem solving and general satisfaction questions on the other are as expected, supporting validity. CONCLUSIONS: D-QUEST (and therefore also QUEST) proves itself to be a highly applicable, reliable and valid instrument to assess user-satisfaction of users of all kinds of assistive device provisions.

Adult↗

PubMed2004

The reliability and validity of the Xhosa version of the EQ-5D.

SETTING: This study aimed to examine the reliability and validity of the Xhosa version of the EQ-5D, a Health Related Quality of Life measure which is often used as an outcome measure in clinical trials, within an urban Xhosa speaking population. SUBJECTS AND OUTCOME MEASURES: The test-retest reliability was examined on a community and institutional sample of 88 subjects, who were interviewed twice, one week apart. Forty-nine out- and in-patients participated in the second part of the study, in which the concurrent validity of the EQ-5D against existing Xhosa measures of similar domains as the EQ-5D was examined. RESULTS: The Intraclass correlation (ICC) co-efficients between the first and second interviews ranged from 0.39 to 0.75 in different domains. The ICC for the Visual Analogue Scale of health state was 0.63. In the validity study, those who reported no problems with mobility demonstrated a significantly higher gait velocity. There was a significant difference between the rank ordering of scores on the four domains of self-care, usual activities pain/discomfort and anxiety/depression and the scores obtained on the 'gold standard' tests. RESULTS AND CONCLUSIONS: It is concluded that, although some domains might need to be examined further, the Xhosa EQ-5D is a valid and reliable instrument with which to determine HRQoL in an urban Xhosa speaking population. In order to ensure validity of results in multicultural research and drug trials, it is essential that more outcome measures are subjected to rigorous translation and testing of validity and reliability.

Activities of Daily Living↗