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PubMed2005

Prevalence of scalp scaling in prepubertal children.

OBJECTIVE: To determine the prevalence and most common etiologies of scalp scaling in infants and prepubertal children and the specificity of head and neck lymphadenopathy for the diagnosis of tinea capitis associated with scalp scaling. DESIGN/METHODS: A cross-sectional study of 300 children, 200 from an urban general pediatric practice and 100 from 2 urban pediatric dermatology practices, was conducted. Half of the subjects were <2 years old, and half were 2 to 10 years old. Demographic data, medical history, and clinical data noting the presence of scalp scaling and other scalp signs and symptoms, as well as adenopathy of the head and neck, were collected. RESULTS: Scalp scaling was seen in 66 (22%) children. There was an insignificantly higher prevalence of scalp scaling in those <2 years old compared with the 2- to 10-year-old group. In those <2 years old with scalp scaling, the most common diagnoses were seborrheic dermatitis (thick, adherent, greasy scale predominantly in the frontal and/or vertex areas of the scalp) and atopic dermatitis/eczema. Among those 2 to 10 years old with scalp scaling, the most common diagnoses were nonspecific (fine, white) scaling, seborrheic dermatitis, and atopic dermatitis/eczema. Nine (3%) patients were culture-positive for a dermatophyte, all of whom were black, and grew Trichophyton tonsurans. More than half (52.7%) of all patients had head and neck adenopathy. The presence of posterior nodes was significantly associated with atopic dermatitis/eczema and marginally associated with a positive dermatophyte culture. The presence of scalp scaling plus posterior adenopathy was significantly associated with seborrheic dermatitis and a positive dermatophyte culture in the entire study population and with atopic dermatitis in the pediatric dermatology clinics. CONCLUSIONS: Scalp scaling was common in children 0 to 10 years old. Infantile-type seborrheic dermatitis was noted in both age groups: it was 3 times as likely in children <2 years old (18%) than in those 2 to 10 years old (6%). Contrary to traditional teaching, seborrheic dermatitis can be found in preadolescent children. Atopic dermatitis/eczema was associated with scalp scaling in both age groups. Head and neck adenopathy was very common and nonspecific for any 1 diagnosis. Posterior adenopathy with concurrent scalp scaling was significantly associated with seborrheic dermatitis, a positive dermatophyte culture, and atopic dermatitis. In this nonselected pediatric population, scalp scaling with adenopathy was not associated exclusively with tinea capitis.

Age Distribution↗

PubMed2000

[Jichi Medical School Social Support Scale (JMS-SSS) revision and tests for validity and reliability].

OBJECTIVE: To develop a perceived social support scale for the Japanese. METHODS: Participants consisted of a total of 2,150 residents who responded to a perceived social support scale questionnaire in four communities involved in the Jichi Medical School Cohort Study at the study baseline in 1992-1994 (Analysis I) and 380 residents of Akaike town who responded to a questionnaire survey with the revised scale in 1999 (Analysis II). The first analysis was performed to confirm cross validity of the perceived social support scale measuring the availability of functional support from the spouse, family, and friends. The factor structures estimated for each district were compared with each other. The second analysis was set to revise the scale, modified in terms of a 4-point scoring format. The correlation between each item and a social desirability scale score, Cronbach alpha, and correlation coefficients between the revised scale scores and the original scale scores were calculated. RESULTS: Cross validity was confirmed based on the similarity of the factor structures of the responses obtained from the four different communities. Four selected indices supported the constancy of the factor structures across the communities. For the revised scale, two items were removed from the original scale-items measuring spousal support because of their statistically significant correlations with the social desirability scale score. The first principal component accounted for 57.0% of variance for spousal support, 68.2% for family support, and 67.0% for friends support and uni-dimensionality of the scales was confirmed. Alpha coefficients of the scales were .89, .95, and .94, respectively. Social support levels were stable over a mean period of 6.2 years. CONCLUSIONS: On an empirical basis, we have been able to develop a perceived social support scale. Homogeneous data from three different sources were obtained which were free from social desirability response bias and thus applicable for Japanese adults.

Adult↗

PubMed1992

[Interobserver variation in the application of 2 disability scales in heart patients].

OBJECTIVE: To examine the use of the Rankin scale for the assessment of disability in patients with ischaemic heart disease. SETTING: University Hospital Utrecht. DESIGN: Prospective interobserver study. PATIENTS AND METHODS: Fifty-two outpatients with heart disease (previous myocardial infarction, angina or both) were separately interviewed by four physicians (residents or specialists), viz., two cardiologists and two neurologists. The degree of disability was recorded by each observer on two different scales: the modified Rankin scale, a six-point scale developed from a neurological background, and the four-point scale developed by the New York Heart Association (NYHA). The agreement rates for the observers (23 in all) were corrected for chance (kappa-statistics; maximum 1.0). RESULTS: Total agreement on both scales was found for six of the participating 51 patients and for 10 and 11 patients when the Rankin scale and the NYHA scale were considered separately. Kappa values were 0.21 for the Rankin scale and 0.24 for the NYHA scale. The weighted kappa values were 0.56 and 0.47, respectively. The agreement among neurologists and cardiologists was comparable. CONCLUSION: The agreement rates of cardiologists and neurologists in the use of the Rankin scale and the NYHA scale in outpatients with heart disease are at best satisfactory. The good results of an earlier study with the Rankin scale in stroke patients were not achieved. This study indicates that the Rankin scale may be useful for the assessment of disability from heart disease particularly in patients with neurological disease, but there is room for further improvement.

Angina Pectoris↗

PubMed2004

The PedsQL Multidimensional Fatigue Scale in pediatric rheumatology: reliability and validity.

OBJECTIVE: . The PedsQL (Pediatric Quality of Life Inventory) is a modular instrument designed to measure health related quality of life (HRQOL) in children and adolescents ages 2-18 years. The recently developed 18-item PedsQL Multidimensional Fatigue Scale was designed to measure fatigue in pediatric patients and comprises the General Fatigue Scale (6 items), Sleep/Rest Fatigue Scale (6 items), and Cognitive Fatigue Scale (6 items). The PedsQL 4.0 Generic Core Scales were developed as the generic core measure to be integrated with the PedsQL Disease-Specific Modules. The PedsQL 3.0 Rheumatology Module was designed to measure pediatric rheumatology-specific HRQOL. Methods. The PedsQL Multidimensional Fatigue Scale, Generic Core Scales, and Rheumatology Module were administered to 163 children and 154 parents (183 families accrued overall) recruited from a pediatric rheumatology clinic. Results. Internal consistency reliability for the PedsQL Multidimensional Fatigue Scale Total Score (a = 0.95 child, 0.95 parent report), General Fatigue Scale (a = 0.93 child, 0.92 parent), Sleep/Rest Fatigue Scale (a = 0.88 child, 0.90 parent), and Cognitive Fatigue Scale (a = 0.93 child, 0.96 parent) were excellent for group and individual comparisons. The validity of the PedsQL Multidimensional Fatigue Scale was confirmed through hypothesized intercorrelations with dimensions of generic and rheumatology-specific HRQOL. The PedsQL Multidimensional Fatigue Scale distinguished between healthy children and children with rheumatic diseases as a group, and was associated with greater disease severity. Children with fibromyalgia manifested greater fatigue than children with other rheumatic diseases. CONCLUSION: The results confirm the initial reliability and validity of the PedsQL Multidimensional Fatigue Scale in pediatric rheumatology.

Activities of Daily Living↗

PubMed2006

Psychopathological rating scales for diagnostic use in adults with attention-deficit/hyperactivity disorder (ADHD).

The diagnosis of attention-deficit hyperactivity disorder (ADHD) in adults is a complex procedure which should include retrospective assessment of childhood ADHD symptoms either by patient recall or third party information, diagnostic criteria according to DSM-IV, current adult ADHD psychopathology including symptom severity and pervasiveness, functional impairment, quality of life and comorbidity. In order to obtain a systematic database for the diagnosis and evaluation of the course ADHD rating scales can be very useful. This article reviews rating instruments that have found general acceptance. The Wender-Utah Rating Scale (WURS) and the Childhood Symptoms Scale by Barkley and Murphy try to make a retrospective assessment of childhood ADHD symptoms. The Connors Adult ADHD Rating Scales (CAARS), the Current Symptoms Scales by Barkley and Murphy (CSS), the Adult Self Report Scale (ASRS) by Adler et al. and Kessler et al. or the Attention Deficit Hyperactivity Disorder--Self Report Scale (ADHD-SR by Rösler et al.) are self report rating scales focusing mainly on the DSM-IV criteria. The CAARS and the CSS have other report forms too. The Brown ADD Rating Scale (Brown ADD-RS) and the Attention Deficit Hyperactivity Disorder--Other Report Scale (ADHD-OR by Rösler et al.) are instruments for use by clinicians or significant others. Both self rating scales and observer report scales quantify the ADHD symptoms by use of a Likert scale mostly ranging from 0 to 3. This makes the instruments useful to follow the course of the disease quantitatively. Comprehensive diagnostic interviews not only evaluate diagnostic criteria, but also assess different psychopathological syndrome scores, functional disability measures, indices of pervasiveness and information about comorbid disorders. The most comprehensive procedures are the Brown ADD Diagnostic Form and the Adult Interview (AI) by Barkley and Murphy. An instrument of particular interest is the Wender Reimherr Interview (WRI) which follows a diagnostic algorithm different from DSM-IV. The interview contains only items delineated from adult psychopathology and not derived from symptoms originally designed for use in children. Other instruments focus on functional impairment, quality of life, comorbid disorders, gender effects and specific psychopathological models.

Adult↗

PubMed2006

Interrater reliability of 3 simplified neurologic scales applied to adults presenting to the emergency department with altered levels of consciousness.

STUDY OBJECTIVE: The Simplified Motor Score was recently found to exhibit equal test performance to the Glasgow Coma Scale (GCS) when predicting 4 clinically important trauma outcomes. The present study tests the interrater reliability of the Simplified Motor Scale, the GCS and its components, and 2 other simplified neurologic scales when applied to patients presenting to the emergency department with altered levels of consciousness from any cause. METHODS: In this prospective observational study, emergency physicians independently assigned the GCS, Simplified Motor Scale, and 2 4-point scales--AVPU (Alert, responds to Verbal stimuli, responds to Painful stimuli, Unresponsive) and ACDU (Alert, Confused, Drowsy, Unresponsive)--to qualifying adult subjects. Two physicians filled out prospective data forms within 5 minutes of each other while remaining blinded to each other's assessments. Data were pooled and analyzed for interrater reliability of all scales using simple agreement, unweighted kappa, Spearman's rho, and Kendall's tau-b. RESULTS: One hundred twenty-six subjects were enrolled, with 6 later excluded. Percentage agreements were 83% for the Simplified Motor Scale, 58% for the ACDU scale, 57% for the AVPU scale, and 42% for the Total GCS. The kappa values were 0.70 for the Simplified Motor Scale, 0.43 for ACDU, 0.41 for AVPU, and 0.32 for the Total GCS. The Simplified Motor Scale also had the highest Spearman's rho (.85) and second highest Kendall's tau-b (0.81). CONCLUSION: The Simplified Motor Scale has the best interrater reliability for the assessment of altered level of consciousness of traumatic and nontraumatic cause among the scales tested.

Adolescent↗

PubMed2003

Comparison of the Claassen and Fisher CT classification scale to predict ischemia after aneurysmatic SAH?

BACKGROUND: Delayed cerebral ischemia (DCI) is an important cause of morbidity and mortality after aneurysmatic subarachnoid hemorrhage (SAH). The severity of SAH, reflected by the amount of blood in the initial CCT, is a well-established predictor of DCI and infarction. The Fisher CT scale is widely used to predict DCI, but recent studies criticised the scale due to the fact that this scale does not differentiate between intracerebral blood clots and intraventricular hemorrhage. Thus Claasen et al. recently proposed a new grading scale to predict DCI. The aim of this study was to compare clinical scales with the CT findings and to verify this newly developed scale in a different population in order to predict DCI.[nl] PATIENTS AND METHODS: We selected from our databank of patients suffering from aneurysmatic SAH 292 cases who had been treated between 1995 and 2000. The data acquisition included clinical data, radiological diagnostic data, the postoperative surgical course as well as a follow-up according to the Glasgow outcome scale.[nl] RESULTS: 83 out of 292 patients (28.5 %) developed ischemic lesions on the CT scans reflecting DCI. The severity of SAH according to the Hunt and Hess grading, the Fisher CT scale and the Claassen CT scale correlated statistically significant to DCI. All three scales showed an increasing odds ratio, but the most consistent increase was demonstrated by the Fisher scale.[nl] CONCLUSIONS: The newly proposed Claassen CT scale provides no additional information and seems not to be superior compared to the well-established Fisher scale to predict DCI.

Adult↗

PubMed1994

A new attempt to solve the scale-up problem for granulation using response surface methodology.

Scale-up from lab to production is always problematic for the development of pharmaceuticals. In granulation, an optimal formulation of binder solution determined in a lab scale is often different than that in a production scale. A new mathematical procedure to solve this scale-up problem is assessed. Granules were prepared in the two manufacturing scales (2- and 5-kg scale) by using a high-speed mixer granulator. In the manufacturing process, the binder solution plays an essential role in the formation of granules with desired physical properties, in close conformity with the manufacturing scale. A computerized optimizing technique based on a response surface methodology was developed to study the scale-up problem in the manufacturing of granules. For this purpose, a new mathematical function was introduced for the first time, which is namely an integrated optimization function. A universal optimal formulation unaffected by manufacturing scale could be obtained by minimizing the integrated optimization function. Predicted values such as yield, mean granule size, and uniformity of granule size agreed well with experimental ones on both scales. Furthermore, the optimized characteristics measured at the production scale coincided well with those obtained at laboratory scale, suggesting that this approach could be very useful in minimizing scale-up problems.

Drug Compounding↗

PubMed2000

Fecal Incontinence Quality of Life Scale: quality of life instrument for patients with fecal incontinence.

PURPOSE: This goal of this research was to develop and evaluate the psychometrics of a health-related quality of life scale developed to address issues related specifically to fecal incontinence, the Fecal Incontinence Quality of Life Scale. METHODS: The Fecal Incontinence Quality of Life Scale is composed of a total of 29 items; these items form four scales: Lifestyle (10 items), Coping/Behavior (9 items), Depression/Self-Perception (7 items), and Embarrassment (3 items). RESULTS: Psychometric evaluation of these scales demonstrates that they are both reliable and valid. Each of the scales demonstrate stability over time (test/retest reliability) and have acceptable internal reliability (Cronbach alpha >0.70). Validity was assessed using discriminate and convergent techniques. Each of the four scales of the Fecal Incontinence Quality of Life Scale was capable of discriminating between patients with fecal incontinence and patients with other gastrointestinal problems. To evaluate convergent validity, the correlation of the scales in the Fecal Incontinence Quality of Life Scale with selected subscales in the SF-36 was analyzed. The scales in the Fecal Incontinence Quality of Life Scale demonstrated significant correlations with the subscales in the SF-36. CONCLUSIONS: The psychometric evaluation of the Fecal Incontinence Quality of Life Scale showed that this fecal incontinence-specific quality of life measure produces both reliable and valid measurement.

Adaptation, Psychological↗

PubMed2005

Item response theory was used to shorten EORTC QLQ-C30 scales for use in palliative care.

BACKGROUND AND OBJECTIVE: The goal was to develop a shortened version of the EORTC QLQ-C30 for use in palliative care. We wanted to keep as few items as possible in each scale while still being able to compare results with studies using the original scales. We examined the possibilities of shortening the physical functioning, cognitive functioning, fatigue, and nausea and vomiting scales. STUDY DESIGN AND SETTING: The shortening was based on 2,366 (physical functioning) and 10,815 (three other scales) observations, respectively. We used item response theory to construct scoring algorithms for predicting scores on the original scales. RESULTS: Evaluations showed that a three-item physical scale, a two-item fatigue scale, and a one-item nausea or vomiting scale predicted the scores on the original scales with excellent agreement and had measurement abilities similar to the original scales with no loss or only a little loss in power to detect group differences. The results of the cognitive functioning scale indicated problems when predicting scores from a shortened version. CONCLUSION: Given the favorable results for the physical functioning, fatigue, and nausea or vomiting scales we expect that the shortened versions of these scales will be included in the abbreviated version of the EORTC QLQ-C30 for palliative care.

Cognition↗

PubMed2004

Optimizing motion scaling and magnification in robotic surgery.

BACKGROUND: Motion scaling is one possible advantage of robotic surgery. The aim of this study was to determine which scaling optimized precision and speed at different magnifications. METHODS: Three levels of motion scaling were tested at each of 3 camera magnifications. Surgically nave subjects (n = 12) were randomized as to the order of magnification level testing (3.5x, 6.5x, 9.5x) and motion scalings (10:1, 5:1, 1:1). The subjects were asked to pierce a needle through 6 printed microtargets; then accuracy and drill completion time were scored. RESULTS: At 3.5x magnification, no differences between groups were observed. At 6.5x magnification, the 5:1 scaling was superior to the 1:1 scaling in total errors, and the 10:1 scaling was significantly slower. At 9.5x magnification, 10:1 scaling resulted in fewer errors than 1:1 with no difference in time. Overall, the 10:1 and 5:1 scalings resulted in fewer errors. The 5:1 scaling resulted in less drill completion time than the 10:1 scaling. The 9.5x magnification resulted in the fewest errors. CONCLUSIONS: Motion scaling reduces the number of errors at higher magnifications, but can increase the task completion time. It is necessary to optimize both the motion scaling and magnification components of robotic systems to balance precision and speed.

Adolescent↗

PubMedDate not supplied

[Comparison of two assessment tools of antidepressant side-effects: UKU scale versus spontaneous notification].

BACKGROUND AND AIM OF THE STUDY: Overall, the efficacy of the newer antidepressants: serotonin selective reuptake inhibitors (SSRI), selective serotonin/norepinephrine reuptake inhibitor (SNRI), noradrenergic and specific serotonergic antidepressant (NaSSA) and tianeptine is similar to that of the tricyclics, and so their acceptability/safety becomes a selection criterion for the clinician. However, side-effect assessment comes up against several difficulties: distinguishing between somatic symptoms caused by the depression and those caused by the treatment -- which assessment tool to use (spontaneous notification, standardized scales that are not specific for the side effects caused by psychotropic drugs, standardised scales specific for the side effects caused by psychotropic drugs, meta-analysis, etc.) -- which data sources to consult (anecdotal reports, reviews, prospective studies), and which data set to use, etc. As a result, the question of the exhaustiveness and reliability of the data consulted by the clinician can arise. We therefore conducted a comparative study in patients treated with these newer antidepressants, of 2 antidepressants side-effect assessment tools: spontaneous notification (SN) versus the UKU scale, a standardised scale specific for the side effects of psychotropic drugs. METHODOLOGY: The depressed outpatients were selected from a psychiatric unit in a French psychiatric hospital and from a non-hospital consulting room. The main inclusion criteria were: male or female subjects, suffering from major depression without melancholia or psychotic features or suffering from mood disorders (according to DSM IV criteria), who had been treated for at least 4 weeks with one of the newer antidepressants. The main exclusion criteria were: any other psychiatric disorder, a serious physical disorder, treatment with neuroleptics, mood-changing drugs or other antidepressants, and patients who were not able to understand the questionnaire. The investigation was carried out by a clinical pharmacist. RESULTS: Fifty patients were included in the study. There were 18 men and 32 women. The mean age was 53.5 15.9 years [22 - 77], the mean period of treatment was 24 30.5 months [1 - 127] and 52% of the patients received concomitant medication with anxiolitic or hypnotic drug(s). The percentage of patients who reported at least one side effect was significantly higher for the UKU scale than for SN (84% vs 58%, p<0.01). The ratio between SN and UKU scale scores was 2/3. A similar pattern was found for the total number of side effects (n=177 vs n=47, p<0.001). The ratio between the total number of side effects for the SN and UKU scale was 1/4. The side effects were divided into five subgroups: psychiatric, neurovegetative, sexual, neurological and others. In all these subgroups, the number of side effects reported was significantly higher when the UKU scale was used than when SN was used. The values were as follows: psychiatric (n=44 vs n=15, p<0.001), neurovegetative (n=59 vs n=15, p<0.001), sexual (n=36 vs n=10, p<0.001), neurological (n=11 vs n=2, p<0.001) and other side effects (n=27 vs n=5, p<0.001). Nineteen side effects were only reported when SN was used (for example: dry eyes, incompatibility with alcohol, euphoria...). Twenty-four side effects were only reported when the UKU scale was used (for example: increased libido, loss of bodyweight...). The side effects had no impact on daily life in most of 80% of the patients; there was no significant difference between the patient's assessment of the discomfort caused by side effects and the clinician's assessment. In 90% of cases, the side effects did not lead to any change in the treatment. DISCUSSION: The findings of this study show that the collection of data regarding side effects depends on the assessment tool used: the number of side effects reported was significantly higher when the UKU scale was used than when SN was used. However, this finding must viewed with caution, because it has been showed that checklists can induce symptoms in suggestible patients. Neurovegetative troubles are the most commonly reported side effects, and neurological troubles the least often reported. This matches the tolerability profile of these antidepressants. The disorders that were least frequently spontaneously reported were the neurological, sexual and "other" side effects. These emerged only when the clinician asked the patient about them. The 19 side effects that were only reported when SN was used were side effects that were not included in the UKU scale or that had not been present during the three days before we started the investigation. The 34 side effects that were only reported when the UKU scale was used were either side effects with no apparent link with the treatment (for example: micturition troubles) or embarrassing effects (such as increased libido). CONCLUSION: Our findings show that the collection of data on side effects depends on the assessment tool used. These findings need to be confirmed by large-scale comparative studies, and the standardization of the assessment of side effects is a question that needs to be raised.

Adult↗

PubMed2003

Usefulness of a linear analog scale questionnaire to measure health-related quality of life in elderly patients with chronic obstructive pulmonary disease.

OBJECTIVES: To examine the validity, discriminatory ability, and responsiveness of health-related quality-of-life (HRQoL) questionnaires using a linear analog scale (Quality of Life (QOL) scale) for chronic obstructive pulmonary disease (COPD). DESIGN: Cross-sectional and longitudinal. SETTING: Outpatient. PARTICIPANTS: One hundred two elderly subjects with mild to severe COPD. MEASUREMENTS: Scores on the QOL scale, the St. George's Respiratory Questionnaire (SGRQ), and the 36-item Short-Form Health Survey questionnaire (SF-36) and various clinical parameters were recorded. The correlations between these QOL questionnaires and various clinical parameters were then examined. The responses of 31 elderly COPD patients to the QOL scale and the SGRQ before and 3 months after the completion of a comprehensive pulmonary rehabilitation program were compared longitudinally. RESULTS: On cross-sectional study, the QOL scale showed a significant correlation with the total score and three components of the SGRQ. The QOL scale correlated significantly with all components of the SF-36, but the total SGRQ score correlated with only six components of the SF-36, excluding vitality and the mental health index. Both the QOL scale and the total score of the SGRQ correlated significantly with the oxygen cost diagram (OCD), Morale scale, 6-minute walking distance (6MWD), forced expiratory volume in 1 second, and instrumental activities of daily living (IADL) score. When subjects were divided into three groups according to disease severity (mild, moderate, severe) using American Thoracic Society guidelines, the total SGRQ score discriminated between the three groups. The QOL scale could not discriminate between mild and moderate or moderate and severe. On longitudinal study, 3 months after finishing the comprehensive pulmonary rehabilitation program, the QOL scale, the SGRQ, 6MWD, and OCD all showed significant improvement. The difference in the QOL scale after the comprehensive pulmonary rehabilitation program showed a significant correlation with changes in the SGRQ total score and the OCD but not with the 6MWD. CONCLUSION: The QOL scale is similar to more-complex questionnaires such as the SGRQ in terms of validity and responsiveness for evaluating disease-specific HRQoL in elderly COPD patients. In clinical settings, the QOL scale, as a simple questionnaire, may be useful for disease-specific HRQoL assessments in elderly COPD patients.

Aged↗

PubMed2004

Oropharyngeal dysphagia in amyotrophic lateral sclerosis: neurological and dysphagia specific rating scales.

BACKGROUND: Oropharyngeal dysphagia is highly prevalent in amyotrophic lateral sclerosis (ALS). Patients with dysphagia and weight loss are frequently offered gastrostomy. Although the neurological basis of dysphagia in ALS is complex, there are currently no specifically validated scales for dysphagia in ALS, and the reliability of existing generic scales has not been assessed. METHODS: We undertook a prospective study of 25 patients who fulfilled the criteria for definite or probable ALS. We examined the reliability of the Dysphagia Outcome Severity Scale (DOSS) and the Aspiration-Penetration Rating Scale (APRS) and the correlation between these scales and the Norris ALS Scale and ALS Functional Rating Scale-R (ALS FRS-R). RESULTS: Using the Pearson Product-Moment Correlation, an expected high linear association between the two disease specific neurological scales was demonstrated. Both dysphagia scales were found to be reliable. Interrelationship evaluation showed a low association between Norris and ALS FRS-R scores and DOSS and APRS. However, examination found specific subsections to be significantly correlated, particularly the Norris bulbar sections (NBS) and the DOSS. CONCLUSIONS: Generic dysphagia scales are reliable indicators of dysphagia in ALS. The bulbar components of the ALS specific scales is sensitive to dysphagia. The bulbar section of the Norris scale can be utilised as an independent and reliable indicator of the severity of dysphagia in ALS. In the absence of availability of detailed swallowing assessment using videofluoroscopy, these scales, i.e., the Norris and to a lesser degree the ALS FRS-R bulbar sections, are adequate to diagnose and follow clinically significant dysphagia in ALS, and can be used as an indicator for dysphagia treatment initiation.

Adult↗

PubMed2006

Validation of a handheld display device for an expandable labeled magnitude scale (LMS).

Palmtop computers provide a possible avenue for the convenient collection of subjective ratings from individuals outside of a fixed laboratory setting. One disadvantage of these computers is the small size of their display screens, which may reduce the resolution of responses available as compared with standard display screens. One plausible solution to this problem is to use a scale that expands contingent on an initial response made by the subject, so that the final response is made from a scale with finer resolution. To validate this approach, we compared taste intensity judgments of six sucrose solutions (0.03, 0.06, 0.12, 0.24, 0.48, and 0.96 M), using a labeled magnitude scale either presented in expandable form on a palmtop computer (Palm scale) or in conventional (nonexpandable) form on a standard 17'' PC monitor (PC scale). Twenty-four subjects rated all six sucrose solutions thrice, using both scale types, the different scales being used on different days of testing. The scales led to very similar taste intensity ratings at all but the lowest concentration, which was rated less intense on the Palm scale. The Palm scale was used with slightly less precision than the PC scale for the weakest solution concentrations. In summary, the responses of the two scales were similar enough to validate the use of the expandable scale on the palmtop computer outside the laboratory setting.

Adult↗

PubMed1993

Scales for assessing perceptions of health hazard susceptibility.

Two studies examined the effectiveness of a variety of commonly used likelihood scales (dichotomous scale, five-point verbally-labeled scale, odds scale, percentage scale, etc.) for assessing perceptions of personal susceptibility to health and safety risks. Two direct evaluation criteria (subjects' ratings of how easy it was to use a scale and of how well the scale reflected their feelings) and three additional measures of validity and reliability (the agreement of scale-derived ranks with a direct ranking, the magnitude of correlations between risk perceptions and appropriate risk factors, and the stability of scores over time) were used to compare the scales. Increasing the number of scale categories did not necessarily improve performance. In fact, a scale with seven verbally-labeled categories performed as well as or better than other scales on all evaluation criteria. These data may help health education researchers in selecting scales to measure perceptions of susceptibility to harm.

Adult↗

PubMed2004

Development and psychometric evaluation of the pediatric anesthesia emergence delirium scale.

BACKGROUND: Emergence delirium has been investigated in several clinical trials. However, no reliable and valid rating scale exists to measure this phenomenon in children. Therefore, the authors developed and evaluated the Pediatric Anesthesia Emergence Delirium (PAED) scale to measure emergence delirium in children. METHODS: A list of scale items that were statements describing the emergence behavior of children was compiled, and the items were evaluated for content validity and statistical significance. Items that satisfied these evaluations comprised the PAED scale. Each item was scored from 1 to 4 (with reverse scoring where applicable), and the scores were summed to obtain a total scale score. The degree of emergence delirium varied directly with the total score. Fifty children were enrolled to determine the reliability and validity of the PAED scale. Scale validity was evaluated using five hypotheses: The PAED scale scores correlated negatively with age and time to awakening and positively with clinical judgment scores and Post Hospital Behavior Questionnaire scores, and were greater after sevoflurane than after halothane. The sensitivity of the scale was also determined. RESULTS: Five of 27 items that satisfied the content validity and statistical analysis became the PAED scale: (1) The child makes eye contact with the caregiver, (2) the child's actions are purposeful, (3) the child is aware of his/her surroundings, (4) the child is restless, and (5) the child is inconsolable. The internal consistency of the PAED scale was 0.89, and the reliability was 0.84 (95% confidence interval, 0.76-0.90). Three hypotheses supported the validity of the scale: The scores correlated negatively with age (r = -0.31, P <0.04) and time to awakening (r = -0.5, P <0.001) and were greater after sevoflurane anesthesia than halothane (P <0.008). The sensitivity was 0.64. CONCLUSIONS: These results support the reliability and validity of the PAED scale.

Anesthesia Recovery Period↗

PubMed2004

Coherence and discontinuity in the scaling of species' distribution patterns.

The spatial distribution of a species can be characterized at many different spatial scales, from fine-scale measures of local population density to coarse-scale geographical-range structure. Previous studies have shown a degree of correlation in species' distribution patterns across narrow ranges of scales, making it possible to predict fine-scale properties from coarser-scale distributions. To test the limits of such extrapolation, we have compiled distributional information on 16 species of British plants, at scales ranging across six orders of magnitude in linear resolution (1 m to 100 km). As expected, the correlation between patterns at different spatial scales tends to degrade as the scales become more widely separated. There is, however, an abrupt breakdown in cross-scale correlations across intermediate (ca. 0.5 km) scales, suggesting that local and regional patterns are influenced by essentially non-overlapping sets of processes. The scaling discontinuity may also reflect characteristic scales of human land use in Britain, suggesting a novel method for analysing the 'footprint' of humanity on a landscape.

Demography↗