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PubMed2003

[Gingival risks of fixed prostheses at the Institute of Odontology and Stomatology of Dakar (I.O.S.)].

The realisation of a bridgework involves a direct action on the gingival marginal edge. It is submitted to peremptoriness of execution that one of the objectives is to respect the periodontium with a great rigour. In the opposite case it can become a greater aggression agent, source of prosthetic failures we carried out this report in order to evaluate in the framework of a pedagogic operational programme of crown and bridge prosthesis, the superficial periodontal risks linked to the preparation of the abutment teeth and to the prosthetic chain. We examined a randomised sample of 50 patients chosen from the Dakar LOS prosthetic consultation. On the periodontium initially sound we noted inflammatory lesions of the superficial periodontium from the beginning to the end of the treatment we used the Russel periodontal index. The whole individual scores summarised on a collective chart have been submitted to the statistical analysis of the independence by using the chi-square test. The population consulting in bridge work at the Dakar LOS is relatively young, 33 years in a average with a sex ratio of 1.17 and it shows a moderate (60% of the cases) and severe periodontal seizure (40% of the cases) dealing significantly with the type of prosthesis and the axial and occlusal morphology of the prosthesis pieces. This study shows that prosthesis rehabilitation in the frame work of a clinical training at the Dakar I.O.S. includes relatively high risks of periodontium aggression that we would minimise by setting more correctly the indications of the bridge work and by bringing more rigour to the record and the postpone of the patients occlusion in the laboratory conception of the prosthesis pieces.

Adult↗
PubMed1998

Risk factors and their relationship to prognosis in myelodysplastic syndromes.

Recent efforts have been directed at improving the methodology for predicting clinical outcomes in patients with myelodysplastic syndromes (MDS). This review focuses on the development of a consensual, prognostic, risk-based analysis system generated by the International MDS Risk Analysis Workshop. In the workshop, cytogenetic, morphological, and clinical data were combined and collated from a relatively large group of patients with primary MDS. Critical prognostic variables were evaluated using the data set. Based on these findings, the International Prognostic Scoring System (IPSS) was developed, compared with other systems, and shown to provide more accurate prognoses regarding survival and evolution to acute myeloid leukemia in MDS patients. The improvement was due to several features of the workshop model: more refined cytogenetic categorization, inclusion of cytopenias, improved subdivision of marrow blast percentages, four subgroups defining outcome, and separate stratification for age. The IPSS should result in better-defined clinical outcomes in MDS and provide a framework for future studies determining the possible role of molecular determinants (e.g. oncogenes, tumor suppressor genes, cytokine expression and responsiveness) for evaluating prognoses. The IPSS will likely prove useful in the design and analysis of therapeutic trials in MDS as well as in patient management.

Humans↗
PubMed2003

Music reduces sensation and distress of labor pain.

Labor pain is often severe, and analgesic medication may not be indicated. In this randomized controlled trial we examined the effects of music on sensation and distress of pain in Thai primiparous women during the active phase of labor. The gate control theory of pain was the theoretical framework for this study. Randomization with a computerized minimization program was used to assign women to a music group (n = 55) or a control group (n = 55). Women in the intervention group listened to soft music without lyrics for 3 hours starting early in the active phase of labor. Dual visual analog scales were used to measure sensation and distress of pain before starting the study and at three hourly posttests. While controlling for pretest scores, one-way repeated measures analysis of covariance indicated that those in the music group had significantly less sensation and distress of pain than did the control group (F (1, 107) = 18.69, p <.001, effect size =.15, and F (1, 107) = 14.87, p <.001, effect size =.12), respectively. Sensation and distress significantly increased across the 3 hours in both groups (p <.001), except for distress in the music group during the first hour. Distress was significantly lower than sensation in both groups (p <.05). In this controlled study, music--a mild to moderate strength intervention--consistently provided significant relief of severe pain across 3 hours of labor and delayed the increase of affective pain for 1 hour. Nurses can provide soft music to laboring women for greater pain relief during the active phase when contractions are strong and women suffer.

Adult↗
PubMed2004

Automatic kernel regression modelling using combined leave-one-out test score and regularised orthogonal least squares.

This paper introduces an automatic robust nonlinear identification algorithm using the leave-one-out test score also known as the PRESS (Predicted REsidual Sums of Squares) statistic and regularised orthogonal least squares. The proposed algorithm aims to achieve maximised model robustness via two effective and complementary approaches, parameter regularisation via ridge regression and model optimal generalisation structure selection. The major contributions are to derive the PRESS error in a regularised orthogonal weight model, develop an efficient recursive computation formula for PRESS errors in the regularised orthogonal least squares forward regression framework and hence construct a model with a good generalisation property. Based on the properties of the PRESS statistic the proposed algorithm can achieve a fully automated model construction procedure without resort to any other validation data set for model evaluation.

Algorithms↗
PubMed2024

Assessment of Gene Set Enrichment Analysis using curated RNA-seq-based benchmarks.

Pathway enrichment analysis is a ubiquitous computational biology method to interpret a list of genes (typically derived from the association of large-scale omics data with phenotypes of interest) in terms of higher-level, predefined gene sets that share biological function, chromosomal location, or other common features. Among many tools developed so far, Gene Set Enrichment Analysis (GSEA) stands out as one of the pioneering and most widely used methods. Although originally developed for microarray data, GSEA is nowadays extensively utilized for RNA-seq data analysis. Here, we quantitatively assessed the performance of a variety of GSEA modalities and provide guidance in the practical use of GSEA in RNA-seq experiments. We leveraged harmonized RNA-seq datasets available from The Cancer Genome Atlas (TCGA) in combination with large, curated pathway collections from the Molecular Signatures Database to obtain cancer-type-specific target pathway lists across multiple cancer types. We carried out a detailed analysis of GSEA performance using both gene-set and phenotype permutations combined with four different choices for the Kolmogorov-Smirnov enrichment statistic. Based on our benchmarks, we conclude that the classic/unweighted gene-set permutation approach offered comparable or better sensitivity-vs-specificity tradeoffs across cancer types compared with other, more complex and computationally intensive permutation methods. Finally, we analyzed other large cohorts for thyroid cancer and hepatocellular carcinoma. We utilized a new consensus metric, the Enrichment Evidence Score (EES), which showed a remarkable agreement between pathways identified in TCGA and those from other sources, despite differences in cancer etiology. This finding suggests an EES-based strategy to identify a core set of pathways that may be complemented by an expanded set of pathways for downstream exploratory analysis. This work fills the existing gap in current guidelines and benchmarks for the use of GSEA with RNA-seq data and provides a framework to enable detailed benchmarking of other RNA-seq-based pathway analysis tools.

Humans↗
PubMedDate not supplied

Developmental models of social cognition in assessing the role of family stress in relatives' predictions following traumatic brain injury.

The present study extended the utilization of developmental models of social cognition to the investigation of stress and relatives' perception of traumatic brain injury (TBI) survivors. Structured interviews were conducted with 21 TBI survivors utilizing interpersonal negotiation strategies (INS) and self understanding (self) in the framework of Selman's model of social perspective-taking and Damon and Hart's multidimensional model of self understanding. A relative group composed of 21 participants was interviewed and their predictions of the responses of the TBI survivors to the action domain of the INS stories were obtained. The relative participant group was also administered the Beck Anxiety and Depression Inventories and Leeds Scales of Depression and Anxiety. The relationships among relative groups' predictive scores, INS and self domains and stress levels were analysed. The result of the survivor groups responses on INS and self were in agreement with the previous findings that TBI survivors respond at psychosocially immature levels. Comparison of INS action scores obtained by the survivor group and predicted by relative group were within one developmental level of each other in 87.4% of the cases. Fifty-two per cent of the relative group scored in mild to moderate or greater depression and 48% scored in the mild to moderate range of anxiety on the Beck scales. Person correlation coefficients indicated significant negative correlations between Beck scores and predictive INS scores. ANOVA indicated significantly higher Beck depression scores in relatives of TBI survivors living in residential facilities than relatives of TBI survivors in an outpatient treatment programme. The study supports the view that developmental social cognition methods appear to advance our understanding of psychosocial adjustments and relatives' perceptions of social cognition in TBI survivors.

Activities of Daily Living↗
PubMed2000

A comparison of agreement and sensitivity to change between AIMS2 and a short form of AIMS2 (AIMS2-SF) in more than 1,000 rheumatoid arthritis patients.

OBJECTIVE: To examine the agreement between and compare the sensitivity to change of the Arthritis Impact Measurement Scale (AIMS2) and AIMS2 Short Form (AIMS2-SF) in a large sample of rheumatoid arthritis (RA) patients examined within the framework of a longitudinal observational study. METHODS: Data were collected from patients in a community based RA register by a postal survey in April 1994 (1,030 respondents) and again in 1996 (1,153 respondents), comprising AIMS2, Modified Health Assessment Questionnaire (MHAQ), Medical Outcome Survey SF-36, and other commonly used health status measures. The degree of agreement was examined by plotting differences between AIMS2 and AIMS2-SF against the mean of the 2 scores for the 5 main components. The upper and lower limits of agreement (mean diff. +/- 1.96 SD) were calculated and plotted. The intraclass correlation coefficients were computed by repeated measurement ANOVA. Validity was assessed on the basis of external indicators of health status, and responsiveness on the basis of standardized response means. RESULTS: The AIMS2 and AIMS2-SF showed substantial to near-perfect agreement. Best agreement was seen for the physical and affect components. Better agreement for the symptom component was obtained when replacing item 42 with item 38. Internal consistency was high in all components. The 2 forms correlated similarly with scores from other instruments within the same domains, showing similar construct validity. There was no difference in responsiveness between the 2 forms when using changes in patient assessed global disease activity as external indicator of change in health status, and responsiveness for the physical and symptom dimension was similar to other instruments (SF-36, MHAQ). CONCLUSION: The AIMS2-SF is amenable for use in large surveys with a modification of one item in the symptom scale.

Arthritis, Rheumatoid↗
PubMedDate not supplied

[Different life-space structures: different styles of aging].

By using life space data, among the participants of the Bonn Longitudinal Study of Aging (BLSA) two groups were selected, sample A consisting of subjects that perceived only few, sample B of subjects that perceived many changes and many symptoms of aging.--The two groups reached the same scores in mental tests, but these scores and the life space data correlated positively in sample A, yet negatively in sample B. By nine behavior ratings group A was characterized as being more balanced than group B as to control and mood. By six categories group A was described as experiencing more satisfaction, group B as suffering more stress. In nine social roles group A showed more activity and more satisfaction than did group B.--These findings were interpreted, in the framework of a theory of self-regulation, as examples of different patterns of coping with developmental tasks.

Aged↗
PubMed2026

Shielding the First 24 Postnatal Months of Life: A Proposal for a Prospective Cohort Study of Early-Life Electromagnetic Exposure and Autism Risk.

BACKGROUND: Autism Spectrum Disorder (ASD) involves Mirror Neuron System (MNS) dysfunction, driving core social and imitative impairments. Systemic physiological alterations such as autonomic dysregulation, mitochondrial dysfunction and neuroinflammation are known to impair synchronization and plasticity of neuronal clusters. A less-evident environmental cofactor, coinciding with rising ASD prevalence, is the considerable world-wide increase in electromagnetic radiation (EMR) overall exposure among children. Experimental evidence shows how low-intensity EMR influences cellular processes, via voltage-gated calcium channels (VGCCs), oxidative stress, and mitochondrial metabolism. The Resonant Convergence framework, allow to predict how chronic EMR exposure during the first 24 postnatal months of life can act as a factor in ASD pathogenesis. The best candidate mechanism is chronic Ion Cyclotron Resonance (ICR) detuning the Ca2+-calmodulin pathway, thus disrupting MNS synchronization. METHODS AND ANALYSIS: A prospective observational pilot cohort study (24-month follow-up) proposes to enroll 1000 full-term newborns into two arms: an EMR-reduced cohort (n = 500, rest and sleep-phase Faraday shielding) and a standard exposure cohort (n = 500). Exposure is quantified via radiofrequency (RF)/extremely low frequency(ELF) measurements, proximity analysis, device inventories and wearable dosimetry. The primary endpoint is a continuous neurodevelopmental trajectory score (joint attention, language, electroencephalogram (EEG) mu-rhythm); binary ASD diagnosis (Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), Autism Diagnostic Interview-Revised (ADI-R)) is a secondary, exploratory endpoint. Moreover, an optional genomic screening will evaluate gene-environment interactions within extremely low-frequency electromagnetic field (ELF-EMF) vulnerable pathways, including ASD-associated genes upregulated by RF via bromodomain and extraterminal protein (BET)-mediated epigenetic mechanisms. Analyses will employ risk ratios, Fisher's exact tests and logistic regression adjusted for confounders; mixed-effects and Bayesian modeling will evaluate longitudinal outcomes and exposure reduction effects. Given a 2-3% baseline prevalence, approximately 20-30 ASD cases are expected. The study is therefore powered for exploratory signal detection rather than definitive causal inference, providing the critical baseline data required to justify and design future confirmatory trials. Sex-stratified modeling will address the 4:1 male-to-female prevalence ratio. ETHICS AND DISSEMINATION: Ethics committee approval is not yet sought; full protocol review and approval will be obtained prior to the study initiation, in strict accordance with the Declaration of Helsinki. Written parental informed consent will be mandatory for all participants prior to enrollment. Study findings and methodological milestones will be disseminated through peer-reviewed international scientific publications. This protocol provides a structured methodological framework for the first prospective investigation of sleep-phase EMR reduction as a potential modulator of ASD incidence during early neurodevelopment. Results will inform adequately powered confirmatory trials in electromagnetic neurodevelopmental epidemiology.

autism spectrum disorder↗
PubMed1999

Development and psychometric testing of the Breastfeeding Self-Efficacy Scale.

Many new mothers discontinue breastfeeding prematurely. Researchers have shown that maternal confidence is an important factor in the continuation of breastfeeding. The purpose of this methodological study was to develop and conduct preliminary psychometric assessment of an instrument to measure confidence in new breastfeeding mothers. Using self-efficacy theory as a conceptual framework, the Breastfeeding Self-Efficacy Scale (BSES) was developed and content validity was judged by a panel of experts and through interviews with experienced breastfeeding mothers. Following a pilot test, the revised BSES was assessed with 130 in-hospital breastfeeding mothers for reliability and validity, including internal consistency, principal components factor analysis, comparison of contrasted groups, and correlations with measures of similar constructs. Support for predictive validity was demonstrated with positive correlations between BSES scores and infant feeding patterns at 6 weeks postpartum. Following further testing, this instrument may be used to identify new mothers with low breastfeeding confidence who are at high risk to prematurely discontinue breastfeeding.

Adolescent↗
PubMed2004

Paroxetine in the treatment of depressed patients with haematological malignancy: an open-label study.

OBJECTIVE: The efficacy and tolerability of paroxetine in the treatment of depressive disorders is well known, however, its efficacy and safety for the treatment of depression in patients with cancer has been poorly studied. Therefore this study was aimed at evaluating the efficacy and tolerability of paroxetine in the treatment of depressed patients with haematological malignancy (HM). METHOD: Fifty-two patients with major depressive disorder (MDD) based on DSM-IV criteria along with comorbid HM were allotted to an 8 week trial with a flexible-dose regime of paroxetine in combination with their chemotherapy or supportive pharmacotherapy. The treatment response was assessed at baseline, week 2, week 4 and week 8 with the 17-item Hamilton rating scale for depression (HAM-D17), the Montgomery Asberg depression rating scale (MADRS) and the clinical global impression-severity (CGI-S). Side effects were collected with reported adverse events and laboratory tests throughout the study period. RESULTS: 44.2% of 52 patients completed the 8 week trial. Scores on the HAM-D17, MADRS and CGI-s (last observation carried forward, LOCF) at baseline were significantly reduced with a mean reduction of 30.5%, 32.8% and 39.1%, respectively, after 8 weeks treatment with paroxetine. CONCLUSION: In this preliminary study, paroxetine was found to be effective and moderately tolerated in the treatment of depressed patients with HM, and the present study calls for a controlled study in this field to extend and form a framework on the psychopharmacological data in this field.

Adult↗
PubMed2006

Life mapping: a 'Therapeutic Document' approach to needs assessment.

This study tested the effectiveness of The Life Map designed by the authors for holistic needs assessment for the promotion of mental health based on the World Health Organisation's six Quality of Life domains (1985). Tests were conducted of test-retest reliability and validity (criterion, discriminant, construct and concurrent) compared with an existing validated needs assessment, the Camberwell Assessment of Needs Inventory CAN-R. For main analyses, 43 mental health service users (SUs) were age-sex matched with 43 of non-service users (non-SUs). The Life Map significantly discriminated between these two study groups. Non-parametric correlations in each group showed significant relationship between a general quality of life question and the 'well-being' and the 'influence over' scores in each of the six domains. Consistent significant agreement was found in test-retests conducted 2 weeks apart. Qualitative data in the Life Map was able to conceptualise the quantitative Life Map scores. This makes the Life Map a tool to improve communication between user and care-provider using a reliable felt and expressed needs assessment that empowers the service user with a 'voice' and empowers the care-provider with the capacity to compare aggregated needs between localities and for change over time. The limitations of this study, the Life Map's utility to facilitate meeting Standards 1 and 2 of the UK's National Service Framework for adult mental health and future directions are discussed.

Adolescent↗
PubMed2005

Affective temperaments in clinically-well subjects in Turkey: initial psychometric data on the TEMPS-A.

BACKGROUND: This is a first attempt to evaluate the reliability and factor structure replicability of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire (TEMPS-A) in its Turkish Version. The questionnaire is a self-report 110-item measure that postulates five affective temperaments-the depressive, cyclothymic, irritable, hyperthymic, and anxious-which embody both strengths and liabilities along affective lines. METHODS: The questionnaire was administered to 658 clinically-well subjects in a Turkish university circle. We undertook item analysis and test-retest reliability. We then examined internal consistency through factor analysis with PCA rotation. RESULTS: We found good to excellent test-retest reliability (0.73-0.91), and internal consistency (0.77-0.85). We deleted 10 items with factor loading <0.20 for their own subscales, resulting in a questionnaire with 99 items. Despite considerable overlap between depressive and cognitive anxiety traits, a distinct "nervous"-anxious factor emerged as well, and the hypothesized (original English) 5-factor structure of the TEMPS-A was supported. Cut-offs for each temperament were based on z-scores higher than +2S.D. Dominant irritable (3.7%), nervous-anxious (3.7%) and depressive (3.1%) temperaments were the most common in this population, whereas dominant cyclothymic (1.7%) and hyperthymic (1.2%) temperaments were relatively uncommon. These temperaments tended to lose their intensity with age. As expected, women scored significantly higher on the nervous-anxious, and men on the hyperthymic temperaments. LIMITATIONS: The sample was composed of younger subjects with higher education than the general population of Turkey. Although the distribution of the scores for each of the temperaments deviated somewhat from normal curves, for heuristic reasons we did attempt to provide prevalence rates based on z-scores. CONCLUSION: In this preliminary version of the TEMPS-A, we have retained 100 (of the original 110) traits loading >0.20. Some deleted items referred to sleep, others appeared socially desirability traits in the Turkish culture endorsed by many subjects. Nonetheless, item analyses within each factor revealed traits indicative of personal assets (specific to each temperament) along with those which might represent vulnerability to affective illness. This is in line with the hypothesized original theoretical framework of the senior authors. Even in this "first pass," in its Turkish version the TEMPS-A is a reliable and valid instrument. Further refinement of the instrument will require the study of a nationally representative sample in Turkey.

Adolescent↗
PubMed2006

Substance-abusing mothers and disruptions in child custody: an attachment perspective.

Using an attachment framework, we examined (1) whether substance-abusing mothers' perceptions of how they were parented were related to the severity of their substance abuse and psychological maladjustment and (2) whether these two factors mediated the association between mothers' perceptions of how they were parented and their children's placement out of home. There were 108 mothers of 248 children who completed interviews upon admission to a methadone maintenance program for women. Measures included lifetime risk composite scores derived from the Addiction Severity Index, the Parental Bonding Instrument, and a demographics questionnaire. A multilevel modeling approach was used to model effects of the hierarchically organized data (e.g., children nested within families). Findings are consistent with an attachment perspective on parenting suggesting that the internal psychological processes of a parent play a critical role in the continuity of parenting.

Adjustment Disorders↗
PubMed2026

Global gut microbiome atlas identifies epidemiologic-stage-specific signatures in inflammatory bowel disease.

The global rise of inflammatory bowel disease (IBD) reflects environmental shifts, yet how these changes are embedded in the gut microbial ecology remains unclear. We construct a microbiome atlas comprising 245,627 profiles. By classifying countries into three epidemiologic stages, we establish a framework. As the IBD burden increases, the gut microbial alpha diversity declines, and community structures form distinct clusters. This transition is characterized by a gradient of core genera. Integrating six shotgun metagenomic cohorts, we identify the depletion of anabolic pathways in IBD patients. Strain-level analysis reveals that epidemiologic staging shapes genetic architecture within species, identifying an IBD-enriched subclade of Eisenbergiella associated with elevated fecal cholic acid. We develop a microbial inflammatory risk score (MIRS), based on 19 genera, that discriminates IBD from controls (area under the curve [AUC] = 0.92). MIRS correlates with IBD prevalence. Our study provides an atlas linking epidemiology to microbiome ecology and strain evolution, offering a foundation for population-level surveillance and interventions in IBD.

Humans↗
PubMed2004

Diversity Arrays Technology (DArT) for whole-genome profiling of barley.

Diversity Arrays Technology (DArT) can detect and type DNA variation at several hundred genomic loci in parallel without relying on sequence information. Here we show that it can be effectively applied to genetic mapping and diversity analyses of barley, a species with a 5,000-Mbp genome. We tested several complexity reduction methods and selected two that generated the most polymorphic genomic representations. Arrays containing individual fragments from these representations generated DArT fingerprints with a genotype call rate of 98.0% and a scoring reproducibility of at least 99.8%. The fingerprints grouped barley lines according to known genetic relationships. To validate the Mendelian behavior of DArT markers, we constructed a genetic map for a cross between cultivars Steptoe and Morex. Nearly all polymorphic array features could be incorporated into one of seven linkage groups (98.8%). The resulting map comprised approximately 385 unique DArT markers and spanned 1,137 centimorgans. A comparison with the restriction fragment length polymorphism-based framework map indicated that the quality of the DArT map was equivalent, if not superior, to that of the framework map. These results highlight the potential of DArT as a generic technique for genome profiling in the context of molecular breeding and genomics.

Chromosome Mapping↗
PubMed2003

Development and operation of a quality assurance system for deviations from standard operating procedures in a clinical cell therapy laboratory.

BACKGROUND: Errors and accidents, or deviations from standard operating procedures, other policy, or regulations must be documented and reviewed, with corrective actions taken to assure quality performance in a cellular therapy laboratory. Though expectations and guidance for deviation management exist, a description of the framework for the development of such a program is lacking in the literature. Here we describe our deviation management program, which uses a Microsoft Access database and Microsoft Excel to analyze deviations and notable events, facilitating quality assurance (QA) functions and ongoing process improvement. METHODS: Data is stored in a Microsoft Access database with an assignment to one of six deviation type categories. Deviation events are evaluated for potential impact on patient and product, and impact scores for each are determined using a 0- 4 grading scale. An immediate investigation occurs, and corrective actions are taken to prevent future similar events from taking place. Additionally, deviation data is collectively analyzed on a quarterly basis using Microsoft Excel, to identify recurring events or developing trends. RESULTS: Between January 1, 2001 and December 31, 2001 over 2500 products were processed at our laboratory. During this time period, 335 deviations and notable events occurred, affecting 385 products and/or patients. Deviations within the 'technical error' category were most common (37%). Thirteen percent of deviations had a patient and/or a product impact score > or = 2, a score indicating, at a minimum, potentially affected patient outcome or moderate effect upon product quality. DISCUSSION: Real-time analysis and quarterly review of deviations using our deviation management program allows for identification and correction of deviations. Monitoring of deviation trends allows for process improvement and overall successful functioning of the QA program in the cell therapy laboratory. Our deviation management program could serve as a model for other laboratories in need of such a program.

Cell- and Tissue-Based Therapy↗
PubMed2005

Integrating validity theory with use of measurement instruments in clinical settings.

OBJECTIVE: To present validity concepts in a conceptual framework useful for research in clinical settings. PRINCIPAL FINDINGS: We present a three-level decision rubric for validating measurement instruments, to guide health services researchers step-by-step in gathering and evaluating validity evidence within their specific situation. We address construct precision, the capacity of an instrument to measure constructs it purports to measure and differentiate from other, unrelated constructs; quantification precision, the reliability of the instrument; and translation precision, the ability to generalize scores from an instrument across subjects from the same or similar populations. We illustrate with specific examples, such as an approach to validating a measurement instrument for veterans when prior evidence of instrument validity for this population does not exist. CONCLUSIONS: Validity should be viewed as a property of the interpretations and uses of scores from an instrument, not of the instrument itself: how scores are used and the consequences of this use are integral to validity. Our advice is to liken validation to building a court case, including discovering evidence, weighing the evidence, and recognizing when the evidence is weak and more evidence is needed.

Data Collection↗