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PubMed2003

Measurement of dyspnea: word labeled visual analog scale vs. verbal ordinal scale.

We previously used a verbal ordinal rating scale to measure dyspnea. That scale was easy for subjects to use and the words provided consistency in ratings. We have recently developed a word labeled visual analog scale (LVAS) with labels placed by the subjects, retaining the advantages of a verbal scale while offering a continuous scale that generates parametric data. In a retrospective meta-analysis of data from 43 subjects, individuals differed little in their placement of words on the 100 mm LVAS (mean+/-S.D. for slight=20+/-2.5 mm, moderate=50+/-5 mm and severe=80+/-6 mm) and ratings were distributed uniformly along the scale. A significant stimulus-response correlation was obtained for both the LVAS (r(2)=0.98) and for the verbal ordinal scale (Spearman r=0.94). The resolution of the two scales differed only slightly. With meaningful verbal anchors, well-defined end-points, and clear instructions about the specific sensation to be rated, both scales provide valid measures of dyspnea.

Data Interpretation, Statistical↗
PubMed1993

Scales for mental state and daily living activities for the elderly: clinical behavioral scales for assessing demented patients.

In the diagnosis, treatment, and care of dementia patients in the senile stage, comprehensive evaluation of ability in daily life and mental function is needed. Using a simple behavioral rating scale for the mental states (NM scale) and activities of daily living (N-ADL) of the elderly, we evaluated 250 elderly subjects. According to the NM scale, the scores for subjects in whom the severity was clinically diagnosed were as follows: normal, 50-48; borderline, 47-43; mild dementia, 42-31; moderate dementia, 30-17; and severe dementia, 16-0. Screening for dementia and determining its severity were readily accomplished using the NM scale, and basic activities in the daily life of the elderly could be evaluated effectively using the N-ADL. There was a significant correlation (r = 0.863) between the Hasegawa dementia scale and the NM scale (p < 0.001), a significant correlation (r = -0.947) between intellectual function scores of the GBS scale and the NM scale, and a significant correlation (r = 0.944) between motor function score of the GBS scale and the N-ADL score. Evaluations of daily life activities can be made not only by psychiatrists and clinical psychologists, but by nonspecialists as well, because they are based on data obtained by observation of daily life behaviors; thus, assessment is appropriate both in clinical settings and in places of living.

Activities of Daily Living↗
PubMed2000

A comparison of the responsiveness of the Nottingham extended activities of daily living scale, London handicap scale and SF-36.

PURPOSE: Clinical trials require scales which are sensitive to the effects of intervention. This study examined the sensitivity to change of three generic health status measurement scales commonly used in evaluations of interventions in chronic, disabling disease. METHODS: Questionnaires comprising the SF-36, London Handicap Scale and Nottingham Extended Activities of Daily Living scale were administered to 81 patients before and after hip replacement. Changes were quantified as 'effect sizes'. RESULTS: Eighty nine per cent of patients reported improvements three months after surgery. The largest changes were seen on the SF-36 pain scale (effect size 1.2 at three months, 1.5 at 6-12 months), physical function (1.1, 1.3) and role limitation--physical (0.8, 1.2) scales. The London Handicap Scale also measured large changes (effect sizes 0.6, 0.9), but the Extended Activities of Daily Living scale was insensitive to change (effect sizes 0.1, 0.2). CONCLUSIONS: Some of the SF-36 dimensions were very sensitive to change. The London Handicap Scale was also reasonably responsive, and has the advantage of being a single, utility-based, score. The simpler Extended ADL score was poorly responsive.

Activities of Daily Living↗
PubMed2007

Examination of the new MMPI-2 Response Bias Scale (Gervais): relationship with MMPI-2 validity scales.

Validity scales were recently developed to improve assessment of symptom validity beyond original MMPI-2 validity scales. In an initial study, the Response Bias Scale (RBS; Gervais, 2005) was developed based upon non-head-injury claimant performances on a cognitive effort measure, the Word Memory Test (WMT). The present study examined relationships of the RBS with numerous MMPI-2 validity scales in a sample of 211 participants with secondary gain (SG) or no secondary gain (NSG). Of the validity scales observed, RBS yielded the largest effect size difference between groups (d = .65), followed closely by FBS (d = .60) and the L-scale (d = .51). Overall, RBS correlated most significantly (r = .74, p < .001) with FBS, but also showed significant correlations with most other validity scales for both groups. RBS further demonstrated significant correlations (p < .001) with all clinical scales except for Mf. Findings suggest that RBS and FBS may represent a similar construct of symptom validity, and may outperform other MMPI-2 validity scales in discriminating SG and NSG groups. Findings provide preliminary support for use of RBS within the forensic context.

Bias↗
PubMed2002

Ten-year review of rating scales. IV: scales assessing trauma and its effects.

OBJECTIVE: This article summarizes scales assessing trauma and its effects on youths. METHOD: We sampled trauma-related articles published over the past 25 years, with an emphasis on the past decade, selected scales with at least several publications, and reviewed their properties. Those with minimally adequate psychometric properties and continued literature citations or a special niche are presented. RESULTS: Most of trauma-related scales are relatively new, reflecting the evolving interest in juvenile trauma. Therefore, they do not have the depth of psychometric examination nor the breadth of applications described for previously reviewed scales. However, they have been applied to various traumatic situations. These scales assess a range of trauma-related symptoms and behaviors, including posttraumatic stress disorder, symptoms related to posttraumatic stress disorder, and dissociation. Additionally, several scales assess the trauma itself. CONCLUSIONS: Trauma-related scales show promise for research and clinical use in understanding youths' responses to trauma. However, their utility for treatment planning and for accountability in practice is generally not as clear. The potential user must clearly define the goals of measurement and use these scales within their limited roles. With these caveats, trauma-related scales may assist our work with traumatized youths.

Adolescent↗
PubMed2001

Scaling properties of scale-free evolving networks: continuous approach.

The scaling behavior of scale-free evolving networks, arising in areas such as communications, scientific citations, collaborations, etc., is studied. We derive universal scaling relations describing properties of such networks, and indicate the limits of their validity. We show that the main properties of scale-free evolving networks may be described in the framework of a simple continuous approach. The simplest models of networks, growing according to a mechanism of preferential attachment of links to nodes, are used. We consider different forms of this preference, and demonstrate that the range of preferential attachments producing scale-free networks is wide. We also obtain scaling relations for networks with nonlinear, accelerating growth, and describe the temporal evolution of the arising distributions. Size effects-the cutoffs of these distributions-introduce restrictions for the observation of power-law dependences. Mainly we discuss the so-called degree distribution, i.e., the distribution of the number of connections of nodes. A scaling form of the distribution of links between pairs of individual nodes for a growing network of citations is also studied. We describe the effects of differences between nodes. The "aging" of nodes changes the exponents of the distributions. The appearance of a single node with high fitness changes the degree distribution of a network dramatically. If its fitness exceeds some threshold value, this node captures a finite part of all links of the network. We show that permanent random damage to a growing scale-free network-a permanent deletion of some links-radically changes the values of the scaling exponents. Results of other kinds of permanent damage are described.

Journal Article↗
PubMed2005

Dalhousie dyspnea scales: construct and content validity of pictorial scales for measuring dyspnea.

BACKGROUND: Because there are no child-friendly, validated, self-report measures of dyspnea or breathlessness, we developed, and provided initial validation, of three, 7-item, pictorial scales depicting three sub-constructs of dyspnea: throat closing, chest tightness, and effort. METHODS: We developed the three scales (Throat closing, Chest tightness, and Effort) using focus groups with 25 children. Subsequently, seventy-nine children (29 children with asthma, 30 children with cystic fibrosis. and 20 children who were healthy) aged 6 to 18 years rated each picture in each series, using a 0-10 scale. In addition, each child placed each picture in each series on a 100-cm long Visual Analogue Scale, with the anchors "not at all" and "a lot". RESULTS: Children aged eight years or older rated the scales in the correct order 75% to 98% correctly, but children less than 8 years of age performed unreliably. The mean distance between each consecutive item in each pictorial scale was equal. CONCLUSION: Preliminary results revealed that children aged 8 to 18 years understood and used these three scales measuring throat closing, chest tightness, and effort appropriately. The scales appear to accurately measure the construct of breathlessness, at least at an interval level. Additional research applying these scales to clinical situations is warranted.

Adolescent↗
PubMed2004

The Menopause Rating Scale (MRS) scale: a methodological review.

BACKGROUND: This paper compiles data from different sources to get a first comprehensive picture of psychometric and other methodological characteristics of the Menopause Rating Scale (MRS) scale. The scale was designed and standardized as a self-administered scale to (a) to assess symptoms/complaints of aging women under different conditions, (b) to evaluate the severity of symptoms over time, and (c) to measure changes pre- and postmenopause replacement therapy. The scale became widespread used (available in 10 languages). METHOD: A large multinational survey (9 countries in 4 continents) from 2001/ 2002 is the basis for in depth analyses on reliability and validity of the MRS. Additional small convenience samples were used to get first impressions about test-retest reliability. The data were centrally analyzed. Data from a postmarketing HRT study were used to estimate discriminative validity. RESULTS: Reliability measures (consistency and test-retest stability) were found to be good across countries, although the sample size for test-retest reliability was small. VALIDITY: The internal structure of the MRS across countries was astonishingly similar to conclude that the scale really measures the same phenomenon in symptomatic women. The sub-scores and total score correlations were high (0.7-0.9) but lower among the sub-scales (0.5-0.7). This however suggests that the subscales are not fully independent. Norm values from different populations were presented showing that a direct comparison between Europe and North America is possible, but caution recommended with comparisons of data from Latin America and Indonesia. But this will not affect intra-individual comparisons within clinical trials. The comparison with the Kupperman Index showed sufficiently good correlations, illustrating an adept criterion-oriented validity. The same is true for the comparison with the generic quality-of-life scale SF-36 where also a sufficiently close association has been shown. CONCLUSION: The currently available methodological evidence points towards a high quality of the MRS scale to measure and to compare HRQoL of aging women in different regions and over time, it suggests a high reliability and high validity as far as the process of construct validation could be completed yet.

Adult↗
PubMed2000

Development of an Infrequency-Psychopathology scale for the MMPI-A: the Fp-A Scale.

This article describes the development and initial validation of the Infrequency-Psychopathology scale, Fp-A, for the MMPI-A (Butcher et al., 1992). The scale parallels the Infrequency-Psychopathology scale, F(p), that has been developed for the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). Results demonstrated that the 40-item Fp-A scale is superior to the F scale at discriminating between faking-bad and accurate reports of psychopathology, although the improvement over F was modest, particularly when compared to the improvement found for the F(p) scale. The difference seemed to reflect the superiority of the MMPI-A F scale to the MMPI-2 F scale. Even so, the findings suggest that the identification of overreporting on the MMPI-A could potentially be enhanced by using Fp-A as an adjunct to the F scale.

Adolescent↗
PubMed2000

Formulation variables affecting drug release from xanthan gum matrices at laboratory scale and pilot scale.

The purpose of this research was to study processing variables at the laboratory and pilot scales that can affect hydration rates of xanthan gum matrices containing diclofenac sodium and the rate of drug release. Tablets from the laboratory scale and pilot scale proceedings were made by wet granulation. Swelling indices of xanthan gum formulations prepared with different amounts of water were measured in water under a magnifying lens. Granules were thermally treated in an oven at 60 degrees C, 70 degrees C, and 80 degrees C to study the effects of elevated temperatures on drug release from xanthan gum matrices. Granules from the pilot scale formulations were bulkier compared to their laboratory scale counterparts, resulting in more porous, softer tablets. Drug release was linear from xanthan gum matrices prepared at the laboratory scale and pilot scales; however, release was faster from the pilot scales. Thermal treatment of the granules did not affect the swelling index and rate of drug release from tablets in both the pilot and laboratory scale proceedings. On the other hand, the release from both proceedings was affected by the amount of water used for granulation and the speed of the impeller during granulation. The data suggest that processing variables that affect the degree of wetness during granulation, such as increase in impeller speed and increase in amount of water used for granulation, also may affect the swelling index of xanthan gum matrices and therefore the rate of drug release.

Chemistry, Pharmaceutical↗
PubMed2003

Convergent validity of the MCMI-III personality disorder scales and the MMPI-2 scales.

The MCMI-III personality disorder scales (Millon, 1994) were empirically validated in a sample of prisoners, psychiatric inpatients, and outpatients (N = 477). The scale intercorrelations were congruent with those obtained by Millon, Davis, and Millon (1997). We conclude that our Flemish/Dutch version shows no significant differences with the original version of the MCMI-III as far as intercorrelations are concerned. Convergent validity of the MCMI-III personality disorder scales was evaluated by the correlational data between the MCMI-III personality disorder scales and the MMPI-2 clinical (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) and personality disorder (Somwaru & Ben-Porath, 1995) scales. Improved convergence was obtained compared with previous versions of the MCMI-I. Only the compulsive MCMI-III personality disorder scale remains problematic. The scale even showed negative correlations with some of the related clinical scales and with the corresponding personality disorder scales of the MMPI-2.

Adolescent↗
PubMed2004

[Drug Addiction Self-Help Recovery scale (DASH-scale): an approach to the measurement of recovery from drug addiction in self-help program among drug addicts].

The purpose of the study was to develop a scale for measuring the recovery in self-help program for drug addicts. Our study sites were fourteen self-help groups for drug addicts called "DARC: Drug Addiction Rehabilitation Center". DARC activities were based on Narcotics Anonymous types of self-help program. The 25-items DASH-scale questionnaire was developed using data, which were obtained through in-depth interview among DARC staff. A cross-sectional study among recovering addicts participating in "DARC" activities was implemented from Jan 2004 to Feb 2004. 164 subjects were responded to our questionnaire. Factor analysis was carried out and items with weaker or split loadings were removed. Factor analysis of DASH-scale results produced a surprisingly clean four-factor solution. 19-items were left to form the final DASH-scale; regular life-style (6 items), acceptance of drug addiction (5 items), sympathy with member (5 items), reborn (3 items). The internal consistency (Cronbach's Alpha) of these scales was very high (0.87). Low but significant concurrent correlations were observed between the DASH-scale and the Rosenberg Self-Esteem Scale (0.22), Purpose in Life Test (0.35). Discriminant validity of the DASH-scale was supported by significant increase with exposed period of self-help program. Evidence supports the DASH-scale was possible to measure recovery in self-help program.

Adult↗
PubMed2005

A composite disease activity scale for clinical practice, observational studies, and clinical trials: the patient activity scale (PAS/PAS-II).

OBJECTIVE: To develop and validate a composite patient self-report disease activity scale for use in clinical practice and in observational studies and clinical trials. METHODS: A total of 9078 patients with rheumatoid arthritis completed detailed questionnaires that included measure of quality of life in the form of utilities. We evaluated several disease activity scales by measuring their agreement with the utility scales, and also their assessed ability to predict mortality and prescription for anti-tumor necrosis factor therapy. RESULTS: A composite index composed of a visual analog scale (VAS) for pain, a patient global VAS, and the Health Assessment Questionnaire (HAQ) or the HAQ II formed the Patient Activity Scale (PAS) and PAS-II. These scales performed as well as or better than longer, more complex scales. CONCLUSION: A simple, useful clinical scale, the PAS or PAS-II, can be formed by the use of common clinical variables. It is well correlated with and relevant to a wide range of clinical variables. This scale should be useful for comparative studies, clinical care, and regulatory documentation.

Aged↗
PubMed1994

[Quantity-frequency scale (QF Scale) for adolescent problem drinking].

From 1990 to 1992, we surveyed 14,438 Japanese high school students from nine prefectures on drinking behavior. Based on this survey, we developed a new Quantity-Frequency Scale (QF Scale) for adolescent problem drinking. Each adolescent is scored from 0 to 6 by the QF Scale, which is composed of scores of drinking quantities and frequencies. Adolescents were assessed as normal adolescent, drinkers and problem drinkers by QF Scale scores. The normal adolescent (score 0) categorized by the QF Scale drinks none or little and obeys the Law Prohibiting Adolescents from Drinking. The drinker (score 1-3) categorized by the QF Scale drinks at least several times a year, but drinks little each time. The problem drinker (score 4-6) categorized by the QF Scale drinks several times a week and has at least two drink (1 drink is equivalent to a glass of beer) each time, once a week with at least 3 drinks, or once or twice a month with at least 6 drinks each time. The problem drinkers show a physical, psychological and social high risk for alcohol. The validity of the QF Scale was examined. The results showed that the problem drinkers had significantly frequent blackout, significantly frequent drinking when they had emotional conflicts or they were alone, and drank significantly more hard liquor than the drinkers and normal adolescents. Among the high school students surveyed, 39.5% were normal adolescents, 43.2% were drinkers and 17.4% were problem drinkers. In conclusion, the QF Scale is a useful instrument for assessment of adolescent problem drinking.

Adolescent↗
PubMed1995

Differential validity of the MMPI-2 Subtle and Obvious scales with psychiatric inpatients: scale 2.

The construct and concurrent validity of the MMPI-2 Scale 2 Subtle and Obvious scales were examined for a group of 67 psychiatric inpatients. Validity coefficients for the Obvious scale were uniformly greater than those for the Full and Subtle scales. Subtle scale validity coefficients were negative and attenuated the validity of the Full clinical scale. Use of Obvious items resulted in more accurate prediction of assessed suicide risk, while inclusion of the Subtle items did not add any useful information in the prediction of assessed suicide risk or psychiatric diagnosis. It is recommended that future research that uses the MMPI-2 basic clinical scales examine the differential validity of the Subtle and Obvious scales.

Adolescent↗
PubMed1986

Comparison between the Brief Psychiatric Rating Scale and the Manchester Scale for the rating of schizophrenic symptoms.

A reliability study was carried out to compare the short Manchester Scale (MS) to the longer Brief Psychiatric Rating Scale (BPRS), to see if similar items scored the same aspect of pathology and to find the sources of error. The raters were a psychiatrist and a psychologist cum medical student; they had recently arrived in Britain, came from different cultures and had not used the scale previously. Comparisons between the scales were made by interviewing the patients separately and together using either one or both scales. The items on the MS showed a higher interrater reliability as compared to the BPRS, both with independent and simultaneous ratings. Items based on observation only correlated poorly as compared to items based on verbal report. Lower between-scale correlations for delusions and affect were observed even where the same rater used the two scales, suggesting that the scales have different meanings for these items. The MS is a suitable alternative to the BPRS for quantifying schizophrenic symptoms.

Affect↗
PubMedDate not supplied

Depression in Alzheimer's disease: receiver operating characteristic analysis of the Cornell Scale for Depression in Dementia and the Hamilton Depression Scale.

This study compares the performance of the Cornell Scale for Depression in Dementia (CSDD) and the Hamilton Depression Scale (HDS) in detecting Research Diagnostic Criteria (RDC) major depression in subjects with mild-to-moderate Alzheimer's disease (AD). Thirty-four subjects with this diagnosis and their caregivers were interviewed. The senior author conducted a diagnostic interview to determine RDC diagnosis. An investigator, blind to diagnosis, obtained demographic information and administered the Mini Mental State Examination, Global Deterioration Scale, CSDD and HDS. For each depression scale, the correlation with the RDC diagnosis of major depression was calculated, as were the sensitivity and specificity at various cutoff scores. Nonparametric receiver operating characteristic analysis was used to compare the performance of the two scales. The area under the receiver operating characteristic curve was .91 for the CSDD and .87 for the HDS. This differed from chance to a highly significant degree for both the CSDD and the HDS but the difference between the two scales was not statistically significant. Although the precision of the present study is limited by the small sample size, a cutpoint of 7 provided reasonable performance for both the CSDD and the HDS, yielding a sensitivity of .90 for both scales and a specificity of .75 for the CSDD and 0.63 for the HDS. Although the CSDD and the HDS are rating scales rather than diagnostic instruments, receiver operating characteristic analysis indicates that both demonstrate statistically significant discriminating ability for RDC major depression in mild to moderate, probable AD.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

The brief psychiatric rating scale: effect of scaling system on clinical response assessment.

The Brief Psychiatric Rating Scale (BPRS) is an 18-item rating scale frequently used to assess change in psychopathology in schizophrenic patients in antipsychotic drug trials. BPRS items may be rated by the use of either a 1 to 7 or 0 to 6 scaling system, with the 1 or 0 rating indicating no pathology, respectively. When percent change in BPRS total score is used as an index of change, measurement considerations indicate that the 0 to 6 scaling system is preferable. Furthermore, when the 1 to 7 scaling system is used, patients whose initial BPRS values fall at the lower end of the range are classified as responders at a lower rate than are patients with higher initial scores. The adoption of the 0 to 6 scaling system for the BPRS and other rating scales, such as the Positive and Negative Syndrome Scale, is advocated.

Antipsychotic Agents↗