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PubMed2001

Pain measurement in TMD patients: evaluation of precision and sensitivity of different scales.

The aim of this study was to evaluate the precision and sensitivity of four different pain rating scales in 59 temporomandibular disorders (TMD) patients. The capacity of describing changes in symptoms during treatment was also addressed. All patients were asked to answer four pain scales: Visual Analogue Scale (VAS), Numerical Scale (NS), Behaviour Rating Scale (BRS) and Verbal Scale (VS). Two measurements were taken before any treatment. After beginning it, follow-ups and repeated measurements were taken 1 week, 15 days, and every month for 6 months. Statistical analysis showed significant differences (P < 0.05) for all scales, but the NS (P > 0.05), when the two initial measurements were analysed. Regarding the sensitivity, all pain scales demonstrated general symptom improvement of 30-50%, when initial and final figures were compared (P < 0.01). Also, the most significant improvement occurred in the first 2 months after beginning the management programme. Authors concluded that the NS was more accurate to measure reproducibility of pain. As for the capacity of expressing changes during the treatment, all scales demonstrated symptom decrease of 30-50% in a period of 6 months. Caution when analysing the results is recommended because of the subjective aspect of pain measurement, the absence of a 'gold standard' for comparison and the natural fluctuation of TMD symptoms.

Adolescent↗

PubMed1999

Prospective cross-validation of Doppler ultrasound examination and gray-scale ultrasound imaging for discrimination of benign and malignant pelvic masses.

OBJECTIVE: To cross-validate, prospectively, the diagnostic performance of established ultrasound methods for discrimination of benign and malignant pelvic masses. METHODS: A total of 173 consecutive women with a pelvic mass judged clinically to be of adnexal origin underwent preoperative ultrasound examination including color and spectral Doppler techniques. A total of 149 tumors were benign, and 24 were malignant. The sensitivity and false-positive rate with regard to malignancy were calculated for the following methods, using cut-off values recommended in previous publications: Lerner score; ultrasound morphology, i.e. tumors without solid components being classified as benign and tumors with solid components as malignant; tumor color score; pulsatility index; resistance index; time-averaged maximum velocity; peak systolic velocity; the combined use of ultrasound morphology and tumor color score and the combined use of ultrasound morphology and peak systolic velocity. Sensitivity and false-positive rate were also calculated for subjective evaluation of the gray-scale ultrasound image and for subjective evaluation of the gray-scale ultrasound image supplemented with subjective evaluation of color Doppler ultrasound examination. The confidence with which the diagnosis was made, based on subjective evaluation, was rated on a visual analog scale. RESULTS: Subjective evaluation of the gray-scale ultrasound image was by far the best method for distinguishing benign from malignant tumors (sensitivity 88%, false-positive rate 4%), followed in descending order by subjective evaluation of the gray-scale ultrasound image supplemented with color Doppler examination, the Lerner score and the time-averaged maximum velocity. Adding Doppler examination to subjective evaluation of the gray-scale image did not increase the number of correct diagnoses, but it increased the confidence with which a correct diagnosis was made in 14% of tumors. In 11 tumors (6% of the series as a whole), the addition of Doppler examination changed the diagnosis based on subjective evaluation of the gray-scale ultrasound image from an incorrect (n = 1) or uncertain (n = 10) diagnosis to a correct and confident diagnosis. CONCLUSION: In experienced hands, subjective evaluation of the gray-scale ultrasound image is the best ultrasound method for discriminating between benign and malignant adnexal masses. The main advantage of adding Doppler examination to subjective evaluation of the gray-scale image is an increase in the confidence with which a correct diagnosis is made.

Adnexal Diseases↗

PubMed2001

Impact of pediatric epilepsy on the family: a new scale for clinical and research use.

PURPOSE: There is no brief, global instrument available that specifically measures the psychosocial impact of pediatric epilepsy on the family. An 11-item scale was created for parents' use to evaluate the influence of epilepsy on the major aspects of their family and child's life. This will be a helpful tool both in the clinical setting and as an outcome measure for research studies. METHODS: Mothers rated their child's quality of life on a visual analogue scale (1-6) and completed the Impact of Pediatric Epilepsy Scale (IPES), which assesses the impact on academic achievement, participation in activities, health, relationships with family and with peers and siblings, social activities, self-esteem, and the caregiver's hopes for their child's future adapted from the scale developed by Jacoby. External validation was determined by comparison of the IPES with physicians' reports of the characteristics of the child's epilepsy and neurological limitations and parents' ratings on the Family Environment Scale or Parenting Stress Index. In addition, each school-aged child completed the Piers-Harris Children's Self-Concept Scale, Brother-Sister Questionnaire, and Loneliness Scale. Teachers of children completed the Academic Performance Rating Scale. Seven days later, retest reliability of the IPES was evaluated. RESULTS: Ninety-seven mothers of children aged 2-16 years completed the IPES and the appropriate family and age-related questionnaires. Internal validation on the IPES yielded a Cronbach's a for the scale of 0.92. A significant Pearson's correlation indicated that total scores were consistent over time (r = 0.81). Spearman's correlations for the individual items were also significant, ranging from 0.48 to 0.78. Significant Spearman's correlations also indicated that quality of life was negatively related to impact on each of the 11 items of psychosocial function. Children with IPES scores above the median differed in some psychosocial aspects from those who scored below. Their parents were more stressed, their siblings were more respectful, they had lower self-esteem, and they experienced more emotional problems. Total impact was also significantly related to seizure frequency, total number of medications taken, number of visits to a physician in the previous year, and number of nights spent in hospital for neurological reasons. CONCLUSIONS: The IPES is an accurate, acceptable, and quick measurement tool that reflects the way in which childhood epilepsy has an impact on the child and on family life. It may be helpful in routine clinical care and may be useful in the research setting to find ways to improve the lives of children with epilepsy.

Adolescent↗

PubMed1987

The perception of time in scale model environments.

It has been claimed that when subjects observe differently-scaled model environments their experience of temporal duration is compressed relative to standard clock time in the same proportion as the scale of the model being observed. A series of experiments is reported in which subjects made judgements of duration while observing model environments of different scale. In each experiment, two similar model environments of different scale were presented. Three different kinds of model were used: scale model railways, sitting-room models, and abstract nonrepresentional models. Despite considerable individual variability, significant effects were obtained. Smaller scale was, up to a point, related to a compression of subjective time relative to clock time, although the effect was nowhere near as great as that previously reported. Also, when scale was reduced beyond a certain point the effect on judgements of duration was eliminated, or even reversed. It is suggested that the effect of time compression is related to differences in the density of the information to be processed in environments of different scale, and that there may be an optimum value for information density related both to the scale and to the type of environment.

Adolescent↗

PubMed1988

Renorming Russell's version of the Wechsler Memory Scale.

Several studies of Russell's version of the Wechsler Memory Scale found that the Logical Memory Scales appeared to be normed too high, indicating a need for renorming. This study produces such a renorming by developing new scale scores and age/education corrections. The scaling used a new method, "reference scale norming". The z scores for 12 tests in the Rennick version of the Halstead-Reitan Battery were averaged and used to establish a reference scale. Scale scores for the memory tests were derived from this scale. The results of this study demonstrated that the earlier Logical Memory Scale norms were in fact too high; this error is corrected.

Adult↗

PubMed1991

Development and validation of a condom self-efficacy scale for college students.

This study proposed to develop and validate a scale for the college population that measures self-efficacy in using condoms. The Condom Use Self-Efficacy Scale (CUSES) was derived from several sources and consisted of 28 items describing an individual's feelings of confidence about being able to purchase condoms, put them on and take them off, and negotiate their use with a new sexual partner. This scale was administered to a sample of 768 college students. It was found to possess adequate reliability (Cronbach's alpha = .91; test-retest correlation = .81) and correlated well with the Attitude Toward the Condom Scale (r = .51) and the Contraceptive Self-Efficacy Scale for women (r = .55). Our scale also correlated with a measure of intention to use condoms (r = .40) but was unrelated to a measure of social desirability. Students who differed on measures of previous condom use as well as on sexual intercourse experience also showed significant differences on this scale in the expected direction, indicating evidence of this scale's discriminant validity. The potential uses of this scale in a college population are discussed, along with the issues underlying condom usage self-efficacy.

Adolescent↗

PubMed2001

Assessment of suicidal ideation in young men and women: the incremental validity of the MMPI-2 content scales.

This study of 139 women and 75 men investigated the incremental validity of the MMPI-2 in assessing suicidal ideation by examining the unique contribution of the 15 content scales beyond what is provided by the 13 basic validity and clinical scales. A multivariate analysis of variance resulted in a significant difference on the validity, clinical, and content scales for young men and women. Women scored significantly higher than men on the Hypochondriasis, Depression, Conversion Hysteria, and Masculinity-Femininity scales and lower than men on the Hypomania, Fears, Anger, and Type A scales. The results of the hierarchical regression analyses indicated that for women, hopelessness and reasons for living; the Correction, Paranoia, Conversion Hysteria, Psychopathic Deviate, and Hypomania scales; and the Anger content scale contributed significantly to the prediction of suicidal ideation. For men, hopelessness, the Lie and Hypomania scales, and the Type A content scale contributed significantly to the prediction of suicidal ideation. Thus, it would appear that a different pattern of concerns and difficulties are manifested in young men and women related to suicidal ideation. Limitations of the present study and future directions for research are discussed.

Adult↗

PubMed1994

Evidence for construct validity of the TMJ scale in a sample of chronic post-traumatic headache patients.

The construct validity of the TMJ Scale was examined in a sample of chronic post-traumatic headache patients. Clinical indicators of temporomandibular (TM) dysfunction and measures of psychosocial distress were compared with relevant scales of the TMJ Scale. The clinical indicators were first subjected to principal components analysis. The resulting factor scores correlated significantly with selected physical domain scales of the TMJ Scale. The factor scores also significantly predicted the TMJ Global Scale in a regression analysis. Selected psychosocial domain scales of the TMJ Scale correlated strongly with measures of depression and anger and a clinical diagnosis of post-traumatic stress disorder. The results support the validity of the TMJ Scale and demonstrates its utility with post-traumatic headache patients.

Accidents, Traffic↗

PubMed2006

A systematic review of the Tardieu Scale for the measurement of spasticity.

BACKGROUND: The Tardieu Scale has been suggested a more appropriate clinical measure of spasticity than the Ashworth or modified Ashworth Scales. It appears to adhere more closely to Lance's definition of spasticity as it involves assessment of resistance to passive movement at both slow and fast speeds. OBJECTIVE: To review the available literature in which the Tardieu Scale has been used or discussed as a measure of spasticity, with a view to determining its validity and reliability. STUDY DESIGN: A systematic review of all literature found related to the Tardieu Scale (keywords: Tardieu scale, spasticity) from Pubmed and Ovid databases, including medline, CINAHL, EMBASE, Journals at Ovid full text, EBM reviews and Cochrane database of systematic reviews. Hand searching was also used to track the source literature. CONCLUSIONS: In theory, we can acknowledge that the Tardieu Scale does, in fact, adhere more closely to Lance's definition of spasticity. However, there is a dearth of literature investigating validity and reliability of the scale. Some studies have identified the Tardieu Scale to be more sensitive than other measures, to change following treatment with botulinum toxin. Further studies need to be undertaken to clarify the validity and reliability of the scale for a variety of muscle groups in adult neurological patients.

Disability Evaluation↗

PubMed2006

Construct validity and dimensional structure of the ASIA motor scale.

BACKGROUND/OBJECTIVE: The use of the American Spinal Injury Association (ASIA) motor score as an outcome measure requires metrological study. This paper tests the hypothesis that a more accurate representation of motor function is obtained using separate upper and lower extremity scales rather than combining all 20 key muscle ratings into a single ASIA motor score. METHODS: We analyzed archived data from 6116 ASIA motor scale records extracted from the National Spinal Cord Injury Statistical Center Database. RESULTS: The hypothesis that separate scales more accurately represent motor function than a single motor scale was supported (chi2(difference) = 2596; df=1; P < 0.0001). Two scales account for 87% of the variance, whereas a single scale accounts for only 82%. Lower extremity function is well represented in both solutions; however, upper extremity function is accurately represented only with the use of 2 separate scales. CONCLUSIONS: The use of components of the ASIA standards for other than classification of spinal cord injury needs study. Several lines of study converge to provide strong support for the existence of 2 distinctive dimensions underlying the ASIA motor scale. The use of a single motor score in spinal cord injury research should be questioned and justified to the extent possible. The use of upper and lower extremity scales will lead to a reduction in measurement error when the motor score is used as an outcome measure. The confirmation of 2 separate dimensions underlying the ASIA motor score will enable more accurate representation of motor function in spinal cord injury research.

Adolescent↗

PubMedDate not supplied

Experiences with the French Aging Males' Symptoms (AMS) scale.

INTRODUCTION: The aim of this paper is to report on experiences gained from the application of the French version of the Aging Males' Symptoms (AMS) scale, to show correlations with other relevant scales and to provide population reference values for France. METHODS: A representative survey based on an existing, representative population panel was performed in France (963 males, aged 15 + years). Other AMS data from Europe were then used for comparison. Mean scores of the French AMS scale do not systematically differ from the data of other European studies. The population reference values obtained for France strongly suggest that the scale measures can appreciate the level of well-being whatever the patients' age; however, some variables, such as age and family income, can influence the total AMS scores. Comparisons with the generic quality-of-life scale, SF-12, and a depression scale, HAD, have shown good correlations, as have comparisons with the ADAM questionnaire. CONCLUSION: The French AMS scale is a standardized, valid and simple health-related quality of life (HRQoL) scale, with results comparable to other published European findings. The results also indicate that the AMS scale can be used to measure and compare HRQoL in those less than 40 years of age.

Adolescent↗

PubMed1999

Goal attainment scaling as a measure of clinically important change in nursing-home patients.

OBJECTIVES: To assess the feasibility, validity and responsiveness of an individualized measure--goal attainment scaling-in long-term care. DESIGN: Prospective descriptive study. SETTING: One academic and three community-based long-term care facilities. SUBJECTS: 53 nursing-home patients seen in consultation between July 1996 and June 1997. INTERVENTION: Specialized geriatric medicine consultation. MAIN OUTCOME MEASURES: Effect size and relative efficiency of the Barthel index, hierarchical assessment of balance and mobility, global deterioration scale, axis 8 (behaviour) of the brief cognitive rating scale, cumulative illness rating scale and the goal attainment scale. RESULTS: Mean goal attainment scale at follow-up was 46+/-7. The goal attainment scale was the most responsive measure, with an effect size of 1.29 and a relative efficiency of 53.7. The goal attainment scale did not correlate well with the other measures (-0.22 to 0.17). CONCLUSION: Goal attainment scaling is a feasible and responsive measure in long-term care. Although fewer problems in nursing-home patients than elderly inpatients are susceptible to intervention, clinically important goals can be achieved in this population.

Activities of Daily Living↗

PubMed2006

Evaluating the properties of a stage-specific self-efficacy scale for physical activity using classical test theory, confirmatory factor analysis and item response modeling.

The purpose of this paper was to evaluate the psychometric properties of a stage-specific self-efficacy scale for physical activity with classical test theory (CTT), confirmatory factor analysis (CFA) and item response modeling (IRM). Women who enrolled in the Women On The Move study completed a 20-item stage-specific self-efficacy scale developed for this study [n=226, 51.1% African-American and 48.9% Hispanic women, mean age = 49.2 (+/-7.0) years, mean body mass index = 29.7 (+/-6.4)]. Three analyses were conducted: (i) a CTT item analysis, (ii) a CFA to validate the factor structure and (iii) an IRM analysis. The CTT item analysis and the CFA results showed that the scale had high internal consistency (ranging from 0.76 to 0.93) and a strong factor structure. Results also showed that the scale could be improved by modifying or eliminating some of the existing items without significantly altering the content of the scale. The IRM results also showed that the scale had few items that targeted high self-efficacy and the stage-specific assumption underlying the scale was rejected. In addition, the IRM analyses found that the five-point response format functioned more like a four-point response format. Overall, employing multiple methods to assess the psychometric properties of the stage-specific self-efficacy scale demonstrated the complimentary nature of these methods and it highlighted the strengths and weaknesses of this scale.

Adult↗

PubMed2005

Variability in net ecosystem exchange from hourly to inter-annual time scales at adjacent pine and hardwood forests: a wavelet analysis.

Orthonormal wavelet transformation (OWT) is a computationally efficient technique for quantifying underlying frequencies in nonstationary and gap-infested time series, such as eddy-covariance-measured net ecosystem exchange of CO2 (NEE). We employed OWT to analyze the frequency characteristics of synchronously measured and modeled NEE at adjacent pine (PP) and hardwood (HW) ecosystems. Wavelet cospectral analysis showed that NEE at PP was more correlated to light and vapor pressure deficit at the daily time scale, and NEE at HW was more correlated to leaf area index (LAI) and temperature, especially soil temperature, at seasonal time scales. Models were required to disentangle the impacts of environmental drivers on the components of NEE, ecosystem carbon assimilation (Ac) and ecosystem respiration (RE). Sensitivity analyses revealed that using air temperature rather than soil temperature in RE models improved the modeled wavelet spectral frequency response on time scales longer than 1 day at both ecosystems. Including LAI improved RE model fit on seasonal time scales at HW, and incorporating parameter variability improved the RE model response at annual time scales at both ecosystems. Resolving variability in canopy conductance, rather than leaf-internal CO2, was more important for modeling Ac at both ecosystems. The PP ecosystem was more sensitive to hydrologic variables that regulate canopy conductance: vapor pressure deficit on weekly time scales and soil moisture on seasonal to interannual time scales. The HW ecosystem was sensitive to water limitation on weekly time scales. A combination of intrinsic drought sensitivity and non-conservative water use at PP was the basis for this response. At both ecosystems, incorporating variability in LAI was required for an accurate spectral representation of modeled NEE. However, nonlinearities imposed by canopy light attenuation were of little importance to spectral fit. The OWT revealed similarities and differences in the scale-wise control of NEE by vegetation with implications for model simplification and improvement.

Carbon Dioxide↗

PubMed2001

Evaluating the psychometric properties of a scale to measure medical students' career-related values.

PURPOSE: To develop and validate a survey instrument to measure medical students' career-related values. METHOD: A literature review yielded seven content domains that consistently correlated with medical students' career choices: biosocial orientation, bioscientific orientation, academic interest, prestige, income, desire to avoid role strain, and desire for role support. Item pools for the content domains were developed by examining previously published questionnaires and research and by interviewing health professionals, medical students, and premedical students. The instrument was tested in two phases. In phase 1, a 96-item questionnaire was mailed to all 847 students at the University of Minnesota School of Medicine. Results were submitted to item analysis and exploratory factor analysis. Construct validity of the questionnaire was assessed by (1) seeing if the seven scales correlated to one another in expected directions, (2) correlating students' survey responses with their self-reported interests in primary care, surgery, or radiology, and (3) seeing if anticipated sex differences were realized across the seven content domains. In phase 2, a random subgroup of 134 students was sent the final 46-item instrument twice to determine its short-term test-retest reliability. RESULTS: In phase 1, 670 students (79.2%) returned usable questionnaires. Seven scales corresponding to the content domains emerged from factor analyses. Cumulatively, they accounted for 43.9% of the variance in students' responses, and their internal consistency coefficients ranged from.71 to.87. All scales correlated with one another in the directions expected and, with two exceptions, at highly significant levels. High scores on bioscientific orientation, prestige, and income scales correlated positively with students' interest in surgery or radiology careers, but correlated negatively with their interest in primary care. High scores on biosocial orientation and avoid role strain scales correlated positively with students' interest in primary care, but correlated negatively with students' interest in surgery or radiology. Women had higher scores than did men on biosocial orientation, avoid role strain, and role support scales and lower scores on bioscientific orientation, academic interest, prestige, and income. Of these, all but the difference in role support scores were highly significant. In phase 2, 89 students (66%) returned questionnaires. Test-retest reliability for the seven scales ranged from.83 to.92. CONCLUSIONS: The seven scales pertaining to students' career-related values collectively demonstrated high internal consistency, short-term test-retest reliability, and evidence of construct validity. If predictive validity can be demonstrated in future research, the scales could have important applications for researchers, guidance counselors, and students, and they might also be useful to administrators who wish to identify students interested in primary care earlier in the students' training.

Adult↗

PubMed2000

Clinical outcome scales for use in a rabbit model of cervical myelopathy.

This study determined the ability of an upper extremity Tarlov scale, a lower extremity Tarlov scale, and the Durham scale to predict the development of myelopathy and the likelihood of survival in a rabbit model of surgical treatments for cervical spondylotic myelopathy. Forty-eight rabbits were evaluated using the scales after cervical spinal surgery. Logistic regression analysis revealed that all three scales could predict the occurrence of myelopathy. However, only the Durham and lower extremity Tarlov scales also predicted the likelihood of survival. The Durham scale is offered as a useful predictor of myelopathy and survival in an animal model of surgical treatments for cervical spondylotic myelopathy. The lower extremity Tarlov scale is also a useful predictor of outcome; however, the upper extremity Tarlov scale is not recommended.

Animals↗

PubMed1983

Do category rating scales produce biased preference weights for a health index?

Category rating scales are frequently used to measure social preferences in health decision models. The use of category rating scale methods has been questioned because subjects allegedly attempt to use rating scale categories equally often. This results in scale values that are contingent upon the context in which a stimulus is presented. In Experiment 1, subjects were randomly divided into five groups that rated a series of health case descriptions using the category method. Extensive pretesting had established the scale values for the stimuli. For one group, all values of the stimuli were evenly distributed across the response scale (as determined by pretests). For a second group, only items from the top of the scale were used; for a third group, only items with low values were used; for the fourth group items with low and high values (but not middle range) were presented; and for the fifth, items with medium values were presented. The results demonstrated that the values for items remain essentially the same, regardless of the group in which they are presented. These results were confirmed and extended in a second experiment. Experiment 3 demonstrated that subjects will attempt to use categories equally often when the stimuli are not health case descriptions but only when the response continuum and end-points of the rating scale are poorly defined. It is suggested that rating scales can provide valid and reliable results if the response continuum is made clear to subjects.

Decision Theory↗

PubMed2001

PedsQL 4.0: reliability and validity of the Pediatric Quality of Life Inventory version 4.0 generic core scales in healthy and patient populations.

BACKGROUND: The PedsQL (Pediatric Quality of Life Inventory) (Children's Hospital and Health Center, San Diego, California) is a modular instrument for measuring health-related quality of life (HRQOL) in children and adolescents ages 2 to 18. The PedsQL 4.0 Generic Core Scales are multidimensional child self-report and parent proxy-report scales developed as the generic core measure to be integrated with the PedsQL Disease-Specific Modules. The PedsQL 4.0 Generic Core Scales consist of 23 items applicable for healthy school and community populations, as well as pediatric populations with acute and chronic health conditions. METHODS: The 4 PedsQL 4.0 Generic Core Scales (Physical, Emotional, Social, School) were administered to 963 children and 1,629 parents (1,677 subjects accrued overall) recruited from pediatric health care settings. Item-level and scale-level measurement properties were computed. RESULTS: Internal consistency reliability for the Total Scale Score (alpha = 0.88 child, 0.90 parent report), Physical Health Summary Score (alpha = 0.80 child, 0.88 parent), and Psychosocial Health Summary Score (alpha = 0.83 child, 0.86 parent) were acceptable for group comparisons. Validity was demonstrated using the known-groups method, correlations with indicators of morbidity and illness burden, and factor analysis. The PedsQL distinguished between healthy children and pediatric patients with acute or chronic health conditions, was related to indicators of morbidity and illness burden, and displayed a factor-derived solution largely consistent with the a priori conceptually-derived scales. CONCLUSION: The results demonstrate the reliability and validity of the PedsQL 4.0 Generic Core Scales. The PedsQL 4.0 Generic Core Scales may be applicable in clinical trials, research, clinical practice, school health settings, and community populations.

Acute Disease↗