Showing papers on "Intraclass correlation published in 2008"

The Montreal cognitive assessment as a screening tool for cognitive impairment in Parkinson's disease.

Abstract: Cognitive impairment is common in Parkinson's disease (PD) and can occur early in the disease course. No effective screening test exists for detection of early or mild cognitive impairment in PD. We examined the Montreal Cognitive Assessment (MoCA) as a screening tool for cognitive dysfunction in PD. The test-retest intraclass correlation coefficient was 0.79 and the interrater intraclass correlation coefficient was 0.81. The correlation coefficient between the MoCA and a neuropsychologic battery was 0.72. The MoCA is reliable and valid in the PD population and warrants further study as a screening tool for cognitive dysfunction.

Reliability and validity studies of the Turkish version of the Epworth Sleepiness Scale

Abstract: The Epworth Sleepiness Scale (ESS) is a self-administered eight-item questionnaire that is widely used in English speaking countries for assessment of daytime sleepiness in adults. The aim of this study was to investigate the reliability and validity of the ESS in the Turkish language. The Turkish version of the ESS (ESStr) was applied to 194 healthy controls and 150 consecutive subjects attending the sleep centre with symptoms of sleep-disordered breathing. Test–retest reliability of the ESStr was tested in a separate group of 30 subjects. The ESStr scores of 60 subjects with mild to severe obstructive sleep apnoea (OSA) were compared with the ESStr scores of 60 healthy controls matched for age, gender, and body mass index (BMI). Concurrent validity with the Functional Outcomes of Sleep Questionnaire (FOSQtr) was also assessed in 12 subjects. The questionnaire had a high level of internal consistency as measured by Cronbach’s alpha (≥0.86). The test–retest intraclass correlation coefficient was r = 0.81 (95% confidence interval: 0.64–0.90) (p < 0.001) and Spearman’s correlation coefficient was r = 0.80 (p = 0.01). The control group had lower ESStr scores than subjects with sleep-disordered breathing (3.6 ± 3 vs 12.6 ± 6, respectively; p < 0.001). Subjects with mild sleep-disordered breathing also had lower scores of the ESStr than those with moderate and severe sleep-disordered breathing (10 ± 6.2 vs 14 ± 5. and 10 ± 6.2 vs 16 ± 5.4, respectively; both p < 0.05), but there were no significant differences between moderate and severe subjects with sleep apnoea. There were significant correlations between the ESStr and total FOSQtr and its subscales (r = −0.22 to r = −0.92; all p = 0.05). Factor analysis of item scores showed that the ESStr had only one factor. The ESStr is a reliable and valid measure of daytime sleepiness. These features and the simplicity of the ESStr make it a valuable measure for clinical management and research.

Reliability and validity of the IPAQ-Chinese: the Guangzhou Biobank Cohort study.

Abstract: Introduction: Valid measurements of self-reported physical activity are very limited in Chinese populations, especially the elderly. Therefore, we examined the validity and reliability of the Chinese version of the International Physical Activity Questionnaire (IPAQ-C) in older Chinese people. Methods: Two hundred twenty-four older adults (66.1% women, 33.9% men, mean age 65.2 +/- 5.7 yr) were randomly selected from the Guangzhou Biobank Cohort Study, a prospective cohort of older Chinese in Southern China. To examine the test-retest reliability, the participants completed the IPAQ-C twice during a 7-d interval. The criterion validity of the IPAQ-C was tested with pedometry. Results: Good reliability was observed between the repeated IPAQ-C, with intraclass correlation coefficients (ICC) ranging from 0.81 to 0.89. Total activity measured by IPAQ-C correlated moderately with the pedometer-measured steps (partial r = 0.33 adjusted for sex, age, and education; P < 0.001). The walking domain of IPAQ-C was strongly associated with the number of steps (partial r = 0.58, P < 0.001), but there were no significant associations between other activity domains of the IPAQ-C and the pedometer data. Conclusion: This is the first reported validation study of an international standardized questionnaire (IPAQ-C) in older Chinese adults. Our study shows that the IPAQ-C is adequately valid and reliable for assessing total physical activity and that it may be a useful instrument for generating internationally comparable data on physical activity in this population.

Reliability of Ashworth and Modified Ashworth Scales in Children with Spastic Cerebral Palsy

Abstract: Measurement of spasticity is a difficult and unresolved problem, partly due to its complexity and the fact that there are many factors involved. In the assessment of spasticity in the pediatric disabled population, methods that are easily used in practice are ordinal scales that still lack reliability. A prospective cross-sectional observational study was planned to determine the reliability of the Ashworth Scale (AS) and the Modified Ashworth Scale (MAS) in children with spastic cerebral palsy (CP). The study included 38 children with spastic diplegic CP. The mean age for the children was 52.9 months (SD: 19.6) ranging from 18 to 108 months. The functional levels of children were classified according to the Gross Motor Function Classification System. 20 children were in Level II (52.6%), 18 were in Level III (47.4%) and 9 were in Level I (23.7%). Spasticity in hip flexors, adductors, internal rotators, hamstrings, gastrocnemius were assessed by AS and MAS. Each child was assessed by three physiotherapists in two different sessions, a week apart. The intrarater reliability was determined by paired comparison of measurements for each therapist for the two assessments. Interrater reliability was determined by paired comparisons of the three therapists' measurements on the same day. The inter and intrarater reliability of the scales were evaluated by the intraclass correlation coefficient (ICC). According to ICC scores, interrater reliability of AS and MAS varied from moderate to good. ICC scores of AS were between 0.54 and 0.78 and MAS were between 0.61–0.87. Test-retest results of AS and MAS varied from poor to good. ICC values were between 0.31 and 0.82 for AS and between 0.36 and 0.83 for MAS. The interrater and intrarater reliability of AS and MAS are related to muscle and joint characters. The repetition of measurements by the same physiotherapist, and experience may not affect reliability. These scales are not very reliable and assessments of spasticity using these scales should be therefore interpreted with great caution.

Reliability and validity of two frequently used self-administered physical activity questionnaires in adolescents

Abstract: To create and find accurate and reliable instruments for the measurement of physical activity has been a challenge in epidemiological studies. We investigated the reliability and validity of two different physical activity questionnaires in 71 adolescents aged 13–18 years; the WHO, Health Behaviour in Schoolchildren (HBSC) questionnaire, and the International Physical Activity Questionnaire (IPAQ, short version). The questionnaires were administered twice (8–12 days apart) to measure reliability. Validity was assessed by comparing answers from the questionnaires with a cardiorespiratory fitness test (VO2peak) and seven days activity monitoring with the ActiReg, an instrument measuring physical activity level (PAL) and total energy expenditure (TEE). Intraclass correlation coefficients for reliability for the WHO HBSC questionnaire were 0.71 for frequency and 0.73 for duration. For the frequency question, there was a significant difference between genders; 0.87 for girls and 0.59 for boys (p < 0.05). The intraclass correlation coefficients the IPAQ varied between 0.10 and 0.62 for the reliability. Spearman correlation coefficients for validity for both the WHO HBSC questionnaire and the IPAQ (recoded into low, moderate and high activity) measured against VO2peak were fair, ranging between 0.29 – 0.39. The WHO HBSC questionnaire measured against VO2peak for girls were acceptable, ranging between 0.30 – 0.55. Both questionnaires, except the walking question in IPAQ, showed a low correlation with PAL and TEE, ranging between 0.01 and 0.29. These data indicate that the WHO HBSC questionnaire had substantial reliability and were acceptable instrument for measuring cardiorespiratory fitness, especially among girls. None of the questionnaires however seemed to be a valid instrument for measuring physical activity compared to TEE and PAL in adolescents.

Measurement properties of the CESD scale among individuals with spinal cord injury.

Abstract: Depression is common after spinal cord injury (SCI), yet it can be difficult and costly to diagnose. Screening tools such as the Center for Epidemiological Studies Depression scale (CESD) can assist with case identification; however, insufficient knowledge of their measurement properties exists to use them in the SCI population. To assess the reliability and validity of the CESD-20 and the CESD-10. Tertiary care centre in Vancouver, British Columbia, Canada. A 2-week retest study of 47 individuals with traumatic SCI. Subjects ⩾19, who had their SCI for ⩾1 year and had American Spinal Injury Association Impairment scale ranking of A or B. Short Form-36 (SF-36) subscales and a visual analogue scale for fatigue (VAS-F) were used to assess validity using Pearson's correlations coefficients. Internal consistency was assessed using Cronbach's alpha, retest reliability was assessed using intraclass correlation coefficients (ICCs) and Bland–Altman plots. Normative data are presented based on key demographic and clinical factors. Cronbach's alpha was 0.91 and 0.86 and retest reliability was ICC=0.87 (95% confidence interval (CI) 0.79–0.93) and ICC=0.85 (95% CI 0.75–0.92) for the CESD-20 and CESD-10, respectively. Minimal bias was evident based on the Bland–Altman plots. The strongest correlations were with outcomes representing mental health (r=−0.71), vitality (r=−0.60) and the VAS-F (r=0.57). The weakest correlation was with the physical function score of the SF-36 (r=−0.37). The CESD-20 and CESD-10 are quick and easy to use. This study provides evidence in support of the reliability and validity.

Reliability, validity and ability to detect change of the Personal and Social Performance scale in patients with stable schizophrenia.

Abstract: This report describes the measurement properties of the Personal and Social Performance scale (PSP), a clinician-reported measure of severity of personal and social dysfunction, in an outpatient population with stabilized schizophrenia. Pooled data from two similar antipsychotic clinical studies were analyzed (n=411). The PSP showed good test-retest reliability (intraclass correlation coefficient=0.79). The PSP was more highly correlated with the Strauss-Carpenter Level of Function, an instrument measuring a similar construct, than the Positive and Negative Syndrome Scale, an instrument measuring a different construct. There was a statistically significant difference between mean PSP scores in subjects grouped by their severity rating on the Clinical Global Impression-Severity (CGI-S) (mild or less versus at least moderate), indicating the ability to discriminate between known groups. Effect sizes for mean change in the PSP based on 1-category improvement (0.72) or worsening (-0.88) versus no change in the CGI-S were moderate to large, demonstrating the ability to detect change. Estimates of between-group minimum important difference suggest that a 7-point improvement in the PSP may be clinically meaningful in a clinical trial setting. Initial reliability and validity assessments suggest the PSP may be a useful measure of social functioning in patients with stable schizophrenia.

Concurrent validity of four clinical tests used to measure hamstring flexibility.

Abstract: The purpose of this study was to examine the concurrent validity of 4 clinical tests used to measure hamstring muscle length. A pilot study (N = 10) was conducted to determine the intratester reliability of 4 hamstring length measures: knee extension angle (KEA), sacral angle (SA), straight leg raise (SLR), and sit and reach (SR). The pilot investigation revealed good to excellent intratester reliability (intraclass correlation coefficient = 0.92-0.95) for each of the 4 tests. Eighty-one subjects (42 men and 39 women) participated in the main investigation. Subjects were randomly tested for each of 4 assessments of hamstring length. Concurrent validity was determined using linear regression, correlation, and kappa statistics. Correlation coefficients corresponding to the concurrent validity of the six combinations of the 4 clinical tests revealed poor to fair correlation (r = 0.45-0.65). The correlation coefficients for each pair from greatest to least were SR-SA= 0.65, SLR-SR = 0.65, KEA-SLR = 0.63, KEA-SR = 0.57, SLR-SA = 0.50, and KEA-SA = 0.45. Despite the common clinical use of these measures to assess hamstring length, these tests do not have sufficient concurrent validity to be used interchangeably or to assume that they each measure the same construct (hamstring length). Based on the results of this investigation and a review of the literature, the authors recommend that researchers, clinicians, and strength and conditioning specialists adopt the KEA test as the gold standard measure for hamstring muscle length.

Psychometric properties of the Fear-Avoidance Beliefs Questionnaire and Tampa Scale of Kinesiophobia in patients with neck pain.

Abstract: Objective: To examine selected psychometric properties of these instruments in a cohort of patients with mechanical neck pain. Design: Cohort design of 78 subjects completing self-report measures of pain, disability, and the Fear-Avoidance Beliefs Questionnaire Work (FABQW) and Physical Activity (FABQPA) subscales, as well as the Tampa Scale of Kinesiophobia (TSK) at baseline and a 2-day follow-up. Intraclass correlation coefficients were used to calculate test–retest reliability, and Cronbach's alpha was used to calculate internal consistency. Concurrent validity was analyzed between the FABQPA, FABQW, TSK, pain, and disability using Pearson correlation coefficients and hierarchical linear regression modeling. Results: The FABQPA and FABQW subscales exhibited substantial test–retest reliability, whereas the TSK exhibited moderate reliability. Internal consistency was high for all measures. The FABQW subscale was the only measure that significantly contributed to the regression model for both pain and disability in this group of patients with neck pain. Conclusions: Whereas the reliability and internal consistency of all measures ranged between moderate and substantial, the results of this study suggest weaker relationships between measures of fear and avoidance beliefs and pain/disability among patients with mechanical neck pain than has been reported among patients with low-back pain.

Comparing preference-based quality-of-life measures: results from rehabilitation patients with musculoskeletal, cardiovascular, or psychosomatic disorders.

Abstract: To compare the EQ-5D, 15D, HUI 2, HUI 3, SF-6D, and QWB-SA in terms of their descriptive statistics, score distribution, agreement and responsiveness in a sample of German rehabilitation inpatients. Patients with musculoskeletal (N = 106), cardiovascular (N = 88), and psychosomatic (N = 70) disorders completed questionnaires at the beginning (baseline) and end (follow-up) of their inpatient treatment. Comparisons addressed the proportion of missing data, distributional properties, agreement, and responsiveness. Intraclass correlation coefficients (ICC), paired t-tests, and standardized response means (SRM) were computed. Mean index scores at baseline ranged from 0.48 (HUI 3; psychosomatic) to 0.86 (15D; cardiovascular). At baseline, ceiling effects across all patient groups ranged from zero (SF-6D; cardiovascular and psychosomatic) to 21.6% (EQ-5D; cardiovascular). ICCs ranged from 0.26 (EQ-5D–QWB-SA; cardiovascular) to 0.80 (HUI 2–HUI 3; musculoskeletal). Substantial differences in responsiveness were observed between measures. Results obtained with different preference-based quality-of-life measures in a sample of patients with mild to moderate disease severity are not equivalent. As differences between measures may have considerable effects in health economic evaluation studies, careful selection of instruments for a given study is essential.

Measurement of dental implant stability by resonance frequency analysis and damping capacity assessment: comparison of both techniques in a clinical trial.

Abstract: Purpose: Two noninvasive methods to measure dental implant stability are damping capacity assessment (Periotest) and resonance frequency analysis (Osstell). The objective of the present study was to assess the correlation of these 2 techniques in clinical use. Materials and Methods: Implant stability of 213 clinically stable loaded and unloaded 1-stage implants in 65 patients was measured in triplicate by means of resonance frequency analysis and Periotest. Descriptive statistics as well as Pearson’s, Spearman’s, and intraclass correlation coefficients were calculated with SPSS 11.0.2. Results: The mean values were 57.66 ± 8.19 implant stability quotient for the resonance frequency analysis and –5.08 ± 2.02 for the Periotest. The correlation of both measuring techniques was –0.64 (Pearson) and –0.65 (Spearman). The single-measure intraclass correlation coefficients for the ISQ and Periotest values were 0.99 and 0.88, respectively (95% CI). No significant correlation of implant length with either resonance frequency analysis or Periotest could be found. However, a significant correlation of implant diameter with both techniques was found (P < .005). The correlation of both measuring systems is moderate to good. It seems that the Periotest is more susceptible to clinical measurement variables than the Osstell device. The intraclass correlation indicated lower measurement precision for the Periotest technique. Additionally, the Periotest values differed more from the normal (Gaussian) curve of distribution than the ISQs. Both measurement techniques show a significant correlation to the implant diameter. Conclusion: Resonance frequency analysis appeared to be the more precise technique. INT J ORAL MAXILLOFAC IMPLANTS 2008;23:525–530

The cultural adaptation, reliability and validity of neck disability index in patients with neck pain: a Turkish version study.

Abstract: Study Design. The cultural adaptation of Neck Disability Index (NDI), the validity and reliability of Turkish version. Objective. The aim of this study was to conduct a study concerning the cultural adaptation of NDI and investigate the validity and reliability of its Turkish version in patients with neck pain. Summary of Background Data. The NDI is a reliable evaluation instrument for disability but there is no published Turkish version. Methods. Eighty-eight patients with neck pain for at least 3 months were included in the study. NDI, The Neck Pain and Disability Scale, and Visual Analogue Scale (VAS) were completed by all subjects. Test-retest reliability was determined by using intraclass correlation coefficient and Pearson correlation analysis. For the determination of concurrent validity, the relation between NDI and VAS was examined by Pearson correlation analysis and for the determination of construct validity, the relation between NDI and Neck Pain and Disability Scale was investigated. Results. Intraclass correlation coefficient score for test-retest reliability was 0.979 (95% confidence interval = 0.968-0.986). For concurrent validity, the relation between NDI and VAS was investigated, the rvalue for test and retest was 0.508 and 0.620, respectively (P < 0.0001). For construct validity, the relation between NDI and the Turkish version of Neck Pain and Disability Scale was investigated, the r value for test and retest was 0.659 (P< 0.0001) and 0.728 (P < 0.0001), respectively. Conclusion. The results suggest that the Turkish version of the NDI validated in this study is an easy to understand, reliable, and valid instrument for the measurement of the limitation of activities of daily living and pain caused by neck disorders in the Turkish-speaking population.

Validation of the Chinese Pain Catastrophizing Scale (HK-PCS) in patients with chronic pain.

Abstract: Objective. This study was conducted to examine the psychometric properties of a Chinese translation of the Pain Catastrophizing Scale (HK-PCS). Design/Patients. Patients aged 18–79 years (N = 130) with chronic nonmalignant pain attending an outpatient multidisciplinary pain center in Hong Kong participated in this cross-sectional study. Method. Subjects completed a set of health-related instruments: HK-PCS, Hospital Anxiety and Depression Scale, Roland Morris Disability Questionnaire, SF-36 Health Survey, and a general demographic questionnaire. Data were analyzed for the distribution, internal consistency, reliability, and construct validity. Results. A satisfactory internal consistency was found (α = 0.927). The item–total correlation coefficients ranged from 0.575 to 0.777. The intraclass correlation coefficient was 0.969 for the total HK-PCS score, 0.956 for helplessness, 0.945 for magnification, and 0.910 for rumination. Confirmatory factor analysis verified a second-order factor structure with the comparative fit index = 1.00, root mean square error of approximation = 0.038, and normed fit index = 0.99 (χ2(58) = 68.84, P = 0.16). Significant correlations were found for pain intensity, disability, anxiety, and depression (r = 0.223–0.597, P 0.05), which is contrary to the existing literature. Conclusion. This study has illustrated satisfactory psychometric properties of the HK-PCS. We provide evidence for the validity and reliability of the HK-PCS as an instrument for measuring pain catastrophizing in the Chinese patient with chronic pain.

Reliability and concurrent validity of the Expanded Timed Up-and-Go test in older people with impaired mobility.

Abstract: Background and Purpose. ‘Expanded Timed Up-and-Go’ (ETUG) was developed to assess each of the subtasks of the ‘Timed Up-and-Go’ (TUG). The aim of the study was to test the intrarater, interrater, test–retest reliability and internal consistency of the ETUG, and the concurrent validity with the TUG. Methods. The present study is a reliability and a validity study. Twenty-eight subjects (80 ± 4.1 years) with balance and gait problems were included. Three raters timed the ETUG subtasks from a video, using a computer-based scoring programme, and the total ETUG time was calculated. TUG was registered by a regular stopwatch. Results. The intrarater and interrater reliability (intraclass correlation [ICC][1,1]) ranged from 0.55 to 0.97. The test–retest reliability (ICC[1,1]) ranged from 0.54 to 0.85. The absolute measurement error of the total time (1.96 Sw) was 2.8 seconds. The internal consistency (Cronbach's alpha) was 0.74. The correlation (Pearson's r) between ETUG total time and TUG after correcting for attenuation caused by restricted reliability in each of the measures was 0.85. Conclusion. The ETUG scored from a video shows a good reliability for experienced raters and acceptable internal consistency. The ETUG showed a higher reliability than TUG when tested on the same sample of older subjects with impaired mobility, and the high concurrent validity between ETUG and TUG suggests that the two tests may have similar properties. Since ETUG also adds new information compared with TUG, we suggest that ETUG is an interesting alternative to existing clinical tests of mobility. Copyright © 2008 John Wiley & Sons, Ltd.

Cross-Cultural Adaptation and Validation of the Foot Function Index for Use in German-Speaking Patients with Foot Complaints:

Abstract: Background:The purpose of this study was to cross-culturally adapt the Foot Function Index (FFI) for use in German-speaking patients with foot complaints.Materials and Methods:The FFI was adapted for the German language according to the recommended forward/backward translation protocol. The following metric properties were assessed in 53 consecutive patients (mean age, 57.2 years; 39 women) undergoing foot surgery at our department: feasibility, reliability (intraclass correlation coefficient ICC), internal consistency (Cronbach's alpha, CA), and construct validity (correlation with the Short Form (SF-36), a VAS assessing pain, a VAS assessing function, and the University of California at Los Angeles (UCLA) activity scale.Results:The German FFI (FFI-D) comprised 18 items separated into a pain and a disability subscale. Completion of the FFI-D was feasible. The reliability and the internal consistency were both excellent with an ICC of 0.98 and a CA of 0.97 for the total score. We found moderate to high co...

Age-specific reliability of two grip-strength dynamometers when used by children.

Abstract: Background: The Jamar dynamometer and the Martin vigorimeter, two instruments often used to assess grip strength, have good validity and reliability when employed to evaluate adults. Grip strength measurements are often performed to assess children with hand disorders. However, the reliability of these measurements when used to assess children under the age of twelve years is unknown. In addition, it is not clear whether reliability differs between younger and older children. The purpose of this study was to establish test-retest reliability for different age groups and to determine which instrument is the most reliable. Methods: One hundred and four children from a primary school were included. Subjects were divided into three groups: four to six, seven to nine, and ten to twelve years of age. The grip strength of both hands was measured with the Lode dynamometer (equivalent to the Jamar dynamometer) and with the Martin vigorimeter. The mean of three maximum voluntary contractions was recorded for all measurements. A retest was performed after a mean interval of twenty-nine days. Results: In the total group, the intraclass correlation coefficient for the Lode dynamometer was 0.97 (95% confidence interval, 0.95 to 0.98) for the dominant hand and 0.95 (95% confidence interval, 0.92 to 0.96) for the nondominant hand and the intraclass correlation coefficient for the Martin vigorimeter was 0.84 (95% confidence interval, 0.77 to 0.89) for the dominant hand and 0.86 (95% confidence interval, 0.80 to 0.90) for the nondominant hand. The intraclass correlation coefficients in the different age groups were lower than those in the total group because of a lower between-subject variation. The normalized smallest detectable difference between the test and retest values was approximately 25% for the Lode dynamometer and approximately 31% for the Martin vigorimeter. Conclusions: Both the Lode dynamometer and the Martin vigorimeter are reliable instruments with which to measure the grip strength of children under twelve years of age; however, the Lode dynamometer has better test-retest reliability. Furthermore, comparison of the smallest detectable differences showed the Lode dynamometer to be a more accurate instrument.

Psychometric properties of the Greek version of the NEI-VFQ 25.

Abstract: To evaluate the reliability and construct validity of a Greek version of the NEI-VFQ-25 in patients with chronic ophthalmic diseases. We developed the Greek version of the instrument using forward and backward translation. One hundred-eighty-six patients responded to the questionnaire. To examine reliability, Cronbach's alpha for each subscale was used as an index of internal consistency. Test-retest reliability was evaluated with intraclass correlation coefficients. Regarding construct validity, both convergent and discriminant validities were calculated by means of multi-trait analysis. Rasch analysis was used to estimate the visual ability required by each item for a particular response, and each patient's visual ability. Correspondingly, instrument validity was evaluated by estimating the distribution of residuals for item and subject measures. Four patient groups were studied, each including participants with a single cause of visual impairment. Group 1 consisted of 84 glaucoma subjects. Group 2 included 30 subjects with age-related macular degeneration (ARMD); group 3 included 25 subjects with dry-eye syndrome, whereas group 4 included 18 cataract patients. Twenty-nine healthy individuals comprised the control group. NEI-VFQ scores (mean ± SD) for the glaucoma, ARMD, dry-eye, cataract and control groups were: 76.9 ± 20.2, 70.9 ± 20.2, 81.6 ± 16.5, 73.5 ± 24.0 and 93.7 ± 8.9 respectively. Item analysis revealed no significant data skewing. Cronbach's alpha ranged from 0.678 to 0.926, with most subscales having high internal consistency. Intraclass correlation coefficient ranged from 0.717 to 0.910 for all subscales. All items passed the convergent and discriminant validity tests. Strong correlations were detected between visual acuity and "general vision", "distant activities" and "near activities" subscales. Significant correlations were also detected between visual field deficits and the "peripheral vision" and "general vision" subscales. Rasch analysis revealed potential weaknesses of the instrument that are associated with the assumptions of the model itself. Specifically, low precision of the "agreement" items was detected in the estimation of visual ability. Twenty-three percent of the subjects had fit statistics that fell outside the tolerance box. Although traditional validation methods indicated that the Greek version of the NEI-VFQ-25 is a valid and reliable instrument for VS-QoL assessment, Rasch analysis detected significant misfits to the model, especially of the "agreement" items. This means that results of the corresponding subscales should be interpreted with extreme caution.

Development, reliability, and validity of the Handwriting Proficiency Screening Questionnaire (HPSQ).

Abstract: OBJECTIVE. This study was used to (1) develop an occupational therapy screening questionnaire (the Handwriting Proficiency Screening Questionnaire [HPSQ]) to identify handwriting difficulties among schoolaged children and (2) examine its reliability and validity. METHOD. The questionnaire’s content validity was established. Internal consistency, interrater and test–retest reliability, and concurrent and construct validity were initiated. Participants included 7- to 14-year-old (N = 230) typically developing school-aged children. RESULTS. The tool demonstrated good internal consistency (α = .90). Test–retest reliability for the score revealed an intraclass correlation coefficient (ICC) of .84 and interrater reliability of ICC =.92 for the total questionnaire score. Construct and concurrent validity were also confirmed. CONCLUSION. The HPSQ is suitable for use by occupational therapists for identification of handwriting defi ciency among school-aged children and is appropriate for varied academic and clinical uses. More studies with larger samples of varied age groups are required to further support the questionnaire’s reliability and validity. Rosenblum, S. (2008). Development, reliability, and validity of the Handwriting Proficiency Screening Questionnaire

Reliability and validity of the myositis disease activity assessment tool.

Abstract: OBJECTIVE: To test the interrater reliability and validity of the Myositis Disease Activity Assessment Tool, which consists of the Myositis Intention-to-Treat Activity Index and the Myositis Disease Activity Assessment Visual Analog Scales. METHODS: Two phases of the study were conducted to assess the reliability and validity of the tool, which was modified following the first phase. In the first phase of the reliability study, 123 adult myositis patients were evaluated in 7 centers, and in the second phase 40 patients were evaluated in 2 centers. The validity study included 294 patients in 5 centers in the first phase and 65 patients in 3 centers in the second phase. The interrater reliability was assessed using intraclass correlation coefficients. The criterion validity was calculated using sensitivity, specificity, and positive predictive value (PPV) of a grade of A in any system. Spearman's rank correlation coefficient was used to measure the convergent validity of cross-sectional scores between the 2 instruments. RESULTS: There was a 2:1 ratio of female to male patients. There was no significant difference in mean age at diagnosis (46.3 versus 46.8 years) and mean disease duration (7.7 versus 10 years) between the 2 groups recruited for the different phases of the study. There was an improvement in interrater reliability in the second phase of the study. There was a significant improvement in the validity of the assessment tool following modification of the tool. The sensitivity, specificity, and PPV of a grade of A in any system improved from 86%, 92%, and 67% in the first phase to 96%, 94%, and 83%, respectively, in the second phase. Convergent validity between the 2 activity tools showed good correlation, ranging from 0.8 to 0.94, for the individual organ systems. CONCLUSION: This is the first major attempt to assess the reliability and validity of a disease activity index in myositis. Our findings indicate that, following within-study modification, the tool appears to be a reliable and valid instrument to assess myositis disease activity.

Construct validity and reliability of the disability of arm, shoulder and hand questionnaire for upper extremity complaints in rheumatoid arthritis.

Abstract: Objective The Disability of Arm, Shoulder and Hand (DASH) questionnaire is a tool for measuring physical function and symptoms of the upper extremity. Although widely used, it is not validated for rheumatoid arthritis (RA). In this study the DASH was validated for this patient group. Methods In total, 102 patients participated in this study. For the validation, the questionnaires of the DASH, the Health Assessment Questionnaire (HAQ), the Medical Outcomes Study Short Form-36 (SF-36), and the Arthritis Impact Measurement Scale (AIMS2) were used. Patients were examined clinically before completing the questionnaires. Pain was scored by each patient using a visual analog scale (VAS). The DiseaseActivity Score (DAS28) was obtained and grip strength was measured. Reliability was tested by a second DASH questionnaire after 2 days. Validity was tested using a Pearson correlation analysis for the relevant domains of the questionnaires and for the clinical aspects. Results The reliability of the DASH was excellent (intraclass correlation coefficient 0.97). Internal consistency was strong (Cronbach’s alpha 0.97). Validity was proven with excellent results for Pearson correlation with the relevant domains of the questionnaires: HAQ, r = 0.88; SF-36, r = 0.70; and AIMS2, r = 0.85. The clinical scores had a relatively low correlation with the DASH (DAS28, r = 0.42; and grip strength, r = 0.41–0.48), except for the VAS (r = 0.60–0.65). Conclusion The DASH is a reliable and valid questionnaire in patients with RA. It can be used as a measurement tool of physical disability of the upper extremity.