Measuring disability and function in older women: psychometric properties of the late-life function and disability instrument. Creating a computer adaptive test version of the late-life function and disability instrument. Performance-Based Versus Patient-Reported Physical Function: What Are the Underlying Predictors? Validity of an exercise test based on habitual gait speed in mobility-limited older adults. Use of Condition-Specific Patient-Reported Outcome Measures in Clinical Trials among Patients with Wrist Osteoarthritis: A Systematic Review Assessment of study quality for systematic reviews: a comparison of the Cochrane Collaboration Risk of Bias Tool and the Effective Public Health Practice Project Quality Assessment Tool: methodological research. Development of a brief measure to assess quality of life in obesity. Effects of Strength Training versus Power Training on Physical Performance in Prefrail Community-Dwelling Older Adults The Assessment of Quality of Life (AQoL) instrument: a psychometric measure of Health-Related Quality of Life Cervical Spine Outcomes Questionnaire: Its Development and Psychometric Properties A menopause-specific quality of life questionnaire: development and psychometric properties. High-Intensity Resistance Training Improves Muscle Strength, Self-Reported Function, and Disability in Long-Term Stroke Survivors Effects of an Oral Nutritional Supplementation Plus Physical Exercise Intervention on the Physical Function, Nutritional Status, and Quality of Life in Frail Institutionalized Older Adults: The ACTIVNES Study. Psychometric properties of the patient activation measure among multimorbid older adults. Comparison of the University of California-Los Angeles Shoulder Scale and the Simple Shoulder Test with the shoulder pain and disability index: single-administration reliability and validity. Comparison of the SF6D, the EQ5D, and the oswestry disability index in patients with chronic low back pain and degenerative disc disease PROMIS PF CAT Outperforms the ODI and SF-36 Physical Function Domain in Spine Patients Evaluation of Neuropsychiatric Function in Phenylketonuria: Psychometric Properties of the ADHD Rating Scale-IV and Adult ADHD Self-Report Scale Inattention Subscale in Phenylketonuria. Psychometric Properties of Patient-Reported Outcome Measures for Hip Arthroscopic Surgery Reliability and Validity of 6 Measures of Pain, Function, and Disability for Ankle Arthroplasty and Arthrodesis Psychometric properties of the National Eye Institute-Refractive Error Quality of Life instrument. Psychometric properties of cancer survivors’ unmet needs survey Validation of the AQLQ12+ among adolescents and adults with persistent asthma Impact of Exercise to Improve Gait Efficiency on Activity and Participation in Older Adults With Mobility Limitations: A Randomized Controlled Trial The Bournemouth Questionnaire: a short-form comprehensive outcome measure. II. Psychometric properties in neck pain patients.
BACKGROUND The recent development of the Late-Life Function and Disability Instrument ( LL-FDI ) was an important contribution to the measurement of function and disability in older adults . The present study examined the psychometric properties and construct validity of the LL-FDI measure in a sample of older women . METHODS Older black ( n = 81 ) and white ( n = 168 ) women completed the LL-FDI  , several measures of physical function , and physical activity measures , and had their body mass index assessed at baseline of an ongoing prospect i ve study . Confirmatory factor analyses ( CFA ) and correlational analyses were used to examine factorial and construct validity of the measure . RESULTS The CFA , using an iterative model modification technique , result ed in an acceptable 15-item solution for the function component and an 8-item solution for the disability component . This abbreviated instrument demonstrated high correlations with the original scales . Construct validity for the LL-FDI was supported . Participants who demonstrated better physical function , reported being more active , and had lower body mass index reported less disability and less difficulty with function on the LL-FDI . CONCLUSIONS The LL-FDI appears to be an effective instrument for assessing function and disability in older women , and the abbreviated version reported here may prove useful in certain circumstances due to its brevity . However , continued determination of the construct validity of the complete and abbreviated scales is recommended BACKGROUND This study applied item response theory ( IRT ) and computer adaptive testing ( CAT ) method ologies to develop a prototype function and disability assessment instrument for use in aging research . Herein , we report on the development of the CAT version of the Late-Life Function and Disability Instrument ( Late-Life FDI ) and evaluate its psychometric properties . METHODS We used confirmatory factor analysis , IRT methods , validation , and computer simulation analyses of data collected from 671 older adults residing in residential care facilities . We compared accuracy , precision , and sensitivity to change of scores from CAT versions of two Late-Life FDI scales with scores from the fixed-form instrument . Score estimates from the prototype CAT versus the original instrument were compared in a sample of 40 older adults . RESULTS Distinct function and disability domains were identified within the Late-Life FDI item bank and used to construct two prototype CAT scales . Using retrospective data , scores from computer simulations of the prototype CAT scales were highly correlated with scores from the original instrument . The results of computer simulation , accuracy , precision , and sensitivity to change of the CATs closely approximated those of the fixed-form scales , especially for the 10- or 15-item CAT versions . In the prospect i ve study , each CAT was administered in <3 minutes and  CAT scores were highly correlated with scores generated from the original instrument . CONCLUSIONS CAT scores of the Late-Life FDI were highly comparable to those obtained from the full-length instrument with a small loss in accuracy , precision , and sensitivity to change Background Functional limitations have been operationally defined for studies of rehabilitation science through measures of physical performance and patient-reported function . Although conceived as representing similar concepts , differences between these 2 modes of measuring physical functioning have not been adequately characterized scientifically . Objective The purpose of this study was to compare the Short Physical Performance Battery ( SPPB ) with the function component of the Late-Life Function and Disability Instrument ( LLFDI ) with respect to their association with physiologic factors and other psychosocial and health factors potentially influencing rehabilitative care . Design This study was a cross-sectional analysis of baseline data from a sample of community-dwelling older adults ( N=137 ) with mobility limitations enrolled in a r and omized controlled trial of exercise . Methods A performance-based measure of function ( the SPPB ) and a self-report measure of function ( the LLFDI ) served as functional outcomes . Physiologic factors included measures of leg strength , leg velocity , and exercise tolerance test ( ETT ) duration , which served as a surrogate measure of aerobic capacity . Psychosocial and health factors included age , sex , height , body mass index , number of chronic conditions , depression , and falls efficacy . Results Separate multivariable regression models predicting SPPB and LLFDI scores described 33 % and 42 % of the variance in each outcome ( R2 ) , respectively . Leg velocity and ETT duration were positively associated with both performance-based and patient-reported functional measures . Leg strength and age were positively associated with SPPB scores , whereas number of chronic conditions , sex , and falls efficacy were associated with the LLFDI scores . Limitations This study included older adults with mobility limitations and may not generalize to other population s. Conclusions Performance-based and patient-reported measures of physical function appear to assess different aspects of an older person 's functioning . The SPPB was associated with age and physiologic factors , whereas patient-reported function measured by the LLFDI was associated with these factors as well as with psychosocial and health factors OBJECTIVE To evaluate whether a customized exercise tolerance testing ( ETT ) protocol based on an individual 's habitual gait speed ( HGS ) on level ground would be a valid mode of exercise testing older adults . Although ETT provides a useful means to risk-stratify adults , age-related declines in gait speed paradoxically limit the utility of st and ard ETT protocol s for evaluating older adults . A customized ETT protocol may be a useful alternative to these st and ard methods , and this study hypothesized that this alternative approach would be valid . DESIGN We performed a cross-sectional analysis of baseline data from a r and omized controlled trial of older adults with observed mobility problems . Screening was performed using a treadmill-based ETT protocol customized for each individual 's HGS . We determined the content validity by assessing the results of the ETTs , and we evaluated the construct validity of treadmill time in relation to the Physical Activity Scale for the Elderly ( PASE ) and the Late Life Function and Disability Instrument ( LLFDI ) . SETTING Outpatient rehabilitation center . PARTICIPANTS Community-dwelling , mobility-limited older adults ( N=141 ) . INTERVENTIONS Not applicable . MAIN OUTCOME MEASURES Cardiac instability , ETT duration , peak heart rate , peak systolic blood pressure , PASE , and LLFDI . RESULTS Acute cardiac instability was identified in 4 of the participants who underwent ETT . The remaining participants ( n=137 , 68 % female ; mean age , 75.3 y ) were included in the subsequent analyses . Mean exercise duration was 9.39 minutes , with no significant differences in duration s being observed after evaluating among tertiles by HGS status . Mean peak heart rate and mean peak systolic blood pressure were 126.6 beats/min and 175.0 mmHg , respectively . Within separate multivariate models ,  ETT duration in each of the 3 gait speed groups was significantly associated ( P<.05 ) with PASE and LLFDI . CONCLUSIONS Mobility-limited older adults can complete this customized ETT protocol , allowing for the identification of acute cardiac instability and the achievement of optimal exercise parameters Background . This paper aim ed to identify condition-specific patient-reported outcome measures used in clinical trials among people with wrist osteoarthritis and summarise empirical peer- review ed evidence supporting their reliability , validity , and responsiveness to change . Methods . A systematic review of r and omised controlled trials among people with wrist osteoarthritis was undertaken . Studies reporting reliability , validity , or responsiveness were identified using a systematic reverse citation trail audit procedure . Psychometric properties of the instruments were examined against predefined criteria and summarised . Results . Thirteen clinical trials met inclusion criteria . The most common patient-reported outcome was the disabilities of the arm , shoulder , and h and question naire ( DASH ) . The DASH , the  Michigan H and Outcomes Question naire ( MHQ ) , the  Patient Evaluation Measure ( PEM ) , and the  Patient-Reported Wrist Evaluation ( PRWE ) had evidence supporting their reliability , validity , and responsiveness . A post-hoc review of excluded studies revealed the AUSCAN Osteoarthritis H and Index as another suitable instrument that had favourable reliability , validity , and responsiveness . Conclusions . The DASH , MHQ , and AUSCAN Osteoarthritis H and Index instruments were supported by the most favourable empirical evidence for validity , reliability , and responsiveness . The PEM and PRWE also had favourable empirical evidence reported for these elements . Further psychometric testing of these instruments among people with wrist osteoarthritis is warranted BACKGROUND The Cochrane Collaboration is strongly encouraging the use of a newly developed tool , the Cochrane Collaboration Risk of Bias Tool ( CCRBT ) , for all review groups . However , the psychometric properties of this tool to date have yet to be described . Thus , the objective of this study was to add information about psychometric properties of the CCRBT including inter-rater reliability and concurrent validity , in comparison with the Effective Public Health Practice Project Quality Assessment Tool ( EPHPP ) . METHODS Both tools were used to assess the method ological quality of 20 r and omized controlled trials included in our systematic review of the effectiveness of knowledge translation interventions  to improve the management of cancer pain . Each study assessment was completed independently by two review ers using each tool . We analysed the inter-rater reliability of each tool 's individual domains , as well as final grade assigned to each study . RESULTS The EPHPP had fair inter-rater agreement for individual domains and excellent agreement for the final grade . In contrast , the CCRBT had slight inter-rater agreement for individual domains and fair inter-rater agreement for final grade . Of interest , no agreement between the two tools was evident in their final grade assigned to each study . Although both tools were developed to assess ' quality of the evidence ' , they appear to measure different constructs . CONCLUSIONS Both tools performed quite differently when evaluating the risk of bias or method ological quality of studies in knowledge translation interventions for cancer pain . The newly introduced CCRBT assigned these studies a higher risk of bias . Its psychometric properties need to be more thoroughly vali date d , in a range of research fields , to underst and fully how to interpret results from its application OBJECTIVE Obesity research ers have a growing interest in measuring the impact of weight and weight reduction on quality of life . The Impact of Weight on  Quality of Life question naire ( IWQOL ) was the first self-report instrument specifically developed to assess the effect of obesity on quality of life . Although the IWQOL has demonstrated excellent psychometric properties , its length ( 74 items ) makes it somewhat cumbersome as an outcome measure in clinical research . This report describes the development of a 31-item version of the IWQOL ( IWQOL-Lite ) . RESEARCH METHODS AND PROCEDURES IWQOLs from 996 obese patients and controls were used to develop the IWQOL-Lite . Psychometric properties of the IWQOL-Lite were examined in a separate cross-validation sample of 991 patients and controls . RESULTS Confirmatory factor analysis provided strong support for the adequacy of the scale structure . The five identified scales of the IWQOL-Lite  ( Physical Function , Self-Esteem , Sexual Life , Public Distress , and Work ) and the total IWQOL-Lite score demonstrated excellent psychometric properties . The reliability of the IWQOL-Lite scales ranged from 0.90 to 0.94 and was 0.96 for the total score . Correlations between the IWQOL-Lite and collateral measures supported the construct validity of the IWQOL-Lite . Changes in  IWQOL-Lite scales over time correlated significantly with changes in weight , supporting its sensitivity to change . Significant differences in IWQOL-Lite scale and total scores were found among groups differing in body mass index , supporting the utility of the IWQOL-Lite across the body mass index spectrum . DISCUSSION The IWQOL-Lite appears to be a psychometrically sound and clinical ly sensitive brief measure of quality of life in obese persons Background : It has been unclear which training mode is most effective and feasible for improving physical performance in the risk group of prefrail community-dwelling older adults . Objective : The purpose of the present study was to compare the effects of strength training ( ST ) versus power training ( PT ) on functional performance in prefrail older adults . This study was registered at clinical trials.gov as NCT00783159 . Methods : 69 community-dwelling older adults ( > 65 years ) who were prefrail according to the definition of Fried were included in a 12-week exercise program . The participants were r and omized into an ST group , a PT group and a control group . All participants were supplemented with vitamin D3 orally before entering the intervention period . The primary outcome was the global score on the Short Physical Performance Battery ( SPPB ) . Secondary outcomes were muscle power , appendicular lean mass ( aLM ) measured by dual energy X-ray absorptiometry and self-reported functional deficits ( Short Form of the Late-Life Function and Disability Instrument , SF-LLFDI ) . Results : Regarding changes in the SPPB score during the intervention , significant heterogeneity between the groups was observed ( p = 0.023 ) . In pair-wise comparisons , participants in both training groups significantly ( PT : p = 0.012 , ST : 0.009 ) increased their SPPB score ( PT : Δmean = 0.8 , ST : Δmean = 1.0 ) compared to the control group , with no statistical difference among training groups ( p = 0.301 ) . No statistical differences were found in changes in aLM ( p = 0.769 ) , muscle power ( p = 0.308 ) and SF-LLFDI ( p = 0.623 ) between the groups . Muscle power significantly increased ( p = 0.017 ) under vitamin D3 intake . Conclusions : In prefrail community-dwelling adults , PT is not superior to ST , although both training modes result ed in significant improvements in physical performance . With regard to dropout rates , ST appears to be advantageous compared to PT . The high prevalence of vitamin D3 deficiency and the slight improvement of physical performance under vitamin D3 supplementation among study participants underline the relevance of this approach in physical exercise interventions This paper describes constructing the Assessment of Quality of Life ( AQoL ) instrument ; design ed to measure health-related quality of life ( HRQoL )  , and to be the descriptive system for a multi-attribute utility instrument . Unlike previous utility instruments ' descriptive systems , the AQoL 's has been developed using state-of-the-art psychometric procedures . The result is a descriptive system which emphasizes five different facets of HRQoL and which can cl aim to have construct validity . Based on the WHO 's definition of health a model of HRQoL was developed . Items were written by focus groups of doctors and the research ers . These were administered to a construction sample , comprising hospital patients , and community members chosen at r and om . Final construction was through an iterative process of factor and reliability analyses . The AQoL measures 5 dimensions : illness , independent living , social relationships , physical senses and psychological wellbeing . Each has three items . Exploratory factor analysis showed the dimensions were orthogonal , and each was unidimensional . Internal consistency was α = 0.81 . Structural equation modeling explored its internal structure ; the comparative fit index was 0.90 . These preliminary results indicate the AQoL has the prerequisite qualities for a psychometric HRQoL instrument for evaluation ; replication with a larger sample is needed to verify these findings . Scaling it for economic evaluation using utilities is being undertaken . Respondents have indicated the AQoL is easy to underst and and is quickly completed . Its initial properties suggest it may be widely applicable Study Design . A cross-sectional study was conducted to analyze a convenience sample of patients seeking treatment for cervical spine conditions . Objective . To develop and evaluate the psychometric properties of a comprehensive , disease-specific question naire for characterizing complaints of neck pain and evaluating the outcomes of treatments for these complaints . Summary of Background Data . There currently are a number of generic and disease-specific instruments for assessing complaints of neck pain . None comprehensively cover the wide range of factors considered essential in evaluating treatment outcomes . Methods . The authors developed a comprehensive , disease-specific question naire for characterizing complaints of neck pain and evaluating the outcomes of treatments for these complaints . In this study , 216 patients who underwent surgery for cervical spine disorders completed the Cervical Spine Outcomes Question naire before treatment , then at 3 and 6 months after treatment . The data were used to evaluate the reliability , validity , and responsiveness of the question naire . Results . The authors have shown that the Cervical Spine Outcomes Question naire has high test – retest reliability , good construct validity , and responsiveness to change after treatment . Conclusions . The Cervical Spine Outcomes Question naire is a comprehensive , disease-specific instrument for assessing complaints of neck pain and evaluating the outcomes of treatments for these complaints . It provides information on demographics , pain severity , functional disability , psychological distress , physical symptoms , health care utilization , and satisfaction . It appears to be acceptable to patients , easy to administer , highly reliable , valid , and responsive . It should be considered for use in monitoring patients with cervical spine conditions and in studies of cervical spine disorders and their treatments OBJECTIVE To develop a condition-specific quality of life question naire for the menopause with documented psychometric properties , based on women 's experience . METHODS SUBJECTS Women 2 - 7 years post-menopause with a uterus and not currently on hormone replacement therapy . Question naire development : A list of 106 menopause symptoms was reduced using the importance score method . Replies to the item-reduction question naire from 88 women result ed in a 30-item question naire with four domains , vasomotor , physical , psychosocial and sexual , and a global quality of life question . Psychometric properties : A separate sample of 20 women was used to determine face validity , and a panel of experts was used to confirm content validity . Reliability , responsiveness and construct validity were determined within the context of a r and omized controlled trial . Construct validation involved comparison with the Neugarten and Kraines'Somatic , Psychosomatic and Psychologic subscales , the reported intensity of hot flushes , the General Well-Being Schedule , Channon and Ballinger 's Vaginal Symptoms Score and Libido Index , and the Life Satisfaction Index . RESULTS The face validity score was 4.7 out of a possible 5 . Content validity was confirmed . Test-retest reliability measures , using intraclass correlation coefficients were 0.81 , 0.79 , 0.70 and 0.55 for the physical , psychosocial , sexual domains and the quality of life question . The intraclass correlation coefficient for the vasomotor domain was 0.37 but there is evidence of systematic change . Discriminative construct validity showed correlation coefficients of 0.69 for the physical domain , 0.66 and 0.40 for the vasomotor domain , 0.65 and -0.71 for the psychosocial domain , 0.48 and 0.38 for the sexual domain , and 0.57 for the quality of life question . Evaluative construct validity showed correlation coefficients of 0.60 for the physical domain , 0.28 for the vasomotor domain , 0.55 and -0.54 for the psychosocial domain , 0.54 and 0.32 for the sexual domain , and 0.12 for the quality of life question . Responsiveness scores ranged from 0.78 to 1.34 . CONCLUSIONS The MENQOL ( Menopause-Specific Quality of Life ) question naire is a self-administered instrument which functions well in differentiating between women according to their quality of life and in measuring changes in their quality of life Background and Purpose — To evaluate the efficacy of supervised high-intensity progressive resistance training ( PRT ) on lower extremity strength , function , and disability in older , long-term stroke survivors . Methods — Forty-two volunteers aged 50 years and above , 6 months to 6 years after a single mild to moderate stroke , were r and omized into either a control group of upper extremity stretching or a PRT group that received a 12-week supervised high-intensity resistance training program consisting of bilateral leg press ( LP ) , unilateral paretic and nonparetic knee extension ( KE ) , ankle dorsiflexion ( DF ) , and plantarflexion ( PF ) exercises .  Functional performance was assessed using the 6-minute walk , stair-climb time , repeated chair-rise time , and habitual and maximal gait velocities . Self-reported changes in function and disability were evaluated using the Late Life Function and Disability Instrument ( LLFDI ) . Results — Single-repetition maximum strength significantly improved in the PRT group for LP ( 16.2 % ) , paretic KE ( 31.4 % ) , and nonparetic KE ( 38.2 % ) with no change in the control group . Paretic ankle DF ( 66.7 % versus −24.0 % ) , paretic ankle PF ( 35.5 % versus −20.3 % ) , and nonparetic ankle PF ( 14.7 % versus −13.8 % ) significantly improved in the PRT group compared with the control . The PRT group showed significant improvement in self-reported function and disability with no change in the control . There was no significant difference between groups for any performance-based measure of function . Conclusions — High-intensity PRT improves both paretic and nonparetic lower extremity strength after stroke , and results in reductions in functional limitations and disability OBJECTIVES The objective of this study was to assess the effects of a hyperproteic , hypercaloric oral nutritional supplement with prebiotic fiber , vitamin D , and calcium , plus a st and ardized physical intervention , in the functional status , strength , nutritional status , and quality of life of frail institutionalized older adults . DESIGN Multicentric prospect i ve observational study under usual clinical practice conditions . SETTING Four nursing homes from Burgos ( 2 ) , Albacete , and Madrid , Spain . PARTICIPANTS Participants included 91 institutionalized older adults ( age ≥70 ) , able to walk 50 m , and meeting at least 3 of the Fried frailty phenotype criteria . INTERVENTION Daily intake of two 200-mL bottles of an oral nutritional supplement , each bottle containing 300 kcal , 20 g protein , 3 g fiber , 500 IU vitamin D , and 480 mg calcium , plus a st and ardized physical exercise training consisting of flexibility , balance , and strengthening exercises for arms and legs , 5 days per week . MEASUREMENTS Short Physical Performance Battery ( SPPB ) , Short-Form-Late-Life Function and Disability Instrument ( SF-LLFDI ) function subscale , h and grip strength , EuroQoL-5 Dimensions visual analogic scale ( EQ5DVAS ) , weight , body mass index ( BMI ) , and Short-Form Mini Nutritional Assessment ( MNA-SF ) at baseline and 6 and 12 weeks . RESULTS Forty-eight participants ( 52.7 % ) improved at least 1 point in the SPPB at week 6 , and 44 ( 48.4 % ) did so at week 12 ; 39 participants ( 42.9 % ) improved at least 2 points in the SF-LLFDI at week 6 , and 46 ( 50.5 % ) at week 12 . Participants improved their quality of life measured with the EQ5DVAS by 6 % ( 95 % confidence interval [ CI ] 3%-10 % ) at week 6 , and by 5 % ( 95 % CI 0%-10 % ) at week 12 . They also improved their nutritional status ( weight gain , BMI increase , and higher MNA-SF scores at 6- and 12-week follow-up ) . This improvement was higher in participants with more frailty criteria , lower functional level , lower vitamin D levels , and poorer nutritional status . CONCLUSION A 12-week intervention with oral nutritional supplementation plus physical exercise improves function , nutritional status , and quality of life in frail institutionalized older adults OBJECTIVES The Patient Activation Measure ( PAM ) quantifies the extent to which people are informed about and involved in their health care . Objectives were to determine the psychometric properties of PAM among multimorbid older adults and evaluate a theoretical , four-stage model of patient activation . Methods . A cross-sectional analysis was used to assess the psychometric properties of PAM . Internal consistency was assessed using Cronbach α . Construct validity was evaluated using general linear modeling to compute associations between PAM scores and health-related behaviors , functional status , and health care quality . Latent class analysis was used to evaluate the theoretical four-stage structure of patient activation . STUDY SETTING Participants in a r and omized trial of Guided Care ( N = 855 ) , a model of comprehensive health care for older adults with chronic conditions that put them at risk of using health services heavily during the coming year . PRINCIPAL FINDINGS Higher PAM activation scores and stage were positively associated with higher functional status , health care quality , and adherence to some health behaviors . Latent class analysis supported the multistage theory of patient activation . CONCLUSIONS The PAM is a reliable , valid , and potentially clinical ly useful measure of patient activation for multimorbid older adults BACKGROUND AND PURPOSE Shoulder scales are often used to evaluate treatment efficacy , yet little is known about the psychometric properties of these scales . Only one scale has undergone psychometric scrutiny : the Shoulder Pain and Disability Index ( SPADI ) . This study compared 2 shoulder measures -the University of California-Los Angeles ( UCLA ) Shoulder Scale and the Simple Shoulder Test (SST)-with the SPADI . SUBJECTS One hundred ninety-two patients with shoulder disorders were recruited from one physician 's office to complete the self-report sections of the 3 scales . METHODS Cronbach alpha values and st and ard errors of measurement ( SEM ) were calculated for each of the multi-item subscales . Validity was examined through calculation of correlation coefficients among the 3 scales . Factor analysis was completed to assess the underlying constructs of the SPADI and the SST . RESULTS Cronbach alpha values ranged from.85 to.95 . The SEM values for the multi-item scales ranged from 4.75 to 11.65 . Evidence for validity to reflect function was indicated by the correlation between the SST and the SPADI disability subscale . The factor analysis of the SPADI revealed loading on 1 factor , whereas the SST loaded on 2 factors . CONCLUSION AND DISCUSSION All scales demonstrated good internal consistency , suggesting that all items for each scale measure the same construct . However , the SEMs for all scales were high . Factor loading was inconsistent , suggesting that patients may not distinguish between pain and function Background The need for cost effectiveness analyses in r and omized controlled trials that compare treatment options is increasing . The selection of the optimal utility measure is important , and a central question is whether the two most commonly used indexes - the EuroQuol 5D ( EQ5D ) and the Short Form 6D ( SF6D ) – can be used interchangeably . The aim of the present study was to compare change scores of the EQ5D and SF6D utility indexes in terms of some important measurement properties . The psychometric properties of the two utility indexes were compared to a disease-specific instrument , the Oswestry Disability Index ( ODI ) , in the setting of a r and omized controlled trial for degenerative disc disease . Methods In a r and omized controlled multicentre trial , 172 patients who had experienced low back pain for an average of 6 years were r and omized to either treatment with an intensive back rehabilitation program or surgery to insert disc prostheses .  Patients filled out the ODI , EQ5D , and SF-36 at baseline and two-year follow up . The utility indexes was compared with respect to measurement error , structural validity , criterion validity , responsiveness , and interpretability according to the COSMIN taxonomy . Results At follow up , 113 patients had change score values  for all three instruments . The SF6D had better similarity with the disease-specific instrument ( ODI ) regarding sensitivity , specificity , and responsiveness . Measurement error was lower for the SF6D ( 0.056 ) compared to the EQ5D ( 0.155 ) . The minimal important change score value was 0.031 for SF6D and 0.173 for EQ5D . The minimal detectable change score value at a 95 % confidence level were 0.157 for SF6D and 0.429 for EQ5D , and the difference in mean change score values ( SD ) between them was 0.23 ( 0.29 ) and so exceeded the clinical significant change score value for both instruments . Analysis of psychometric properties indicated that the indexes are unidimensional when considered separately , but that they do not exactly measure the same underlying construct . Conclusions This study indicates that the difference in important measurement properties between EQ5D and SF6D is too large to consider them interchangeable . Since the similarity with the “ gold st and ard ” ( the disease-specific instrument ) was quite different , this could indicate that the choice of index should be determined by the diagnosis Study Design . The Oswestry Disability Index v2.0 ( ODI ) , SF36 Physical Function Domain ( SF-36 PFD ) , and PROMIS Physical Function CAT v1.2 ( PF CAT ) question naires were prospect ively collected from 1607 patients complaining of back or leg pain , visiting a university-based spine clinic . All question naires were collected electronically , using a tablet computer . Objective . The aim of this study was to compare the psychometric properties of the PROMIS PF CAT with the ODI and SF36 Physical Function Domain in the same patient population . Summary of Background Data . Evidence -based decision-making is improved by using high- quality patient-reported outcomes measures . Prior studies have revealed the shortcomings of the ODI and SF36 , commonly used in spine patients . The PROMIS Network has developed measures with excellent psychometric properties . The Physical Function domain , delivered by Computerized Adaptive Testing ( PF CAT ) , performs well in the spine patient population , though to- date direct comparisons with common measures have not been performed . Methods . St and ard Rasch analysis was performed to directly compare the psychometrics of the PF CAT , ODI , and SF36 PFD . Spearman correlations were computed to examine the correlations of the three instruments . Time required for administration was also recorded . Results . One thous and six hundred seven patients were administered all assessment s. The time required to answer all items in the PF CAT , ODI , and SF-36 PFD was 44 , 169 , and 99 seconds . The ceiling and floor effects were excellent for the PF CAT ( 0.81 % , 3.86 % ) , while the ceiling effects were marginal and floor effects quite poor for the ODI ( 6.91 % and 44.24 % ) and SF-36 PFD ( 5.97 % and 23.65 % ) . All instruments significantly correlated with each other . Conclusion . The PROMIS PF CAT outperforms the ODI and SF-36 PFD in the spine patient population and is highly correlated . It has better coverage , while taking less time to administer with fewer questions to answer . Level of Evidence : BACKGROUND Previous qualitative research among adults and parents of children with phenylketonuria ( PKU ) has identified inattention as an important psychiatric aspect of this condition . The parent-reported ADHD Rating Scale-IV ( ADHD RS-IV ) and the Adult ADHD Self-Report Scale ( ASRS ) have been vali date d for measuring inattention symptoms in persons with attention-deficit/hyperactivity disorder ( ADHD ) ; however , their psychometric attributes for measuring PKU-related inattention have not been established . OBJECTIVE The primary objective of this investigation was to demonstrate the reliability , validity , and responsiveness of the  ADHD RS-IV  and  ASRS inattention symptoms subscales in a r and omized controlled trial of patients with PKU aged 8 years or older . METHODS A post hoc analysis investigated the psychometric properties ( Rasch model fit , reliability , construct validity , and responsiveness ) of the ADHD RS-IV and ASRS inattention subscales using data from a phase 3b , double-blind , placebo-controlled clinical trial in those with PKU aged 8 years or older . RESULTS The Rasch results revealed good model fit , and reliability analyses revealed strong internal consistency reliability ( α ≥ 0.87 ) and reproducibility ( intraclass correlation coefficient ≥ 0.87 ) for both measures . Both inattention measures demonstrated the ability to discriminate between known groups ( P < 0.001 ) created by the Clinical Global Impression-Severity scale . Correlations between the ADHD RS-IV and the ASRS with the Clinical Global Impression-Severity scale and the age-appropriate Behavior Rating Inventory of Executive Function Working Memory subscale were consistently moderate to strong ( r ≥ 0.56 ) . Similarly , results of the change score correlations were of moderate magnitude ( r ≥ 0.43 ) for both measures when compared with changes over time in Behavior Rating Inventory of Executive Function Working Memory subscales . CONCLUSIONS These findings of reliability , validity , and responsiveness of both the ADHD RS-IV and the ASRS inattention scales , in addition to content validation results , support their use for the assessment of inattention symptoms among persons with PKU aged 8 years or older in both clinical and research setting Background : Patient-reported outcomes ( PROs ) are considered the gold st and ard when evaluating outcomes in a surgical population . While the psychometric properties of some PROs have been tested , the properties of newer PROs in patients undergoing hip arthroscopic surgery  remain somewhat unknown . Purpose : To evaluate the reliability , validity , responsiveness , and interpretability of 5 PROs ( Copenhagen Hip and Groin Outcome Score [ HAGOS ] , Hip Disability and Osteoarthritis Outcome Score [ HOOS ] , Hip Outcome Score [ HOS ] , International Hip Outcome Tool [ iHOT-33 ] , and Modified Harris Hip Score [ MHHS ] ) in a population undergoing hip arthroscopic surgery  and also to provide a recommendation of the best PROs in patients undergoing hip arthroscopic surgery . Study Design : Cohort study ( diagnosis ) ; Level of evidence , 2 . Methods : Study participants were adults ( mean age , 37 ± 11 years ) who had undergone hip arthroscopic surgery 12 to 24 months previously and pain-free , healthy age-matched controls ( mean age , 35 ± 11 years ) . Baseline characteristics including age , height , weight , waist girth , physical activity , and occupation were collected for both groups . The  hip arthroscopic surgery group completed the 5 PRO question naires on 3 occasions , while the  healthy control group  completed the PRO question naires on 1 occasion . The reliability ( test-retest reliability [ intraclass correlation coefficient , or ICC ] and minimal detectable change [ MDC ] ) , validity ( construct validity , ability to detect a difference between groups , acceptability including floor and ceiling effects ) , responsiveness , and interpretability ( minimal important change [ MIC ] ) of each measure were calculated . Results : The test-retest reliability of PROs was excellent ( ICC , 0.91 - 0.97 ) , with an MDC of < 20 % . The HOOS , HAGOS , and iHOT-33 had acceptable content validity . All PROs demonstrated construct validity and were able to detect a difference between the hip arthroscopic surgery and control groups . No measures demonstrated a floor effect ; however , the MHHS and subscales relating to activities of daily living of the HOOS , HOS , and HAGOS demonstrated a ceiling effect . The HOOS , iHOT-33 , and MHHS demonstrated adequate responsiveness , and the MIC for all measures was < 11 points of a possible 100 points . Conclusion : The PROs of the HOOS and iHOT-33 demonstrate psychometric properties that may enable research ers and clinicians to use them with confidence in a population undergoing hip arthroscopic  surgery . The psychometric properties of the MHHS , HOS , and some subscales of the HAGOS are reduced , and these PROs may be less valuable in this group Background : Patient-reported outcome measures are increasingly used evaluating clinical care . Many measures used to assess operative hindfoot interventions vary in content , and some have not been psychometrically vali date d in this population . The purpose of this study was to compare measurement properties of  6 lower-extremity patient-reported outcome measures  , and to evaluate their reliability and validity in light of patients ’ preferences . Methods : Cross-sectional survey of 42 preoperative and 100 postoperative patients completed 6 lower-extremity outcome measures  on 2 occasions : Foot Function Index ( FFI ) , Ankle Osteoarthritis Scale ( AOS ) , patient-reported items of the  American  Orthopaedic Foot & Ankle Society Question naire ( AOFAS ) , Lower Extremity Functional Scale ( LEFS ) , Western Ontario and McMaster Universities Osteoarthritis Index ( WOMAC ) , and the Short Musculoskeletal Function Assessment ( SMFA ) , as well as measures of preference , and symptoms . Results : Internal consistency was good to excellent for all scales and subscales ( α = .84-.97 ; ICC [ 2,1 ] = .81-.96 ) . Correlations between scales ranged from .50 ( WOMACStiffness and FFIActivity Limitations ) to .92 ( LEFS and SMFAOverall , WOMACPain and AOSOverall , FFIOverall and AOFASOverall ) . Higher correlations occurred within instruments ( r = .97 AOSPain and AOSOverall ) and between similar subscales from different instruments ( r = .91 WOMACPain and AOSPain ) . Construct validity showed moderate to high correlations to global ratings of Pain , Stiffness , and difficulty performing Daily Activities . The highest correlations ( r > .75 ) occurred between Pain and AOSOverall ( r = .84 ) , stiffness and WOMACStiffness ( r = .81 ) , and Daily Activities and AOSDisability ( r = .87 ) . Patients rated instruments by preference . FFI , WOMAC , LEFS , and SMFA rated favorably for length . FFI , WOMAC , LEFS , and AOFAS rated high for underst and ability . FFI was rated by postoperative patients as most likely to capture change due to surgery . SMFA rated the best overall . Conclusions : Direct comparison of instruments revealed similarity between scales in construct validity and reliability . Patient preferences supported the use of these scales . Foot-specific instruments offered no clear advantage over lower-extremity instruments . Level of Evidence : Level II , prospect i ve comparative study OBJECTIVE To estimate the psychometric properties of a vision-targeted measure of health-related quality of life , the National Eye Institute-Refractive Error Quality of Life survey ( NEI-RQL ) , which includes 13 scales design ed to assess the impact of refractive error and its correction on day-to-day life . DESIGN Cross-sectional survey . PARTICIPANTS The NEI-RQL was self-administered by 667 myopes , 380 hyperopes , and 114 emmetropes recruited from the practice s of 6 medical centers . All participants had near and distance visual acuity of 20/32 or better in the worse eye while benefiting from their current method for correction of refractive error ( glasses , contact lens , refractive surgery ) .  METHODS Mean scores , st and ard deviations , internal consistency reliability , and test-retest intraclass correlations were estimated for the NEI-RQL scales . Item discrimination was assessed by item-scale correlations . Construct validity was evaluated by assessing the sensitivity of scale scores to type of refractive error , type of refractive error correction , and spherical equivalent . Construct validity of the NEI-RQL was compared to those of the Medical Outcomes Study 36-item short-form health survey ( SF-36 ) and the National Eye Institute Vision Functioning Question naire ( NEI VFQ-25 ) in a r and om sub sample of respondents . MAIN OUTCOME MEASURES The 13 NEI-RQL scales-clarity of vision , expectations , near vision , far vision , diurnal fluctuations , activity limitations , glare , symptoms , dependence on correction , worry , suboptimal correction , appearance , and satisfaction with correction . RESULTS Emmetropes tended to score significantly better on the NEI-RQL scales than myopes and hyperopes . The method of refractive error correction was also associated with NEI-RQL scores . In addition , the NEI-RQL multi-item scales accounted for 29 % of the variance in the NEI-RQL satisfaction with correction item beyond that explained by the SF-36 and the NEI VFQ-25 . CONCLUSION These results support the reliability and construct validity of the NEI-RQL . The instrument appears to be useful for comparisons of people with different types of correction for refractive error Purpose This study aims to develop a psychometrically rigorous instrument to measure the unmet needs of adult cancer survivors who are 1 to 5 years post-cancer diagnosis . “ Unmet needs ” distinguishes between problems which survivors experience and problems which they desire help in managing . Methods The survey was developed from a comprehensive literature review , qualitative analysis of the six most important unmet needs of 71 cancer survivors , review of the domains and items by survivors and experts , cognitive interviews and a pilot test of 100 survivors . A stratified r and om sample of 550 cancer survivors , selected from a population -based Cancer Registry , completed a mailed survey to establish reliability and validity . Results The final 89-item  Survivors Unmet Needs Survey ( SUNS ) has high acceptability , item test – retest reliability and internal consistency ( Chronbach ’s alpha 0.990 ) , face , content and construct validity . Five subscales measure Emotional Health needs ( 33 items , 19.4 % of variance ) , Access and Continuity of Care ( 22 items , 15.1 % ) , Relationships ( 15 items , 12.1 % ) , Financial Concerns ( 11 items , 10.3 % ) and Information needs ( eight items , 8.1 % of the variance ) . Conclusions This instrument has strong psychometric properties and is useful for determining the prevalence and predictors of cancer survivors ’ unmet needs across types of cancer , length of survivorship and socio-demographic characteristics . Use of the SUNS will enable more effective targeting of programmes and services and guide policy and health planning decisions . Relevance This study is an important step toward evidence -based planning and management of problems which the growing survivor population requires assistance in managing Background To date , there is limited psychometric evidence on the Asthma Quality of Life Question naire ( AQLQ12 + ) among population s that include adolescents and adults . Objective To provide evidence of the psychometric properties of the AQLQ12 + as a measure of asthma-specific quality of life ( QOL ) in patients with persistent asthma treated with a combination of inhaled glucocorticoid and long-acting beta2-agonist  , as well as explore the predictors of at least a minimally important AQLQ12 + improvement . Methods The psychometric properties of the AQLQ12 + were assessed through post hoc analysis of two large ( n = 740 and 778 ) Phase III , r and omized , double-blinded , placebo-controlled efficacy studies of mometasone furoate/formoterol fumarate ( MF/F ) combination compared with monotherapy in subjects with persistent asthma previously treated with either low-dose or medium-dose inhaled glucocorticoids .  Results With 15 % and 8 % participation from 12- to 17-year olds , blinded trial data demonstrated excellent reproducibility ( ICC range : 0.76–0.85 ) and moderate-to-strong construct validity with other measures of asthma health at baseline and over time for the AQLQ12 + . A greater percentage of the MF/F treatment group ( 44 % ) achieved an important change at 26 weeks on the AQLQ12 +  compared with formoterol fumarate ( F , 23 % ) and placebo ( 18 % ) treatment groups in the low-dose study ( P < 0.001 ) and the medium-dose study ( 50 % ( MF/F ) versus 34 % ( F ) and 23 % ( placebo ) ; P < 0.001 ) . Pre-r and omization nighttime awakenings and rescue medications use were significant predictors of AQLQ12 + improvement . Conclusions These findings provide strong support for the measurement properties of the AQLQ12 + among patients with persistent asthma and confidence in the AQLQ12 + improvements demonstrated by the MF/F treatment group Background Definitive evidence that exercise interventions that improve gait also reduce disability is lacking . A task-oriented , motor sequence learning exercise intervention has been shown to reduce the energy cost of walking and improve gait speed , but whether the intervention also improves activity and participation has not been demonstrated . Objective The objective of this study was to compare the impact of a task-oriented , motor sequence learning exercise ( TO ) intervention and the impact of an impairment-oriented , multicomponent exercise ( IO ) intervention on activity and participation outcomes in older adults with mobility limitations . The mediating effects of a change in the energy cost of walking on changes in activity and participation also were determined . Design This study was a single-blind , r and omized controlled trial . Setting The study was conducted in an ambulatory clinical research training center . Participants The study participants were 47 older adults ( mean age=77.2 years , SD=5.5 ) with slow and variable gait . Intervention The intervention was a 12-week , physical therapist – guided program of TO or IO . Measurements Measures of activity ( gait speed over an instrumented walkway ; daily physical activity measured with an accelerometer ; confidence in walking determined with the Gait Efficacy Scale ; and physical function determined with the total , basic lower-extremity , and advanced lower-extremity components of the Late-Life Function and Disability Instrument [ Late-Life FDI ] ) and participation ( disability limitation dimension and instrumental role [ home and community task performance ] domain components of the Late-Life FDI ) were recorded before and after the intervention . The energy cost of walking was determined from the rate of oxygen consumption during self-paced treadmill walking at the physiological steady state st and ardized by walking speed . An adjusted comparison of activity and participation outcomes in the treatment arms was made by use of an analysis of covariance model , with baseline and change in energy cost of walking added to the model to test for mediation . Tests were used to determine the significance of the mediating effects . Results Activity improved in TO but not in IO for confidence in walking ( Gait Efficacy Scale ; mean adjusted difference=9.8 [ SD=3.5 ] ) and physical function ( Late-Life FDI basic lower-extremity component ; mean adjusted difference=3.5 [ SD=1.7 ] ) . Improvements in TO were marginally greater than those in IO for gait speed , physical activity , and total physical function . Participation improved marginally more in TO than in IO for disability limitations and instrumental role . Limitations The older adults were r and omized to the intervention group , but differences in baseline measures had to be accounted for in the analyses . Conclusions A TO intervention that improved gait also led to improvements in some activity and participation outcomes in older adults with mobility limitations OBJECTIVE To modify an existing outcome measure ( Bournemouth Question naire [ BQ ] ) for use in patients with nonspecific neck pain and test its psychometric properties . DESIGN Prospect i ve longitudinal study in which the question naire was administered on 3 occasions ( pretreatment , retest , and posttreatment ) . SETTING Anglo-European College of Chiropractic outpatient clinic and 8 field chiropractic practice s. METHOD Seven core items relating to the biopsychosocial model of pain were included in the original question naire ( back BQ ) . The wording of one of these items ( disability in activities of daily living ) was modified to include activities likely to be affected by neck pain . Testing of the neck BQ was carried out in 102 patients with nonspecific neck pain . RESULTS The instrument demonstrated high internal consistency on 3 administrations ( Cronbach 's alpha = 0.87 , 0.91 , 0.92 ) . All 7 items were retained on the basis that they each significantly contributed to the total score ( item-corrected total score correlations > 0.43 ) and to the instrument 's responsiveness to clinical change ( item change-corrected total change score correlations > 0.42 ) . The instrument was reliable in test-retest administrations in stable subjects ( ICC = 0.65 ) . The instrument demonstrated acceptable construct validity and longitudinal construct validity with established external measures . The treatment effect size of the instrument was found to be high ( 1.67 ) . CONCLUSION The neck BQ covers the salient dimensions of the biopsychosocial model of pain , is quick and easy to complete , and has been shown to be reliable , valid , and responsive to clinical ly significant change in patients with nonspecific neck pain . Its use as an outcome measure in clinical trials and outcomes research is recommended
High test-retest reliability was found for the Function component , while results for the Disability component were more variable .
Conclusions There is extensive evidence to support the construct validity and sensitivity to change of the LLFDI among various clinical population s of community-dwelling older adults .
Background The choice of measure for use as a primary outcome in geriatric research is contingent upon the construct of interest and evidence for its psychometric properties .
The Late-Life Function and Disability Instrument ( LLFDI ) has been widely used to assess functional limitations and disability in studies with older adults .
The primary aim of this systematic review was to evaluate the current available evidence for the psychometric properties of the LLFDI .