ObjectiveTo identify malnutrition assessment methods in cancer patients and assess their content validity based on internationally accepted definitions for malnutrition.Study Design and SettingSystematic review of studies in cancer patients that operationalized malnutrition as a variable, published since 1998. Eleven key concepts, within the three domains reflected by the malnutrition definitions acknowledged by European Society for Clinical Nutrition and Metabolism (ESPEN) and the American Society for Parenteral and Enteral Nutrition (ASPEN): A: nutrient balance; B: changes in body shape, body area and body composition; and C: function, were used to classify content validity of methods to assess malnutrition. Content validity indices (M-CVIA–C) were calculated per assessment method. Acceptable content validity was defined as M-CVIA–C ≥ 0.80.
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Serious games foster the acquisition of complex problem-solving skills. Assessment of such skills should be in line with instruction, and within a serious game environment its content validity should equal face-to-face assessment. Research on assessment in serious gaming has remained rather scarce. This article shows how assessment can be implemented in serious gaming in a way that assures content validity. The core of the authors’ validation method entails mapping learning activities (as contained in the game scenario) on performance indicators and outputs (as derived from formal attainment levels). They present how they have elaborated and applied the method for an assessment game for ICT managers in secondary vocational education. They describe the procedure and extent to which this assessment is content-valid compared to face-to-face assessment.
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In the Netherlands, over 40% of nursing home residents are estimated to have visual impairments. This results in the loss of basic visual abilities. The nursing home environment fits more or less to residents’ activities and social participation. This is referred to as environmental fit. To raise professional awareness of environmental fit, an Environmental Observation tool for the Visually Impaired was developed. This tool targets aspects of the nursing home environment such as ‘light’, the use of ‘colours and contrasts’ and ‘furnishing and obstacles’. Objective of this study is to validate the content of the observation tool to have a tool applicable for practice. Based on the content validity approach, we invited a total of eight experts, six eye care professionals and two building engineering researchers, to judge the relevance of the items. The Item Content Validity approach was applied to determine items to retain and reject. The content validity approach led to a decrease in the number of items from 63 to 52. The definitive tool of 52 items contains 21 for Corridors, 17 for the Common Room, and 14 for the Bathroom. All items of the definite tool received an Item-Content Validity Index of 0.875 and a Scale-Content Validity Index of 0.71. The content validity index of the scale and per item has been applied, resulting in a tool that can be applied in nursing homes. The tool might be a starting point of a discussion among professional caregivers on environmental interventions for visually impaired older adults in nursing homes
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Background: Recently, research focus has shifted to the combination of all 24-h movement behaviors (physical activity, sedentary behavior and sleep) instead of each behavior separately. Yet, no reliable and valid proxy-report tools exist to assess all these behaviors in 0–4-year-old children. By involving end-users (parents) and key stakeholders (researchers, professionals working with young children), this mixed-methods study aimed to 1) develop a mobile application (app)-based proxy-report tool to assess 24-h movement behaviors in 0–4-year-olds, and 2) examine its content validity. Methods: First, we used concept mapping to identify activities 0–4-year-olds engage in. Parents (n = 58) and professionals working with young children (n = 21) generated a list of activities, sorted related activities, and rated the frequency children perform these activities. Second, using multidimensional scaling and cluster analysis, we created activity categories based on the sorted activities of the participants. Third, we developed the My Little Moves app in collaboration with a software developer. Finally, we examined the content validity of the app with parents (n = 14) and researchers (n = 6) using focus groups and individual interviews. Results: The app has a time-use format in which parents proxy-report the activities of their child, using eight activity categories: personal care, eating/drinking, active transport, passive transport, playing, screen use, sitting/lying calmly, and sleeping. Categories are clarified by providing examples of children’s activities. Additionally, 1–4 follow-up questions collect information on intensity (e.g., active or calm), posture, and/or context (e.g., location) of the activity. Parents and researchers considered filling in the app as feasible, taking 10–30 min per day. The activity categories were considered comprehensive, but alternative examples for several activity categories were suggested to increase the comprehensibility and relevance. Some follow-up questions were considered less relevant. These suggestions were adopted in the second version of the My Little Moves app. Conclusions: Involving end-users and key stakeholders in the development of the My Little Moves app resulted in a tailored tool to assess 24-h movement behaviors in 0–4-year-olds with adequate content validity. Future studies are needed to evaluate other measurement properties of the app.
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Rationale: Inadequate operationalisation of the multidimensial concept of malnutrition may result in inadequate evaluation of nutritional status. In this review we aimed to assess content validity of methods used to assess malnutrition in cancer patients, according to domains directly derived from European Society for Clinical Nutrition and Metabolism (ESPEN) and American Society for Parenteral and Enteral Nutrition (ASPEN) definitions for malnutrition. Methods: Studies on malnutrition in adult cancer patients published between 1999 and 2013 were considered eligible. Methods to assess malnutrition were classified using 13 indicators within three domains that the malnutrition definitions of ESPEN and ASPEN have in common: A) Nutrient balance; B) Changes in body shape, body area and body composition; and C) Body function.Content validity index per method (M-CVIA-C) was calculated by averaging indicator scores weighted per domain, quantifying to what extent the methods covered the construct of malnutrition. Acceptable content validity was defined as M-CVIA-C ≥0.80.Results: 40 Different methods within 166 articles were identified. Median M-CVIA-C was 0.22 (interquartile range: 0.08-0.53). None of the methods reached M-CVIA-C=0.80. Mini Nutritional Assessment (MNA; M-CVIA-C=0.75), Nutritional Screening Questionnaire (NSQ; M-CVIA-C=0.56) and Scored Patient-Generated Subjective Global Assessment (PG-SGA; M-CVIA-C=0.53) were responsible for the top 25% of M-CVIA-C scores. Conclusion: Content validity of methods that assess malnutrition in cancer patients varies widely and is unacceptable in terms of M-CVIA-C. MNA, NSQ and PG-SGA showed highest scores in terms of content validity. Conflict of interest: None.
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Validity and Reproducibility of a New Treadmill Protocol: The Fitkids Treadmill Test. Med. Sci. Sports Exerc., Vol. 47, No. 10, pp. 2241–2247, 2015. Purpose: This study aimed to investigate the validity and reproducibility of a new treadmill protocol in healthy children and adolescents: the Fitkids Treadmill Test (FTT). Methods: Sixty-eight healthy children and adolescents (6–18 yr) were randomly divided into a validity group (14 boys and 20 girls; mean T SD age, 12.9 T 3.6 yr) that performed the FTT and Bruce protocol, both with respiratory gas analysis within 2 wk, and a reproducibility group (19 boys and 15 girls; mean T SD age, 13.5 T 3.5 yr) that performed the FTT twice within 2 wk. A subgroup of 21 participants within the reproducibility group performed both FTT with respiratory gas analysis. Time to exhaustion (TTE) was the main outcome of the FTT. Results: V˙ O2peak measured during the FTT showed excellent correlation with V˙ O2peak measured during the Bruce protocol (r = 0.90; P G 0.01). Backward multiple regression analysis provided the following prediction equations for V˙ O2peak (LIminj1) for boys and girls, respectively: V˙ O2peak FTT ¼ j0:748 þ ð0:117 TTEFTTÞ þ ð0:032 bodymassÞ þ 0:263, and V˙ O2peak FTT ¼ j0:748 þ ð0:117 TTEFTTÞ þ ð0:032 bodymassÞ [R2 ¼ 0:935; SEE ¼ 0:256LI min j1]. Cross-validation of the regression model showed an R2 value of 0.76. Reliability statistics for the FTT showed an intraclass correlation coefficient of 0.985 (95% confidence interval, 0.971–0.993; P G 0.001) for TTE. Bland–Altman analysis showed a mean bias of j0.07 min, with limits of agreement between +1.30 and j1.43 min. Conclusions: Results suggest that the FTT is a useful treadmill protocol with good validity and reproducibility in healthy children and adolescents. Exercise performance on the FTT and body mass can be used to adequately predict V˙ O2peak when respiratory gas analysis is not available.
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Objectives To assess the content validity and psychometric characteristics of the Knowledge about Older Patients Quiz (KOP‐Q), which measures nurses' knowledge regarding older hospitalized adults and their certainty regarding this knowledge. Design Cross‐sectional. Setting Content validity: general hospitals. Psychometric characteristics: nursing school and general hospitals in the Netherlands. Participants Content validity: 12 nurse specialists in geriatrics. Psychometric characteristics: 107 first‐year and 78 final‐year bachelor of nursing students, 148 registered nurses, and 20 nurse specialists in geriatrics. Measurements Content validity: The nurse specialists rated each item of the initial KOP‐Q (52 items) on relevance. Ratings were used to calculate Item‐Content Validity Index and average Scale‐Content Validity Index (S‐CVI/ave) scores. Items with insufficient content validity were removed. Psychometric characteristics: Ratings of students, nurses, and nurse specialists were used to test for different item functioning (DIF) and unidimensionality before item characteristics (discrimination and difficulty) were examined using Item Response Theory. Finally, norm references were calculated and nomological validity was assessed. Results Content validity: Forty‐three items remained after assessing content validity (S‐CVI/ave = 0.90). Psychometric characteristics: Of the 43 items, two demonstrating ceiling effects and 11 distorting ability estimates (DIF) were subsequently excluded. Item characteristics were assessed for the remaining 30 items, all of which demonstrated good discrimination and difficulty parameters. Knowledge was positively correlated with certainty about this knowledge. Conclusion The final 30‐item KOP‐Q is a valid, psychometrically sound, comprehensive instrument that can be used to assess the knowledge of nursing students, hospital nurses, and nurse specialists in geriatrics regarding older hospitalized adults. It can identify knowledge and certainty deficits for research purposes or serve as a tool in educational or quality improvement programs.
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Purpose: The Scored Patient-Generated Subjective Global Assessment (PG-SGA©) is a globally recognized and used nutritional screening, assessment, monitoring, and triaging tool. The aim of this study was to translate and culturally adapt the original English PG-SGA for the Japanese speaking populations and to assess its linguistic validity (i.e., comprehensibility, difficulty) and content validity, as perceived by Japanese patients and healthcare professionals. Methods: In accordance with methodology used in previous Dutch, Thai, German, and Norwegian PG-SGA studies, we followed the ten steps of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Principles of Good Practice for Translation and Cultural Adaptation for Patient-Reported Outcome Measures. The study enrolled 50 patients and 50 healthcare professionals (HCPs) to evaluate the comprehensibility and difficulty of the translated and culturally adapted PG-SGA. The HCPs also evaluated the content validity of the translation. We evaluated each item and quantified scale indices for content validity (item content validity index (I-CVI), scale content validity index (S-CVI)), comprehensibility (item comprehensibility index (I-CI), scale comprehensibility index (S-CI)), and difficulty (item difficulty index (I-DI), scale difficulty index (S-DI)). Results: Patients evaluated the comprehensibility and difficulty of the patient component as excellent (S-CI = 0.97, S-DI = 0.96). The professionals rated the Japanese version of both components of the PG-SGA as very relevant (S-CVI = 0.94). The professionals evaluated the comprehensibility of the professional component as being acceptable (S-CI = 0.88) but difficult (S-DI = 0.69), based predominantly on items related to physical examination (I-DI = 0.33–0.67). Conclusion: The PG-SGA was systematically translated and culturally adapted for the Japanese setting according to the ISPOR process. The Japanese version of the PG-SGA was perceived as comprehensive, easy to use, and relevant. Perceived difficulty in professional components, specifically in the context of metabolic demand and physical examination, will require appropriate training for professionals in order to optimize implementation.
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Objective: The Tilburg Frailty Instrument (TFI) is an instrument for assessing frailty in community-dwelling older people. Since its development, many studies have been carried out examining the psychometric properties. The aim of this study was to provide a review of the main findings with regard to the reliability and validity of the TFI. Methods: We conducted a literature search in the PubMed and CINAHL databases on May 30, 2020. An inclusion criterion was the use of the entire TFI, part B, referring to the 15 components. No restrictions were placed on language or year of publication. Results: In total, 27 studies reported about the psychometric properties of the TFI. By far, most of the studies (n = 25) were focused on community-dwelling older people. Many studies showed that the internal consistency and test–retest reliability are good, which also applies for the criterion and construct validity. In many studies, adverse outcomes of interest were disability, increased health-care utilization, lower quality of life, and mortality. Regarding disability, studies predominantly show results that are excellent, with an area under the curve (AUC) >0.80. In addition, the TFI showed good associations with lower quality of life and the findings concerning mortality were at least acceptable. However, the association of the TFI with some indicators of health-care utilization can be indicated as poor (eg, visits to a general practitioner, hospitalization). Conclusion: Since population aging is occurring all over the world, it is important that the TFI is available and well known that it is a user-friendly instrument for assessing frailty and its psychometric properties being qualified as good. The findings of this assessment can support health-care professionals in selecting interventions to reduce frailty and delay its adverse outcomes, such as disability and lower quality of life.
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Objective: To determine content validity of the Muscle Power Sprint Test (MPST) and construct validity and reliability of the MPST, 10x5 Meter Sprint Test (10x5MST), slalom test and one stroke push test (1SPT) in wheelchair-using youth with spina bifida (SB). Design: Clinimetric study Setting: Rehabilitation centers, SB outpatient services, private practices Participants: A convenience sample of 53 children (5-19 years, 32 boys / 21 girls) with SB who use a manual wheelchair. Participants were recruited in the Netherlands through rehabilitation centers, SB outpatient services, pediatric physical therapists and the BOSK (Association of and by parents of children, adolescents and adults with a disability). Interventions: Not applicable. Main Outcome Measures: Construct validity of the the MPST was determined by comparing results with the arm-cranking Wingate Anaerobic test (WAnT) using paired t-tests and Pearson Correlation Coefficients, while content validity was assessed using time based criteria for anaerobic testing . Construct validity of the 10x5MST, slalom test and 1SPT was analyzed by hypothesis testing using Pearson Correlation Coefficients and Multiple Regression. For reliability, Intra Class Correlation coefficients (ICC) and smallest detectable changes (SDC) were calculated. Results: For the MPST, mean exercise time of four sprints was 28.1 sec. (±6.6 sec.). Correlations between the MPST and WAnT were high (r>0.72, p<0.01). Excellent correlations were found between the 10x5MST and slalom test (r=0.93, p<0.01), while correlations between the10x5MST or slalom test and MPST and 1SPT were moderate (r=-0.56- -0.70; r=0.56, p<0.01). The 1SPT was explained for 38% by wheelchair mass (Beta -0.489) and total upper muscle strength (Beta 0.420). All ICCs were excellent (ICC>0.95) but the SDCs varied widely. Conclusions: The MPST, 10x5MST and slalom test are valid and reliable tests in wheelchair-using youth with SB for measuring respectively anaerobic performance or agility. For the 1SPT, both validity and reliability are questionable.
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