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International Journal of Environmental... Jan 2021Sleep quality is an important clinical construct since it is increasingly common for people to complain about poor sleep quality and its impact on daytime functioning....
Sleep quality is an important clinical construct since it is increasingly common for people to complain about poor sleep quality and its impact on daytime functioning. Moreover, poor sleep quality can be an important symptom of many sleep and medical disorders. However, objective measures of sleep quality, such as polysomnography, are not readily available to most clinicians in their daily routine, and are expensive, time-consuming, and impractical for epidemiological and research studies., Several self-report questionnaires have, however, been developed. The present review aims to address their psychometric properties, construct validity, and factorial structure while presenting, comparing, and discussing the measurement properties of these sleep quality questionnaires. A systematic literature search, from 2008 to 2020, was performed using the electronic databases PubMed and Scopus, with predefined search terms. In total, 49 articles were analyzed from the 5734 articles found. The psychometric properties and factor structure of the following are reported: Pittsburgh Sleep Quality Index (PSQI), Athens Insomnia Scale (AIS), Insomnia Severity Index (ISI), Mini-Sleep Questionnaire (MSQ), Jenkins Sleep Scale (JSS), Leeds Sleep Evaluation Questionnaire (LSEQ), SLEEP-50 Questionnaire, and Epworth Sleepiness Scale (ESS). As the most frequently used subjective measurement of sleep quality, the PSQI reported good internal reliability and validity; however, different factorial structures were found in a variety of samples, casting doubt on the usefulness of total score in detecting poor and good sleepers. The sleep disorder scales (AIS, ISI, MSQ, JSS, LSEQ and SLEEP-50) reported good psychometric properties; nevertheless, AIS and ISI reported a variety of factorial models whereas LSEQ and SLEEP-50 appeared to be less useful for epidemiological and research settings due to the length of the questionnaires and their scoring. The MSQ and JSS seemed to be inexpensive and easy to administer, complete, and score, but further validation studies are needed. Finally, the ESS had good internal consistency and construct validity, while the main challenges were in its factorial structure, known-group difference and estimation of reliable cut-offs. Overall, the self-report questionnaires assessing sleep quality from different perspectives have good psychometric properties, with high internal consistency and test-retest reliability, as well as convergent/divergent validity with sleep, psychological, and socio-demographic variables. However, a clear definition of the factor model underlying the tools is recommended and reliable cut-off values should be indicated in order for clinicians to discriminate poor and good sleepers.
Topics: Humans; Psychometrics; Reproducibility of Results; Sleep; Sleep Initiation and Maintenance Disorders; Sleep Wake Disorders; Surveys and Questionnaires
PubMed: 33530453
DOI: 10.3390/ijerph18031082 -
Journal of Medical Internet Research Nov 2021The internet is now a major source of health information. With the growth of internet users, eHealth literacy has emerged as a new concept for digital health care.... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The internet is now a major source of health information. With the growth of internet users, eHealth literacy has emerged as a new concept for digital health care. Therefore, health professionals need to consider the eHealth literacy of consumers when providing care utilizing digital health technologies.
OBJECTIVE
This study aimed to identify currently available eHealth literacy instruments and evaluate their measurement properties to provide robust evidence to researchers and clinicians who are selecting an eHealth literacy instrument.
METHODS
We conducted a systematic review and meta-analysis of self-reported eHealth literacy instruments by applying the updated COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) methodology.
RESULTS
This study included 7 instruments from 41 articles describing 57 psychometric studies, as identified in 4 databases (PubMed, CINAHL, Embase, and PsycInfo). No eHealth literacy instrument provided evidence for all measurement properties. The eHealth literacy scale (eHEALS) was originally developed with a single-factor structure under the definition of eHealth literacy before the rise of social media and the mobile web. That instrument was evaluated in 18 different languages and 26 countries, involving diverse populations. However, various other factor structures were exhibited: 7 types of two-factor structures, 3 types of three-factor structures, and 1 bifactor structure. The transactional eHealth literacy instrument (TeHLI) was developed to reflect the broader concept of eHealth literacy and was demonstrated to have a sufficient low-quality and very low-quality evidence for content validity (relevance, comprehensiveness, and comprehensibility) and sufficient high-quality evidence for structural validity and internal consistency; however, that instrument has rarely been evaluated.
CONCLUSIONS
The eHealth literacy scale was the most frequently investigated instrument. However, it is strongly recommended that the instrument's content be updated to reflect recent advancements in digital health technologies. In addition, the transactional eHealth literacy instrument needs improvements in content validity and further psychometric studies to increase the credibility of its synthesized evidence.
Topics: Delivery of Health Care; Health Literacy; Humans; Psychometrics; Reproducibility of Results; Surveys and Questionnaires; Telemedicine
PubMed: 34779781
DOI: 10.2196/30644 -
Obesity Reviews : An Official Journal... Aug 2021The impact of screen-based devices on children's health and development cannot be properly understood without valid and reliable tools that measure screen time within... (Review)
Review
The impact of screen-based devices on children's health and development cannot be properly understood without valid and reliable tools that measure screen time within the evolving digital landscape. This review aimed to summarize characteristics of measurement tools used to assess screen time in young children; evaluate reporting of psychometric properties; and examine time trends related to measurement and reporting of screen time. A systematic review of articles published in English across three databases from January 2009 to April 2020 was undertaken using PROSPERO protocol (registration: CRD42019132599) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included articles measured screen time as outcome, exposure, or confounder in children 0-6 years. The search identified 35,868 records, 1035 full-text articles were screened for eligibility, and 622 met inclusion criteria. Most measures (60%) consisted of one to three items and assessed duration of screen time on a usual day. Few measures assessed content (11%) or coviewing (7%). Only 40% of articles provided a citation for the measure, and only 69 (11%) reported psychometric properties-reliability n = 58, validity n = 19, reliability and validity n = 8. Between 2009 and 2019, the number of published articles increased from 28 to 71. From 2015, there was a notable increase in the proportion of articles published each year that assessed exposure to mobile devices in addition to television. The increasing number of published articles reflects increasing interest in screen time exposure among young children. Measures of screen time have generally evolved to reflect children's contemporary digital landscape; however, the psychometric properties of measurement tools are rarely reported. There is a need for improved measures and reporting to capture the complexity of children's screen time exposures.
Topics: Child; Child Health; Child, Preschool; Humans; Psychometrics; Reproducibility of Results; Screen Time
PubMed: 33960616
DOI: 10.1111/obr.13260 -
BMJ (Clinical Research Ed.) Nov 2020To evaluate the Edinburgh Postnatal Depression Scale (EPDS) for screening to detect major depression in pregnant and postpartum women. (Meta-Analysis)
Meta-Analysis
Accuracy of the Edinburgh Postnatal Depression Scale (EPDS) for screening to detect major depression among pregnant and postpartum women: systematic review and meta-analysis of individual participant data.
OBJECTIVE
To evaluate the Edinburgh Postnatal Depression Scale (EPDS) for screening to detect major depression in pregnant and postpartum women.
DESIGN
Individual participant data meta-analysis.
DATA SOURCES
Medline, Medline In-Process and Other Non-Indexed Citations, PsycINFO, and Web of Science (from inception to 3 October 2018).
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
Eligible datasets included EPDS scores and major depression classification based on validated diagnostic interviews. Bivariate random effects meta-analysis was used to estimate EPDS sensitivity and specificity compared with semi-structured, fully structured (Mini International Neuropsychiatric Interview (MINI) excluded), and MINI diagnostic interviews separately using individual participant data. One stage meta-regression was used to examine accuracy by reference standard categories and participant characteristics.
RESULTS
Individual participant data were obtained from 58 of 83 eligible studies (70%; 15 557 of 22 788 eligible participants (68%), 2069 with major depression). Combined sensitivity and specificity was maximised at a cut-off value of 11 or higher across reference standards. Among studies with a semi-structured interview (36 studies, 9066 participants, 1330 with major depression), sensitivity and specificity were 0.85 (95% confidence interval 0.79 to 0.90) and 0.84 (0.79 to 0.88) for a cut-off value of 10 or higher, 0.81 (0.75 to 0.87) and 0.88 (0.85 to 0.91) for a cut-off value of 11 or higher, and 0.66 (0.58 to 0.74) and 0.95 (0.92 to 0.96) for a cut-off value of 13 or higher, respectively. Accuracy was similar across reference standards and subgroups, including for pregnant and postpartum women.
CONCLUSIONS
An EPDS cut-off value of 11 or higher maximised combined sensitivity and specificity; a cut-off value of 13 or higher was less sensitive but more specific. To identify pregnant and postpartum women with higher symptom levels, a cut-off of 13 or higher could be used. Lower cut-off values could be used if the intention is to avoid false negatives and identify most patients who meet diagnostic criteria.
REGISTRATION
PROSPERO (CRD42015024785).
Topics: Depression, Postpartum; Depressive Disorder, Major; Female; Humans; Pregnancy; Pregnancy Complications; Prenatal Care; Psychometrics; Sensitivity and Specificity
PubMed: 33177069
DOI: 10.1136/bmj.m4022 -
International Journal of Environmental... Sep 2021Health-related quality of life (HRQOL) is an essential measure that is used to assess the effect of chronic disease management on the health status of an individual.... (Review)
Review
Health-related quality of life (HRQOL) is an essential measure that is used to assess the effect of chronic disease management on the health status of an individual. Previous studies have identified various instruments used in the measuring of diabetes-specific health-related quality of life (HRQOL). The aim of this paper is to provide a systematic review of the various instruments used for the diabetes-specific measure of HRQOL, and place emphasis on its content and measurement properties. Methods Preferred Reporting Items for Systematic Reviews and Meta analyses (PRISMA) guidelines was used. A systematic search strategy was used to identify publications reporting diabetes HRQOL measures. The search terms used were: "diabetes quality of life", "measurements", and "instruments". The database that was searched includes PubMed, Science Direct, CINAHL, and Medline. Articles written in the English language and published from January 1990 to December 2020 were included. Those articles that did not measure HRQOL for diabetic patients were excluded. Results: A total of seventeen instruments met the inclusion criteria and included in the review. The appraisal of diabetes scale (ADS), Audit of Diabetes-Dependent QOL measure (ADDQOL), Diabetes Health Profile (DHP), and Problem Areas in Diabetes (PAID) are more suitable for single-scale questionnaires when investigating one or more specific aspects of diabetes-specific quality of life (QOL). The ADDQOL, ADS, Diabetes Impact Measurement Scales (DIMS), Diabetes Quality of Life Clinical Trial Questionnaire (DQLCTQ-R), Malay Version of Diabetes Quality of Life (DQOL), Iranian Diabetes Quality of Life (IRDQOL), Brief Clinical Inventory, and PAID are relevant measures of HRQOL for insulin dependent diabetes mellitus (IDDM) and non-insulin dependent diabetes mellitus (NIDDM) patients. The Asian Diabetes Quality of Life AsianDQOL, The Chinese Short Version of DQOL, Elderly Diabetes Burden Scale (EDBS), Malay Version of Diabetes Quality of Life (DQOL), are relevant measures of HRQOL for NIDDM patients. Only two instruments assess for responsiveness, namely PAID and DQLCTQ-R. In PAID, the effect sizes ranged from 0.32 to 0.65 for interventions. The DQLCTQ-R four domains were responsive to clinical change in metabolic control. Based on this review ADDQOL, DSQOLS, and EDBS psychometric properties are sufficient. Conclusion: Most studies did not check for responsiveness, and future studies should prioritize responsiveness to change, which was not included in the psychometric finding of the reviewed instruments.
Topics: Aged; Diabetes Mellitus, Type 2; Humans; Iran; Psychometrics; Quality of Life; Surveys and Questionnaires
PubMed: 34501838
DOI: 10.3390/ijerph18179245 -
Neuropsychobiology 2023The utility of heart rate variability (HRV) for characterizing psychological stress is primarily impacted by methodological considerations such as study populations,... (Review)
Review
The utility of heart rate variability (HRV) for characterizing psychological stress is primarily impacted by methodological considerations such as study populations, experienced versus induced stress, and method of stress assessment. Here, we review studies on the associations between HRV and psychological stress, examining the nature of stress, ways stress was assessed, and HRV metrics used. The review was performed according to the PRISMA guidelines on select databases. Studies that examined the HRV-stress relationship via repeated measurements and validated psychometric instruments were included (n = 15). Participant numbers and ages ranged between 10 and 403 subjects and 18 and 60 years, respectively. Both experimental (n = 9) and real-life stress (n = 6) have been explored. While RMSSD was the most reported HRV metric (n = 10) significantly associated with stress, other metrics, including LF/HF (n = 7) and HF power (n = 6) were also reported. Various linear and nonlinear HRV metrics have been utilized, with nonlinear metrics used less often. The most frequently used psychometric instrument was the State-Trait Anxiety Inventory (n = 10), though various other instruments have been reported. In conclusion, HRV is a valid measure of the psychological stress response. Standard stress induction and assessment protocols combined with validated HRV measures in different domains will improve the validity of findings.
Topics: Humans; Adult; Heart Rate; Stress, Psychological
PubMed: 37290411
DOI: 10.1159/000530376 -
The Lancet. Psychiatry Jan 2021A major barrier to improving care effectiveness for mental health is a lack of consensus on outcomes measurement. The International Consortium for Health Outcomes...
A major barrier to improving care effectiveness for mental health is a lack of consensus on outcomes measurement. The International Consortium for Health Outcomes Measurement (ICHOM) has already developed a consensus-based standard set of outcomes for anxiety and depression in adults (including the Patient Health Questionnaire-9, the Generalised Anxiety Disorder 7-item Scale, and the WHO Disability Schedule). This Position Paper reports on recommendations specifically for anxiety, depression, obsessive-compulsive disorder, and post-traumatic stress disorder in children and young people aged between 6 and 24 years. An international ICHOM working group of 27 clinical, research, and lived experience experts formed a consensus through teleconferences, an exercise using an adapted Delphi technique (a method for reaching group consensus), and iterative anonymous voting, supported by sequential research inputs. A systematic scoping review identified 70 possible outcomes and 107 relevant measurement instruments. Measures were appraised for their feasibility in routine practice (ie, brevity, free availability, validation in children and young people, and language translation) and psychometric performance (ie, validity, reliability, and sensitivity to change). The final standard set recommends tracking symptoms, suicidal thoughts and behaviour, and functioning as a minimum through seven primarily patient-reported outcome measures: the Revised Children's Anxiety and Depression Scale, the Obsessive Compulsive Inventory for Children, the Children's Revised Impact of Events Scale, the Columbia Suicide Severity Rating Scale, the KIDSCREEN-10, the Children's Global Assessment Scale, and the Child Anxiety Life Interference Scale. The set's recommendations were validated through a feedback survey involving 487 participants across 45 countries. The set should be used alongside the anxiety and depression standard set for adults with clinicians selecting age-appropriate measures.
Topics: Adolescent; Anxiety; Child; Consensus; Depression; Humans; Internationality; Obsessive-Compulsive Disorder; Psychometrics; Sickness Impact Profile; Stress Disorders, Post-Traumatic; Treatment Outcome; Young Adult
PubMed: 33341172
DOI: 10.1016/S2215-0366(20)30356-4 -
Journal of Medical Systems Jan 2022In clinical practice, assessing digital health literacy is important to identify patients who may encounter difficulties adapting to digital health using digital...
In clinical practice, assessing digital health literacy is important to identify patients who may encounter difficulties adapting to digital health using digital technology and service. We developed the Digital Health Technology Literacy Assessment Questionnaire (DHTL-AQ) to assess the ability to use digital health technology, services, and data. The DHTL-AQ was developed in three phases. In the first phase, the conceptual framework and domains and items were generated from a systematic literature review using relevant theory and surveys. In the second phase, a cross-sectional survey with 590 adults age ≥ 18 years was conducted at an academic hospital in Seoul, Korea in January and February 2020 to test face validity of the items. Then, psychometric validation was conducted to determine the final items and cut-off scores of the DHTL-AQ. The eHealth literacy scale, the Newest Vital Sign, and 10 mobile app task ability assessments were examined to test validity. The final DHTL-AQ includes 34 items in two domains (digital functional and digital critical literacy) and 4 categories (Information and Communications Technology terms, Information and Communications Technology icons, use of an app, evaluating reliability and relevance of health information). The DHTL-AQ had excellent internal consistency (overall Cronbach's α = 0.95; 0.87-0.94 for subtotals) and acceptable model fit (CFI = 0.821, TLI = 0.807, SRMR = 0.065, RMSEA = 0.090). The DHTL-AQ was highly correlated with task ability assessment (r = 0.7591), and moderately correlated with the eHealth literacy scale (r = 0.5265) and the Newest Vital Sign (r = 0.5929). The DHTL-AQ is a reliable and valid instrument to measure digital health technology literacy.
Topics: Adolescent; Adult; Biomedical Technology; Cross-Sectional Studies; Digital Technology; Humans; Psychometrics; Reproducibility of Results; Surveys and Questionnaires
PubMed: 35072816
DOI: 10.1007/s10916-022-01800-8 -
British Journal of Anaesthesia Jun 2022There are very few patient-centred global outcome measures of recovery in the days or weeks after surgery. This meta-analysis evaluated the psychometric properties and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
There are very few patient-centred global outcome measures of recovery in the days or weeks after surgery. This meta-analysis evaluated the psychometric properties and clinical acceptability of the 15-item quality of recovery (QoR-15) scale.
METHODS
We searched bibliographic databases for studies undertaking psychometric evaluation of the QoR-15 or using the QoR-15 as an outcome measure after surgery. Record screening, data extraction, and quality assessments were independently done by two researchers. Weighted averages estimating overall summary statistics across all the studies were calculated using random-effects meta-analysis. Pooled correlation coefficients were transformed using a Fisher z-transformation and then back-transformed to calculate pooled results. The four co-primary endpoints were validity, reliability, responsiveness, and clinical utility of the QoR-15 scale.
RESULTS
A total of 26 unique studies met the eligibility criteria, yielding up to 22 847 patients across 16 countries, in 15 languages. A further 172 studies in a further 18 countries and six languages used the QoR-15 as an outcome measure. The QoR-15 had excellent discriminant validity, with the mean difference in QoR-15 scores in patients with and without postoperative complications (9.6; 95% confidence interval [CI], 5.9-13.3; P<0.001), and good convergent validity (for a global visual analogue recovery scale, pooled r=0.63; 95% CI, 0.54-0.71). There was excellent reliability: internal consistency (pooled α=0.85; 95% CI, 0.83-0.87), split-half reliability=0.80 (95% CI, 0.75-0.84), and test-retest reliability=0.97 (95% CI, 0.95-0.98). There was also high responsiveness (pooled standardised response mean=0.87; 95% CI, 0.65-1.08), patient recruitment into evaluation studies (96%; 95% CI, 93-99), and excellent completion and return rates (91%; 95% CI, 84-96). The mean time to complete the QoR-15 was 2.7 (95% CI, 2.2-3.1) min.
CONCLUSIONS
The QoR-15 is a valid, reliable, and responsive patient-centred outcome metric in surgical patients. It is highly acceptable to both patients and clinicians.
REGISTRATION
Open Science Framework Identifier: DOI 10.17605/OSF.IO/78HTA.
Topics: Anesthesia Recovery Period; Humans; Outcome Assessment, Health Care; Psychometrics; Reproducibility of Results; Surveys and Questionnaires
PubMed: 35430086
DOI: 10.1016/j.bja.2022.03.009 -
Quality of Life Research : An... Mar 2021Although the EQ-5D has a long history of use in a wide range of populations, the newer five-level version (EQ-5D-5L) has not yet had such extensive experience. This...
PURPOSE
Although the EQ-5D has a long history of use in a wide range of populations, the newer five-level version (EQ-5D-5L) has not yet had such extensive experience. This systematic review summarizes the available published scientific evidence on the psychometric properties of the EQ-5D-5L.
METHODS
Pre-determined key words and exclusion criteria were used to systematically search publications from 2011 to 2019. Information on study characteristics and psychometric properties were extracted: specifically, EQ-5D-5L distribution (including ceiling and floor), missing values, reliability (test-retest), validity (convergent, known-groups, discriminate) and responsiveness (distribution, anchor-based). EQ-5D-5L index value means, ceiling and correlation coefficients (convergent validity) were pooled across the studies using random-effects models.
RESULTS
Of the 889 identified publications, 99 were included for review, representing 32 countries. Musculoskeletal/orthopedic problems and cancer (n = 8 each) were most often studied. Most papers found missing values (17 of 17 papers) and floor effects (43 of 48 papers) to be unproblematic. While the index was found to be reliable (9 of 9 papers), individual dimensions exhibited instability over time. Index values and dimensions demonstrated moderate to strong correlations with global health measures, other multi-attribute utility instruments, physical/functional health, pain, activities of daily living, and clinical/biological measures. The instrument was not correlated with life satisfaction and cognition/communication measures. Responsiveness was addressed by 15 studies, finding moderate effect sizes when confined to studied subgroups with improvements in health.
CONCLUSIONS
The EQ-5D-5L exhibits excellent psychometric properties across a broad range of populations, conditions and settings. Rigorous exploration of its responsiveness is needed.
Topics: Activities of Daily Living; Female; Humans; Male; Psychometrics; Reproducibility of Results; Surveys and Questionnaires
PubMed: 33284428
DOI: 10.1007/s11136-020-02688-y