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| 2. |
- Grimby, Gunnar, 1933, et al.
(författare)
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The use of raw scores from ordinal scales: time to end malpractice?
- 2012
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Ingår i: Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081. ; 44:2, s. 97-8
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 3. |
- Küçükdeveci, Ayşe A, et al.
(författare)
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Strategies for assessment and outcome measurement in physical and rehabilitation medicine: an educational review.
- 2011
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Ingår i: Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081. ; 43:8, s. 661-72
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this educational review, which is based upon expert opinion, is to describe to clinicians training in Physical and Rehabilitation Medicine and research students training to work in the field, the appropriate attributes and standards required for assessment and outcome measurement. "What to assess" is discussed in the context of the conceptual framework provided by the International Classification of Functioning, Disability and Health, supplemented with quality of life as an additional construct. The reasons for making the assessment, and the context in which the assessment will be used, are then considered. Examples of recommendations of some international organizations regarding what and how to assess are presented. Suggestions are made about the selection of assessment tools, including examples from two diagnostic groups: stroke and rheumatoid arthritis. Finally, the basic psychometric standards required for any assessment tool, and additional requirements for outcome assessment, are explained.
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| 5. |
- Lundgren Nilsson, Åsa, 1965, et al.
(författare)
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Construct validity of the psychological general well being index (PGWBI) in a sample of patients undergoing treatment for stress-related exhaustion: a rasch analysis.
- 2013
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Ingår i: Health and Quality of Life Outcomes. - : Springer Science and Business Media LLC. - 1477-7525. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: Purpose: The Psychological General Well Being Index (PGWBI) is a widely used scale across many conditions. Over time issues have been raised about the dimensional structure of the scale, and it has not yet been subjected to scrutiny by modern Psychometric approaches. The current study thus evaluates the PGWBI with Rasch- and factor analysis. METHODS: Consecutive patients recruited to a tertiary stress clinic were administered the PGBWI as part of routine clinical assessment at baseline and three months. Data from the scale was subjected to Factor Analyses and to Rasch analysis. In both cases adjustments for local independence violations were allowed. RESULTS: 179 patients were recruited, with a mean age of 43 years, and of whom 70% were female. An initial Confirmatory Factor Analysis (CFA) with baseline data failed, but the modification indices also indicated considerable levels of local dependency requiring errors to be correlated. An EFA highlighted positive and negative effect domains. Rasch analysis confirmed that fit of data to the model was influenced by local dependency, and that in practice if the items from the six underlying domains were treated as six 'super' items, the scale was shown to measure one dominant construct of well being. An interval scale transformation was therefore possible. A significant improvement in well-being was observed over a three month period. CONCLUSION: The PGWBI scale has satisfactory internal construct validity when tested with modern psychometric techniques, using data obtained from patients treated for stress-related exhaustion. The instrument has qualities that make it suitable also for monitoring well-being during interventions for stress-related exhaustion/clinical burnout.
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| 6. |
- Lundgren Nilsson, Åsa, 1965, et al.
(författare)
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Construct Validity of the Swedish version of the Revised Piper Fatigue Scale in an oncology sample – a Rasch analysis.
- 2014
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Ingår i: Value in Health. - : Elsevier BV. - 1098-3015 .- 1524-4733. ; 17:4, s. 360-363
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Objectives Fatigue is a common and distressing symptom in cancer patients due to both the disease and its treatments. The concept of fatigue is multidimensional and includes both physical and mental components. The 22-item Revised Piper Fatigue Scale (RPFS) is a multidimensional instrument developed to assess cancer-related fatigue. This study reports on the construct validity of the Swedish version of the RPFS from the perspective of Rasch measurement. Methods The Swedish version of the RPFS was answered by 196 cancer patients fatigued after 4 to 5 weeks of curative radiation therapy. Data from the scale were fitted to the Rasch measurement model. This involved testing a series of assumptions, including the stochastic ordering of items, local response dependency, and unidimensionality. A series of fit statistics were computed, differential item functioning (DIF) was tested, and local response dependency was accommodated through testlets. Results The Behavioral, Affective and Sensory domains all satisfied the Rasch model expectations. No DIF was observed, and all domains were found to be unidimensional. The Mood/Cognitive scale failed to fit the model, and substantial multidimensionality was found. Splitting the scale between Mood and Cognitive items resolved fit to the Rasch model, and new domains were unidimensional without DIF. Conclusions The current Rasch analyses add to the evidence of measurement properties of the scale and show that the RPFS has good psychometric properties and works well to measure fatigue. The original four-factor structure, however, was not supported.
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| 7. |
- Lundgren Nilsson, Åsa, 1965, et al.
(författare)
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Cross-cultural validity of functional independence measure items in stroke: a study using Rasch analysis.
- 2005
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Ingår i: Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977. ; 37:1, s. 23-31
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To analyse cross-cultural validity of the Functional Independence Measure (FIM) in patients with stroke using the Rasch model. SETTINGS: Thirty-one rehabilitation facilities within 6 different countries in Europe. PARTICIPANTS: A total of 2546 in-patients at admission, median age 63 years. METHODS: Data from the FIM were evaluated with the Rasch model, using the Rasch analysis package RUMM2020. A detailed analysis of scoring functions of the 7 categories of the FIM items was undertaken prior to testing fit to the model. Categories were re-scored where necessary. Analysis of Differential Item Functioning was undertaken in pooled data for each of the FIM motor and social-cognitive scales, respectively. RESULTS: Disordered thresholds were found on most items when using 7 categories. Fit to the Rasch model varied between countries. Differential Item Functioning was found by country for most items. Adequate fit to the Rasch model was achieved when items were treated as unique for each country and after a few country-specific items were removed. CONCLUSION: Clinical collected data from FIM for patients with stroke cannot be pooled in its raw form, or compared across countries. Comparisons can be made after adjusting for country-specific Differential Item Functioning, though the adjustments for Differential Item Functioning and rating scales may not generalize to other samples.
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| 8. |
- Lundgren Nilsson, Åsa, 1965, et al.
(författare)
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Cross-diagnostic validity in a generic instrument: an example from the Functional Independence Measure in Scandinavia
- 2006
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Ingår i: Health Qual Life Outcomes. ; 4
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: To analyse the cross-diagnostic validity of the Functional Independence Measure (FIM) motor items in patients with spinal cord injury, stroke and traumatic brain injury and the comparability of summed scores between these diagnoses. METHODS: Data from 471 patients on FIM motor items at admission (stroke 157, spinal cord injury 157 and traumatic brain injury 157), age range 11-90 years and 70 % male in nine rehabilitation facilities in Scandinavia, were fitted to the Rasch model. A detailed analysis of scoring functions of the seven categories of the FIM motor items was made prior to testing fit to the model. Categories were re-scored where necessary. Fit to the model was assessed initially within diagnosis and then in the pooled data. Analysis of Differential Item Functioning (DIF) was undertaken in the pooled data for the FIM motor scale. Comparability of sum scores between diagnoses was tested by Test Equating. RESULTS: The present seven category scoring system for the FIM motor items was found to be invalid, necessitating extensive rescoring. Despite rescoring, the item-trait interaction fit statistic was significant and two individual items showed misfit to the model, Eating and Bladder management. DIF was also found for Spinal Cord Injury, compared with the other two diagnoses. After adjustment, it was possible to make appropriate comparisons of sum scores between the three diagnoses. CONCLUSION: The seven-category response function is a problem for the FIM instrument, and a reduction of responses might increase the validity of the instrument. Likewise, the removal of items that do not fit the underlying trait would improve the validity of the scale in these groups. Cross-diagnostic DIF is also a problem but for clinical use sum scores on group data in a generic instrument such as the FIM can be compared with appropriate adjustments. Thus, when planning interventions (group or individual), developing rehabilitation programs or comparing patient achievements in individual items, cross-diagnostic DIF must be taken into account.
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| 10. |
- Lundgren Nilsson, Åsa, 1965, et al.
(författare)
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Patient-reported outcome measures in osteoarthritis : a systematic search and review of their use and psychometric properties.
- 2018
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Ingår i: RMD Open. - : BMJ. - 2056-5933. ; 4:2
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Patient-reported outcome measures (PROM) or self-completed questionnaires have been used to report outcomes in osteoarthritis (OA) for over 35 years. Choices will always need to be made about what should be measured and, if relevant, what would be the most appropriate PROM to use. The current study aims to describe the available PROMs used in OA and their performance quality, so that informed choices can be made about the most appropriate PROM for a particular task.Methods: The study included a systematic search for PROMs that have been in use over 17 years (period 2000-2016), and to catalogue their psychometric properties, and to present the evidence in a user-friendly fashion.Results: 78 PROMs were identified with psychometric evidence available. The domains of pain, self-care, mobility and work dominated, whereas domains such as cleaning and laundry and leisure, together with psychological and contextual factors, were poorly served. The most frequently used PROMs included the Western Ontario McMaster Osteoarthritis Index, the Short Form 36 and the Knee Disability and Osteoarthritis Outcome Score which, between them, appeared in more than 4000 papers. Most domains had at least one PROM with the highest level of psychometric evidence.Conclusion: A broad range of PROMs are available for measuring OA outcomes. Some have good psychometric evidence, others not so. Some important psychological areas such as self-efficacy were poorly served. The study provides a current baseline for what is available, and identifies the shortfall in key domains if the full biopsychosocial model is to be explored.
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