The Spanish version of the FibroFatigue Scale: validation of a questionnaire for the observer's assessment of fibromyalgia and chronic fatigue syndrome

OBJECTIVE: To examine some of the psychometric properties of the Spanish version of the FibroFatigue Scale (FFS). METHODS: FFS was administered to 120 patients diagnosed with fibromyalgia and chronic fatigue syndrome. Internal consistency was evaluated by using Cronbach's alpha, test-retest reliability with weighted kappa and construct validity by correlations among FFS, the Fibromyalgia Impact Questionnaire (FIQ), the EuroQol 5D (EQ-5D) and the Hospital Anxiety and Depression Scale (HADS). The interrater reliability was tested using analysis of variance with patients and raters as independent factors. RESULTS: Internal consistency (alpha) was .88, test-retest reliability was .91, and interrater reliability was .93. Significant correlations were obtained between overall FFS and the FIQ (.55, P<.01), the EQ-5D (-.48, P<.01) and the HADS depression subscale (.25, P<.01), but not with the HADS anxiety subscale. CONCLUSION: These results support the reliability and validity of the data obtained with the Spanish version of the FSS.     

Diagnostic Interview for Genetic Studies (DIGS): inter-rater and test-retest reliability and validity in a Spanish population.

OBJECTIVE: To test the reliability and validity of the DIGS in Spanish population. METHODS: Inter-rater and test-retest reliability of the Spanish version of DIGS was tested in 95 inpatients and outpatients. The resultant diagnoses were compared with diagnoses obtained by the LEAD (Longitudinal Expert All Data) procedure as "gold standard". The kappa statistic was used to measure concordance between blind inter-raters and between the diagnoses obtained by LEAD procedure and through the DIGS. RESULTS: Overall kappa coefficient for inter-rater reliability was 0.956. The kappa value for individual diagnosis varied from major depression=0.877 to schizophrenia=1. Test-retest reliability was 0.926. Kappa for all individual target diagnoses ranged from 0.776 (major depression) to 1. Kappa between LEAD procedure and DIGS ranged from 0.704 (major depression) to 0.825 (bipolar I disorder). CONCLUSION: Most of the DSM-IV major psychiatric disorders can be assessed with acceptable to excellent reliability with the Spanish version of the DIGS interview. The Spanish version of DIGS showed an acceptable to excellent concurrent validity. Giving the good reliability and validity of Spanish version of DIGS it should be considered to identify psychiatric phenotypes for genetics studies.     

Measuring common mental disorders in women in Ethiopia

BACKGROUND: There is a dearth of methodological studies critically evaluating reliability, validity and feasibility of measures of common mental disorders (CMD) in low-income countries. METHODS: Test-retest and inter-rater reliability of categorisation of CMD caseness, according to locally agreed criteria using the Comprehensive Psychopathological Rating Scale (CPRS), was measured in 99 women from out-patient clinics (inter-rater) and 99 women from a primary healthcare centre (test-retest) in Ethiopia. The construct validity of CMD as measured with CPRS was assessed with exploratory factor analysis using maximum likelihood with varimax rotation. RESULTS: Test-retest reliability was fair (kappa = 0.29). Subsequent assessment of inter-rater reliability found excellent agreement (kappa = 0.82). The construct of CMD appeared unidimensional, combining depressive, anxiety and somatic symptoms. CONCLUSIONS: Detection of socioculturally meaningful cases of CMD in Ethiopia can be reliably achieved with local psychiatrist assessment using CPRS, although thorough training is essential.     

Inter-rater reliability of family history information on psychiatric disorders in relatives

The family history method in psychiatric family studies is an important and necessary way of obtaining information on family members who are not available for personal interview. Studies on the validity of this method have shown that family history information on psychiatric disorders in relatives is neither accurate nor sensitive but highly specific. However, its inter-rater reliability has rarely been assessed, even though this is a prerequisite for adequate validity. In the present investigation we examined the inter-rater reliability of family history information obtained with a semi-structured and symptom-oriented interview. Forty informants were interviewed twice by two different raters within 3 and 20 days. The inter-rater reliability was found to be good for dementia (kappa=0.82, 95 % CI=0.61–1.00), alcohol related disorders (kappa=0.93, 95 % CI=0.80–1.00), for depressive disorders (kappa=0.72, 95 % CI=0.42–1.00), anxiety disorders (kappa=0.75, 95 % CI=0.41–1.00) and any psychiatric disorder (kappa=0.79, 95 % CI=0.66–0.91). We concluded that the family history interview is a useful family study instrument that can be applied reliably by different raters for frequent psychiatric disorders. Received: 13 September 2001 / Accepted: 28 September 2001     

Development of a new seizure severity questionnaire: initial reliability and validity testing

PURPOSE: This report describes the initial steps for development of a new scale to assess seizure severity as a treatment response. METHODS: Standard methodology was used to develop the test instrument. Item generation was performed by selecting items from other questionnaires, and asking patients and epileptologists about seizure components. Face and content validity were assessed in a pilot study with patients and observers. The questionnaire was formatted as a structured interview for a reliability study. Construct validity was assessed with three existing questionnaires. Inter-rater reliability and test-retest reliability were performed as two independent ratings on one day, and one re-interview. RESULTS: Based on item generation and pilot testing (33 patients, 28 observers), the Seizure Severity Questionnaire (SSQ) was organized into warning, activity-movement, and recovery (cognitive, emotional, and physical aspects) stages of seizures. Questions reviewed duration, severity, bothersomeness and overall ratings, and the most bothersome aspect of seizures. The mean SSQ Summary Score was 5.78+/-3.24, inter-rater reliability was 0.76 (N=91), and test-retest reliability was 0.74 (N=63). Construct validity showed statistically significant correlations with other scales. CONCLUSION: This study has explored the psychometric properties of the SSQ for face and content validity, inter-rater and test-retest reliability, and construct validity. The Summary Score reliably represents the major components of seizures.     

The development of a valid and reliable scale for rating anxiety in dementia (RAID)

A rating scale to measure anxiety in dementia sufferers was developed and evaluated in a sample of 51 inpatients and 32 day-hospital patients. Anxiety scores were not related to sex, age, accommodation or DSM-IV diagnosis of the type of dementia. However, both subjects with physical illnesses and subjects with insight into their memory problems had significantly higher anxiety scores.The kappa values for inter-rater reliability ranged from 0.51 to 1 and for test-retest reliability from 0.53 to 1, which indicates moderate to good reliability.The overall agreement on individual items ranged from 82-100% (inter-rater) and 84-100% (test-retest).The professionals working in the care of the elderly and carer groups felt that the scale was comprehensive and all the items in the scale were important, thereby confirming that it has good content validity. The scale significantly correlated with other anxiety scales and also with independent ratings both by a consultant psychiatrist and also nursing staff, indicating good concurrent validity. Anxiety scores were significantly higher in dementia patients who fulfilled modified DSM-IV criteria for anxiety and clinical diagnosis of anxiety disorder.This showed evidence of good criterion validity. Factor analysis showed five factors, including all items of the scale. Scores of 11 and above on the scale indicated significant clinical anxiety. Overall, the scale had good reliability and validity. It should be a useful clinical and research instrument for assessing anxiety in dementia sufferers.     

Assessment of the severity of dementia: validity and reliability of the Chinese (Cantonese) version of the Hierarchic Dementia Scale (CV-HDS)

BACKGROUND: With the rapid growth of the older population, early detection of cognitive deficits is crucial in slowing down functional deterioration of the elderly persons. OBJECTIVES: To examine the validity and reliability of the Chinese (Cantonese) version of the Hierarchic Dementia Scale (CV-HDS) for Chinese older persons in Hong Kong. METHODS: The HDS was translated into Cantonese Chinese. The content and cultural validity were evaluated by six expert panel members. Sixty-two participants with diagnosis of dementia were recruited for evaluation. Inter-rater reliability, test-retest reliability, internal consistency and concurrent validity were examined. RESULTS: The CV-HDS demonstrated satisfactory psychometric properties. inter-rater reliability and test-retest reliability were high (alpha = 0.89 and alpha = 0.94 respectively). High value of Cronbach's alpha (alpha = 0.94) demonstrated good internal consistency. The concurrent validity of CV-HDS, through correlation with its scores with that of the Chinese version of Mini Mental Status Examination, was established (ranged from r = 0.58 to r = 0.78, p < 0.01). CONCLUSIONS: The CV-HDS is a reliable and valid instrument for assessing severity of cognitive impairment in Cantonese speaking Chinese people with dementia. It facilitates treatment planning to optimize the effects of functional training and rehabilitation. Copyright (c) 2008 John Wiley & Sons, Ltd.     

Reliability of a Rating Scale to Assess Post-stroke Psychiatric Symptoms

Background : Various rating scales for post-stroke psychiatric symptoms such as cognitive impairment have long been used in drug efficacy trials in Japan. However, their reliability has not been established. The purpose of the present study was to examine the inter-rater and intra-rater reliability of a rating scale, which has been conventionally used in Japan.
Methods : The most frequent symptoms, including apathy, emotional and cognitive impairment, found in post-stroke patients were assessed using a rating scale comprising 17 items and 4 global assessment scales. Semi-structured interviews of 18 patients with symptoms with various degrees of severity were videotaped. Twelve physicians who were not interviewers independently assessed the severity of symptoms in the 18 patients by replaying the videotapes. This procedure was repeated twice with an interval of two months to examine inter-rater and test-retest reliability.
Results : The results revealed almost satisfactory reliability. Intraclass correlation coefficients were over 0.6 in the inter-rater analysis for most items and the concordance correlation coefficients were over 0.7 in the intra-rater analysis. The rating scale was considered to be reliable, although some items showed relatively low agreement.
Conclusion : The conventional rating scale to assess post-stroke psychiatric symptoms showed satisfactory inter-rater and intra-rater reliability by the videotape method. The validity study should be further investigated.     

Test-retest reliability of the unified Parkinson's disease rating scale in patients with early Parkinson's disease: results from a multicenter clinical trial.

Our objective was to assess the test-retest reliability of the Unified Parkinson's Disease Rating Scale (UPDRS). The UPDRS is the most widely used instrument for measuring severity of parkinsonian symptoms in clinical research and in practice. The validity and inter-rater reliability of this scale have been previously studied. We examined the test-retest (intrarater) reliability of the UPDRS and derived subscales. Four hundred patients with early-stage Parkinson's disease (PD) who were participating in a multicenter clinical trial were evaluated using the UPDRS on two separate occasions (screening and baseline visits) prior to receiving treatment. The same neurologist at each center rated the subjects at both examinations that were, on average, 14.6 +/- 7.6 days apart (range 3-36 days). Test-retest reliability was estimated using the intraclass correlation coefficient (ICC) for the total UPDRS score, the mental, ADL, and motor subscale scores, and other derived subscale scores. Weighted kappa statistics were calculated for individual UPDRS items. The ICCs for the UPDRS scores were as follows: total score, 0.92; mental, 0.74; ADL, 0.85; motor, 0.90. ICCs for derived symptom-based scales ranged from 0.69-0.88. Reliability of specific items was generally lower than for summary scales. Reliability was slightly better in patients for whom the testing interval was within 14 days. Based on conventional standards, the UPDRS scores were found to have excellent test-retest reliability in this sample of patients with early PD rated by academic movement disorder specialists. The findings are in agreement with previous reports on interrater reliability.     

Measurements of acute cerebral infarction: a clinical examination scale

We designed a 15-item neurologic examination stroke scale for use in acute stroke therapy trials. In a study of 24 stroke patients, interrater reliability for the scale was found to be high (mean kappa = 0.69), and test-retest reliability was also high (mean kappa = 0.66-0.77). Test-retest reliability did not differ significantly among a neurologist, a neurology house officer, a neurology nurse, or an emergency department nurse. The stroke scale validity was assessed by comparing the scale scores obtained prospectively on 65 acute stroke patients to the patients' infarction size as measured by computed tomography scan at 1 week and to the patients' clinical outcome as determined at 3 months. These correlations (scale-lesion size r = 0.68, scale-outcome r = 0.79) suggested acceptable examination and scale validity. Of the 15 test items, the most interrater reliable item (pupillary response) had low validity. Less reliable items such as upper or lower extremity motor function were more valid. We discuss methods for improving the reliability and validity of brief examination scales to be used in stroke therapy trials.