Patient‐reported convenience of once‐daily versus three‐times‐daily dosing during long‐term studies of pramipexole in early and advanced Parkinson’s disease

Background and purpose: In chronic diseases including Parkinson’s disease (PD), complex pharmacotherapy dosing schedules are reported to reduce adherence, perhaps leading to less‐effective symptom control and, in PD, more erratic stimulation of dopamine receptors. However, blinded clinical‐trial designs preclude direct comparisons of adherence to various schedules. Methods: In two double‐blind (DB) studies of early PD and one of advanced PD, subjects received three‐times‐daily (t.i.d.) pramipexole or placebo. In open‐label (OL) extensions, subjects took extended‐release, once‐daily (q.d.) pramipexole. At 24 or 32 OL weeks, q.d. versus t.i.d. dosing preference was surveyed by questionnaire. Results: Of 590 DB‐trial completers with early PD, 511 entered the OL extension. Of 374 survey respondents, 94.4% preferred q.d. dosing (72.2% of them found it ‘very much more convenient’ and 27.8%‘more convenient’), 2.7% preferred t.i.d., and 2.9% chose ‘no difference’. Of 465 DB‐trial completers with advanced PD, 391 entered its OL extension. Of 334 survey respondents, 88.9% preferred q.d. dosing (59.9% of them found it ‘very much more convenient’ and 40.1%‘more convenient’), 5.7% preferred t.i.d., and 5.4% chose ‘no difference’. Results excluding DB‐placebo recipients were highly similar. Conclusions: In this first direct comparison of patient preference for q.d. versus t.i.d. dopamine‐agonist dosing, patients with early or advanced PD had a strong preference for q.d. rather than t.i.d. pramipexole. The high proportion of advanced‐PD patients declaring this preference indicates that it does not depend on whether a patient is taking concomitant PD medications dosed more frequently than q.d.     

Psychometric Evaluation of Romanian Translations of the Behavior Problems Inventory-01 and the Nisonger Child Behavior Rating Form

Psychometric properties of Romanian translations of the Behavior Problems Inventory-01 (BPI-01; Rojahn, Matson, Lott, Esbensen, & Smalls, 2001 Rojahn, J., Matson, J. L., Lott, D., Esbensen, A. J. and Smalls, Y. 2001. The Behavior Problems Inventory: An instrument for the assessment of self-injury, stereotyped behavior, and aggression/destruction in individuals with developmental disabilities. Journal of Autism and Developmental Disorders, 31: 577–588. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) and the Nisonger Child Behavior Rating Form (NCBRF; Aman, Tassé, Rojahn, & Hammer, 1996 Aman, M. G., Tassé, M. J., Rojahn, J. and Hammer, D. 1996. The Nisonger CBRF: A child behavior rating form for children with developmental disabilities. Research in Developmental Disabilities, 17: 41–57. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) were explored. Respondents completed the instruments for 115 children and adolescents with intellectual disabilities. Internal consistency of both instruments' total scales was good to excellent (Cronbach's α ranging from .88 to .95) and the subscale internal consistencies were fair to excellent (with α ranging from .74 to .94). The results based on bivariate Spearman correlations and multiple regression analyses provided strong convergent and discriminant validity of both instruments. Overall, the Romanian versions of the behavior rating scales had very good reliability (internal consistencies) and convergent and discriminant validity. It is hoped that this study will be a catalyst for Romanian clinicians and researchers as well as for transcultural researchers working with Romanian individuals with intellectual disabilities to continue the exploration of the utility and psychometric quality not only of the BPI-01 and the NCBRF but also of other English language psychopathology assessment instruments.     

老年原发性失眠的神经心理学测验与P300检测的关系及其意义

目的 了解老年原发性失眠患者认知功能有无损害及其程度. 方法 用神经心理学检测(MMSE、MoCA量表)、P300检测52例老年原发性失眠患者及60例正常体检者. 结果老年原发性失眠患者MoCA量表中视空间与执行功能、注意、延迟回忆得分及总分较对照组显著下降,差异有统计学意义(P＜0.01).MMSE量表评分亦有下降趋势,但差异无统计学意义.P300结果显示无论是靶刺激还是非靶刺激,其诱发出的波明显低平及后移,差异有统计学意义(P＜0.01). 结论 老年原发性失眠患者存在认知功能损害,联合MoCA量表评估及P300检测有助于老年原发性失眠患者早期认知功能损害的诊断.     

Psychometric properties of the Communication Confidence Rating Scale for Aphasia (CCRSA): Phase 2

Background: The construct of communication confidence was introduced by participants and family members during qualitative post-treatment interviews as part of a research study using a computer programme to deliver language therapy. However, there was no standardised method of evaluating communication confidence. Therefore the Communication Confidence Rating Scale for Aphasia (CCRSA) was developed, asking persons to self-rate communication confidence.

Aims: This study reports data from the second phase of the project in which the CCRSA was revised to include 10 items. This revised 10-item self-rating scale of communication confidence (CCRSA) was evaluated psychometrically.

Methods & Procedures: The revised 10-item questionnaire was administered 94 times to 47 participants with aphasia from a variety of settings. Psychometric properties of the 10-item CCRSA were investigated using rating scale (Rasch) analysis.

Outcomes & Results: Person reliability of the 10-item CCRSA was .81. The four-category rating scale demonstrated monotonic increases in average measures from low to high ratings. However, one item (“How confident are you that you can participate in discussions about your finances?”) slightly misfitted the construct defined by the other items (mean square infit?=?1.54, item-measure correlation?=?.48).

Conclusions: Our findings suggest that the CCRSA is a psychometrically sound tool for assessing participants' self-report of communication confidence. Further evaluation of the CCRSA is warranted to examine sensitivity to change and inter- and intra-rater reliability.     

Measuring the social interactions of people with traumatic brain injury and their communication partners: The adapted Kagan scales

Background: Considerable attention has been given to the nature of communication impairments of individuals with TBI (Coelho, 2007 Coelho, C. A. 2007. Management of discourse deficits following traumatic brain injury: Progress, caveats, and needs. Seminars in Speech & Language, 28(2): 122–135.  [Google Scholar]; Ylvisaker, Turkstra, & Coelho, 2005 Ylvisaker, M., Turkstra, L. S. and Coelho, C. 2005. Behavioral and social interventions for individuals with traumatic brain injury: A summary of the research with clinical implications. Seminars in Speech & Language, 26: 256–267. [Crossref], [PubMed] , [Google Scholar]). However, there have been few data focusing on the way communication partners deal with the often distressing sequelae of TBI.

Aims: This study reports inter- and intra-rater reliability of the Adapted Measure of Support in Conversation (MSC) and Measure of Participation in Conversation (MPC) for TBI interactions.

Method & Procedures: The MSC and MPC were adapted to reflect theoretical models of cognitive-communication support for people with TBI. A total of 10 casual and 10 purposeful TBI interactions were independently rated by two raters to establish inter-rater reliability and by one rater on two separate occasions to determine intra-rater reliability.

Outcomes & Results: Excellent inter-rater agreement was established on the MSC (ICC?=?0.85–0.97) and the MPC (ICC?=?0.84–0.89). Intra-rater agreement was also strong (MSC: ICC?=?0.80–0.90; MPC: ICC?=?0.81–0.92). Over 90% of all ratings scored within 0.5 on a 9-point scale.

Conclusions: This is the first scale to measure the communication partner during TBI interactions. It shows promise in evaluating communication partner training programmes.     

Self-reported consumer satisfaction in mental health services: Validation of a self-rating version of the UKU-Consumer Satisfaction Rating Scale

The UKU-Consumer Satisfaction Rating Scale (UKU-ConSat) for the evaluation of consumer satisfaction in mental health services was constructed for assessments by independent professional interviewers. In the present study, a patient self-reported version of the scale is validated against the original version. The Spearman's rank correlation between single items, subscores and the total of the original scale and the self-assessment version was found to be good. Another main finding was an acceptable unidimensionality of the self-rating version of the UKU-Consumer Satisfaction rating scale, evaluated by a Mokken analysis. Furthermore, the internal consistency by Cronbach's alpha was found to be satisfactory. The results show that the patient self-rating version is psychometrically sound and therefore suitable for use in ordinary clinical practice. Being a part of a concept for continuous quality control and development in mental health services, the self-rating version of the UKU-ConSat promotes an open collaborative dialogue between professionals and users. A further advantage is that it saves professional time.     

The Geriatric Depression Scale and the Cornell Scale for Depression in Dementia. A validity study

The study is a validation study of two psychogeriatric depression rating scales, The Geriatric Depression Scale (GDS) and the Cornell Scale for Depression in Dementia (CSDD). The sensitivity and specificity, and the convergent and criterion validity of the two scales as well as the inter-rater reliability of the CSDD are reported. Two independent clinicians using the ICD-10 for depression and dementia, the Clinical Global Impression (CGI), the Hamilton Depression rating scale 17-items and the Mini-Mental-State Examination (MMSE), interviewed each patient or control subject. One hundred forty-five persons of 65 years or more of age were included, 73 were depressed only, 36 depressed and demented; 36 persons were control subjects, 11 of these were demented. The inter-rater reliabilities were high or very high equalling perfect correlation. There was very high convergent validity between the screening tools and the severity scales; the shorter versions of the GDS (15-, 10- or four-item version) had lower though still almost perfect correlations. The criterion validity in the total population showed the CSDD as the better scale with sensitivity and specificity of 93% and 97% with a cut-off value of ≥6. The GDS versions had sensitivities and specificities ranging from 82% to 90% and 75% to 94% respectively with cut-off values ≥9, 4, 3 and 1. The CSDD retained its validity and specificity as a screening tool for depression in a population of demented, while the GDS versions all diminished in validity. The GDS and the CSDD are both valid screening tools for depression in the elderly; however, the CSDD alone seems to be equally valid in populations of demented and non-demented.     

Reliability and validity of the Danish version of the Calgary Depression Scale for Schizophrenia

Depressive symptoms within the range of schizophrenic syndromes constitute a major diagnostic and therapeutic problem. Earlier research has indicated that available depression scales are not adequate when examining mood disturbances in patients with schizophrenia. We have made an attempt to estimate the reliability and validity of the Danish version of the Calgary Depression Scale for Schizophrenia. The external validity has been analysed in relation to the Major Depression Inventory (MDI). The internal validity has been analysed by using Loevinger's coefficient of homogeneity as the primary statistic. For the inter-observer reliability the intra-class coefficients have been calculated. It was shown that a subscale of the Calgary scale has sufficient reliability and validity.     

Which dyskinesia scale best detects treatment response?

Numerous scales assess dyskinesia in Parkinson's disease (PD), variably focusing on anatomical distribution, phenomenology, time, severity, and disability. No study has compared these scales and their relative ability to detect change related to an established treatment. We conducted a randomized placebo‐controlled trial of amantadine, assessing dyskinesia at baseline and at 4 and 8 weeks using the following scales: Unified Dyskinesia Rating Scale (UDysRS), Lang‐Fahn Activities of Daily Living Dyskinesia Rating Scale (LF), 26‐Item Parkinson's Disease Dyskinesia scale (PDD‐26), patient diaries, modified Abnormal Involuntary Movements Scale (AIMS), Rush Dyskinesia Rating Scale (RDRS), dyskinesia items from the Movement Disorder Society–sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS‐UPDRS), and Clinical Global Impression (severity and change: CGI‐S, CGI‐C). Scale order was randomized at each visit, but raters were aware of each scale as it was administered. Sensitivity to treatment was assessed using effect size. Sixty‐one randomized dyskinetic PD subjects (31 amantadine, 30 placebo) completed the study. Four of the 8 scales (CGI‐C, LF, PDD‐26, and UDysRS) detected a significant treatment. The UDysRS Total Score showed the highest effect size (η² = 0.138) for detecting treatment‐related change, with all other scales having effect sizes < 0.1. No scale was resistant to placebo effects. This study resolves 2 major issues useful for future testing of new antidyskinesia treatments: among tested scales, the UDysRS, having both subjective and objective dyskinesia ratings, is superior for detecting treatment effects; and the magnitude of the UDysRS effect size from amantadine sets a clear standard for comparison for new agents. © 2012 Movement Disorder Society