Reliability and validity of a new scale on internal coherence (ICS) of cancer patients

<p>Abstract</p> <p>Background</p> <p>Current inventories on quality of life used in oncology mainly focus on functional aspects of patients in the context of disease adaption and treatments (side) effects (EORTC QLQ C30) or generically the status of common functions (Medical Outcome Study SF 36). Beyond circumscribed dimensions of quality of life (i.e., physical, emotional, social, cognitive etc.), there is a lack of inventories which also address other relevant dimensions such as the 'sense of coherence' (SOC) in cancer patients. SOC is important because of its potential prognostic relevance in cancer patients, but the current SOC scale has mainly been validated for psychiatric and psychosomatic patients. Our two-step validation study addresses the internal coherence (ICS) scale, which is based on expert rating, using specific items for oncological patients, with respect to its reliability, validity and sensitivity to chemotherapy.</p> <p>Methods</p> <p>The items were tested on 114 participants (57 cancer patients and a matched control group), alongside questions on autonomic regulation (aR), the Hospital Anxiety and Depression Scale (HADS), self-regulation (SRQ) and Karnofsky the Performance-Index (KPI). A retest of 65 participants was carried out after a median time span of four weeks.</p> <p>In the second part of the study, the ICS was used to assess internal coherence during chemotherapy in 25 patients with colorectal carcinoma (CRC) and 17 breast cancer patients. ICS was recorded before, during and 4 – 8 weeks after treatment.</p> <p>Results</p> <p>The 10-item scale of 'internal coherence' (ICS) shows good to very good reliability: Cronbach-α r = 0.91, retest-reliability r = 0.80. The ICS correlates with r = 0.43 – 0.72 to the convergence criteria (all p < 0.001). We are able to show decreased ICS-values after the third cycle for CRC and breast cancer patients, with a subsequent increase of ICS scores after the end of chemotherapy.</p> <p>Conclusion</p> <p>The ICS has good to very good reliability, validity and sensitivity to chemotherapy.</p

Assessing Theoretical Conclusions With Blinded Inference to Investigate a Potential Inference Crisis

Scientific advances across a range of disciplines hinge on the ability to make inferences about unobservable theoretical entities on the basis of empirical data patterns. Accurate inferences rely on both discovering valid, replicable data patterns and accurately interpreting those patterns in terms of their implications for theoretical constructs. The replication crisis in science has led to widespread efforts to improve the reliability of research findings, but comparatively little attention has been devoted to the validity of inferences based on those findings. Using an example from cognitive psychology, we demonstrate a blinded-inference paradigm for assessing the quality of theoretical inferences from data. Our results reveal substantial variability in experts’ judgments on the very same data, hinting at a possible inference crisis

Challenging some common beliefs

The authors review their own empirical work inspired by the adaptive toolbox metaphor. The review examines factors influencing strategy selection and execution in multi-attribute inference tasks (e.g., information costs, time pressure, memory retrieval, dynamic environments, stimulus formats, intelligence). An emergent theme is the re-evaluation of contingency model claims about the elevated cognitive costs of compensatory in comparison with non-compensatory strategies. Contrary to common assertions about the impact of cognitive complexity, the empirical data suggest that manipulated variables exert their influence at the meta-level of deciding how to decide (i.e., which strategy to select) rather than at the level of strategy execution. An alternative conceptualisation of strategy selection, namely threshold adjustment in an evidence accumulation model, is also discussed and the difficulty in distinguishing empirically between these metaphors is acknowledged

Approximating rationality under incomplete information: Adaptive inferences for missing cue values based on cue-discrimination

In a highly uncertain world, individuals often have to make decisions in situations with incomplete information. We investigated in three experiments how partial cue information is treated in complex probabilistic inference tasks. Specifically, we test a mechanism to infer missing cue values that is based on the discrimination rate of cues (i.e., how often a cue makes distinct predictions for choice options). We show analytically that inferring missing cue values based on discrimination rate maximizes the probability for a correct inference in many decision environments and that it is therefore adaptive to use it. Results from three experiments show that individuals are sensitive to the discrimination rate and use it when it is a valid inference mechanism but rely on other inference mechanisms, such as the cues' base-rate of positive information, when it is not. We find adaptive inferences for incomplete information in environments in which participants are explicitly provided with information concerning the base-rate and discrimination rate of cues (Exp. 1) as well as in environments in which they learn these properties by experience (Exp. 2). Results also hold in environments of further increased complexity (Exp. 3). In all studies, participants show a high ability to adaptively infer incomplete information and to integrate this inferred information with other available cues to approximate the naive Bayesian solution