a web application to estimate scores from different patient-reported outcome measures on a common scale

Background Recently, a growing number of Item-Response Theory (IRT) models has been published, which allow estimation of a common latent variable from data derived by different Patient Reported Outcomes (PROs). When using data from different PROs, direct estimation of the latent variable has some advantages over the use of sum score conversion tables. It requires substantial proficiency in the field of psychometrics to fit such models using contemporary IRT software. We developed a web application (http://www.common- metrics.org), which allows estimation of latent variable scores more easily using IRT models calibrating different measures on instrument independent scales. Results Currently, the application allows estimation using six different IRT models for Depression, Anxiety, and Physical Function. Based on published item parameters, users of the application can directly estimate latent trait estimates using expected a posteriori (EAP) for sum scores as well as for specific response patterns, Bayes modal (MAP), Weighted likelihood estimation (WLE) and Maximum likelihood (ML) methods and under three different prior distributions. The obtained estimates can be downloaded and analyzed using standard statistical software. Conclusions This application enhances the usability of IRT modeling for researchers by allowing comparison of the latent trait estimates over different PROs, such as the Patient Health Questionnaire Depression (PHQ-9) and Anxiety (GAD-7) scales, the Center of Epidemiologic Studies Depression Scale (CES-D), the Beck Depression Inventory (BDI), PROMIS Anxiety and Depression Short Forms and others. Advantages of this approach include comparability of data derived with different measures and tolerance against missing values. The validity of the underlying models needs to be investigated in the future

www.common-metrics.org: a web application to estimate scores from different patient-reported outcome measures on a common scale

BACKGROUND: Recently, a growing number of Item-Response Theory (IRT) models has been published, which allow estimation of a common latent variable from data derived by different Patient Reported Outcomes (PROs). When using data from different PROs, direct estimation of the latent variable has some advantages over the use of sum score conversion tables. It requires substantial proficiency in the field of psychometrics to fit such models using contemporary IRT software. We developed a web application ( http://www.common-metrics.org ), which allows estimation of latent variable scores more easily using IRT models calibrating different measures on instrument independent scales. RESULTS: Currently, the application allows estimation using six different IRT models for Depression, Anxiety, and Physical Function. Based on published item parameters, users of the application can directly estimate latent trait estimates using expected a posteriori (EAP) for sum scores as well as for specific response patterns, Bayes modal (MAP), Weighted likelihood estimation (WLE) and Maximum likelihood (ML) methods and under three different prior distributions. The obtained estimates can be downloaded and analyzed using standard statistical software. CONCLUSIONS: This application enhances the usability of IRT modeling for researchers by allowing comparison of the latent trait estimates over different PROs, such as the Patient Health Questionnaire Depression (PHQ-9) and Anxiety (GAD-7) scales, the Center of Epidemiologic Studies Depression Scale (CES-D), the Beck Depression Inventory (BDI), PROMIS Anxiety and Depression Short Forms and others. Advantages of this approach include comparability of data derived with different measures and tolerance against missing values. The validity of the underlying models needs to be investigated in the future

Relaxational behavior of the infinite-range Ising spin-glass in a transverse field

We study the zero-temperature behavior of the infinite-ranged Ising spin glass in a transverse field. Using spin summation techniques and Monte Carlo methods we characterize the zero-temperature quantum transition. Our results are well compatible with a value $\nu=\frac{1}{4}$ for the correlation length exponent, $z=4$ for the dynamical exponent and an algebraic decay $t^{-1}$ for the imaginary-time correlation function. The zero-temperature relaxation of the energy in the presence of the transverse field shows that the system monotonically reaches the ground state energy due to tunneling processes and displays strong glassy effects.Comment: 15 pages + 5 Figures, Revte

An initial psychometric evaluation of the German PROMIS® v1.2 Physical Function item bank in patients with a wide range of health conditions

Objectives: To translate the PROMIS® Physical Function (PF) item bank version 1.2 into German, and to investigate psychometric properties of resulting full bank and seven derived short forms. Design: Cross-sectional psychometric study. Setting: Inpatient and outpatient clinics of the Department of Psychosomatic Medicine at Charité - Universitätsmedizin Berlin, Germany. Subjects: Ten adult patients with various chronic diseases participated in cognitive debriefing interviews. The final item bank was administered to n=266 adult patients with a broad range of medical conditions. Interventions: Patient-reported outcome assessment as part of routine care. Main measures: PROMIS v1.2 PF bank; MOS SF-36® PF scale (PF-10). Results: Cross-cultural adaptation of the item bank followed established guidelines. For the final German translation, the corrected item-total correlations ranged from 0.44 to 0.84. Cronbach’s Alpha was high for each PROMIS PF short form (α=0.88-0.96). The full PROMIS PF bank and most short forms correlated highly with the SF-36 PF-10 (r=0.85-0.90), with the exception of PROMIS Upper Extremity (r=0.64). PROMIS Upper Extremity showed ceiling effects and lower agreement with the full bank than other short forms. Unidimensionality was supported for all PROMIS PF measures using traditional factor analysis and nonparametric item response theory. Conclusions: The German PROMIS PF bank was found to be conceptually equivalent to the English version and fulfilled the psychometric requirements for use of short forms in clinical practice. Future studies should pay particular attention to samples with upper extremity functional limitations to further investigate the dimensional structure of physical function as conceptualized according to PROMIS

A conjectured scenario for order-parameter fluctuations in spin glasses

We study order-parameter fluctuations (OPF) in disordered systems by considering the behavior of some recently introduced paramaters $G,G_c$ which have proven very useful to locate phase transitions. We prove that both parameters G (for disconnected overlap disorder averages) and $G_c$ (for connected disorder averages) take the respective universal values 1/3 and 13/31 in the $T\to 0$ limit for any {\em finite} volume provided the ground state is {\em unique} and there is no gap in the ground state local-field distributions, conditions which are met in generic spin-glass models with continuous couplings and no gap at zero coupling. This makes $G,G_c$ ideal parameters to locate phase transitions in disordered systems much alike the Binder cumulant is for ordered systems. We check our results by exactly computing OPF in a simple example of uncoupled spins in the presence of random fields and the one-dimensional Ising spin glass. At finite temperatures, we discuss in which conditions the value 1/3 for G may be recovered by conjecturing different scenarios depending on whether OPF are finite or vanish in the infinite-volume limit. In particular, we discuss replica equivalence and its natural consequence $\lim_{V\to\infty}G(V,T)=1/3$ when OPF are finite. As an example of a model where OPF vanish and replica equivalence does not give information about G we study the Sherrington-Kirkpatrick spherical spin-glass model by doing numerical simulations for small sizes. Again we find results compatible with G=1/3 in the spin-glass phase.Comment: 18 pages, 9 postscript figure

Trajectories of Health-Related Quality of Life and HbA1c Values of Children and Adolescents With Diabetes Mellitus Type 1 Over 6 Months: A Longitudinal Observational Study

Introduction: To achieve optimized blood glucose concentrations (assessed by HbA1c) and high health-related quality of life (HRQL), children and adolescents with diabetes mellitus type 1 (T1DM) must follow strict disease management strategies. This study aims to investigate HRQL of children and adolescents with T1DM and its association with HbA1c values over the course of 6 months. Methods: Patients aged 7-17 years (n = 203) with T1DM provided HRQL data on a monthly basis. HRQL was measured using the Kids-CAT, a computer-adaptive test (CAT) comprising five generic HRQL domains. HbA1c concentrations were assessed at baseline, at 3 and 6 months. We explored the trajectory of HRQL at the domain level using linear mixed effects models. Further, we investigated the association between HRQL and HbA1c concentrations over time using path analysis models. Results: Children and adolescents with T1DM reported high scores across all HRQL domains over time. However, those with an HbA1c concentrations of \u3e 9.0% reported significantly lower scores in physical well-being and parent relations compared with those with an HbA1c concentration of \u3c 7.5%. Path analysis models revealed a minimal temporal relationship between HbA1c and HRQL, with a small negative impact of HbA1c on physical well-being, psychological well-being and parent relations. Conclusion: Although observed HRQL of young patients with T1DM was comparable to age-related German-speaking reference population over the course of 6 months, those with an HbA1c concentration \u3e 9.0% reported lower scores in selected HRQL domains. Thus, special attention should be drawn to HRQL of children and adolescents with higher HbA1c concentrations. The minimal relationship between HbA1c and HRQL indicates that the two therapy goals, i.e., achievement and maintenance of glycemic targets and high HRQL, should be considered and evaluated independently in clinical routine. Trial Registration: DRKS00006326 (German Clinical Trial Register), date of registration: August 1st, 2014

Varying the item format improved the range of measurement in patient-reported outcome measures assessing physical function

BACKGROUND: Physical function (PF) is a core patient-reported outcome domain in clinical trials in rheumatic diseases. Frequently used PF measures have ceiling effects, leading to large sample size requirements and low sensitivity to change. In most of these instruments, the response category that indicates the highest PF level is the statement that one is able to perform a given physical activity without any limitations or difficulty. This study investigates whether using an item format with an extended response scale, allowing respondents to state that the performance of an activity is easy or very easy, increases the range of precise measurement of self-reported PF. METHODS: Three five-item PF short forms were constructed from the Patient-Reported Outcomes Measurement Information System (PROMIS(R)) wave 1 data. All forms included the same physical activities but varied in item stem and response scale: format A ( Are you able to ... ; without any difficulty / unable to do ); format B ( Does your health now limit you ... ; not at all / cannot do ); format C ( How difficult is it for you to ... ; very easy / impossible ). Each short-form item was answered by 2217-2835 subjects. We evaluated unidimensionality and estimated a graded response model for the 15 short-form items and remaining 119 items of the PROMIS PF bank to compare item and test information for the short forms along the PF continuum. We then used simulated data for five groups with different PF levels to illustrate differences in scoring precision between the short forms using different item formats. RESULTS: Sufficient unidimensionality of all short-form items and the original PF item bank was supported. Compared to formats A and B, format C increased the range of reliable measurement by about 0.5 standard deviations on the positive side of the PF continuum of the sample, provided more item information, and was more useful in distinguishing known groups with above-average functioning. CONCLUSIONS: Using an item format with an extended response scale is an efficient option to increase the measurement range of self-reported physical function without changing the content of the measure or affecting the latent construct of the instrument

A phytolith supported biosphere-hydrosphere predictive model for Southern Ethiopia:Insights into paleoenvironmental changes and human landscape preferences since the last glacial maximum

During the past 25 ka, southern Ethiopia has undergone tremendous climatic changes, from dry and relatively cold during the Last Glacial Maximum (LGM, 25–18 ka) to the African Humid Period (AHP, 15–5 ka), and back to present-day dry conditions. As a contribution to better understand the effects of climate change on vegetation and lakes, we here present a new Predictive Vegetation Model that is linked with a Lake Balance Model and available vegetation-proxy records from southern Ethiopia including a new phytolith record from the Chew Bahir basin. We constructed a detailed paleo-landcover map of southern Ethiopia during the LGM, AHP (with and without influence of the Congo Air Boundary) and the modern-day potential natural landcover. Compared to today, we observe a 15–20% reduction in moisture availability during the LGM with widespread open landscapes and only few remaining forest refugia. We identify 25–40% increased moisture availability during the AHP with prevailing forests in the mid-altitudes and indications that modern anthropogenic landcover change has affected the water balance. In comparison with existing archaeological records, we find that human occupations tend to correspond with open landscapes during the late Pleistocene and Holocene in southern Ethiopia

Cardiovascular MRI Compared to Echocardiography to Identify Cardioaortic Sources of Ischemic Stroke: A Systematic Review and Meta-Analysis

Background: To compare the diagnostic yield of echocardiography and cardiovascular MRI (CMR) to detect structural sources of embolism, in patients with ischemic stroke with a secondary analysis of non-stroke populations. Methods and Results: We searched MEDLINE/Embase (from 01.01.2000 to 24.04.2021) for studies including CMR to assess prespecified sources of embolism. Comparison included transthoracic and/or transesophageal echocardiography. Two authors independently screened studies, extracted data and assessed bias using the QUADAS-2 tool. Estimates of diagnostic yield were reported and pooled. Twenty-seven studies with 2,525 patients were included in a study-level analysis. Most studies had moderate to high risk of bias. Persistent foramen ovale, complex aortic plaques, left ventricular and left atrial thrombus were the most common pathologies. There was no difference in the yield of left ventricular thrombus detection between both modalities for stroke populations (4 studies), but an increased yield of CMR in non-stroke populations (28.1 vs. 16.0%, P < 0.001, 10 studies). The diagnostic yield in stroke patients for detection of persistent foramen ovale was lower in CMR compared to transoesophageal echocardiography (29.3 vs. 53.7%, P < 0.001, 5 studies). For both echocardiography and CMR the clinical impact of the management consequences derived from many of the diagnostic findings remained undetermined in the identified studies. Conclusions: Echocardiography and CMR seem to have similar diagnostic yield for most cardioaortic sources of embolism except persistent foramen ovale and left ventricular thrombus. Randomized controlled diagnostic trials are necessary to understand the impact on the management and potential clinical benefits of the assessment of structural cardioaortic stroke sources. Registration: PROSPERO: CRD42020158787