ON THE STRUCTURAL VALIDITY OF BESTEST, MINI-BESTEST AND BRIEF-BESTEST.

Missing (Letter

Bibliometric indicators and core journals in physical and rehabilitation medicine.

Background and objective: the concept of the "standing" of scientific journals (in terms of influence, prestige, popular ity, etc.) is multi-dimensional and cannot be captured adequately by a single indicator. The aim of this report is to compare and comment on different bibliometric indicators related to some leading journals in rehabilitation, in order to provide further insights regarding their practical usefulness for Physical and Rehabilitation Medicine. Discussion: The commonly used Journal Impact Factor and the new SCImago Journal Rank indicator are measures of average "impact per paper". Other new measures show potentially useful complementarities with them and warrant further attention. For example, the Eigenfactor score represents a measure of total "citation impact" and seems sufficiently to express the "importance" of a journal. In fact, the information conveyed by the Eigenfactor score corresponds to a general consensus of journal status in Physical and Rehabilitation Medicine, as expressed by the European Consensus Committee on "International Rehabilitation Journals" and captured by a survey among European Physical and Rehabilitation Medicine researchers

Measurement precision of the Pain Catastrophizing Scale and its short forms in chronic low back pain

The Pain Catastrophizing Scale (PCS) is a widely studied tool to assess pain catastrophizing for chronic low back pain (LBP). Short forms of the PCS exist, but their measurement precision at individual level is unclear. This study aimed to analyze the Rasch psychometric characteristics of the PCS and three of its short forms (two 4-item and one 6-item) in a sample of 180 Italian-speaking patients with chronic LBP, and compare their measurement precision at the individual level. We performed a Rasch analysis on each version of the PCS and calculated test information functions (TIFs) to examine conditional measurement precision. Rasch analysis showed appropriate rating category functioning, unidimensionality, and acceptable fit to the Rasch model for all PCS versions. This represented a prerequisite for performing further advanced psychometric analyses. According to TIFs, the PCS full scale showed-at any score level-higher measurement precision in estimating individual pain catastrophizing than its short forms (which had unacceptably high standard errors of measurement). Our results show acceptable conditional precision of the PCS full scale in estimating pain catastrophizing. However, further studies are needed to confirm its diagnostic accuracy at individual level. On the other hand, the study warns against use of the three PCS short forms for clinical decision-making at the individual level

Rasch validation of the Activities-specific Balance Confidence Scale and its short versions in patients with Parkinson's disease.

Accepted Jan 10, 2014; Epub ahead of print Mar 28, 2014IntroductIonPostural instability is a key feature of advanced Parkinson's dis-ease (PD) (1), often leading to falls with dramatic consequences (2). Balance impairment can also induce psychological reactions, such as reduced balance confidence and increased fear of fall-ing. Balance confidence (a construct exploring fall-related self-efficacy) and fear of falling may be protective if they interfere only with hazardous activity and increase caution in performing daily living tasks. On the other hand, they can be maladaptive if their effect is to restrict mobility, independence and social par -ticipation, leading to further deconditioning, functional decline and poorer quality of life (3). Therefore, balance confidence is a construct that needs to be clearly understood, accurately meas-ured, and requires timely, appropriate management within fall risk assessment and fall prevention programmes (4).Balance confidence is often analysed with the Activities-specific Balance Confidence scale (ABC) (5), which has been shown to have sound psychometric properties in older adults (5, 6) and people with lower-limb amputations (7, 8) and stroke (9). In subjects with PD, the ABC has only recently been validated (10), by means of a Classical Test Theory approach, while the short versions of ABC proposed for PD (11–13) have undergone only preliminary validation.However, the Classical Test Theory approach does not take into account some standard criteria and attributes (concerning both single items and total score) that need to be considered when evaluating the measurement properties of a tool (14). Rasch analysis is being increasingly recommended in the development and evaluation of clinical tools for healthcare to verify if they comply with the theoretical requirements of measurement, including dimensionality analysis and item-level scale evaluation (15).The aim of this study was to analyse the psychometric prop-erties of the ABC and its 3 short versions in subjects with PD, using both Classical Test Theory and Rasch analysis, in order to determine whether fundamental measurement properties are satisfied and to provide insights into the optimal use of these questionnaires. METHOD

Is the Rivermead Mobility Index a suitable outcome measure in lower limb amputees?--A psychometric validation study.

Objective: To examine the internal consistency, validity, responsiveness and test scalability of the Rivermead Mobility Index. Design: Methodological research (consecutive sampling, prospective longitudinal study). Patients: 140 unilateral lower limb amputees (79 above-knee and 61 below-knee). Methods: The Rivermead Mobility Index was administered to all patients at the beginning (T0) and at the end (T2) of the prosthetic training. In 70 of the patients, the Functional Independence Measure and a timed walking test were also carried out. Results: The Cronbach's alpha of the Rivermead Mobility Index was 0.85 and the item-to-total correlation coefficients rpb ranged from 0.33 to 0.74 (p 0.0001), for the items considered, at T0; 4 correlations were not calculated due to the extremely low variability of some item responses (mode 98%). The correlation (rs) of Rivermead Mobility Index score with the motor subscale of the Functional Independence Measure was 0.83 at T0 and 0.69 at T2 (p 0.0001, for both) and that with timed walking test 0.70 (p 0.0001) at T2. The effect size was 1.35. The scalability coefficients were below the limits of acceptability. Conclusion: When applied in lower limb amputees, the Rivermead Mobility Index is an ordinal measure with adequate levels of a series of psychometric properties, which seems more useful for epidemiological studies than for clinical decision-making in single patients. Further steps should be considered to improve its item selection, response format and scaling properties

Scale Shortening and Decrease in Measurement Precision: Analysis of the Pain Self-Efficacy Questionnaire and Its Short Forms in an Italian-Speaking Population With Neck Pain Disorders

OBJECTIVE: Short (2- and 4-item) forms of the Pain Self-Efficacy Questionnaire (PSEQ) have been proposed, but their measurement precision at the individual level is unclear.The purpose of this study was to analyze the Rasch psychometric characteristics of PSEQ and its 3 short forms (one 4-item and two 2-item versions) in an Italian-speaking population with neck pain disorders and compare their measurement precision at the individual level through calculation of the test information function (TIF).METHODS: Secondary analysis of data from a prospective single-group observational study was conducted. In 161 consecutive participants (mean age=45 y (SD=14); 104 women) with neck pain disorders, a Rasch analysis was performed on each version of PSEQ (full scale plus 3 short forms), and the TIF was calculated to examine the degree of measurement precision in estimating person ability over the whole measured construct (pain self-efficacy).RESULTS: In all versions of PSEQ, the rating scale fulfilled the category functioning criteria, and all items showed an adequate fit to the Rasch model. The TIF showed a bell-shaped distribution of information, with an acceptable measurement precision (standard error<0.5) for persons with a wide range of ability; conversely, measurement precision was unacceptably low in each short form (particularly the two 2-item versions).CONCLUSIONS: The results confirm and expand reports on the sound psychometric characteristics of PSEQ, showing for the first time its conditional precision in estimating pain self-efficacy measures in Italian individuals with neck pain disorders. The study cautions against use of the 3 PSEQ short forms for individual-level clinical decision making.IMPACT: Short scales are popular in rehabilitation settings largely because they can save assessment time and related costs. The psychometric characteristics of the 10-item PSEQ were confirmed and deepened, including its precision in estimating individual pain self-efficacy at different levels of this latent variable. On the other hand, low measurement precision of the 3 PSEQ short forms caution against their use for individual judgments

Construct validity of the Quebec Back Pain Disability Scale: a factor analytic and Rasch study

Studies on structural validity of the Quebec Back Pain Disability Scale (QBPDS) showed uncertain unidimensionality

Head-to-head Rasch comparison of the Prosthesis Evaluation Questionnaire-Mobility Section and the Prosthetic Mobility Questionnaire 2.0 in Italian lower-limb prosthesis Users

The Prosthesis Evaluation Questionnaire-Mobility Section (PEQ-MS) and the Prosthetic Mobility Questionnaire (PMQ 2.0) are two validated self-report questionnaires assessing mobility in people with lower-limb amputation

Responsiveness and minimal important change of the Quebec Back Pain Disability Scale in Italian patients with chronic low back pain undergoing multidisciplinary rehabilitation

Background: There is still a lack of information concerning MIC of the QBPDS, that limits its use for clinical and research purposes. Aim: Evaluating responsiveness and minimal important change (MIC) of the Quebec Back Pain Disability Scale (QBPDS) in Italians with chronic low back pain (LBP). Design: Methodological research based on an observational study. Setting: Outpatient rehabilitation hospital. Population: Two hundred and one patients with chronic LBP. Methods: At the beginning and end of a multidisciplinary rehabilitation programme, patients completed the QBPDS. At the end of treatment, they completed a 7-level global perceived effect (GPE) scale, which was split to obtain a dichotomous outcome (improved vs. stable). Responsiveness was calculated by distribution-based [effect size (ES); standardised response mean (SRM); minimum detectable change (MDC95)] and anchor-based methods [Receiver Operating Characteristics (ROC) curves]. ROC curves were also used to compute the MIC (based on QBPDS change score, both absolute and expressed as percentage). Correlations between the change score of the QBPDS and GPE were calculated. Results: The ES was 0.29, the SRM was 0.43, and the MDC95 was 12 points. ROC analysis of the absolute change scores showed a MIC value of 6 points, with an area under the curve (AUC), sensitivity, and specificity of 0.83 (95%C.I. 0.77-0.90), 77.7% and 80.8%, respectively. ROC analysis based on the percent change score from baseline revealed a MIC of 18% with an AUC, sensitivity and specificity of 0.85 (95%C.I. 0.79-0.91), 80.6% and 80.8%, respectively. Correlation between change score of the QBPDS and GPE was ρ=-0.67. Conclusions: The QBPDS score change (expressed in both absolute value and percentage from baseline) was sensitive in detecting clinical changes in Italian subjects with chronic LBP undergoing multidisciplinary rehabilitation. In clinical practice, we recommend -where absolute change is lower than MDC- to rely on the MIC taking into account the percentage change from baseline condition. Clinical rehabilitation impact: The present study investigated the responsiveness and MIC of the QBPDS in a group of patients with chronic LBP. Our findings showed that the QBPDS score may classify with good to excellent discriminatory accuracy subjects who consider themselves as improved. Where examining change, we recommend to consider both MICs we provided (expressing score change both in absolute value and as a percentage from baseline), and disregard values lower than MDC95, not being discernible from measurement error