Development and Validation of a Hypertension Prevalence Estimator Tool For Use in Clinical Settings.
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ABSTRACT:
SUBMITTER: Ritchey M
PROVIDER: S-EPMC4935656 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Intervention in the early years can help to mitigate the risks that early language and communication difficulties pose for later learning and well-being. Critical to this is the capacity of early years educators to evaluate language development accurately in the classroom in order to target individual support effectively. This article reports on the development and testing of the Early Language in Play Settings (eLIPS) tool, an observational measure of child language. An action research model was used in the design of the tool with the result that the methodology adopted was compatible with an early years child-centered approach. Observations of children in play settings were used to gather information about early language through subscales measuring social communication, receptive and expressive language. A series of preliminary trials with 3- to 5-year-olds, established that the eLIPS measures have concurrent validity with scores from a standardized language assessment, the Clinical Evaluation of Language Fundamentals-Preschool 2 UK . Investigation of internal consistency showed reliability for use by researchers and early years educators together with inter-rater reliability across these groups. It was concluded that eLIPS has potential as a tool to assist early years educators in understanding individual patterns of language acquisition in a play-based environment and for framing team discussions about approaches to early language support.
| S-EPMC7412886 | biostudies-literature
Project description:ObjectiveTo develop and validate a photographic method aimed at making assessment of dietary intake in school canteens non-obstrusive, practical and feasible.MethodsThe study was conducted in two elementary schools representing two different school canteen systems; main dish being served by canteen staff (Iceland), and complete self-serving (Sweden). Food items in serving and leftovers were weighed and photographed. Trained researchers estimated weights of food items by viewing the photographs and comparing them with pictures of half and full reference portions with known weights. Plates of servings and leftovers from 48 children during five school days (n = 448 plates) and a total of 5967 food items were estimated. The researchers' estimates were then compared with the true weight of the foods and the energy content calculated.ResultsWeighed and estimated amounts correlated across meals both in grams and as total energy (0.853-0.977, p<0.001). The agreement between estimated energy content in school meals was close to the true measurement from weighed records; on average 4-19 kcal below true values. Organisation of meal service impacted the efficacy of the method as seen in the difference between countries; with Iceland (served by canteen staff) having higher rate of acceptable estimates than Sweden (self-serving), being 95% vs 73% for total amount (g) in serving. Iceland more often had serving size between or above the half and full reference plates compared with Sweden.ConclusionsThe photographic method provides acceptable estimates of food and energy intake in school canteens. However, greater accuracy can be expected when foods are served by canteen staff compared with self-serving.
| S-EPMC5053534 | biostudies-literature
Project description:BackgroundAlthough 80% of children with disabilities live in developing countries, there are few culturally appropriate developmental assessment tools available for these settings. Often tools from the West provide misleading findings in different cultural settings, where some items are unfamiliar and reference values are different from those of Western populations.Methods and findingsFollowing preliminary and qualitative studies, we produced a draft developmental assessment tool with 162 items in four domains of development. After face and content validity testing and piloting, we expanded the draft tool to 185 items. We then assessed 1,426 normal rural children aged 0-6 y from rural Malawi and derived age-standardized norms for all items. We examined performance of items using logistic regression and reliability using kappa statistics. We then considered all items at a consensus meeting and removed those performing badly and those that were unnecessary or difficult to administer, leaving 136 items in the final Malawi Developmental Assessment Tool (MDAT). We validated the tool by comparing age-matched normal children with those with malnutrition (120) and neurodisabilities (80). Reliability was good for items remaining with 94%-100% of items scoring kappas >0.4 for interobserver immediate, delayed, and intra-observer testing. We demonstrated significant differences in overall mean scores (and individual domain scores) for children with neurodisabilities (35 versus 99 [p<0.001]) when compared to normal children. Using a pass/fail technique similar to the Denver II, 3% of children with neurodisabilities passed in comparison to 82% of normal children, demonstrating good sensitivity (97%) and specificity (82%). Overall mean scores of children with malnutrition (weight for height <80%) were also significantly different from scores of normal controls (62.5 versus 77.4 [p<0.001]); scores in the separate domains, excluding social development, also differed between malnourished children and controls. In terms of pass/fail, 28% of malnourished children versus 94% of controls passed the test overall.ConclusionsA culturally relevant developmental assessment tool, the MDAT, has been created for use in African settings and shows good reliability, validity, and sensitivity for identification of children with neurodisabilities.
| S-EPMC2876049 | biostudies-literature
Project description:BackgroundThe HIV Neurobehavioral Research Center International Neurobehavioral Battery is a culturally valid battery sensitive to the neurocognitive (NC) effects of HIV-infection. However, its lengthy administration time makes the battery impractical in resource-limited settings, like South Africa, which are often faced with an overwhelming disease burden, a lack of neurological and neuropsychological (NP) expertise, and staff shortages. The present study therefore sought to develop an abbreviated version of the HNRC Battery and validate this battery in a sample of people with HIV (PWH) in South Africa.ObjectiveThe present study therefore sought to develop an abbreviated version of the HNRC battery and validate this battery in a sample of people with HIV (PWH) in South Africa.MethodSix measures were selected based on the NC test performances of 103 HIV-positive and 135 HIV-negative South African adults. For the validation, a subgroup of 103 PWH completed the full version of the battery, while the other subgroup of 52 PWH completed only the abbreviated version. Deficit scores of each participant were calculated. These scores were used as the gold standard against which the abbreviated battery was compared.ResultsThere was a reduction of 81% in administration time when compared to the full version of the battery. The abbreviated battery demonstrated good sensitivity (75.0%) and excellent specificity (94.9%) when compared with the full version. The abbreviated battery showed good diagnostic accuracy in identifying NC impairment in an HIV-positive South African sample with a significant reduction in administration time, making it a more practical option in busy South African clinic settings.ConclusionThe results of this study may facilitate the growth of neuroAIDS research and aid initial identification of HIV-related NC impairment in resource-constrained settings. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
| S-EPMC9992844 | biostudies-literature
Project description:AimThe aim of the study reported here was to address the need to assess and train teamwork and non-technical skills in the context of Resuscitation. Specifically, we sought to develop a tool that is feasible to use and psychometrically sound to assess team behaviours during cardiac arrest resuscitation attempts.MethodsTo ensure validity, reliability, and feasibility, the Observational Skill based Clinical Assessment tool for Resuscitation (OSCAR) was developed in 3 phases. A review of the literature leading to initial tool development was followed by an assessment of face and content validity, and finally a thorough reliability assessment, using Cronbach's α to assess internal consistency and intraclass correlation to assess inter-rater reliability.ResultsOSCAR was developed methodically, and tested for face and content validity. Cronbach's α results ranged from 0.736 to 0.965 demonstrating high internal consistency, and intraclass correlation results ranged from 0.652 to 0.911, all of which are strongly significant and indicate good inter-rater reliability.ConclusionOn the basis of our results, we conclude that OSCAR is psychometrically robust, scientifically sound, and clinically relevant. We have developed the Observational Skill-based Clinical Assessment tool for Resuscitation (OSCAR) for the assessment of non-technical skills in Resuscitation teams. We propose the use of this tool in simulation and real Cardiac Arrest Resuscitation attempts to assess, guide and train non-technical skills to team members, to improve patient safety and maximise the chances of successful resuscitation.
| S-EPMC3121958 | biostudies-literature
Project description:BackgroundThe use of obstetric early-warning-systems (EWS) has been recommended to improve timely recognition, management and early referral of women who have or are developing a critical illness. Development of such prediction models should involve a statistical combination of predictor clinical observations into a multivariable model which should be validated. No obstetric EWS has been developed and validated for low resource settings. We report on the development and validation of a simple prediction model for obstetric morbidity and mortality in resource-limited settings.MethodsWe performed a multivariate logistic regression analysis using a retrospective case-control analysis of secondary data with clinical indices predictive of severe maternal outcome (SMO). Cases for design and validation were randomly selected (n = 500) from 4360 women diagnosed with SMO in 42 Nigerian tertiary-hospitals between June 2012 and mid-August 2013. Controls were 1000 obstetric admissions without SMO diagnosis. We used clinical observations collected within 24 h of SMO occurrence for cases, and normal births for controls. We created a combined dataset with two controls per case, split randomly into development (n = 600) and validation (n = 900) datasets. We assessed the model's validity using sensitivity and specificity measures and its overall performance in predicting SMO using receiver operator characteristic (ROC) curves. We then fitted the final developmental model on the validation dataset and assessed its performance. Using the reference range proposed in the United Kingdom Confidential-Enquiry-into-Maternal-and-Child-Health 2007-report, we converted the model into a simple score-based obstetric EWS algorithm.ResultsThe final developmental model comprised abnormal systolic blood pressure-(SBP > 140 mmHg or < 90 mmHg), high diastolic blood pressure-(DBP > 90 mmHg), respiratory rate-(RR > 40/min), temperature-(> 38 °C), pulse rate-(PR > 120/min), caesarean-birth, and the number of previous caesarean-births. The model was 86% (95% CI 81-90) sensitive and 92%- (95% CI 89-94) specific in predicting SMO with area under ROC of 92% (95% CI 90-95%). All parameters were significant in the validation model except DBP. The model maintained good discriminatory power in the validation (n = 900) dataset (AUC 92, 95% CI 88-94%) and had good screening characteristics. Low urine output (300mls/24 h) and conscious level (prolonged unconsciousness-GCS < 8/15) were strong predictors of SMO in the univariate analysis.ConclusionWe developed and validated statistical models that performed well in predicting SMO using data from a low resource settings. Based on these, we proposed a simple score based obstetric EWS algorithm with RR, temperature, systolic BP, pulse rate, consciousness level, urinary output and mode of birth that has a potential for clinical use in low-resource settings..
| S-EPMC7488502 | biostudies-literature
Project description:[This corrects the article DOI: 10.1371/journal.pone.0169975.].
| S-EPMC5513555 | biostudies-other
Project description:Several multivariable risk prediction models have been developed to asses an individual's risk of developing specific cancers. Such models can be used in a variety of settings for prevention, screening, and guiding investigations and treatments. Models aimed at predicting future disease risk that contains lifestyle factors may be of particular use for targeting health promotion activities at an individual level. This type of cancer risk prediction is not yet available in the UK. We have adopted the approach used by the well-established U.S.-derived "YourCancerRisk" model for use in the UK population, which allow users to quantify their individual risk of developing individual cancers relative to the population average risk. The UK version of "YourCancerRisk" computes 10-year cancer risk estimates for 11 cancers utilizing UK figures for prevalence of risk factors and cancer incidence. Because the prevalence of risk factors and the incidence rates for cancer are different between the U.S. and the UK population, this UK model provides more accurate estimates of risks for a UK population. Using an example of breast cancer and data from UK Biobank cohort, we demonstrate that the individual risk factor estimates are similar for the U.S. and UK populations. Assessment of the performance and validation of the multivariate model predictions based on a binary score confirm the model's applicability. The model can be used to estimate absolute and relative cancer risk for use in Primary Care and community settings and is being used in the community to guide lifestyle change. Cancer Prev Res; 10(7); 421-30. ©2017 AACR.
| S-EPMC5501968 | biostudies-literature
Project description:ImportanceClinician compassion is a vital element of health care quality. Currently, there appears to be no validated and feasible method for health care organizations to measure patient assessment of clinician compassion on a large scale.ObjectiveTo develop and validate a tool for measuring patient assessment of clinician compassion that can be used in conjunction with the Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) survey.Design, setting, and participantsThis prospective cohort study took place from June 1 to August 30, 2018, at a US academic health care system among a pilot cohort consisting of 3325 adult patients and a validation cohort consisting of 3483 adult patients, both of whom had an outpatient clinic visit and completed the CG-CAHPS survey.Main outcomes and measurementsAfter a comprehensive literature review, 12 candidate survey items were developed. Face and construct validity were performed. Candidate items were disseminated to patients in conjunction with the CG-CAHPS survey in a series of 2 studies: (1) exploratory factor analysis in one cohort to determine the factor structure and the most parsimonious set of items; and (2) validity testing in a second cohort using confirmatory factor analysis. Reliability was tested using Cronbach α. Convergent validity was tested with patient assessment of clinician communication and overall satisfaction questions from CG-CAHPS survey.ResultsOverall, 6493 patient responses were analyzed. The mean (SD) age was 60 (15) years, 4239 patients (65.3%) were women, and 5079 (78.2%) were white. Exploratory factor analyses identified a 5-item compassion measure to be the most parsimonious. Confirmatory factor analyses found good fit. The compassion measure demonstrated good internal consistency (α = 0.94) and convergent validity (clinician communication: ρ = 0.44; overall satisfaction: ρ = 0.52) but reflected a patient experience domain (compassionate care) distinct from what is currently captured in the CG-CAHPS survey.Conclusions and relevanceA simple 5-item tool to measure patient assessment of clinician compassion was developed and validated for use in conjunction with CG-CAHPS survey.
| S-EPMC6537812 | biostudies-literature
Project description:BackgroundRare diseases are defined as life-threatening or chronically debilitating diseases with a prevalence of 50 out of 100,000 individuals or less. Orphan medicinal products (OMPs) are intended for the treatment of rare diseases. The assessment of quality of evidence in small populations is often complex. Many generic tools are unfit. Therefore, the aim of this study was to develop and validate a new tool to assess the quality of OMPs' clinical evidence (COMPASS).MethodsFirstly, a draft version of the COMPASS tool, developed by the authors and consisting of three parts, was amended based on suggestions obtained in four rounds of expert consultation. Secondly, the tool was put through three rounds of validation. The data source was information provided on the Orphanet website and in European Public Assessment Report (EPAR) document of the European Medicines Agency.ResultsThe first pilot round revealed a high (92.2%) inter-rater agreement for part one of the tool. After further improvements, the final inter-rater agreement was 86.4% for part two (on methodological quality) and three (on quality of reporting) of the tool. The COMPASS tool does not attempt to score or rank the quality of clinical evidence, but rather to give an outline of various, key elements with respect to quality of clinical evidence of OMP studies.ConclusionsThe COMPASS tool can be applied to assess the quality of evidence of an OMP based on information in the registration dossier, for example by local reimbursement agencies, pharmacists or clinicians. In that way, the tool can contribute to making reimbursement and/or treatment decisions increasingly more founded on the principles of evidence-based decision making.
| S-EPMC3856624 | biostudies-literature