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Research 2 > Outcome measures/reliability and validity (3) > Flashcards

Outcome measures/reliability and validity (3) Flashcards

1
Q

actual results of implementing the plan of care that indicate the impact on functioning?

A

measurement

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2
Q

Outcome measure include: (7)

A
  1. Health of functional status (activity limitations and participation restrictions)
  2. Impairments of body function and structures
  3. Adverse outcomes and complications
  4. Morbidity and mortality
  5. The individual’s self-reported outcomes
  6. The individual’s satisfaction with the care received
  7. Changes in health, wellness, and fitness
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3
Q

T/F most measurements are not directly observable

A

True, much harder for abstract terms (intelligence, health, strength, pain)

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4
Q

Biomarker as a surrogate endpoint -

ex:

A
  • objective, quantifiable characteristics of biological process
  • surrogate endpoint - a substitute for clinically meaningful endpoint
    ex: easier to measure bp than use EKG but easier to measure EKG than morbidity/mortality in long term
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5
Q

T/F test for an outcome measurement should be checked for its reliability and validity.

A

True
Reliability: Consistency
Validity: Accuracy

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6
Q

Reliability -

A
  • extent to which a measurement is consistent and free from error (with as little variation as possible
  • reproducibility / dependability
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7
Q

What makes a reliable PT practitioner?

A

one who will be able to measure repeated outcomes with consistent scores

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8
Q

What makes a reliable test?

A

one that will perform with predictable consistency under set conditions

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9
Q

Why is reliability fundamental to all aspects of measurement?

A
  1. we can have confidence in the data we collect

2. we can draw rational conclusion from those data

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10
Q

Many reliability coefficients are based on measure of correlation, what does that mean?

A

correlation – the degree of association between two sets of data

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11
Q

How do you measure reliability?

A
  1. Draw scatter plot to visualize it

2. compute correlation coefficient (r) to quantify it (larger the r the more correlated)

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12
Q

test-retest reliability

how to check?

A
  1. consistency of repeated measurements that are separated in time stability of a measurement
  2. kappa or correlation coefficient to check
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13
Q

intrarater reliability

how to check?

A
  1. consistency of repeated measurements by the same PT practitioner at different times
  2. kappa or correlation coefficient to check
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14
Q

interrater reliability

how to check?

A
  1. consistency of repeated measurements by the multiple PT practitioners important to be good unless the usefulness of that test is limited
  2. kappa or correlation coefficient to check
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15
Q

internal consistency

how to check?

A
  1. consistency across parts of measurements

2. Cronbach’s alpha to check

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16
Q

Validity -

A

degree to which a test is measuring what it is intended to measure

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17
Q

face validity

Who inspects item?

A
  1. Does the content of the test appear to be suitable to its aims?
  2. the weakest form of the validity
  3. inspection of items for proper selections made by non-experts
18
Q

content validity

Who inspects item?

A
  1. Is the test fully representative of what it aims to measure?
  2. inspection of items for proper selections made by experts
19
Q

construct validity

How do you check this?

A
  1. Does the test measure the concept that it is intended to measure?
  2. correlation, factor analysis, or cluster to check
  3. Strongest
20
Q

Confirmatory factor analysis -

A
  1. Commonly used method to investigate construct validity

2. How well measurement represent the number of constructs

21
Q

Cluster analysis -

A
  1. Commonly used method to investigate construct validity

2. Classify a group of subjects on the basis of a set of measured variables into a number of different groups

22
Q

What is an ordered system for a series of questions that provide an overall rating?

A

Scale

23
Q

Continuous scales

A
  1. Ratio - rep units with equal intervals measure from true zero (distance, age, time)
  2. Interval - rep units with equal intervals but no true 0 (calendar years, temp)
  3. used with continuous variables such as age; blood pressure; years of experience
24
Q

Categorical scales

A
  1. ordinal - numbers indicate rank order (MMT, pain)
  2. nominal - numerals are category labels (gender, blood type)
  3. used with categorical variables such as gender; race; diagnosis
25
Q

Ordinal scales

A

used with ordinal variables such as:

  1. pain measured by minimal; moderate; severe
  2. function by independent; minimal assist; moderate assist; maximal assist; dependent
26
Q

Dichotomous Scale

ex:

A
  1. categorical
  2. a two-point scale;
    ex: Yes/No; True/False
27
Q

5-point Likert Scale

ex:

A
  1. ordinal
  2. a five-point scale;
    ex: Frequency: Always/Often/Sometimes/Rarely/Never
    Quality: Excellent/Good/Fair/Poor/Very Poor
28
Q

Visual Analogue Scale (VAS)

A
  1. continuous
  2. a line with verbal anchors at either end and subject places a mark at a point on the line corresponding to the subject’s rating
29
Q

what is a Performance Based Outcome Measurement?

ex:

A

when the patient is required to perform a set of functional tasks
ex: Functional Independence Measure (FIM) - which assesses the patient’s ability function

30
Q

what is a Self-Reported Outcome Measurement?

ex:

A

when the patient is required to complete a questionnaire
ex: Oswestry Low Back Pain Disability Index (ODI) - which measures the patient’s permanent functional disability including

31
Q

Error parameters -

A
  1. quantify errors in measurements
  2. not as widely reported as the reliability or validity are
  3. important to determine the amount of error associated with a patient’s outcome measure because it always comes with some imprecision
32
Q

Standard Error of Measurement (SEM) -

A

the amount of variability that can be attributed to measurement error

33
Q

Minimal Detectable Change (MDC) -

A

minimal change that a patient must show on the scale to ensure that the observed change is real and not just measurement error

34
Q

Clinical utility considerations -

A
  1. appropriateness of the test for application at the level of pathology or health condition, body function or structure, activity, or participation
  2. precision of the test to accurately measure change
  3. interpretability of the test to the individual’s situation
  4. acceptability of the test to the individual
  5. time and cost of administering the test
35
Q

Timed Up and Go test (TUG)

A
  1. a measure of function with correlates to balance and fall risk
  2. outcome: the time taken to stand up from a standard arm chair, walk a distance of 3 meters
  3. Scale of measurement - continuous scale as it is recorded with the time
  4. performance-based
36
Q

Tinetti Balance Test (Tinetti test)

A
  1. a measure of balance and gait
  2. outcome: based on the number of chronic disabilities
  3. Scale of measurement - continuous scale as it is recorded with the number of chronic disabilities
  4. performance-based
37
Q

Berg Balance Scale (BBS)

A
  1. a measure of balance

2. outcome: total score computed out of maximum = 56

38
Q

T/F Reliability implies validity

A

False, Reliability does not imply validity

39
Q

T/F Reliability is a prerequisite for validity

A

True

40
Q

How to interpret correlation coefficient r -

A

Correlation – the degree of association between two sets of data

  1. a measure of linear association between two variables
  2. a decimal number somewhere between -1 and +1
  3. sign of r indicates the direction of the correlation
  4. absolute value of r indicates the strength of the correlation
41
Q

Cohen’s kappa (k) -

Pr(o)-Pr(e)/ 1 - pr(e)

A
  • a measure of agreement between two categorical variables
    where
    Pr(o): probability of the relative observed agreement among two examiners
    Pr(e): probability of the expected agreement just by chance among two examiners
42
Q

How to interpret Cohen’s kappa (k)?

A
  • a decimal number somewhere between 0 and +1
  • 1 = perfect agreement
  • 0 = no agreement

Research 2 (13 decks)

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