Measurement properties of oral health related patient reported outcome measures in patients with oral cancer: A systematic review using COSMIN checklist

Psychometric Properties of General Oral Health Assessment Index Across Ages: COSMIN Systematic Review

OBJECTIVES

To systematically review the psychometric properties of the Geriatric Oral Health Assessment Index (GOHAI) across age groups using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology.

METHODS

Data: English peer-reviewed articles reporting studies of the development, translation, or validation of GOHAI.

SOURCES

PubMed, Web of Science, and EMBASE from Jan 1990 until December 31, 2023. Methodological evaluation: based on COSMIN methodology. The results are presented overall and for 4 age groups (≥60 years, all ages, <60 years, ≤45 years). Structural validity was summarized qualitatively. Internal consistency and reliability were synthesized via random-effects meta-analysis of T-transformed Cronbach α values, and Fisher's Z transformed correlation coefficients. Construct validity and responsiveness were assessed using effect sizes.

RESULTS

Four hundred ninety-seven records were identified, 72 underwent full-text assessment, resulting in 60 included reports. Structural validity was inconsistent across all age groups and overall. Internal consistency was sufficient with overall α = 0.81, and high evidence quality. Test-retest reliability was consistently sufficient across age groups with overall r = 0.84. For construct validity 361 hypotheses were assessed (37.4% for convergent-, 62.6% for known-groups validity). The percentage of confirmed hypotheses in ≥60-years, all ages, <60-years and ≤45-years were 75.5%, 66.7%, 78.9%, and 88.9%, respectively. Responsiveness was not assessed in the <60-years and ≤45-years age groups, leading to indeterminate overall rating with very low evidence quality.

CONCLUSIONS

This review affirms that GOHAI has sufficient psychometric properties as an oral health-related quality of life instrument in various age groups, but its responsiveness is scarcely researched and its utility for individual-level follow-up is limited. The measurement properties of oral health-related quality of life tools must be scrutinized in the changing demands of personalized and value-based dental care. (PROSPERO registration: CRD42022384132).

Psychometric properties of parental stress scales used in paediatric health care settings: A systematic review1

AIM

To identify scales that assess parental stress in the paediatric clinical population and to analyse their psychometric properties.

METHODS

Four electronic databases (PubMed, Web of Science, PsycINFO, and Scopus) and metasearch engines (Google Scholar and Open Grey) were searched with no time period limitations. Methodological quality was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) and quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach modified by COSMIN. Finally, recommendations were made for the instruments with the highest quality of evidence.

RESULTS

A total of 38 studies reporting on 11 different instruments for assessing parental stress in the paediatric clinical setting were included. Six instruments were 'A' rated (recommended) in the final phase in line with COSMIN guidelines. The Paediatric Inventory for Parents was the instrument that evaluated the highest number of psychometric properties and obtained the highest methodological quality, global assessment, and quality of evidence for the different psychometric properties.

CONCLUSIONS

This systematic review provides an overview of the measurement properties of the parental stress instruments used in the paediatric clinical setting. The Paediatric Inventory for Parents stands out as being one of the most robust instruments for measuring stress in parents with a hospitalised or sick child. Evidence needs to be generated for all the parental stress scales used in the clinical setting.

IMPACT

Given that the psychometric properties of the existing parental stress scales used in paediatric health care settings have not been systematically assessed, the present review utilised comprehensive methods according to COSMIN.

NO PATIENT OR PUBLIC CONTRIBUTION

REPORTING METHOD: PRISMA statement and COSMIN reporting guidelines for studies on measurement properties of patient-reported outcome measures.

Evaluation of Patient-Reported Outcome Measures of Positive Psychosocial Constructs in Children and Adolescent/Young Adults with Cancer: A Systematic Review of Measurement Properties

Introduction: Children, adolescents, and young adults with cancer are a vulnerable population in whom improvements in psycho-oncology care would be valuable. We previously published a scoping review exploring what is known about positive psychological constructs in this population. A key finding was that evidence-based patient-reported outcome measures (PROMs) were needed to standardize psycho-oncology research. Methods: We undertook a systematic review of measurement properties focused on PROMs in the pediatric and adolescent/young adults (AYAs) with cancer populations. We searched for PROMs that measured at least 1 of 15 previously identified, key positive constructs. This systematic review followed COSMIN guidelines, considered the gold standard manual for systematic reviews of measurement properties. Results: We identified 20 (22 if proxy reports are counted separately) unique PROMs that met inclusion criteria. Of those, only five were recommended for use given the current evidence. The remainder may be used if no alternative exists. Only eight PROMs had any evidence of content validity, considered the most important psychometric property by COSMIN. Many studies were at risk of bias owing to incomplete or suboptimal methods. Discussion: Five PROMs are considered reliable for the pediatric and AYA with cancer populations. A number of PROMs require additional research to ensure their items and instructions are comprehensive, relevant, and comprehensible to children and AYAs. Given the overall lack of research, this review may be considered a starting point for the future refinement of a core set of PROMs to measure positive psychological constructs.

Examination of validity, reliability, and interpretability of a self-reported questionnaire on Occupational Balance in Informal Caregivers (OBI-Care) - A Rasch analysis

Objectives

Informal caregivers often experience a restriction in occupational balance. The self-reported questionnaire on Occupational Balance in Informal Caregivers (OBI-Care) is a measurement instrument to assess occupational balance in informal caregivers. Measurement properties of the German version of the OBI-Care had previously been assessed in parents of preterm infants exclusively. Thus, the aim of this study was to examine the measurement properties of the questionnaire in a mixed population of informal caregivers.

Methods

A psychometric study was conducted, applying a multicenter cross-sectional design. Measurement properties (construct validity, internal consistency, and interpretability) of each subscale of the German version of the OBI-Care were examined. Construct validity was explored by assessing dimensionality, item fit and overall fit to the Rasch model, and threshold ordering. Internal consistency was examined with inter-item correlations, item-total correlations, Cronbach’s alpha, and person separation index. Interpretability was assessed by inspecting floor and ceiling effects.

Results

A total of 196 informal caregivers, 171 (87.2%) female and 25 (12.8%) male participated in this study. Mean age of participants was 52.27 (±12.6) years. Subscale 1 was multidimensional, subscale 2 and subscale 3 were unidimensional. All items demonstrated item fit and overall fit to the Rasch model and displayed ordered thresholds. Cronbach’s Alpha and person separation index values were excellent for each subscale. There was no evidence of ceiling or floor effects.

Conclusions

We identified satisfying construct validity, internal consistency, and interpretability. Thus, the findings of this study support the application of the German version of the OBI-Care to assess occupational balance in informal caregivers.

Instruments to assess self-neglect among older adults: A systematic review of measurement properties

OBJECTIVE

To critically appraise, compare, and summarize the measurement properties of existing instruments that assess self-neglect among older adults.

METHODS

Eight electronic databases (PubMed, Scopus, Embase, CINAHL Plus with Full Text, Web of Science, PsycINFO, China National Knowledge Infrastructure, and WanFang Data) were searched from their inception to September 6, 2020. The methodological qualities of the included studies on measurement properties were assessed by using the COnsensus-based Standards for selection of health Measurement INstruments (COSMIN) methodology for systematic reviews of Patient-Reported Outcome Measures (PROMs).

RESULTS

Among the 1184 studies identified, 47 full-text studies were assessed further for their eligibilities. A total of 8 studies were eventually included. The methodological quality of content validity for relevance, comprehensiveness, and comprehensibility of all instruments in this review was doubtful or inadequate. The methodological quality of structural validities in the majority of the studies were very good, while the quality of hypothesis testing for construct validity was doubtful. The internal consistency was assessed by calculating Cronbach's alpha coefficient in all studies. Some measurement properties (e.g., cross-cultural validity/measurement invariance, measurement error, and responsiveness) were not assessed in the reviewed studies.

CONCLUSIONS

This systematic review provides a comprehensive overview of the measurement properties of elder self-neglect instruments. Among the eight instruments identified, none of them demonstrate better properties than any other. Future studies are suggested to use COSMIN methodology as guideline to examine the measurement properties of the developed instruments. Instruments with rigid measurement properties are urgently needed to assess self-neglect among older adults to provide the necessary and valuable information on this particular phenomenon.