Dry powder mixes comprising phase change materials

DOEpatents

Salyer, Ival O.

1994-01-01

A free flowing, conformable powder-like mix of silica particles and a phase change material (PCM) is provided. The silica particles have a critical size of about 0.005 to about 0.025 microns and the PCM must be added to the silica in an amount of 75% or less PCM per combined weight of silica and PCM. The powder-like mix can be used in tableware items, medical wraps, tree wraps, garments, quilts and blankets, and particularly in applications for heat protection for heat sensitive items, such as aircraft flight recorders, and for preventing brake fade in automobiles, buses, trucks and aircraft.

Dry powder mixes comprising phase change materials

DOEpatents

Salyer, Ival O.

1995-01-01

A free flowing, conformable powder-like mix of silica particles and a phase change material (PCM) is provided. The silica particles have a critical size of about 0.005 to about 0.025 microns and the PCM must be added to the silica in an amount of 75% or less PCM per combined weight of silica and PCM. The powder-like mix can be used in tableware items, medical wraps, tree wraps, garments, quilts and blankets, and particularly in applications for heat protection for heat sensitive items, such as aircraft flight recorders, and for preventing brake fade in automobiles, buses, trucks and aircraft.

Psychometric properties and podiatric medical student perceptions of USMLE-style items in a general anatomy course.

PubMed

D'Antoni, Anthony V; DiLandro, Anthony C; Chusid, Eileen D; Trepal, Michael J

2012-01-01

In 2010, the New York College of Podiatric Medicine general anatomy course was redesigned to emphasize clinical anatomy. Over a 2-year period, United States Medical Licensing Examination (USMLE)-style items were used in lecture assessments with two cohorts of students (N =200). Items were single-best-answer and extended-matching formats. Psychometric properties of items and assessments were evaluated, and anonymous student post-course surveys were administered. Mean grades for each assessment were recorded over time and compared between cohorts using analysis of variance. Correlational analyses were used to investigate the relationship between final course grades and lecture examinations. Post-course survey response rates for the cohorts were 71 of 97 (73%) and 81 of 103 (79%). The USMLE-style items had strong psychometric properties. Point biserial correlations were 0.20 and greater, and the range of students answering the items correctly was 25% to 75%. Examinations were highly reliable, with Kuder-Richardson 20 coefficients of 0.71 to 0.76. Students (>80%) reported that single-best-answer items were easier than extended-matching items. Students (>76%) believed that the items on the quizzes/examinations were similar to those found on USMLE Step 1. Most students (>84%) believed that they would do well on the anatomy section of their boards (American Podiatric Medical Licensing Examination [APMLE] Part I). Students valued USMLE-style items. These data, coupled with the psychometric data, suggest that USMLE-style items can be successfully incorporated into a basic science course in podiatric medical education. Outcomes from students who recently took the APMLE Part I suggest that incorporation of USMLE-style items into the general anatomy course was a successful measure and prepared them well.

An Item Bank for Abuse of Prescription Pain Medication from the Patient-Reported Outcomes Measurement Information System (PROMIS®).

PubMed

Pilkonis, Paul A; Yu, Lan; Dodds, Nathan E; Johnston, Kelly L; Lawrence, Suzanne M; Hilton, Thomas F; Daley, Dennis C; Patkar, Ashwin A; McCarty, Dennis

2017-08-01

There is a need to monitor patients receiving prescription opioids to detect possible signs of abuse. To address this need, we developed and calibrated an item bank for severity of abuse of prescription pain medication as part of the Patient-Reported Outcomes Measurement Information System (PROMIS ® ). Comprehensive literature searches yielded an initial bank of 5,310 items relevant to substance use and abuse, including abuse of prescription pain medication, from over 80 unique instruments. After qualitative item analysis (i.e., focus groups, cognitive interviewing, expert review, and item revision), 25 items for abuse of prescribed pain medication were included in field testing. Items were written in a first-person, past-tense format, with a three-month time frame and five response options reflecting frequency or severity. The calibration sample included 448 respondents, 367 from the general population (ascertained through an internet panel) and 81 from community treatment programs participating in the National Drug Abuse Treatment Clinical Trials Network. A final bank of 22 items was calibrated using the two-parameter graded response model from item response theory. A seven-item static short form was also developed. The test information curve showed that the PROMIS ® item bank for abuse of prescription pain medication provided substantial information in a broad range of severity. The initial psychometric characteristics of the item bank support its use as a computerized adaptive test or short form, with either version providing a brief, precise, and efficient measure relevant to both clinical and community samples. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Dry powder mixes comprising phase change materials

DOEpatents

Salyer, I.O.

1995-12-26

A free flowing, conformable powder-like mix of silica particles and a phase change material (PCM) is provided. The silica particles have a critical size of about 0.005 to about 0.025 microns and the PCM must be added to the silica in an amount of 75% or less PCM per combined weight of silica and PCM. The powder-like mix can be used in tableware items, medical wraps, tree wraps, garments, quilts and blankets, and particularly in applications for heat protection for heat sensitive items, such as aircraft flight recorders, and for preventing brake fade in automobiles, buses, trucks and aircraft. 3 figs.

Dry powder mixes comprising phase change materials

DOEpatents

Salyer, I.O.

1994-12-06

A free flowing, conformable powder-like mix of silica particles and a phase change material (PCM) is provided. The silica particles have a critical size of about 0.005 to about 0.025 microns and the PCM must be added to the silica in an amount of 75% or less PCM per combined weight of silica and PCM. The powder-like mix can be used in tableware items, medical wraps, tree wraps, garments, quilts and blankets, and particularly in applications for heat protection for heat sensitive items, such as aircraft flight recorders, and for preventing brake fade in automobiles, buses, trucks and aircraft. 3 figures.

The promise and challenge of including multimedia items in medical licensure examinations: some insights from an empirical trial.

PubMed

Shen, Linjun; Li, Feiming; Wattleworth, Roberta; Filipetto, Frank

2010-10-01

The Comprehensive Osteopathic Medical Licensing Examination conducted a trial of multimedia items in the 2008-2009 Level 3 testing cycle to determine (1) if multimedia items were able to test additional elements of medical knowledge and skills and (2) how to develop effective multimedia items. Forty-four content-matched multimedia and text multiple-choice items were randomly delivered to Level 3 candidates. Logistic regression and paired-samples t tests were used for pairwise and group-level comparisons, respectively. Nine pairs showed significant differences in either difficulty or/and discrimination. Content analysis found that, if text narrations were less direct, multimedia materials could make items easier. When textbook terminologies were replaced by multimedia presentations, multimedia items could become more difficult. Moreover, a multimedia item was found not uniformly difficult for candidates at different ability levels, possibly because multimedia and text items tested different elements of a same concept. Multimedia items may be capable of measuring some constructs different from what text items can measure. Effective multimedia items with reasonable psychometric properties can be intentionally developed.

[Difference analysis among majors in medical parasitology exam papers by test item bank proposition].

PubMed

Jia, Lin-Zhi; Ya-Jun, Ma; Cao, Yi; Qian, Fen; Li, Xiang-Yu

2012-04-30

The quality index among "Medical Parasitology" exam papers and measured data for students in three majors from the university in 2010 were compared and analyzed. The exam papers were formed from the test item bank. The alpha reliability coefficients of the three exam papers were above 0.70. The knowledge structure and capacity structure of the exam papers were basically balanced. But the alpha reliability coefficients of the second major was the lowest, mainly due to quality of test items in the exam paper and the failure of revising the index of test item bank in time. This observation demonstrated that revising the test items and their index in the item bank according to the measured data can improve the quality of test item bank proposition and reduce the difference among exam papers.

Screening Test Items for Differential Item Functioning

ERIC Educational Resources Information Center

Longford, Nicholas T.

2014-01-01

A method for medical screening is adapted to differential item functioning (DIF). Its essential elements are explicit declarations of the level of DIF that is acceptable and of the loss function that quantifies the consequences of the two kinds of inappropriate classification of an item. Instead of a single level and a single function, sets of…

Single item measures of emotional exhaustion and depersonalization are useful for assessing burnout in medical professionals.

PubMed

West, Colin P; Dyrbye, Liselotte N; Sloan, Jeff A; Shanafelt, Tait D

2009-12-01

Burnout has negative effects on work performance and patient care. The current standard for burnout assessment is the Maslach Burnout Inventory (MBI), a well-validated instrument consisting of 22 items answered on a 7-point Likert scale. However, the length of the MBI can limit its utility in physician surveys. To evaluate the performance of two questions relative to the full MBI for measuring burnout. Cross-sectional data from 2,248 medical students, 333 internal medicine residents, 465 internal medicine faculty, and 7,905 practicing surgeons. The single questions with the highest factor loading on the emotional exhaustion (EE) ("I feel burned out from my work") and depersonalization (DP) ("I have become more callous toward people since I took this job") domains of burnout were evaluated in four large samples of medical students, internal medicine residents, internal medicine faculty, and practicing surgeons. Spearman correlations between the single EE question and the full EE domain score minus that question ranged from 0.76-0.83. Spearman correlations between the single DP question and the full DP domain score minus that question ranged from 0.61-0.72. Responses to the single item measures of emotional exhaustion and depersonalization stratified risk of high burnout in the relevant domain on the full MBI, with consistent patterns across the four sampled groups. Single item measures of emotional exhaustion and depersonalization provide meaningful information on burnout in medical professionals.

The 11-item Medication Adherence Reasons Scale: reliability and factorial validity among patients with hypertension in Malaysian primary healthcare settings.

PubMed

Shima, Razatul; Farizah, Hairi; Majid, Hazreen Abdul

2015-08-01

The aim of this study was to assess the reliability and validity of a modified Malaysian version of the Medication Adherence Reasons Scale (MAR-Scale). In this cross-sectional study, the 15-item MAR-Scale was administered to 665 patients with hypertension who attended one of the four government primary healthcare clinics in the Hulu Langat and Klang districts of Selangor, Malaysia, between early December 2012 and end-March 2013. The construct validity was examined in two phases. Phase I consisted of translation of the MAR-Scale from English to Malay, a content validity check by an expert panel, a face validity check via a small preliminary test among patients with hypertension, and exploratory factor analysis (EFA). Phase II involved internal consistency reliability calculations and confirmatory factor analysis (CFA). EFA verified five existing factors that were previously identified (i.e. issues with medication management, multiple medications, belief in medication, medication availability, and the patient's forgetfulness and convenience), while CFA extracted four factors (medication availability issues were not extracted). The final modified MAR-Scale model, which had 11 items and a four-factor structure, provided good evidence of convergent and discriminant validities. Cronbach's alpha coefficient was > 0.7, indicating good internal consistency of the items in the construct. The results suggest that the modified MAR-Scale has good internal consistencies and construct validity. The validated modified MAR-Scale (Malaysian version) was found to be suitable for use among patients with hypertension receiving treatment in primary healthcare settings. However, the comprehensive measurement of other factors that can also lead to non-adherence requires further exploration.

Dry powder mixes comprising phase change materials

DOEpatents

Salyer, Ival O.

1994-01-01

Free flowing, conformable powder-like mix of silica particles and a phase change material (PCM) is provided. The silica particles have a critical size of about 0.005 to about 0.025 microns and the PCM must be added to the silica in an amount of 75% or less PCM per combined weight of silica and PCM. The powder-like mix can be used in tableware items, medical wraps, tree wraps, garments, quilts and blankets, and in cementitious compositions of the type in which it is beneficial to use a PCM material. The silica-PCM mix can also be admixed with soil to provide a soil warming effect and placed about a tree, flower, or shrub.

Dry powder mixes comprising phase change materials

DOEpatents

Salyer, I.O.

1994-02-01

Free flowing, conformable powder-like mix of silica particles and a phase change material (PCM) is provided. The silica particles have a critical size of about 0.005 to about 0.025 microns and the PCM must be added to the silica in an amount of 75% or less PCM per combined weight of silica and PCM. The powder-like mix can be used in tableware items, medical wraps, tree wraps, garments, quilts and blankets, and in cementitious compositions of the type in which it is beneficial to use a PCM material. The silica-PCM mix can also be admixed with soil to provide a soil warming effect and placed about a tree, flower, or shrub. 2 figures.

The 11-item Medication Adherence Reasons Scale: reliability and factorial validity among patients with hypertension in Malaysian primary healthcare settings

PubMed Central

Shima, Razatul; Farizah, Hairi; Majid, Hazreen Abdul

2015-01-01

INTRODUCTION The aim of this study was to assess the reliability and validity of a modified Malaysian version of the Medication Adherence Reasons Scale (MAR-Scale). METHODS In this cross-sectional study, the 15-item MAR-Scale was administered to 665 patients with hypertension who attended one of the four government primary healthcare clinics in the Hulu Langat and Klang districts of Selangor, Malaysia, between early December 2012 and end-March 2013. The construct validity was examined in two phases. Phase I consisted of translation of the MAR-Scale from English to Malay, a content validity check by an expert panel, a face validity check via a small preliminary test among patients with hypertension, and exploratory factor analysis (EFA). Phase II involved internal consistency reliability calculations and confirmatory factor analysis (CFA). RESULTS EFA verified five existing factors that were previously identified (i.e. issues with medication management, multiple medications, belief in medication, medication availability, and the patient’s forgetfulness and convenience), while CFA extracted four factors (medication availability issues were not extracted). The final modified MAR-Scale model, which had 11 items and a four-factor structure, provided good evidence of convergent and discriminant validities. Cronbach’s alpha coefficient was > 0.7, indicating good internal consistency of the items in the construct. The results suggest that the modified MAR-Scale has good internal consistencies and construct validity. CONCLUSION The validated modified MAR-Scale (Malaysian version) was found to be suitable for use among patients with hypertension receiving treatment in primary healthcare settings. However, the comprehensive measurement of other factors that can also lead to non-adherence requires further exploration. PMID:25902719

A single-item self-report medication adherence question predicts hospitalisation and death in patients with heart failure.

PubMed

Wu, Jia-Rong; DeWalt, Darren A; Baker, David W; Schillinger, Dean; Ruo, Bernice; Bibbins-Domingo, Kristen; Macabasco-O'Connell, Aurelia; Holmes, George M; Broucksou, Kimberly A; Erman, Brian; Hawk, Victoria; Cene, Crystal W; Jones, Christine DeLong; Pignone, Michael

2014-09-01

To determine whether a single-item self-report medication adherence question predicts hospitalisation and death in patients with heart failure. Poor medication adherence is associated with increased morbidity and mortality. Having a simple means of identifying suboptimal medication adherence could help identify at-risk patients for interventions. We performed a prospective cohort study in 592 participants with heart failure within a four-site randomised trial. Self-report medication adherence was assessed at baseline using a single-item question: 'Over the past seven days, how many times did you miss a dose of any of your heart medication?' Participants who reported no missing doses were defined as fully adherent, and those missing more than one dose were considered less than fully adherent. The primary outcome was combined all-cause hospitalisation or death over one year and the secondary endpoint was heart failure hospitalisation. Outcomes were assessed with blinded chart reviews, and heart failure outcomes were determined by a blinded adjudication committee. We used negative binomial regression to examine the relationship between medication adherence and outcomes. Fifty-two percent of participants were 52% male, mean age was 61 years, and 31% were of New York Heart Association class III/IV at enrolment; 72% of participants reported full adherence to their heart medicine at baseline. Participants with full medication adherence had a lower rate of all-cause hospitalisation and death (0·71 events/year) compared with those with any nonadherence (0·86 events/year): adjusted-for-site incidence rate ratio was 0·83, fully adjusted incidence rate ratio 0·68. Incidence rate ratios were similar for heart failure hospitalisations. A single medication adherence question at baseline predicts hospitalisation and death over one year in heart failure patients. Medication adherence is associated with all-cause and heart failure-related hospitalisation and death in heart

Potential application of item-response theory to interpretation of medical codes in electronic patient records

PubMed Central

2011-01-01

Background Electronic patient records are generally coded using extensive sets of codes but the significance of the utilisation of individual codes may be unclear. Item response theory (IRT) models are used to characterise the psychometric properties of items included in tests and questionnaires. This study asked whether the properties of medical codes in electronic patient records may be characterised through the application of item response theory models. Methods Data were provided by a cohort of 47,845 participants from 414 family practices in the UK General Practice Research Database (GPRD) with a first stroke between 1997 and 2006. Each eligible stroke code, out of a set of 202 OXMIS and Read codes, was coded as either recorded or not recorded for each participant. A two parameter IRT model was fitted using marginal maximum likelihood estimation. Estimated parameters from the model were considered to characterise each code with respect to the latent trait of stroke diagnosis. The location parameter is referred to as a calibration parameter, while the slope parameter is referred to as a discrimination parameter. Results There were 79,874 stroke code occurrences available for analysis. Utilisation of codes varied between family practices with intraclass correlation coefficients of up to 0.25 for the most frequently used codes. IRT analyses were restricted to 110 Read codes. Calibration and discrimination parameters were estimated for 77 (70%) codes that were endorsed for 1,942 stroke patients. Parameters were not estimated for the remaining more frequently used codes. Discrimination parameter values ranged from 0.67 to 2.78, while calibration parameters values ranged from 4.47 to 11.58. The two parameter model gave a better fit to the data than either the one- or three-parameter models. However, high chi-square values for about a fifth of the stroke codes were suggestive of poor item fit. Conclusion The application of item response theory models to coded

Dry powder mixes comprising phase change materials

DOEpatents

Salyer, Ival O.

1992-01-01

Free flowing, conformable powder-like mix of silica particles and a phase change material (p.c.m.) is disclosed. The silica particles have a critical size of about 7.times.10.sup.-3 to about 7.times.10.sup.-2 microns and the pcm must be added to the silica in an amount of 80 wt. % or less pcm per combined weight of silica and pcm. The powder-like mix can be used in tableware items, medical wraps, tree wraps, garments, quilts and blankets, and in cementitious compositions of the type in which it is beneficial to use a pcm material. The silica-pcm mix can also be admixed with soil to provide a soil warming effect and placed about a tree, flower, or shrub.

Dry powder mixes comprising phase change materials

DOEpatents

Salyer, Ival O.

1993-01-01

Free flowing, conformable powder-like mix of silica particles and a phase change material (p.c.m.) is disclosed. The silica particles have a critical size of about 7.times.10.sup.-3 to about 7.times.10.sup.-2 microns and the pcm must be added to the silica in an amount of 80 wt. % or less pcm per combined weight of silica and pcm. The powder-like mix can be used in tableware items, medical wraps, tree wraps, garments, quilts and blankets, and in cementitious compositions of the type in which it is beneficial to use a pcm material. The silica-pcm mix can also be admixed with soil to provide a soil warming effect and placed about a tree, flower, or shrub.

Dry powder mixes comprising phase change materials

DOEpatents

Salyer, Ival O.

1993-01-01

Free flowing, conformable powder-like mix of silica particles and a phase change material (p.c.m.) is disclosed. The silica particles have a critical size of about 7.times.10.sup.-3 to about 7.times.10.sup.-2 microns and the pcm must be added to the silica in an amount of 80 wt. % or less pcm per combined weight of silica and pcm. The powder-like mix can be used in tableware items, medical wraps, tree wraps, garmets, quilts and blankets, and in cementitious compositions of the type in which it is beneficial to use a pcm material. The silica-pcm mix can also be admixed with soil to provide a soil warming effect and placed about a tree, flower, or shrub.

Dry powder mixes comprising phase change materials

DOEpatents

Salyer, I.O.

1993-10-19

Free flowing, conformable powder-like mix of silica particles and a phase change material (pcm) is disclosed. The silica particles have a critical size of about 7[times]10[sup [minus]3] to about 7[times]10[sup [minus]2] microns and the pcm must be added to the silica in an amount of 80 wt. % or less pcm per combined weight of silica and pcm. The powder-like mix can be used in tableware items, medical wraps, tree wraps, garments, quilts and blankets, and in cementitious compositions of the type in which it is beneficial to use a pcm material. The silica-pcm mix can also be admixed with soil to provide a soil warming effect and placed about a tree, flower, or shrub. 10 figures.

Effects of microwave heating on the migration of substances from melamine formaldehyde tableware.

PubMed

Poovarodom, Ngamtip; Junsrisuriyawong, Kansuda; Sangmahamad, Raweeporn; Tangmongkollert, Pattaree

2014-01-01

Melamine formaldehyde (MF) tableware, after undergoing repeated heating in a microwave oven for 1, 2, 3 or 5 min, was tested for migration into 3% (w/v) acetic acid, a food simulant. Overall migration (OM) consistently increased with an increasing number of heating/washing cycles, while formaldehyde was found at low concentrations or was not detectable. Unexpectedly, the 1-min series caused the most rapid increase in OM; the European Union regulatory limit of 10 mg dm(-2) was exceeded after 25 cycles. The number of cycles required to reach the OM limit rose to 29 and 67 for the 2- and 3-min series, respectively. Only 37 cycles were needed in the case of the 5-min series; however, the cumulative exposure time to microwave irradiation was relatively close to that of the 3-min series. These findings indicate that microwave heating affects the migration of MF in a significantly different manner as compared with conventional heating reported in previous studies. Fourier transform infrared spectroscopy (FTIR) spectra of MF after completing the microwave heating series show that the plastic was not fully cured, as evidenced by the absence of methylene linkages. The majority of migrants obtained from OM tests consisted of low molecular weight methylol melamine derivatives. The results indicate that microwave heating allowed demethylolation, addition and condensation reactions to occur, which was not the case when using conventional heating. This study demonstrates that microwave heating for 1-2 min in a repeated manner is of high concern in terms of consumer health. It was found that the service terms of melamine ware under microwave heating were drastically reduced, by more than 10-fold, as compared with the service terms under conventional heating. Hence, it is strongly recommended that manufacturers of MF articles provide instructions for use, e.g. "Do not use in microwave", which should be clearly visible to consumers and not easily detachable.

Practical Implications of Test Dimensionality for Item Response Theory Calibration of the Medical College Admission Test. MCAT Monograph.

ERIC Educational Resources Information Center

Childs, Ruth A.; Oppler, Scott H.

The use of item response theory (IRT) in the Medical College Admission Test (MCAT) testing program has been limited. This study provides a basis for future IRT analyses of the MCAT by exploring the dimensionality of each of the MCAT's three multiple-choice test sections (Verbal Reasoning, Physical Sciences, and Biological Sciences) and the…

Varying levels of difficulty index of skills-test items randomly selected by examinees on the Korean emergency medical technician licensing examination

PubMed Central

2016-01-01

Purpose: The goal of this study was to characterize the difficulty index of the items in the skills test components of the class I and II Korean emergency medical technician licensing examination (KEMTLE), which requires examinees to select items randomly. Methods: The results of 1,309 class I KEMTLE examinations and 1,801 class II KEMTLE examinations in 2013 were subjected to analysis. Items from the basic and advanced skills test sections of the KEMTLE were compared to determine whether some were significantly more difficult than others. Results: In the class I KEMTLE, all 4 of the items on the basic skills test showed significant variation in difficulty index (P<0.01), as well as 4 of the 5 items on the advanced skills test (P<0.05). In the class II KEMTLE, 4 of the 5 items on the basic skills test showed significantly different difficulty index (P<0.01), as well as all 3 of the advanced skills test items (P<0.01). Conclusion: In the skills test components of the class I and II KEMTLE, the procedure in which examinees randomly select questions should be revised to require examinees to respond to a set of fixed items in order to improve the reliability of the national licensing examination. PMID:26883810

Varying levels of difficulty index of skills-test items randomly selected by examinees on the Korean emergency medical technician licensing examination.

PubMed

Koh, Bongyeun; Hong, Sunggi; Kim, Soon-Sim; Hyun, Jin-Sook; Baek, Milye; Moon, Jundong; Kwon, Hayran; Kim, Gyoungyong; Min, Seonggi; Kang, Gu-Hyun

2016-01-01

The goal of this study was to characterize the difficulty index of the items in the skills test components of the class I and II Korean emergency medical technician licensing examination (KEMTLE), which requires examinees to select items randomly. The results of 1,309 class I KEMTLE examinations and 1,801 class II KEMTLE examinations in 2013 were subjected to analysis. Items from the basic and advanced skills test sections of the KEMTLE were compared to determine whether some were significantly more difficult than others. In the class I KEMTLE, all 4 of the items on the basic skills test showed significant variation in difficulty index (P<0.01), as well as 4 of the 5 items on the advanced skills test (P<0.05). In the class II KEMTLE, 4 of the 5 items on the basic skills test showed significantly different difficulty index (P<0.01), as well as all 3 of the advanced skills test items (P<0.01). In the skills test components of the class I and II KEMTLE, the procedure in which examinees randomly select questions should be revised to require examinees to respond to a set of fixed items in order to improve the reliability of the national licensing examination.

Dry powder mixes comprising phase change materials

DOEpatents

Salyer, I.O.

1992-04-21

A free flowing, conformable powder-like mix of silica particles and a phase change material (p.c.m.) is disclosed. The silica particles have a critical size of about 7 [times] 10[sup [minus]3] to about 7 [times] 10[sup [minus]2] microns and the pcm must be added to the silica in an amount of 80 wt. % or less pcm per combined weight of silica and pcm. The powder-like mix can be used in tableware items, medical wraps, tree wraps, garments, quilts and blankets, and in cementitious compositions of the type in which it is beneficial to use a pcm material. The silica-pcm mix can also be admixed with soil to provide a soil warming effect and placed about a tree, flower, or shrub. 9 figs.

A Comparison between Discrimination Indices and Item-Response Theory Using the Rasch Model in a Clinical Course Written Examination of a Medical School.

PubMed

Park, Jong Cook; Kim, Kwang Sig

2012-03-01

The reliability of test is determined by each items' characteristics. Item analysis is achieved by classical test theory and item response theory. The purpose of the study was to compare the discrimination indices with item response theory using the Rasch model. Thirty-one 4th-year medical school students participated in the clinical course written examination, which included 22 A-type items and 3 R-type items. Point biserial correlation coefficient (C(pbs)) was compared to method of extreme group (D), biserial correlation coefficient (C(bs)), item-total correlation coefficient (C(it)), and corrected item-total correlation coeffcient (C(cit)). Rasch model was applied to estimate item difficulty and examinee's ability and to calculate item fit statistics using joint maximum likelihood. Explanatory power (r2) of Cpbs is decreased in the following order: C(cit) (1.00), C(it) (0.99), C(bs) (0.94), and D (0.45). The ranges of difficulty logit and standard error and ability logit and standard error were -0.82 to 0.80 and 0.37 to 0.76, -3.69 to 3.19 and 0.45 to 1.03, respectively. Item 9 and 23 have outfit > or =1.3. Student 1, 5, 7, 18, 26, 30, and 32 have fit > or =1.3. C(pbs), C(cit), and C(it) are good discrimination parameters. Rasch model can estimate item difficulty parameter and examinee's ability parameter with standard error. The fit statistics can identify bad items and unpredictable examinee's responses.

Reliability and known-group validity of the Arabic version of the 8-item Morisky Medication Adherence Scale among type 2 diabetes mellitus patients.

PubMed

Ashur, S T; Shamsuddin, K; Shah, S A; Bosseri, S; Morisky, D E

2015-12-13

No validation study has previously been made for the Arabic version of the 8-item Morisky Medication Adherence Scale (MMAS-8(©)) as a measure for medication adherence in diabetes. This study in 2013 tested the reliability and validity of the Arabic MMAS-8 for type 2 diabetes mellitus patients attending a referral centre in Tripoli, Libya. A convenience sample of 103 patients self-completed the questionnaire. Reliability was tested using Cronbach alpha, average inter-item correlation and Spearman-Brown coefficient. Known-group validity was tested by comparing MMAS-8 scores of patients grouped by glycaemic control. The Arabic version showed adequate internal consistency (α = 0.70) and moderate split-half reliability (r = 0.65). Known-group validity was supported as a significant association was found between medication adherence and glycaemic control, with a moderate effect size (ϕc = 0.34). The Arabic version displayed good psychometric properties and could support diabetes research and practice in Arab countries.

Evaluation of an antiretroviral medication attitude scale and relationships between medication attitudes and medication nonadherence.

PubMed

Viswanathan, Hema; Anderson, Rodney; Thomas, Joseph

2005-05-01

The objectives of this study were to refine a scale designed to assess attitudes toward antiretroviral medication, to examine variation in medication attitudes across clinical and demographic characteristics, and to assess relationships between medication attitudes and medication nonadherence. A cross-sectional design was used to survey individuals at least 18 years of age, currently on antiretroviral therapy, and served by a regional HIV/AIDS center. The survey was administered by pharmacy students using convenience sampling between February 2002 and August 2002. Nonadherence was measured using a nine-item scale with a higher score indicative of higher nonadherence. An antiretroviral medication attitude scale was developed based on revision of a zidovudine attitude inventory. The sample of 99 patients was predominantly male (79.8%), had an annual income of less than $10,000 (74%), and was comprised of 50% whites and 40.8% blacks. Participants were between 18 and 70 years old. Item reduction using item-total correlations and factor analytic techniques resulted in a 15-item medication attitude scale with good internal consistency (Cronbach alpha coefficient = 0.84). A multiple regression model showed a significant negative relationship between attitude toward medication and medication nonadherence after controlling for covariates including age, education, gender, ethnicity, work status, social support, CD4 cell count and number of antiretroviral medications, suggesting that more positive the attitude toward medication, lower the medication nonadherence. Findings underscore the importance of attitude toward medication as a modifiable factor that can be targeted to improve medication adherence.

A Multilevel Assessment of Differential Item Functioning.

ERIC Educational Resources Information Center

Shen, Linjun

A multilevel approach was proposed for the assessment of differential item functioning and compared with the traditional logistic regression approach. Data from the Comprehensive Osteopathic Medical Licensing Examination for 2,300 freshman osteopathic medical students were analyzed. The multilevel approach used three-level hierarchical generalized…

Reports of Perceived Adverse Events of Stimulant Medication on Cognition, Motivation, and Mood: Qualitative Investigation and the Generation of Items for the Medication and Cognition Rating Scale

PubMed Central

Kovshoff, Hanna; Banaschewski, Tobias; Buitelaar, Jan K.; Carucci, Sara; Coghill, David; Danckaerts, Marina; Dittmann, Ralf W.; Falissard, Bruno; Grimshaw, Dina Gojkovic; Hollis, Chris; Inglis, Sarah; Konrad, Kerstin; Liddle, Elizabeth; McCarthy, Suzanne; Nagy, Peter; Thompson, Margaret; Wong, Ian C.K.; Zuddas, Alessandro

2016-01-01

Abstract Objective: There is no questionnaire to specifically monitor perceived adverse events of methylphenidate (MPH) on cognition, motivation, and mood. The current study therefore had two goals. First, to harvest accounts of such putative events from transcripts of interviews in samples enriched for such potential experiences. Second, to use the derived data to generate items for a new questionnaire that can be used for monitoring such events in medication trials or routine clinical care. Methods: Following a literature search aimed at identifying associations between MPH and cognition and/or motivation, a qualitative semistructured interview was designed to focus specifically on the domains of cognition (i.e., reasoning, depth/breadth of thinking, intellectual capacity, and creativity) and motivation (i.e., drive, effort, and attitudes toward rewards/incentives). Interviews were conducted with 45 participants drawn from the following four groups: (a) clinicians, child and adolescent psychiatrists, and pediatricians specializing in attention-deficit/hyperactivity disorder (ADHD) (n = 15); (2) teachers, with experience of teaching at least 10 medicated children with ADHD (n = 10); (3) parents of children with ADHD (n = 8) treated with MPH; and (4) adolescents/adults with ADHD (n = 12). Purposeful sampling was used to selectively recruit ADHD participants whose histories suggested a degree of vulnerability to MPH adverse events. Data were analyzed using a deductive approach to content analysis. Results: While we probed purposefully for cognitive and motivational adverse events, a third domain, related to mood, emerged from the reports. Therefore, three domains, each with a number of subdomains, were identified from the interview accounts: (i) Cognition (six subdomains; attention/concentration, changes in thinking, reduced creativity, sensory overload, memory, slower processing speed); (ii) motivation (four subdomains; loss of intrinsic motivation

Reports of Perceived Adverse Events of Stimulant Medication on Cognition, Motivation, and Mood: Qualitative Investigation and the Generation of Items for the Medication and Cognition Rating Scale.

PubMed

Kovshoff, Hanna; Banaschewski, Tobias; Buitelaar, Jan K; Carucci, Sara; Coghill, David; Danckaerts, Marina; Dittmann, Ralf W; Falissard, Bruno; Grimshaw, Dina Gojkovic; Hollis, Chris; Inglis, Sarah; Konrad, Kerstin; Liddle, Elizabeth; McCarthy, Suzanne; Nagy, Peter; Thompson, Margaret; Wong, Ian C K; Zuddas, Alessandro; Sonuga-Barke, Edmund J S

2016-08-01

There is no questionnaire to specifically monitor perceived adverse events of methylphenidate (MPH) on cognition, motivation, and mood. The current study therefore had two goals. First, to harvest accounts of such putative events from transcripts of interviews in samples enriched for such potential experiences. Second, to use the derived data to generate items for a new questionnaire that can be used for monitoring such events in medication trials or routine clinical care. Following a literature search aimed at identifying associations between MPH and cognition and/or motivation, a qualitative semistructured interview was designed to focus specifically on the domains of cognition (i.e., reasoning, depth/breadth of thinking, intellectual capacity, and creativity) and motivation (i.e., drive, effort, and attitudes toward rewards/incentives). Interviews were conducted with 45 participants drawn from the following four groups: (a) clinicians, child and adolescent psychiatrists, and pediatricians specializing in attention-deficit/hyperactivity disorder (ADHD) (n = 15); (2) teachers, with experience of teaching at least 10 medicated children with ADHD (n = 10); (3) parents of children with ADHD (n = 8) treated with MPH; and (4) adolescents/adults with ADHD (n = 12). Purposeful sampling was used to selectively recruit ADHD participants whose histories suggested a degree of vulnerability to MPH adverse events. Data were analyzed using a deductive approach to content analysis. While we probed purposefully for cognitive and motivational adverse events, a third domain, related to mood, emerged from the reports. Therefore, three domains, each with a number of subdomains, were identified from the interview accounts: (i) Cognition (six subdomains; attention/concentration, changes in thinking, reduced creativity, sensory overload, memory, slower processing speed); (ii) motivation (four subdomains; loss of intrinsic motivation for goal-directed activities, external

Defining the minimal detectable change in scores on the eight-item Morisky Medication Adherence Scale.

PubMed

Muntner, Paul; Joyce, Cara; Holt, Elizabeth; He, Jiang; Morisky, Donald; Webber, Larry S; Krousel-Wood, Marie

2011-05-01

Self-report scales are used to assess medication adherence. Data on how to discriminate change in self-reported adherence over time from random variability are limited. To determine the minimal detectable change for scores on the 8-item Morisky Medication Adherence Scale (MMAS-8). The MMAS-8 was administered twice, using a standard telephone script, with administration separated by 14-22 days, to 210 participants taking antihypertensive medication in the CoSMO (Cohort Study of Medication Adherence among Older Adults). MMAS-8 scores were calculated and participants were grouped into previously defined categories (<6, 6 to <8, and 8 for low, medium, and high adherence). The mean (SD) age of participants was 78.1 (5.8) years, 43.8% were black, and 68.1% were women. Overall, 8.1% (17/210), 16.2% (34/210), and 51.0% (107/210) of participants had low, medium, and high MMAS-8 scores, respectively, at both survey administrations (overall agreement 75.2%; 158/210). The weighted κ statistic was 0.63 (95% CI 0.53 to 0.72). The intraclass correlation coefficient was 0.78. The within-person standard error of the mean for change in MMAS-8 scores was 0.81, which equated to a minimal detectable change of 1.98 points. Only 4.3% (9/210) of the participants had a change in MMAS-8 of 2 or more points between survey administrations. Within-person changes in MMAS-8 scores of 2 or more points over time may represent a real change in antihypertensive medication adherence.

Do Reading Experts Agree with MCAT Verbal Reasoning Item Classifications?

ERIC Educational Resources Information Center

Jackson, Evelyn W.; And Others

1994-01-01

Examined whether expert raters (n=5) could agree about classification of Medical College Admission Test (MCAT) items and whether they agreed with MCAT student manual in labeling skill being measured by each test item. Results revealed difficulties in replicating authors' labeling of skills for reading items on practice test provided with 1991 MCAT…

Dry powder mixes comprising phase change materials

DOEpatents

Salyer, I.O.

1993-05-18

Free flowing, conformable powder-like mix of silica particles and a phase change material (p.c.m.) is disclosed. The silica particles have a critical size of about 7[times]10[sup [minus]3] to about 7[times]10[sup [minus]2] microns and the p.c.m. must be added to the silica in an amount of 80 wt. % or less p.c.m. per combined weight of silica and p.c.m. The powder-like mix can be used in tableware items, medical wraps, tree wraps, garments, quilts and blankets, and in cementitious compositions of the type in which it is beneficial to use a p.c.m. material. The silica-p.c.m. mix can also be admixed with soil to provide a soil warming effect and placed about a tree, flower, or shrub.

Microwavable thermal energy storage material

DOEpatents

Salyer, Ival O.

1998-09-08

A microwavable thermal energy storage material is provided which includes a mixture of a phase change material and silica, and a carbon black additive in the form of a conformable dry powder of phase change material/silica/carbon black, or solid pellets, films, fibers, moldings or strands of phase change material/high density polyethylene/ethylene-vinyl acetate/silica/carbon black which allows the phase change material to be rapidly heated in a microwave oven. The carbon black additive, which is preferably an electrically conductive carbon black, may be added in low concentrations of from 0.5 to 15% by weight, and may be used to tailor the heating times of the phase change material as desired. The microwavable thermal energy storage material can be used in food serving applications such as tableware items or pizza warmers, and in medical wraps and garments.

Can Item Keyword Feedback Help Remediate Knowledge Gaps?

PubMed Central

Feinberg, Richard A.; Clauser, Amanda L.

2016-01-01

ABSTRACT Background  In graduate medical education, assessment results can effectively guide professional development when both assessment and feedback support a formative model. When individuals cannot directly access the test questions and responses, a way of using assessment results formatively is to provide item keyword feedback. Objective  The purpose of the following study was to investigate whether exposure to item keyword feedback aids in learner remediation. Methods  Participants included 319 trainees who completed a medical subspecialty in-training examination (ITE) in 2012 as first-year fellows, and then 1 year later in 2013 as second-year fellows. Performance on 2013 ITE items in which keywords were, or were not, exposed as part of the 2012 ITE score feedback was compared across groups based on the amount of time studying (preparation). For the same items common to both 2012 and 2013 ITEs, response patterns were analyzed to investigate changes in answer selection. Results  Test takers who indicated greater amounts of preparation on the 2013 ITE did not perform better on the items in which keywords were exposed compared to those who were not exposed. The response pattern analysis substantiated overall growth in performance from the 2012 ITE. For items with incorrect responses on both attempts, examinees selected the same option 58% of the time. Conclusions  Results from the current study were unsuccessful in supporting the use of item keywords in aiding remediation. Unfortunately, the results did provide evidence of examinees retaining misinformation. PMID:27777664

Can Item Keyword Feedback Help Remediate Knowledge Gaps?

PubMed

Feinberg, Richard A; Clauser, Amanda L

2016-10-01

In graduate medical education, assessment results can effectively guide professional development when both assessment and feedback support a formative model. When individuals cannot directly access the test questions and responses, a way of using assessment results formatively is to provide item keyword feedback. The purpose of the following study was to investigate whether exposure to item keyword feedback aids in learner remediation. Participants included 319 trainees who completed a medical subspecialty in-training examination (ITE) in 2012 as first-year fellows, and then 1 year later in 2013 as second-year fellows. Performance on 2013 ITE items in which keywords were, or were not, exposed as part of the 2012 ITE score feedback was compared across groups based on the amount of time studying (preparation). For the same items common to both 2012 and 2013 ITEs, response patterns were analyzed to investigate changes in answer selection. Test takers who indicated greater amounts of preparation on the 2013 ITE did not perform better on the items in which keywords were exposed compared to those who were not exposed. The response pattern analysis substantiated overall growth in performance from the 2012 ITE. For items with incorrect responses on both attempts, examinees selected the same option 58% of the time. Results from the current study were unsuccessful in supporting the use of item keywords in aiding remediation. Unfortunately, the results did provide evidence of examinees retaining misinformation.

42 CFR 414.220 - Inexpensive or routinely purchased items.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Inexpensive or routinely purchased items. 414.220... Durable Medical Equipment and Prosthetic and Orthotic Devices § 414.220 Inexpensive or routinely purchased items. (a) Definitions. (1) Inexpensive equipment means equipment the average purchase price of which...

Automated UMLS-Based Comparison of Medical Forms

PubMed Central

Dugas, Martin; Fritz, Fleur; Krumm, Rainer; Breil, Bernhard

2013-01-01

Medical forms are very heterogeneous: on a European scale there are thousands of data items in several hundred different systems. To enable data exchange for clinical care and research purposes there is a need to develop interoperable documentation systems with harmonized forms for data capture. A prerequisite in this harmonization process is comparison of forms. So far – to our knowledge – an automated method for comparison of medical forms is not available. A form contains a list of data items with corresponding medical concepts. An automatic comparison needs data types, item names and especially item with these unique concept codes from medical terminologies. The scope of the proposed method is a comparison of these items by comparing their concept codes (coded in UMLS). Each data item is represented by item name, concept code and value domain. Two items are called identical, if item name, concept code and value domain are the same. Two items are called matching, if only concept code and value domain are the same. Two items are called similar, if their concept codes are the same, but the value domains are different. Based on these definitions an open-source implementation for automated comparison of medical forms in ODM format with UMLS-based semantic annotations was developed. It is available as package compareODM from http://cran.r-project.org. To evaluate this method, it was applied to a set of 7 real medical forms with 285 data items from a large public ODM repository with forms for different medical purposes (research, quality management, routine care). Comparison results were visualized with grid images and dendrograms. Automated comparison of semantically annotated medical forms is feasible. Dendrograms allow a view on clustered similar forms. The approach is scalable for a large set of real medical forms. PMID:23861827

Microwavable thermal energy storage material

DOEpatents

Salyer, I.O.

1998-09-08

A microwavable thermal energy storage material is provided which includes a mixture of a phase change material and silica, and a carbon black additive in the form of a conformable dry powder of phase change material/silica/carbon black, or solid pellets, films, fibers, moldings or strands of phase change material/high density polyethylene/ethylene vinyl acetate/silica/carbon black which allows the phase change material to be rapidly heated in a microwave oven. The carbon black additive, which is preferably an electrically conductive carbon black, may be added in low concentrations of from 0.5 to 15% by weight, and may be used to tailor the heating times of the phase change material as desired. The microwavable thermal energy storage material can be used in food serving applications such as tableware items or pizza warmers, and in medical wraps and garments. 3 figs.

Item-focussed Trees for the Identification of Items in Differential Item Functioning.

PubMed

Tutz, Gerhard; Berger, Moritz

2016-09-01

A novel method for the identification of differential item functioning (DIF) by means of recursive partitioning techniques is proposed. We assume an extension of the Rasch model that allows for DIF being induced by an arbitrary number of covariates for each item. Recursive partitioning on the item level results in one tree for each item and leads to simultaneous selection of items and variables that induce DIF. For each item, it is possible to detect groups of subjects with different item difficulties, defined by combinations of characteristics that are not pre-specified. The way a DIF item is determined by covariates is visualized in a small tree and therefore easily accessible. An algorithm is proposed that is based on permutation tests. Various simulation studies, including the comparison with traditional approaches to identify items with DIF, show the applicability and the competitive performance of the method. Two applications illustrate the usefulness and the advantages of the new method.

How item banks and their application can influence measurement practice in rehabilitation medicine: a PROMIS fatigue item bank example.

PubMed

Lai, Jin-Shei; Cella, David; Choi, Seung; Junghaenel, Doerte U; Christodoulou, Christopher; Gershon, Richard; Stone, Arthur

2011-10-01

To illustrate how measurement practices can be advanced by using as an example the fatigue item bank (FIB) and its applications (short forms and computerized adaptive testing [CAT]) that were developed through the National Institutes of Health Patient Reported Outcomes Measurement Information System (PROMIS) Cooperative Group. Psychometric analysis of data collected by an Internet survey company using item response theory-related techniques. A U.S. general population representative sample collected through the Internet. Respondents used for dimensionality evaluation of the PROMIS FIB (N=603) and item calibrations (N=14,931). Not applicable. Fatigue items (112) developed by the PROMIS fatigue domain working group, 13-item Functional Assessment of Chronic Illness Therapy-Fatigue, and 4-item Medical Outcomes Study 36-Item Short Form Health Survey Vitality scale. The PROMIS FIB version 1, which consists of 95 items, showed acceptable psychometric properties. CAT showed consistently better precision than short forms. However, all 3 short forms showed good precision for most participants in that more than 95% of the sample could be measured precisely with reliability greater than 0.9. Measurement practice can be advanced by using a psychometrically sound measurement tool and its applications. This example shows that CAT and short forms derived from the PROMIS FIB can reliably estimate fatigue reported by the U.S. general population. Evaluation in clinical populations is warranted before the item bank can be used for clinical trials. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Item Writer Judgments of Item Difficulty versus Actual Item Difficulty: A Case Study

ERIC Educational Resources Information Center

Sydorenko, Tetyana

2011-01-01

This study investigates how accurate one item writer can be on item difficulty estimates and whether factors affecting item writer judgments correspond to predictors of actual item difficulty. The items were based on conversational dialogs (presented as videos online) that focus on pragmatic functions. Thirty-five 2nd-, 3rd-, and 4th-year learners…

The Impact of Receiving the Same Items on Consecutive Computer Adaptive Test Administrations.

ERIC Educational Resources Information Center

O'Neill, Thomas; Lunz, Mary E.; Thiede, Keith

2000-01-01

Studied item exposure in a computerized adaptive test when the item selection algorithm presents examinees with questions they were asked in a previous test administration. Results with 178 repeat examinees on a medical technologists' test indicate that the combined use of an adaptive algorithm to select items and latent trait theory to estimate…

Calibrating the Medical Council of Canada's Qualifying Examination Part I using an integrated item response theory framework: a comparison of models and designs.

PubMed

De Champlain, Andre F; Boulais, Andre-Philippe; Dallas, Andrew

2016-01-01

The aim of this research was to compare different methods of calibrating multiple choice question (MCQ) and clinical decision making (CDM) components for the Medical Council of Canada's Qualifying Examination Part I (MCCQEI) based on item response theory. Our data consisted of test results from 8,213 first time applicants to MCCQEI in spring and fall 2010 and 2011 test administrations. The data set contained several thousand multiple choice items and several hundred CDM cases. Four dichotomous calibrations were run using BILOG-MG 3.0. All 3 mixed item format (dichotomous MCQ responses and polytomous CDM case scores) calibrations were conducted using PARSCALE 4. The 2-PL model had identical numbers of items with chi-square values at or below a Type I error rate of 0.01 (83/3,499 or 0.02). In all 3 polytomous models, whether the MCQs were either anchored or concurrently run with the CDM cases, results suggest very poor fit. All IRT abilities estimated from dichotomous calibration designs correlated very highly with each other. IRT-based pass-fail rates were extremely similar, not only across calibration designs and methods, but also with regard to the actual reported decision to candidates. The largest difference noted in pass rates was 4.78%, which occurred between the mixed format concurrent 2-PL graded response model (pass rate= 80.43%) and the dichotomous anchored 1-PL calibrations (pass rate= 85.21%). Simpler calibration designs with dichotomized items should be implemented. The dichotomous calibrations provided better fit of the item response matrix than more complex, polytomous calibrations.

An Item Gains and Losses Analysis of False Memories Suggests Critical Items Receive More Item-Specific Processing than List Items

ERIC Educational Resources Information Center

Burns, Daniel J.; Martens, Nicholas J.; Bertoni, Alicia A.; Sweeney, Emily J.; Lividini, Michelle D.

2006-01-01

In a repeated testing paradigm, list items receiving item-specific processing are more likely to be recovered across successive tests (item gains), whereas items receiving relational processing are likely to be forgotten progressively less on successive tests. Moreover, analysis of cumulative-recall curves has shown that item-specific processing…

Item Difficulty Modeling of Paragraph Comprehension Items

ERIC Educational Resources Information Center

Gorin, Joanna S.; Embretson, Susan E.

2006-01-01

Recent assessment research joining cognitive psychology and psychometric theory has introduced a new technology, item generation. In algorithmic item generation, items are systematically created based on specific combinations of features that underlie the processing required to correctly solve a problem. Reading comprehension items have been more…

Concurrent validity of single-item measures of emotional exhaustion and depersonalization in burnout assessment.

PubMed

West, Colin P; Dyrbye, Liselotte N; Satele, Daniel V; Sloan, Jeff A; Shanafelt, Tait D

2012-11-01

Burnout is a common problem among physicians and physicians-in-training. The Maslach Burnout Inventory (MBI) is the gold standard for burnout assessment, but the length of this well-validated 22-item instrument can limit its feasibility for survey research. To evaluate the concurrent validity of two questions relative to the full MBI for measuring the association of burnout with published outcomes. DESIGN, PARTICIPANTS, AND MAIN MEASURES: The single questions "I feel burned out from my work" and "I have become more callous toward people since I took this job," representing the emotional exhaustion and depersonalization domains of burnout, respectively, were evaluated in published studies of medical students, internal medicine residents, and practicing surgeons. We compared predictive models for the association of each question, versus the full MBI, using longitudinal data on burnout and suicidality from 2006 and 2007 for 858 medical students at five United States medical schools, cross-sectional data on burnout and serious thoughts of dropping out of medical school from 2007 for 2222 medical students at seven United States medical schools, and cross-sectional data on burnout and unprofessional attitudes and behaviors from 2009 for 2566 medical students at seven United States medical schools. We also assessed results for longitudinal data on burnout and perceived major medical errors from 2003 to 2009 for 321 Mayo Clinic Rochester internal medicine residents and cross-sectional data on burnout and both perceived major medical errors and suicidality from 2008 for 7,905 respondents to a national survey of members of the American College of Surgeons. Point estimates of effect for models based on the single-item measures were uniformly consistent with those reported for models based on the full MBI. The single-item measures of emotional exhaustion and depersonalization exhibited strong associations with each published outcome (all p ≤ 0.008). No conclusion regarding

Evaluation of Item Candidates: The PROMIS Qualitative Item Review

PubMed Central

DeWalt, Darren A.; Rothrock, Nan; Yount, Susan; Stone, Arthur A.

2009-01-01

One of the PROMIS (Patient-Reported Outcome Measurement Information System) network's primary goals is the development of a comprehensive item bank for patient-reported outcomes of chronic diseases. For its first set of item banks, PROMIS chose to focus on pain, fatigue, emotional distress, physical function, and social function. An essential step for the development of an item pool is the identification, evaluation, and revision of extant questionnaire items for the core item pool. In this work, we also describe the systematic process wherein items are classified for subsequent statistical processing by the PROMIS investigators. Six phases of item development are documented: identification of extant items, item classification and selection, item review and revision, focus group input on domain coverage, cognitive interviews with individual items, and final revision before field testing. Identification of items refers to the systematic search for existing items in currently available scales. Expert item review and revision was conducted by trained professionals who reviewed the wording of each item and revised as appropriate for conventions adopted by the PROMIS network. Focus groups were used to confirm domain definitions and to identify new areas of item development for future PROMIS item banks. Cognitive interviews were used to examine individual items. Items successfully screened through this process were sent to field testing and will be subjected to innovative scale construction procedures. PMID:17443114

Item validity vs. item discrimination index: a redundancy?

NASA Astrophysics Data System (ADS)

Panjaitan, R. L.; Irawati, R.; Sujana, A.; Hanifah, N.; Djuanda, D.

2018-03-01

In several literatures about evaluation and test analysis, it is common to find that there are calculations of item validity as well as item discrimination index (D) with different formula for each. Meanwhile, other resources said that item discrimination index could be obtained by calculating the correlation between the testee’s score in a particular item and the testee’s score on the overall test, which is actually the same concept as item validity. Some research reports, especially undergraduate theses tend to include both item validity and item discrimination index in the instrument analysis. It seems that these concepts might overlap for both reflect the test quality on measuring the examinees’ ability. In this paper, examples of some results of data processing on item validity and item discrimination index were compared. It would be discussed whether item validity and item discrimination index can be represented by one of them only or it should be better to present both calculations for simple test analysis, especially in undergraduate theses where test analyses were included.

Methodology for the development and calibration of the SCI-QOL item banks.

PubMed

Tulsky, David S; Kisala, Pamela A; Victorson, David; Choi, Seung W; Gershon, Richard; Heinemann, Allen W; Cella, David

2015-05-01

To develop a comprehensive, psychometrically sound, and conceptually grounded patient reported outcomes (PRO) measurement system for individuals with spinal cord injury (SCI). Individual interviews (n=44) and focus groups (n=65 individuals with SCI and n=42 SCI clinicians) were used to select key domains for inclusion and to develop PRO items. Verbatim items from other cutting-edge measurement systems (i.e. PROMIS, Neuro-QOL) were included to facilitate linkage and cross-population comparison. Items were field tested in a large sample of individuals with traumatic SCI (n=877). Dimensionality was assessed with confirmatory factor analysis. Local item dependence and differential item functioning were assessed, and items were calibrated using the item response theory (IRT) graded response model. Finally, computer adaptive tests (CATs) and short forms were administered in a new sample (n=245) to assess test-retest reliability and stability. A calibration sample of 877 individuals with traumatic SCI across five SCI Model Systems sites and one Department of Veterans Affairs medical center completed SCI-QOL items in interview format. We developed 14 unidimensional calibrated item banks and 3 calibrated scales across physical, emotional, and social health domains. When combined with the five Spinal Cord Injury--Functional Index physical function banks, the final SCI-QOL system consists of 22 IRT-calibrated item banks/scales. Item banks may be administered as CATs or short forms. Scales may be administered in a fixed-length format only. The SCI-QOL measurement system provides SCI researchers and clinicians with a comprehensive, relevant and psychometrically robust system for measurement of physical-medical, physical-functional, emotional, and social outcomes. All SCI-QOL instruments are freely available on Assessment CenterSM.

Item Structural Properties as Predictors of Item Difficulty and Item Association.

ERIC Educational Resources Information Center

Solano-Flores, Guillermo

1993-01-01

Studied the ability of logical test design (LTD) to predict student performance in reading Roman numerals for 211 sixth graders in Mexico City tested on Roman numeral items varying on LTD-related and non-LTD-related variables. The LTD-related variable item iterativity was found to be the best predictor of item difficulty. (SLD)

Emotional intelligence in medical laboratory science

NASA Astrophysics Data System (ADS)

Price, Travis

The purpose of this study was to explore the role of emotional intelligence (EI) in medical laboratory science, as perceived by laboratory administrators. To collect and evaluate these perceptions, a survey was developed and distributed to over 1,400 medical laboratory administrators throughout the U.S. during January and February of 2013. In addition to demographic-based questions, the survey contained a list of 16 items, three skills traditionally considered important for successful work in the medical laboratory as well as 13 EI-related items. Laboratory administrators were asked to rate each item for its importance for job performance, their satisfaction with the item's demonstration among currently working medical laboratory scientists (MLS) and the amount of responsibility college-based medical laboratory science programs should assume for the development of each skill or attribute. Participants were also asked about EI training in their laboratories and were given the opportunity to express any thoughts or opinions about EI as it related to medical laboratory science. This study revealed that each EI item, as well as each of the three other items, was considered to be very or extremely important for successful job performance. Administrators conveyed that they were satisfied overall, but indicated room for improvement in all areas, especially those related to EI. Those surveyed emphasized that medical laboratory science programs should continue to carry the bulk of the responsibility for the development of technical skills and theoretical knowledge and expressed support for increased attention to EI concepts at the individual, laboratory, and program levels.

Item Response Models for Examinee-Selected Items

ERIC Educational Resources Information Center

Wang, Wen-Chung; Jin, Kuan-Yu; Qiu, Xue-Lan; Wang, Lei

2012-01-01

In some tests, examinees are required to choose a fixed number of items from a set of given items to answer. This practice creates a challenge to standard item response models, because more capable examinees may have an advantage by making wiser choices. In this study, we developed a new class of item response models to account for the choice…

Behavioral Health Needs Assessment Survey (BHNAS): Overview of Survey Items and Measures

DTIC Science & Technology

2013-02-12

Vicodin, Tramadol , Tylenol with Codeine, Methadone) • Other (specify all) • Unknown what medication(s) Regarding the use of pain medications...control training • TBI • Pain medication use • Aggressive behavior • Combat exposure • Experiences of intense fear, helplessness, or horror...used on all subsequent versions. Pain Medication Use The pain medication items used in the ninth version of the BHNAS were drawn from the Army

Core neurological examination items for neurology clerks: A modified Delphi study with a grass-roots approach

PubMed Central

Liu, Chi-Hung; Hsu, Li-Ling; Hsiao, Cheng-Ting; Hsieh, Suh-Ing; Chang, Chun-Wei; Huang, Elaine Shinwei; Chang, Yeu-Jhy

2018-01-01

Background With the evolution of treatments for neurological diseases, the contents of core neurological examinations (NEs) for medical students may need to be modified. We aimed to establish a consensus on the core NE items for neurology clerks and compare viewpoints between different groups of panelists. Methods First, a pilot group proposed the core contents of NEs for neurology clerks. The proposed core NE items were then subject to a modified web-based Delphi process using the online software “SurveyMonkey”. A total of 30 panelists from different backgrounds (tutors or learners, neurologists or non-neurologists, community hospitals or medical centers, and different academic positions) participated in the modified Delphi process. Each panelist was asked to agree or disagree on the inclusion of each item using a 9-point Likert scale and was encouraged to provide feedback. We also compared viewpoints between different groups of panelists using the Mann-Whitney U test. Results Eighty-three items were used for the first round of the Delphi process. Of them, 18 without consensus of being a core NE item for the neurology clerks in the first round and another 14 items suggested by the panelists were further discussed in the second round. Finally, 75 items with different grades were included in the recommended NE items for neurology clerks. Conclusions Our findings provide a reference regarding the core NE items for milestone development for neurology clerkships. We hope that prioritizing the NE items in this order can help medical students to learn NE more efficiently. PMID:29771997

Methodology for the development and calibration of the SCI-QOL item banks

PubMed Central

Tulsky, David S.; Kisala, Pamela A.; Victorson, David; Choi, Seung W.; Gershon, Richard; Heinemann, Allen W.; Cella, David

2015-01-01

Objective To develop a comprehensive, psychometrically sound, and conceptually grounded patient reported outcomes (PRO) measurement system for individuals with spinal cord injury (SCI). Methods Individual interviews (n = 44) and focus groups (n = 65 individuals with SCI and n = 42 SCI clinicians) were used to select key domains for inclusion and to develop PRO items. Verbatim items from other cutting-edge measurement systems (i.e. PROMIS, Neuro-QOL) were included to facilitate linkage and cross-population comparison. Items were field tested in a large sample of individuals with traumatic SCI (n = 877). Dimensionality was assessed with confirmatory factor analysis. Local item dependence and differential item functioning were assessed, and items were calibrated using the item response theory (IRT) graded response model. Finally, computer adaptive tests (CATs) and short forms were administered in a new sample (n = 245) to assess test-retest reliability and stability. Participants and Procedures A calibration sample of 877 individuals with traumatic SCI across five SCI Model Systems sites and one Department of Veterans Affairs medical center completed SCI-QOL items in interview format. Results We developed 14 unidimensional calibrated item banks and 3 calibrated scales across physical, emotional, and social health domains. When combined with the five Spinal Cord Injury – Functional Index physical function banks, the final SCI-QOL system consists of 22 IRT-calibrated item banks/scales. Item banks may be administered as CATs or short forms. Scales may be administered in a fixed-length format only. Conclusions The SCI-QOL measurement system provides SCI researchers and clinicians with a comprehensive, relevant and psychometrically robust system for measurement of physical-medical, physical-functional, emotional, and social outcomes. All SCI-QOL instruments are freely available on Assessment CenterSM. PMID:26010963

Preliminary development of an ultrabrief two-item bedside test for delirium.

PubMed

Fick, Donna M; Inouye, Sharon K; Guess, Jamey; Ngo, Long H; Jones, Richard N; Saczynski, Jane S; Marcantonio, Edward R

2015-10-01

Delirium is common, morbid, and costly, yet is greatly under-recognized among hospitalized older adults. To identify the best single and pair of mental status test items that predict the presence of delirium. Diagnostic test evaluation study that enrolled medicine inpatients aged 75 years or older at an academic medical center. Patients underwent a clinical reference standard assessment involving a patient interview, medical record review, and interviews with family members and nurses to determine the presence or absence of Diagnostic and Statistical Manual of Mental Disorders, 4th Edition defined delirium. Participants also underwent the three-dimensional Confusion Assessment Method (3D-CAM), a brief, validated assessment for delirium. Individual items and pairs of items from the 3D-CAM were evaluated to determine sensitivity and specificity relative to the reference standard delirium diagnosis. Of the 201 participants (mean age 84 years, 62% female), 42 (21%) had delirium based on the clinical reference standard. The single item with the best test characteristics was "months of the year backwards" with a sensitivity of 83% (95% confidence interval [CI]: 69%-93%) and specificity of 69% (95% CI: 61%-76%). The best 2-item screen was the combination of "months of the year backwards" and "what is the day of the week?" with a sensitivity of 93% (95% CI: 81%-99%) and specificity of 64% (95% CI: 56%-70%). We identified a single item with >80% and pair of items with >90% sensitivity for delirium. If validated prospectively, these items will serve as an initial innovative screening step for delirium identification in hospitalized older adults. © 2015 Society of Hospital Medicine.

How Often is "Often"? The Use of Imprecise Terms in Exam Items.

ERIC Educational Resources Information Center

Case, Susan M.

This study was designed to gather data on the meaning of imprecise terms from items written by physicians for their students and by test committees for national licensure and certification examinations. A total of 32 members of test committees who write examination items for various medical specialty examinations participated in the study. Each…

Attitudes of medical students toward psychiatry in a Chilean medical school.

PubMed

Valdivieso, Sergio; Sirhan, Marisol; Aguirre, Constanza; Ivelic, Jose Antonio; Aillach, Emilio; Villarroel, Luis

2014-06-01

The authors assess the attitudes of seventh-year medical students with regard to psychiatry and patients with psychiatric illness during the psychiatry clerkship. A 32-item questionnaire regarding attitudes toward psychiatry and patients with psychiatric illness was administered at the beginning of the psychiatry clerkship. One hundred and ten seventh-year students participated in the study, providing responses anonymously. Average negative attitude item score was 2.45 ± 0.3 (range 1.7-3.3). Eighty-three students (75 %) responded to all the questions with an average negative attitude item score of 2.43 ± 0.3 (range 1.7-3.3) and a total negative attitude item score of 77.9 ± 10.3 (range 55-104). Undergraduate students of a Chilean medical school showed fairly positive attitudes toward psychiatry and toward patients with psychiatric illness.

Association between the 8-item Morisky Medication Adherence Scale (MMAS-8) and blood pressure control.

PubMed

Oliveira-Filho, Alfredo Dias; Barreto-Filho, José Augusto; Neves, Sabrina Joany Felizardo; Lyra Junior, Divaldo Pereira de

2012-07-01

Non-adherence to treatment is an important and often unrecognized risk factor that contributes to reduced control of blood pressure (BP). To determine the association between treatment adherence measured by a validated version in Portuguese of the 8-item Morisky Medication Adherence Scale (MMAS-8) and BP control in hypertensive outpatients. A cross-sectional study was carried out with hypertensive patients older than 18 years, treated at six of the Family Health Strategy Units in Maceió (AL), through interviews and home blood pressure measurements, between January and April 2011. Adherence was determined by MMAS-8 version translated for this study. The patients were considered adherent when they had a score equal to 8 at the MMAS-8. The prevalence of adherence among the 223 patients studied was 19.7%, while 34% had controlled BP (> 140/90 mmHg). The average adherence value according to the MMAS-8 was 5.8 (± 1.8). Adherent patients showed to be more prone (OR = 6.1, CI [95%] = 3.0 to 12.0) to have blood pressure control than those who reached mean (6 to <8) or low values (<6) at the adherence score. The Portuguese version of MMAS-8 was showed a significant association with BP control (p = 0.000). The diagnosis of non-adherent behavior through the application of MMAS-8 in patients using of antihypertensive medications was predictive of elevated systolic and diastolic BP.

Examining Differential Item Functions of Different Item Ordered Test Forms According to Item Difficulty Levels

ERIC Educational Resources Information Center

Çokluk, Ömay; Gül, Emrah; Dogan-Gül, Çilem

2016-01-01

The study aims to examine whether differential item function is displayed in three different test forms that have item orders of random and sequential versions (easy-to-hard and hard-to-easy), based on Classical Test Theory (CTT) and Item Response Theory (IRT) methods and bearing item difficulty levels in mind. In the correlational research, the…

42 CFR 414.104 - PEN Items and Services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 3 2012-10-01 2012-10-01 false PEN Items and Services. 414.104 Section 414.104 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Fee Schedules...

42 CFR 414.104 - PEN Items and Services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 3 2013-10-01 2013-10-01 false PEN Items and Services. 414.104 Section 414.104 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Fee Schedules...

42 CFR 414.104 - PEN Items and Services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 3 2011-10-01 2011-10-01 false PEN Items and Services. 414.104 Section 414.104 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Fee Schedules for...

42 CFR 414.104 - PEN Items and Services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 3 2014-10-01 2014-10-01 false PEN Items and Services. 414.104 Section 414.104 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Fee Schedules...

42 CFR 414.104 - PEN Items and Services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false PEN Items and Services. 414.104 Section 414.104 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Fee Schedules for...

The Role of Item Models in Automatic Item Generation

ERIC Educational Resources Information Center

Gierl, Mark J.; Lai, Hollis

2012-01-01

Automatic item generation represents a relatively new but rapidly evolving research area where cognitive and psychometric theories are used to produce tests that include items generated using computer technology. Automatic item generation requires two steps. First, test development specialists create item models, which are comparable to templates…

Assessing item fit for unidimensional item response theory models using residuals from estimated item response functions.

PubMed

Haberman, Shelby J; Sinharay, Sandip; Chon, Kyong Hee

2013-07-01

Residual analysis (e.g. Hambleton & Swaminathan, Item response theory: principles and applications, Kluwer Academic, Boston, 1985; Hambleton, Swaminathan, & Rogers, Fundamentals of item response theory, Sage, Newbury Park, 1991) is a popular method to assess fit of item response theory (IRT) models. We suggest a form of residual analysis that may be applied to assess item fit for unidimensional IRT models. The residual analysis consists of a comparison of the maximum-likelihood estimate of the item characteristic curve with an alternative ratio estimate of the item characteristic curve. The large sample distribution of the residual is proved to be standardized normal when the IRT model fits the data. We compare the performance of our suggested residual to the standardized residual of Hambleton et al. (Fundamentals of item response theory, Sage, Newbury Park, 1991) in a detailed simulation study. We then calculate our suggested residuals using data from an operational test. The residuals appear to be useful in assessing the item fit for unidimensional IRT models.

Item Information and Discrimination Functions for Trinary PCM Items.

ERIC Educational Resources Information Center

Akkermans, Wies; Muraki, Eiji

1997-01-01

For trinary partial credit items, the shape of the item information and item discrimination functions is examined in relation to the item parameters. Conditions under which these functions are unimodal and bimodal are discussed, and the locations and values of maxima are derived. Practical relevance of the results is discussed. (SLD)

Effects and Satisfaction of Medical Device Safety Information Reporting System Using Electronic Medical Record.

PubMed

Jang, Hye Jung; Choi, Young Deuk; Kim, Nam Hyun

2017-04-01

This paper describes an evaluation study on the effectiveness of developing an in-hospital medical device safety information reporting system for managing safety information, including adverse incident data related to medical devices, following the enactment of the Medical Device Act in Korea. Medical device safety information reports were analyzed for 190 cases that took place prior to the application of a medical device safety information reporting system and during a period when the reporting system was used. Also, questionnaires were used to measure the effectiveness of the medical device safety information reporting system. The analysis was based on the questionnaire responses of 15 reporters who submitted reports in both the pre- and post-reporting system periods. Sixty-two reports were submitted in paper form, but after the system was set up, this number more than doubled to 128 reports in electronic form. In terms of itemized reporting, a total of 45 items were reported. Before the system was used, 23 items had been reported, but this increased to 32 items after the system was put to use. All survey variables of satisfaction received a mean of over 3 points, while positive attitude , potential benefits , and positive benefits all exceeded 4 points, each receiving 4.20, 4.20, and 4.13, respectively. Among the variables, time-consuming and decision-making had the lowest mean values, each receiving 3.53. Satisfaction was found to be high for system quality and user satisfaction , but relatively low for time-consuming and decision-making . We were able to verify that effective reporting and monitoring of adverse incidents and the safety of medical devices can be implemented through the establishment of an in-hospital medical device safety information reporting system that can enhance patient safety and medical device risk management.

Item Dependency in an Objective Structured Clinical Examination

ERIC Educational Resources Information Center

Iramaneerat, Cherdsak; Myford, Carol M.; Yudkowsky, Rachel

2006-01-01

An Objective Structured Clinical Examination (OSCE) is an assessment approach employed in medical education, in which residents rotate through multiple stations of standardized clinical tasks to evaluate their clinical competence. Because items used to evaluate residents' performance in each OSCE station are linked to the same task and are rated…

Measurement of specific medical school stress: translation of the "Perceived Medical School Stress Instrument" to the German language.

PubMed

Kötter, Thomas; Voltmer, Edgar

2013-01-01

Medical students encounter specific stressors during their studies. As a result, they develop anxiety, depression and burnout symptoms more frequently than their similarly aged, but employed counterparts. In 1984, Vitaliano et al. published a 13-item instrument for the measurement of stress specific to medical school: the "Perceived Medical School Stress Instrument" (PMSS). Since then, it has been widely applied and validated in English-speaking countries. No German version of the PMSS exists to date. Thus, our aim was to translate the instrument into the German language in order to be able to measure medical school stress in German-speaking countries. The items of the PMSS were translated into German by three separate researchers. The resulting translations were compared and combined with each other to establish a first German version of each item in the PMSS. These items were then translated back into English by two native English speakers to validate the correct primary translation. Based on a revised German version, a cognitive debriefing with 19 German medical students and a theoretical testing on 169 German medical students, the final German translations for each of the 13 items were determined. The PMSS was easily translated into German and there was a high congruency between the primary translations into German and the secondary translations back into English. Incongruities between the translations were solved quickly. The assessment of the German equivalent of the PMSS showed good results regarding its reliability (Cronbach's Alpha 0.81). A German version of the PMSS is now available for measuring the medical school related stress in German-speaking countries.

Effects of Ignoring Item Interaction on Item Parameter Estimation and Detection of Interacting Items

ERIC Educational Resources Information Center

Chen, Cheng-Te; Wang, Wen-Chung

2007-01-01

This study explores the effects of ignoring item interaction on item parameter estimation and the efficiency of using the local dependence index Q[subscript 3] and the SAS NLMIXED procedure to detect item interaction under the three-parameter logistic model and the generalized partial credit model. Through simulations, it was found that ignoring…

Attitude toward mental illness and psychiatry among the medical students and interns in a medical college.

PubMed

Risal, Ajay; Sharma, Pushpa Prasad; Sanjel, Seshananda

2013-01-01

Medical students tend to have a neutral or negative attitude to Psychiatry as a discipline. This study was initiated to explore the attitude towards mental illness and Psychiatry among the medical students and interns in Kathmandu University School of Medical Sciences. A cross-sectional questionnaire based study was conducted among the medical students and interns at Dhulikhel Hospital.Two self-rating scales; Attitudes towards Psychiatry-30 and Attitudes to Mental Illnesswere used to assess attitudes towards mental illness and Psychiatryamong the total 159 subjects. Descriptive statistics and independent sample t-test were applied using SPSS- 16 for analysis. Among the total 159 subjects, 44 (27.7%) were interns. Comparison of means of each item in Attitudes towards Psychiatry-30 and Attitudes to Mental Illnesswas done between males and females, medical students and interns, fi rst semester and ninth semester students. Most of the subjects showed neutral attitude towards all the scoring items; though there were a few signifi cant differences in mean scores of some items in group wise comparison. Overall attitudes towards mental illness and psychiatry among the medical students and interns in our medical school were positive or neutral. A further study with medical students from different institutions is needed to get a detail nationwide picture. attitude; interns; medical students; mental illness; psychiatry.

Cleaning and disinfection of patient care items, in relation to small animals.

PubMed

Weese, J Scott

2015-03-01

Patient care involves several medical and surgical items, including those that come into contact with sterile or other high-risk body sites and items that have been used on other patients. These situations create a risk for infection if items are contaminated, and the implications can range from single infections to large outbreaks. To minimize the risk, proper equipment cleaning, disinfection/sterilization, storage, and monitoring practices are required. Risks posed by different items; the required level of cleaning, disinfection, or sterilization; the methods that are available and appropriate; and how to ensure efficacy, must be considered when designing and implementing an infection control program. Copyright © 2015 Elsevier Inc. All rights reserved.

The Australian Medical Schools Assessment Collaboration: benchmarking the preclinical performance of medical students.

PubMed

O'Mara, Deborah A; Canny, Ben J; Rothnie, Imogene P; Wilson, Ian G; Barnard, John; Davies, Llewelyn

2015-02-02

To report the level of participation of medical schools in the Australian Medical Schools Assessment Collaboration (AMSAC); and to measure differences in student performance related to medical school characteristics and implementation methods. Retrospective analysis of data using the Rasch statistical model to correct for missing data and variability in item difficulty. Linear model analysis of variance was used to assess differences in student performance. 6401 preclinical students from 13 medical schools that participated in AMSAC from 2011 to 2013. Rasch estimates of preclinical basic and clinical science knowledge. Representation of Australian medical schools and students in AMSAC more than doubled between 2009 and 2013. In 2013 it included 12 of 19 medical schools and 68% of medical students. Graduate-entry students scored higher than students entering straight from school. Students at large schools scored higher than students at small schools. Although the significance level was high (P < 0.001), the main effect sizes were small (4.5% and 2.3%, respectively). The time allowed per multiple choice question was not significantly associated with student performance. The effect on performance of multiple assessments compared with the test items as part of a single end-of-year examination was negligible. The variables investigated explain only 12% of the total variation in student performance. An increasing number of medical schools are participating in AMSAC to monitor student performance in preclinical sciences against an external benchmark. Medical school characteristics account for only a small part of overall variation in student performance. Student performance was not affected by the different methods of administering test items.

Medical device development.

PubMed

Panescu, Dorin

2009-01-01

The development of a successful medical product requires not only engineering design efforts, but also clinical, regulatory, marketing and business expertise. This paper reviews items related to the process of designing medical devices. It discusses the steps required to take a medical product idea from concept, through development, verification and validation, regulatory approvals and market release.

Item response theory analysis of the Utrecht Work Engagement Scale for Students (UWES-S) using a sample of Japanese university and college students majoring medical science, nursing, and natural science.

PubMed

Tsubakita, Takashi; Shimazaki, Kazuyo; Ito, Hiroshi; Kawazoe, Nobuo

2017-10-30

The Utrecht Work Engagement Scale for Students has been used internationally to assess students' academic engagement, but it has not been analyzed via item response theory. The purpose of this study was to conduct an item response theory analysis of the Japanese version of the Utrecht Work Engagement Scale for Students translated by authors. Using a two-parameter model and Samejima's graded response model, difficulty and discrimination parameters were estimated after confirming the factor structure of the scale. The 14 items on the scale were analyzed with a sample of 3214 university and college students majoring medical science, nursing, or natural science in Japan. The preliminary parameter estimation was conducted with the two parameter model, and indicated that three items should be removed because there were outlier parameters. Final parameter estimation was conducted using the survived 11 items, and indicated that all difficulty and discrimination parameters were acceptable. The test information curve suggested that the scale better assesses higher engagement than average engagement. The estimated parameters provide a basis for future comparative studies. The results also suggested that a 7-point Likert scale is too broad; thus, the scaling should be modified to fewer graded scaling structure.

The 8-item Morisky Medication Adherence Scale: validation of a Brazilian-Portuguese version in hypertensive adults.

PubMed

de Oliveira-Filho, Alfredo Dias; Morisky, Donald E; Neves, Sabrina Joany Felizardo; Costa, Francisco A; de Lyra, Divaldo Pereira

2014-01-01

The Morisky Medication Adherence Scale (MMAS-8) remains one of the most widely used mechanisms to assess patient adherence. Its translation and testing on languages in addition to English would be very useful in research and in practice. To translate and examine the psychometric properties of the Portuguese version of the structured self-report eight-item Morisky Medication Adherence Scale among patients with hypertension. The study was designed as a cross-sectional survey conducted in six Family Health Units of the Brazilian Unified Health System, in Maceió, between March 2011 and April 2012. After a standard "forward-backward" procedure to translate MMAS-8 into Portuguese, the questionnaire was applied to 937 patients with hypertension. Reliability was tested using a measure of internal consistency (Cronbach's alpha), and test-retest reliability. Validity was confirmed using known groups validity. Three levels of adherence were considered based on the following scores: 0 to <6 (low); 6 to <8 (medium); 8 (high). The mean age of respondents was 57.1 years (SD = 12.7 years), and 71.5% were female. The mean number of prescribed antihypertensives per patient was 1.62 (SD = 0.67). The mean score for the medication adherence scale was 5.78 (SD = 1.88). Moderate internal consistency was found (Cronbach's alpha = 0.682), and test-retest reliability was satisfactory (Spearman's r = 0.928; P < 0.001). A significant relationship between MMAS-8 levels of adherence and BP control (chi-square, 8.281; P = 0.016) was found. 46.0%, 33.6%, and 20.4% of patients had low, medium, and high adherence, respectively. The self-report measure sensitivity, specificity, positive and negative predictive values were 86.1%, 31.2%, 57.4% and 68.3% respectively. Psychometric evaluation of the Portuguese version of the MMAS-8 indicates that it is a reliable and valid measure to detect patients at risk of non-adherence. The MMAS-8 could still be used in routine care to support

Association of health literacy and medication self-efficacy with medication adherence and diabetes control.

PubMed

Huang, Yen-Ming; Shiyanbola, Olayinka O; Smith, Paul D

2018-01-01

The exact pathway linking health literacy, self-efficacy, medication adherence, and glycemic control for type 2 diabetes remains unclear. Understanding the relationship between patient factors, medication adherence, and lower glycated hemoglobin (HbA1c) may help patients better manage their disease. This study examined the association of health literacy and medication self-efficacy with self-reported diabetes medication adherence, and the association of health literacy, medication self-efficacy, and self-reported diabetes medication adherence with HbA1c of patients with type 2 diabetes. This cross-sectional study utilized a face-to-face questionnaire at two family medicine clinics in a Midwestern state among 174 patients; subjects enrolled were at least 20 years old with diagnosed type 2 diabetes, prescribed at least one oral diabetes medicine, and understood English. Questionnaires were administered to assess the participants': health literacy, using the Newest Vital Sign six-item questionnaire (NVS); self-efficacy for medication use, using the 13-item Self-Efficacy for Appropriate Medication Use Scale; and self-report medication adherence, using the eight-item Morisky Medication Adherence Scale. HbA1c values were obtained from participants' electronic medical records. Multiple linear regressions were used to explore the association of health literacy and medication self-efficacy with both medication adherence and HbA1c level after controlling for all other covariates. Self-reported health status (β = 0.17, p = 0.015) and medication self-efficacy (β = 0.53, p < 0.001) were positively associated with diabetes medication adherence. Health literacy was neither associated with diabetes medication adherence (β = -0.04, p = 0.586) nor HbA1c (β = -0.06, p = 0.542). Lower diabetes medication adherence (β = -0.26, p = 0.008) and higher number of prescribed medications (β = 0.28, p = 0.009) were correlated with higher HbA1c. Health literacy, as measured by the NVS

IRT Item Parameter Scaling for Developing New Item Pools

ERIC Educational Resources Information Center

Kang, Hyeon-Ah; Lu, Ying; Chang, Hua-Hua

2017-01-01

Increasing use of item pools in large-scale educational assessments calls for an appropriate scaling procedure to achieve a common metric among field-tested items. The present study examines scaling procedures for developing a new item pool under a spiraled block linking design. The three scaling procedures are considered: (a) concurrent…

NASA Johnson Space Center Medical Licensing Opportunities

NASA Technical Reports Server (NTRS)

Hernandez-Moya, Sonia

2009-01-01

This presentation reviews patented medical items that are available for licensing in the areas of Laboratory Technologies, Medical Devices, Medical Equipment and other technologies that are of interest to the medical community.

A Bifactor Multidimensional Item Response Theory Model for Differential Item Functioning Analysis on Testlet-Based Items

ERIC Educational Resources Information Center

Fukuhara, Hirotaka; Kamata, Akihito

2011-01-01

A differential item functioning (DIF) detection method for testlet-based data was proposed and evaluated in this study. The proposed DIF model is an extension of a bifactor multidimensional item response theory (MIRT) model for testlets. Unlike traditional item response theory (IRT) DIF models, the proposed model takes testlet effects into…

Gender-Based Differential Item Performance in Mathematics Achievement Items.

ERIC Educational Resources Information Center

Doolittle, Allen E.; Cleary, T. Anne

1987-01-01

Eight randomly equivalent samples of high school seniors were each given a unique form of the ACT Assessment Mathematics Usage Test (ACTM). Signed measures of differential item performance (DIP) were obtained for each item in the eight ACTM forms. DIP estimates were analyzed and a significant item category effect was found. (Author/LMO)

Real and Artificial Differential Item Functioning in Polytomous Items

ERIC Educational Resources Information Center

Andrich, David; Hagquist, Curt

2015-01-01

Differential item functioning (DIF) for an item between two groups is present if, for the same person location on a variable, persons from different groups have different expected values for their responses. Applying only to dichotomously scored items in the popular Mantel-Haenszel (MH) method for detecting DIF in which persons are classified by…

Core Items for a Standardized Resource Use Measure: Expert Delphi Consensus Survey.

PubMed

Thorn, Joanna C; Brookes, Sara T; Ridyard, Colin; Riley, Ruth; Hughes, Dyfrig A; Wordsworth, Sarah; Noble, Sian M; Thornton, Gail; Hollingworth, William

2018-06-01

Resource use measurement by patient recall is characterized by inconsistent methods and a lack of validation. A validated standardized resource use measure could increase data quality, improve comparability between studies, and reduce research burden. To identify a minimum set of core resource use items that should be included in a standardized adult instrument for UK health economic evaluation from a provider perspective. Health economists with experience of UK-based economic evaluations were recruited to participate in an electronic Delphi survey. Respondents were asked to rate 60 resource use items (e.g., medication names) on a scale of 1 to 9 according to the importance of the item in a generic context. Items considered less important according to predefined consensus criteria were dropped and a second survey was developed. In the second round, respondents received the median score and their own score from round 1 for each item alongside summarized comments and were asked to rerate items. A final project team meeting was held to determine the recommended core set. Forty-five participants completed round 1. Twenty-six items were considered less important and were dropped, 34 items were retained for the second round, and no new items were added. Forty-two respondents (93.3%) completed round 2, and greater consensus was observed. After the final meeting, 10 core items were selected, with further items identified as suitable for "bolt-on" questionnaire modules. The consensus on 10 items considered important in a generic context suggests that a standardized instrument for core resource use items is feasible. Copyright © 2018. Published by Elsevier Inc.

Component Identification and Item Difficulty of Raven's Matrices Items.

ERIC Educational Resources Information Center

Green, Kathy E.; Kluever, Raymond C.

Item components that might contribute to the difficulty of items on the Raven Colored Progressive Matrices (CPM) and the Standard Progressive Matrices (SPM) were studied. Subjects providing responses to CPM items were 269 children aged 2 years 9 months to 11 years 8 months, most of whom were referred for testing as potentially gifted. A second…

Developing an African youth psychosocial assessment: an application of item response theory.

PubMed

Betancourt, Theresa S; Yang, Frances; Bolton, Paul; Normand, Sharon-Lise

2014-06-01

This study aimed to refine a dimensional scale for measuring psychosocial adjustment in African youth using item response theory (IRT). A 60-item scale derived from qualitative data was administered to 667 war-affected adolescents (55% female). Exploratory factor analysis (EFA) determined the dimensionality of items based on goodness-of-fit indices. Items with loadings less than 0.4 were dropped. Confirmatory factor analysis (CFA) was used to confirm the scale's dimensionality found under the EFA. Item discrimination and difficulty were estimated using a graded response model for each subscale using weighted least squares means and variances. Predictive validity was examined through correlations between IRT scores (θ) for each subscale and ratings of functional impairment. All models were assessed using goodness-of-fit and comparative fit indices. Fisher's Information curves examined item precision at different underlying ranges of each trait. Original scale items were optimized and reconfigured into an empirically-robust 41-item scale, the African Youth Psychosocial Assessment (AYPA). Refined subscales assess internalizing and externalizing problems, prosocial attitudes/behaviors and somatic complaints without medical cause. The AYPA is a refined dimensional assessment of emotional and behavioral problems in African youth with good psychometric properties. Validation studies in other cultures are recommended. Copyright © 2014 John Wiley & Sons, Ltd.

Developing an African youth psychosocial assessment: an application of item response theory

PubMed Central

BETANCOURT, THERESA S.; YANG, FRANCES; BOLTON, PAUL; NORMAND, SHARON-LISE

2014-01-01

This study aimed to refine a dimensional scale for measuring psychosocial adjustment in African youth using item response theory (IRT). A 60-item scale derived from qualitative data was administered to 667 war-affected adolescents (55% female). Exploratory factor analysis (EFA) determined the dimensionality of items based on goodness-of-fit indices. Items with loadings less than 0.4 were dropped. Confirmatory factor analysis (CFA) was used to confirm the scale's dimensionality found under the EFA. Item discrimination and difficulty were estimated using a graded response model for each subscale using weighted least squares means and variances. Predictive validity was examined through correlations between IRT scores (θ) for each subscale and ratings of functional impairment. All models were assessed using goodness-of-fit and comparative fit indices. Fisher's Information curves examined item precision at different underlying ranges of each trait. Original scale items were optimized and reconfigured into an empirically-robust 41-item scale, the African Youth Psychosocial Assessment (AYPA). Refined subscales assess internalizing and externalizing problems, prosocial attitudes/behaviors and somatic complaints without medical cause. The AYPA is a refined dimensional assessment of emotional and behavioral problems in African youth with good psychometric properties. Validation studies in other cultures are recommended. PMID:24478113

Evaluation of psychometric properties and differential item functioning of 8-item Child Perceptions Questionnaires using item response theory.

PubMed

Yau, David T W; Wong, May C M; Lam, K F; McGrath, Colman

2015-08-19

Four-factor structure of the two 8-item short forms of Child Perceptions Questionnaire CPQ11-14 (RSF:8 and ISF:8) has been confirmed. However, the sum scores are typically reported in practice as a proxy of Oral health-related Quality of Life (OHRQoL), which implied a unidimensional structure. This study first assessed the unidimensionality of 8-item short forms of CPQ11-14. Item response theory (IRT) was employed to offer an alternative and complementary approach of validation and to overcome the limitations of classical test theory assumptions. A random sample of 649 12-year-old school children in Hong Kong was analyzed. Unidimensionality of the scale was tested by confirmatory factor analysis (CFA), principle component analysis (PCA) and local dependency (LD) statistic. Graded response model was fitted to the data. Contribution of each item to the scale was assessed by item information function (IIF). Reliability of the scale was assessed by test information function (TIF). Differential item functioning (DIF) across gender was identified by Wald test and expected score functions. Both CPQ11-14 RSF:8 and ISF:8 did not deviate much from the unidimensionality assumption. Results from CFA indicated acceptable fit of the one-factor model. PCA indicated that the first principle component explained >30 % of the total variation with high factor loadings for both RSF:8 and ISF:8. Almost all LD statistic <10 indicated the absence of local dependency. Flat and low IIFs were observed in the oral symptoms items suggesting little contribution of information to the scale and item removal caused little practical impact. Comparing the TIFs, RSF:8 showed slightly better information than ISF:8. In addition to oral symptoms items, the item "Concerned with what other people think" demonstrated a uniform DIF (p < 0.001). The expected score functions were not much different between boys and girls. Items related to oral symptoms were not informative to OHRQoL and deletion of these

Item response theory analysis of the Pain Self-Efficacy Questionnaire.

PubMed

Costa, Daniel S J; Asghari, Ali; Nicholas, Michael K

2017-01-01

The Pain Self-Efficacy Questionnaire (PSEQ) is a 10-item instrument designed to assess the extent to which a person in pain believes s/he is able to accomplish various activities despite their pain. There is strong evidence for the validity and reliability of both the full-length PSEQ and a 2-item version. The purpose of this study is to further examine the properties of the PSEQ using an item response theory (IRT) approach. We used the two-parameter graded response model to examine the category probability curves, and location and discrimination parameters of the 10 PSEQ items. In item response theory, responses to a set of items are assumed to be probabilistically determined by a latent (unobserved) variable. In the graded-response model specifically, item response threshold (the value of the latent variable for which adjacent response categories are equally likely) and discrimination parameters are estimated for each item. Participants were 1511 mixed, chronic pain patients attending for initial assessment at a tertiary pain management centre. All items except item 7 ('I can cope with my pain without medication') performed well in IRT analysis, and the category probability curves suggested that participants used the 7-point response scale consistently. Items 6 ('I can still do many of the things I enjoy doing, such as hobbies or leisure activity, despite pain'), 8 ('I can still accomplish most of my goals in life, despite the pain') and 9 ('I can live a normal lifestyle, despite the pain') captured higher levels of the latent variable with greater precision. The results from this IRT analysis add to the body of evidence based on classical test theory illustrating the strong psychometric properties of the PSEQ. Despite the relatively poor performance of Item 7, its clinical utility warrants its retention in the questionnaire. The strong psychometric properties of the PSEQ support its use as an effective tool for assessing self-efficacy in people with pain

Development and validation of 26-item dysfunctional attitude scale.

PubMed

Ebrahimi, Amrollah; Samouei, Rahele; Mousavii, Sayyed Ghafour; Bornamanesh, Ali Reza

2013-06-01

Dysfunctional Attitude Scale is one of the most common instruments used to assess cognitive vulnerability. This study aimed to develop and validate a short form of Dysfunctional Attitude Scale appropriate for an Iranian clinical population. Participants were 160 psychiatric patients from medical centers affiliated with Isfahan Medical University, as well as 160 non-patients. Research instruments were clinical interviews based on the Diagnostic and Statistical Manual-IV-TR, Dysfunctional Attitude Scale and General Heath Questionnaire (GHQ-28). Data was analyzed using multicorrelation calculations and factor analysis. Based on the results of factor analysis and item-total correlation, 14 items were judged candidates for omission. Analysis of the 26-item Dysfunctional Attitude Scale (DAS-26) revealed a Cronbach's alpha of 0.92. Evidence for the concurrent criterion validity was obtained through calculating the correlation between the Dysfunctional Attitude Scale and psychiatric diagnosis (r = 0.55), GHQ -28 (r = 0.56) and somatization, anxiety, social dysfunction, and depression subscales (0.45,0.53,0.48, and 0.57, respectively). Factor analysis deemed a four-factor structure the best. The factors were labeled as success-perfectionism, need for approval, need for satisfying others, and vulnerability-performance evaluation. The results showed that the Iranian version of the Dysfunctional Attitude Scale (DAS-26) bears satisfactory psychometric properties suggesting that this cognitive instrument is appropriate for use in an Iranian cultural context. Copyright © 2012 Wiley Publishing Asia Pty Ltd.

Measuring resilience after spinal cord injury: Development, validation and psychometric characteristics of the SCI-QOL Resilience item bank and short form.

PubMed

Victorson, David; Tulsky, David S; Kisala, Pamela A; Kalpakjian, Claire Z; Weiland, Brian; Choi, Seung W

2015-05-01

To describe the development and psychometric properties of the Spinal Cord Injury--Quality of Life (SCI-QOL) Resilience item bank and short form. Using a mixed-methods design, we developed and tested a resilience item bank through the use of focus groups with individuals with SCI and clinicians with expertise in SCI, cognitive interviews, and item-response theory based analytic approaches, including tests of model fit and differential item functioning (DIF). We tested a 32-item pool at several medical institutions across the United States, including the University of Michigan, Kessler Foundation, the Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital and the James J. Peters/Bronx Department of Veterans Affairs medical center. A total of 717 individuals with SCI completed the Resilience items. A unidimensional model was observed (CFI=0.968; RMSEA=0.074) and measurement precision was good (theta range between -3.1 and 0.9). Ten items were flagged for DIF, however, after examination of effect sizes we found this to be negligible with little practical impact on score estimates. The final calibrated item bank resulted in 21 retained items. This study indicates that the SCI-QOL Resilience item bank represents a psychometrically robust measurement tool. Short form items are also suggested and computer adaptive tests are available.

Association of health literacy and medication self-efficacy with medication adherence and diabetes control

PubMed Central

Huang, Yen-Ming; Shiyanbola, Olayinka O; Smith, Paul D

2018-01-01

Introduction The exact pathway linking health literacy, self-efficacy, medication adherence, and glycemic control for type 2 diabetes remains unclear. Understanding the relationship between patient factors, medication adherence, and lower glycated hemoglobin (HbA1c) may help patients better manage their disease. This study examined the association of health literacy and medication self-efficacy with self-reported diabetes medication adherence, and the association of health literacy, medication self-efficacy, and self-reported diabetes medication adherence with HbA1c of patients with type 2 diabetes. Methods This cross-sectional study utilized a face-to-face questionnaire at two family medicine clinics in a Midwestern state among 174 patients; subjects enrolled were at least 20 years old with diagnosed type 2 diabetes, prescribed at least one oral diabetes medicine, and understood English. Questionnaires were administered to assess the participants’: health literacy, using the Newest Vital Sign six-item questionnaire (NVS); self-efficacy for medication use, using the 13-item Self-Efficacy for Appropriate Medication Use Scale; and self-report medication adherence, using the eight-item Morisky Medication Adherence Scale. HbA1c values were obtained from participants’ electronic medical records. Multiple linear regressions were used to explore the association of health literacy and medication self-efficacy with both medication adherence and HbA1c level after controlling for all other covariates. Results Self-reported health status (β = 0.17, p = 0.015) and medication self-efficacy (β = 0.53, p < 0.001) were positively associated with diabetes medication adherence. Health literacy was neither associated with diabetes medication adherence (β = −0.04, p = 0.586) nor HbA1c (β = −0.06, p = 0.542). Lower diabetes medication adherence (β = −0.26, p = 0.008) and higher number of prescribed medications (β = 0.28, p = 0.009) were correlated with higher HbA1c

Building medical ethics education to improve Japanese medical students' attitudes toward respecting patients' rights.

PubMed

Saito, Yukiko; Kudo, Yasushi; Shibuya, Akitaka; Satoh, Toshihiko; Higashihara, Masaaki; Aizawa, Yoshiharu

2011-08-01

In medical education, it is important for medical students to develop their ethics to respect patients' rights. Some physicians might make light of patients' rights, because the increased awareness of such rights might make it more difficult for them to conduct medical practice. In the present study, predictors significantly associated with "a sense of resistance to patients' rights" were examined using anonymous self-administered questionnaires. For these predictors, we produced original items with reference to the concept of ethical development and the teachings of Mencius. The subjects were medical students at the Kitasato University School of Medicine, a private university in Japan. A total of 518 students were analyzed (response rate, 78.4%). The average age of enrolled subjects was 22.5 ± 2.7 years (average age ± standard deviation). The average age of 308 male subjects was 22.7 ± 2.8 years, while that of 210 female subjects was 22.1 ± 2.5 years. The item, "Excessive measures to pass the national examination for medical practitioners," was significantly associated with "a sense of resistance to patients' rights." However, other items, including basic attributes such as age and gender, were not significant predictors. If students spent their school time only focusing on the national examination, they would lose the opportunity to receive the ethical education that would allow them to respect patients' rights. That ethical development cannot easily be evaluated with written exams. Thus, along with the acquisition of medical knowledge, educational programs to promote medical students' ethics should be developed.

Military medical graduates' perceptions of organizational culture in Turkish military medical school.

PubMed

Ozer, Mustafa; Bakir, Bilal; Teke, Abdulkadir; Ucar, Muharrem; Bas, Turker; Atac, Adnan

2008-08-01

Organizational culture is the term used to describe the shared beliefs, perceptions, and expectations of individuals in organizations. In the healthcare environment, organizational culture has been associated with several elements of organizational experience that contribute to quality, such as nursing care, job satisfaction, and patient safety. A range of tools have been designed to measure organizational culture and applied in industrial, educational, and health care settings. This study has been conducted to investigate the perceptions of military medical graduates on organizational culture at Gülhane Military Medical School. A measurement of organizational culture, which was developed by the researchers from Akdeniz University, was applied to all military medical graduates in 2004. This was a Likert type scale that included 31 items. Designers of the measurement grouped all these items into five main dimensions in their previous study. The items were scored on a five-point scale anchored by 1: strongly agree and 5: strongly disagree. Study participants included all military physicians who were in clerkship training period at Gulhane Military Medical Academy in 2004. A total of 106 graduates were accepted to response the questionnaire. The mean age of participants was 25.2 +/- 1.1. At the time of study only 8 (7.5%) graduates were married. The study results have showed that the measurement tool with 31 items had a sufficient reliability with a Cronbach's alpha value of 0.91. Factor analysis has resulted a final measurement tool of 24 items with five factors. Total score and the scores of five subdimensions have been estimated and compared between groups based on living city and marital status. The study has shown the dimension of symbol received positive perceptions while the dimension of organizational structure and efficiency received the most negative perceptions. GMMS has a unique organizational culture with its weak and strong aspects. Conducting this kind

Item response theory, computerized adaptive testing, and PROMIS: assessment of physical function.

PubMed

Fries, James F; Witter, James; Rose, Matthias; Cella, David; Khanna, Dinesh; Morgan-DeWitt, Esi

2014-01-01

Patient-reported outcome (PRO) questionnaires record health information directly from research participants because observers may not accurately represent the patient perspective. Patient-reported Outcomes Measurement Information System (PROMIS) is a US National Institutes of Health cooperative group charged with bringing PRO to a new level of precision and standardization across diseases by item development and use of item response theory (IRT). With IRT methods, improved items are calibrated on an underlying concept to form an item bank for a "domain" such as physical function (PF). The most informative items can be combined to construct efficient "instruments" such as 10-item or 20-item PF static forms. Each item is calibrated on the basis of the probability that a given person will respond at a given level, and the ability of the item to discriminate people from one another. Tailored forms may cover any desired level of the domain being measured. Computerized adaptive testing (CAT) selects the best items to sharpen the estimate of a person's functional ability, based on prior responses to earlier questions. PROMIS item banks have been improved with experience from several thousand items, and are calibrated on over 21,000 respondents. In areas tested to date, PROMIS PF instruments are superior or equal to Health Assessment Questionnaire and Medical Outcome Study Short Form-36 Survey legacy instruments in clarity, translatability, patient importance, reliability, and sensitivity to change. Precise measures, such as PROMIS, efficiently incorporate patient self-report of health into research, potentially reducing research cost by lowering sample size requirements. The advent of routine IRT applications has the potential to transform PRO measurement.

A Monte Carlo Study Investigating the Influence of Item Discrimination, Category Intersection Parameters, and Differential Item Functioning Patterns on the Detection of Differential Item Functioning in Polytomous Items

ERIC Educational Resources Information Center

Thurman, Carol

2009-01-01

The increased use of polytomous item formats has led assessment developers to pay greater attention to the detection of differential item functioning (DIF) in these items. DIF occurs when an item performs differently for two contrasting groups of respondents (e.g., males versus females) after controlling for differences in the abilities of the…

Your Medicare Coverage: Durable Medical Equipment (DME) Coverage

MedlinePlus

... test, item, or service covered? Go Durable medical equipment (DME) coverage How often is it covered? Medicare ... B (Medical Insurance) covers medically necessary durable medical equipment (DME) that your doctor prescribes for use in ...

A New Item Selection Procedure for Mixed Item Type in Computerized Classification Testing.

ERIC Educational Resources Information Center

Lau, C. Allen; Wang, Tianyou

This paper proposes a new Information-Time index as the basis for item selection in computerized classification testing (CCT) and investigates how this new item selection algorithm can help improve test efficiency for item pools with mixed item types. It also investigates how practical constraints such as item exposure rate control, test…

Relationship between Item Responses of Negative Affect Items and the Distribution of the Sum of the Item Scores in the General Population

PubMed Central

Kawasaki, Yohei; Ide, Kazuki; Akutagawa, Maiko; Yamada, Hiroshi; Furukawa, Toshiaki A.; Ono, Yutaka

2016-01-01

Background Several studies have shown that total depressive symptom scores in the general population approximate an exponential pattern, except for the lower end of the distribution. The Center for Epidemiologic Studies Depression Scale (CES-D) consists of 20 items, each of which may take on four scores: “rarely,” “some,” “occasionally,” and “most of the time.” Recently, we reported that the item responses for 16 negative affect items commonly exhibit exponential patterns, except for the level of “rarely,” leading us to hypothesize that the item responses at the level of “rarely” may be related to the non-exponential pattern typical of the lower end of the distribution. To verify this hypothesis, we investigated how the item responses contribute to the distribution of the sum of the item scores. Methods Data collected from 21,040 subjects who had completed the CES-D questionnaire as part of a Japanese national survey were analyzed. To assess the item responses of negative affect items, we used a parameter r, which denotes the ratio of “rarely” to “some” in each item response. The distributions of the sum of negative affect items in various combinations were analyzed using log-normal scales and curve fitting. Results The sum of the item scores approximated an exponential pattern regardless of the combination of items, whereas, at the lower end of the distributions, there was a clear divergence between the actual data and the predicted exponential pattern. At the lower end of the distributions, the sum of the item scores with high values of r exhibited higher scores compared to those predicted from the exponential pattern, whereas the sum of the item scores with low values of r exhibited lower scores compared to those predicted. Conclusions The distributional pattern of the sum of the item scores could be predicted from the item responses of such items. PMID:27806132

Measuring resilience after spinal cord injury: Development, validation and psychometric characteristics of the SCI-QOL Resilience item bank and short form

PubMed Central

Victorson, David; Tulsky, David S.; Kisala, Pamela A.; Kalpakjian, Claire Z.; Weiland, Brian; Choi, Seung W.

2015-01-01

Objective To describe the development and psychometric properties of the Spinal Cord Injury - Quality of Life (SCI-QOL) Resilience item bank and short form. Design Using a mixed-methods design, we developed and tested a resilience item bank through the use of focus groups with individuals with SCI and clinicians with expertise in SCI, cognitive interviews, and item-response theory based analytic approaches, including tests of model fit and differential item functioning (DIF). Setting We tested a 32-item pool at several medical institutions across the United States, including the University of Michigan, Kessler Foundation, the Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital and the James J. Peters/Bronx Department of Veterans Affairs medical center. Participants A total of 717 individuals with SCI completed the Resilience items. Results A unidimensional model was observed (CFI = 0.968; RMSEA = 0.074) and measurement precision was good (theta range between −3.1 and 0.9). Ten items were flagged for DIF, however, after examination of effect sizes we found this to be negligible with little practical impact on score estimates. The final calibrated item bank resulted in 21 retained items. Conclusion This study indicates that the SCI-QOL Resilience item bank represents a psychometrically robust measurement tool. Short form items are also suggested and computer adaptive tests are available. PMID:26010971

Consensus on Quality Indicators of Postgraduate Medical E-Learning: Delphi Study.

PubMed

de Leeuw, Robert Adrianus; Walsh, Kieran; Westerman, Michiel; Scheele, Fedde

2018-04-26

The progressive use of e-learning in postgraduate medical education calls for useful quality indicators. Many evaluation tools exist. However, these are diversely used and their empirical foundation is often lacking. We aimed to identify an empirically founded set of quality indicators to set the bar for “good enough” e-learning. We performed a Delphi procedure with a group of 13 international education experts and 10 experienced users of e-learning. The questionnaire started with 57 items. These items were the result of a previous literature review and focus group study performed with experts and users. Consensus was met when a rate of agreement of more than two-thirds was achieved. In the first round, the participants accepted 37 items of the 57 as important, reached no consensus on 20, and added 15 new items. In the second round, we added the comments from the first round to the items on which there was no consensus and added the 15 new items. After this round, a total of 72 items were addressed and, of these, 37 items were accepted and 34 were rejected due to lack of consensus. This study produced a list of 37 items that can form the basis of an evaluation tool to evaluate postgraduate medical e-learning. This is, to our knowledge, the first time that quality indicators for postgraduate medical e-learning have been defined and validated. The next step is to create and validate an e-learning evaluation tool from these items. ©Robert Adrianus de Leeuw, Kieran Walsh, Michiel Westerman, Fedde Scheele. Originally published in JMIR Medical Education (http://mededu.jmir.org), 26.04.2018.

The Consequences of Ignoring Item Parameter Drift in Longitudinal Item Response Models

ERIC Educational Resources Information Center

Lee, Wooyeol; Cho, Sun-Joo

2017-01-01

Utilizing a longitudinal item response model, this study investigated the effect of item parameter drift (IPD) on item parameters and person scores via a Monte Carlo study. Item parameter recovery was investigated for various IPD patterns in terms of bias and root mean-square error (RMSE), and percentage of time the 95% confidence interval covered…

Evaluating Item Fit for Multidimensional Item Response Models

ERIC Educational Resources Information Center

Zhang, Bo; Stone, Clement A.

2008-01-01

This research examines the utility of the s-x[superscript 2] statistic proposed by Orlando and Thissen (2000) in evaluating item fit for multidimensional item response models. Monte Carlo simulation was conducted to investigate both the Type I error and statistical power of this fit statistic in analyzing two kinds of multidimensional test…

Automatic Item Generation: A More Efficient Process for Developing Mathematics Achievement Items?

ERIC Educational Resources Information Center

Embretson, Susan E.; Kingston, Neal M.

2018-01-01

The continual supply of new items is crucial to maintaining quality for many tests. Automatic item generation (AIG) has the potential to rapidly increase the number of items that are available. However, the efficiency of AIG will be mitigated if the generated items must be submitted to traditional, time-consuming review processes. In two studies,…

Evaluation of item candidates for a diabetic retinopathy quality of life item bank.

PubMed

Fenwick, Eva K; Pesudovs, Konrad; Khadka, Jyoti; Rees, Gwyn; Wong, Tien Y; Lamoureux, Ecosse L

2013-09-01

We are developing an item bank assessing the impact of diabetic retinopathy (DR) on quality of life (QoL) using a rigorous multi-staged process combining qualitative and quantitative methods. We describe here the first two qualitative phases: content development and item evaluation. After a comprehensive literature review, items were generated from four sources: (1) 34 previously validated patient-reported outcome measures; (2) five published qualitative articles; (3) eight focus groups and 18 semi-structured interviews with 57 DR patients; and (4) seven semi-structured interviews with diabetes or ophthalmic experts. Items were then evaluated during 3 stages, namely binning (grouping) and winnowing (reduction) based on key criteria and panel consensus; development of item stems and response options; and pre-testing of items via cognitive interviews with patients. The content development phase yielded 1,165 unique items across 7 QoL domains. After 3 sessions of binning and winnowing, items were reduced to a minimally representative set (n = 312) across 9 domains of QoL: visual symptoms; ocular surface symptoms; activity limitation; mobility; emotional; health concerns; social; convenience; and economic. After 8 cognitive interviews, 42 items were amended resulting in a final set of 314 items. We have employed a systematic approach to develop items for a DR-specific QoL item bank. The psychometric properties of the nine QoL subscales will be assessed using Rasch analysis. The resulting validated item bank will allow clinicians and researchers to better understand the QoL impact of DR and DR therapies from the patient's perspective.

Solving the measurement invariance anchor item problem in item response theory.

PubMed

Meade, Adam W; Wright, Natalie A

2012-09-01

The efficacy of tests of differential item functioning (measurement invariance) has been well established. It is clear that when properly implemented, these tests can successfully identify differentially functioning (DF) items when they exist. However, an assumption of these analyses is that the metric for different groups is linked using anchor items that are invariant. In practice, however, it is impossible to be certain which items are DF and which are invariant. This problem of anchor items, or referent indicators, has long plagued invariance research, and a multitude of suggested approaches have been put forth. Unfortunately, the relative efficacy of these approaches has not been tested. This study compares 11 variations on 5 qualitatively different approaches from recent literature for selecting optimal anchor items. A large-scale simulation study indicates that for nearly all conditions, an easily implemented 2-stage procedure recently put forth by Lopez Rivas, Stark, and Chernyshenko (2009) provided optimal power while maintaining nominal Type I error. With this approach, appropriate anchor items can be easily and quickly located, resulting in more efficacious invariance tests. Recommendations for invariance testing are illustrated using a pedagogical example of employee responses to an organizational culture measure.

Development and validation of a short-form Pain Medication Attitudes Questionnaire (PMAQ-14).

PubMed

Elander, James; Said, Omimah; Maratos, Frances A; Dys, Ada; Collins, Hannah; Schofield, Malcolm B

2017-03-01

Attitudes to pain medication are important aspects of adjustment to chronic pain. They are measured by the 47-item Pain Medication Attitudes Questionnaire (PMAQ). To measure those attitudes more quickly and easily, we developed and evaluated a 14-item PMAQ using data from 3 separate surveys of people with pain in the general population. In survey 1, participants (n = 295) completed the 47-item PMAQ and measures of pain, analgesic use, analgesic dependence, and attitudes to self-medication. For each of the 7 PMAQ scales, the 2 items that best preserved the content of the full parent scales were identified using correlation and regression. The 2-item and full parent scales had very similar relationships with other measures, indicating that validity had been maintained. The resulting 14-item PMAQ was then completed by participants in survey 2 (n = 241) and survey 3 (n = 147), along with the same other measures as in survey 1. Confirmatory factor analysis showed that the 14-item PMAQ retained the 7-factor structure of the 47-item version, and correlations with other measures showed that it retained the validity of the 47-item version. The PMAQ scale Need was the most significant independent predictor of analgesic dependence in each of 4 separate multiple regression analyses. This short form of the PMAQ allows attitudes to pain medications to be measured in a valid and more efficient way.

The role of attention in item-item binding in visual working memory.

PubMed

Peterson, Dwight J; Naveh-Benjamin, Moshe

2017-09-01

An important yet unresolved question regarding visual working memory (VWM) relates to whether or not binding processes within VWM require additional attentional resources compared with processing solely the individual components comprising these bindings. Previous findings indicate that binding of surface features (e.g., colored shapes) within VWM is not demanding of resources beyond what is required for single features. However, it is possible that other types of binding, such as the binding of complex, distinct items (e.g., faces and scenes), in VWM may require additional resources. In 3 experiments, we examined VWM item-item binding performance under no load, articulatory suppression, and backward counting using a modified change detection task. Binding performance declined to a greater extent than single-item performance under higher compared with lower levels of concurrent load. The findings from each of these experiments indicate that processing item-item bindings within VWM requires a greater amount of attentional resources compared with single items. These findings also highlight an important distinction between the role of attention in item-item binding within VWM and previous studies of long-term memory (LTM) where declines in single-item and binding test performance are similar under divided attention. The current findings provide novel evidence that the specific type of binding is an important determining factor regarding whether or not VWM binding processes require attention. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Item Purification in Differential Item Functioning Using Generalized Linear Mixed Models

ERIC Educational Resources Information Center

Liu, Qian

2011-01-01

For this dissertation, four item purification procedures were implemented onto the generalized linear mixed model for differential item functioning (DIF) analysis, and the performance of these item purification procedures was investigated through a series of simulations. Among the four procedures, forward and generalized linear mixed model (GLMM)…

Repeated retrieval practice and item difficulty: does criterion learning eliminate item difficulty effects?

PubMed

Vaughn, Kalif E; Rawson, Katherine A; Pyc, Mary A

2013-12-01

A wealth of previous research has established that retrieval practice promotes memory, particularly when retrieval is successful. Although successful retrieval promotes memory, it remains unclear whether successful retrieval promotes memory equally well for items of varying difficulty. Will easy items still outperform difficult items on a final test if all items have been correctly recalled equal numbers of times during practice? In two experiments, normatively difficult and easy Lithuanian-English word pairs were learned via test-restudy practice until each item had been correctly recalled a preassigned number of times (from 1 to 11 correct recalls). Despite equating the numbers of successful recalls during practice, performance on a delayed final cued-recall test was lower for difficult than for easy items. Experiment 2 was designed to diagnose whether the disadvantage for difficult items was due to deficits in cue memory, target memory, and/or associative memory. The results revealed a disadvantage for the difficult versus the easy items only on the associative recognition test, with no differences on cue recognition, and even an advantage on target recognition. Although successful retrieval enhanced memory for both difficult and easy items, equating retrieval success during practice did not eliminate normative item difficulty differences.

Portal of medical data models: information infrastructure for medical research and healthcare.

PubMed

Dugas, Martin; Neuhaus, Philipp; Meidt, Alexandra; Doods, Justin; Storck, Michael; Bruland, Philipp; Varghese, Julian

2016-01-01

Information systems are a key success factor for medical research and healthcare. Currently, most of these systems apply heterogeneous and proprietary data models, which impede data exchange and integrated data analysis for scientific purposes. Due to the complexity of medical terminology, the overall number of medical data models is very high. At present, the vast majority of these models are not available to the scientific community. The objective of the Portal of Medical Data Models (MDM, https://medical-data-models.org) is to foster sharing of medical data models. MDM is a registered European information infrastructure. It provides a multilingual platform for exchange and discussion of data models in medicine, both for medical research and healthcare. The system is developed in collaboration with the University Library of Münster to ensure sustainability. A web front-end enables users to search, view, download and discuss data models. Eleven different export formats are available (ODM, PDF, CDA, CSV, MACRO-XML, REDCap, SQL, SPSS, ADL, R, XLSX). MDM contents were analysed with descriptive statistics. MDM contains 4387 current versions of data models (in total 10,963 versions). 2475 of these models belong to oncology trials. The most common keyword (n = 3826) is 'Clinical Trial'; most frequent diseases are breast cancer, leukemia, lung and colorectal neoplasms. Most common languages of data elements are English (n = 328,557) and German (n = 68,738). Semantic annotations (UMLS codes) are available for 108,412 data items, 2453 item groups and 35,361 code list items. Overall 335,087 UMLS codes are assigned with 21,847 unique codes. Few UMLS codes are used several thousand times, but there is a long tail of rarely used codes in the frequency distribution. Expected benefits of the MDM portal are improved and accelerated design of medical data models by sharing best practice, more standardised data models with semantic annotation and better information

[News items about clinical errors and safety perceptions in hospital patients].

PubMed

Mira, José Joaquín; Guilabert, Mercedes; Ortíz, Lidia; Navarro, Isabel María; Pérez-Jover, María Virtudes; Aranaz, Jesús María

2010-01-01

To analyze how news items about clinical errors are treated by the press in Spain and their influence on patients. We performed a quantitative and qualitative study. Firstly, news items published between April and November 2007 in six newspapers were analyzed. Secondly, 829 patients from five hospitals in four autonomous regions were surveyed. We analyzed 90 cases generating 128 news items, representing a mean of 16 items per month. In 91 news items (71.1%) the source was checked. In 78 items (60.9%) the author could be identified. The impact of these news items was -4.86 points (95% confidence interval [95%CI]: -4.15-5.57). In 59 cases (57%) the error was attributed to the system, in 27 (21.3%) to health professionals, and in 41 (32.3%) to both. Neither the number of columns (p=0.702), nor the inclusion of a sub-header (p=0.195), nor a complementary image (p=0.9) were found to be related to the effect of the error on safety perceptions. Of the 829 patients, 515 (62.1%; 95%CI: 58.8-65.4%) claimed to have recently seen or heard news about clinical errors in the press, on the radio or on television. The perception of safety decreased when the same person was worried about being the victim of a clinical error and had seen a recent news item about such adverse events (chi(2)=15.17; p=0.001). Every week news items about clinical errors are published or broadcast. The way in which newspapers report legal claims over alleged medical errors is similar to the way they report judicial sentences for negligence causing irreparable damage or harm. News about errors generates insecurity in patients. It is advisable to create interfaces between journalists and health professionals. Copyright 2009 SESPAS. Published by Elsevier Espana. All rights reserved.

Interactions Between Item Content And Group Membership on Achievement Test Items.

ERIC Educational Resources Information Center

Linn, Robert L.; Harnisch, Delwyn L.

The purpose of this investigation was to examine the interaction of item content and group membership on achievement test items. Estimates of the parameters of the three parameter logistic model were obtained on the 46 item math test for the sample of eighth grade students (N = 2055) participating in the Illinois Inventory of Educational Progress,…

Item difficulty and item validity for the Children's Group Embedded Figures Test.

PubMed

Rusch, R R; Trigg, C L; Brogan, R; Petriquin, S

1994-02-01

The validity and reliability of the Children's Group Embedded Figures Test was reported for students in Grade 2 by Cromack and Stone in 1980; however, a search of the literature indicates no evidence for internal consistency or item analysis. Hence the purpose of this study was to examine the item difficulty and item validity of the test with children in Grades 1 and 2. Confusion in the literature over development and use of this test was seemingly resolved through analysis of these descriptions and through an interview with the test developer. One early-appearing item was unreasonably difficult. Two or three other items were quite difficult and made little contribution to the total score. Caution is recommended, however, in any reordering or elimination of items based on these findings, given the limited number of subjects (n = 84).

Are Fourth-Year Medical Students Effective Teachers of the Physical Examination to First-Year Medical Students?

PubMed Central

Haist, Steven A; Wilson, John F; Fosson, Sue E; Brigham, Nancy L

1997-01-01

OBJECTIVE To determine if fourth-year medical students are as effective as faculty in teaching the physical examination to first-year medical students. DESIGN Stratified randomization of the first-year students. SETTING A public medical school. PARTICIPANTS All 100 first-year medical students in one medical school class were randomly assigned (controlling for gender) to either a faculty or a fourth-year student preceptor for the Physical Examination Module. MAIN RESULTS The first-year students of faculty preceptors scored no differently on the written examination than the students of the fourth-year medical student preceptors (82.8% vs 80.3%, p = .09) and no differently on a standardized patient practical examination (95.5% vs 95.4%, p = .92). Also, the first-year students rated the two groups of preceptors similarly on an evaluation form, with faculty rated higher on six items and the student preceptors rated higher on six items (all p > .10). The fourth-year student preceptors rated the experience favorably. CONCLUSIONS Fourth-year medical students were as successful as faculty in teaching first-year medical students the physical examination as measured by first-year student’s performances on objective measures and ratings of teaching effectiveness.

A Study of the Homogeneity of Items Produced From Item Forms Across Different Taxonomic Levels.

ERIC Educational Resources Information Center

Weber, Margaret B.; Argo, Jana K.

This study determined whether item forms ( rules for constructing items related to a domain or set of tasks) would enable naive item writers to generate multiple-choice items at three taxonomic levels--knowledge, comprehension, and application. Students wrote 120 multiple-choice items from 20 item forms, corresponding to educational objectives…

Construct validity and reliability of the Single Checking Administration of Medications Scale.

PubMed

O'Connell, Beverly; Hawkins, Mary; Ockerby, Cherene

2013-06-01

Research indicates that single checking of medications is as safe as double checking; however, many nurses are averse to independently checking medications. To assist with the introduction and use of single checking, a measure of nurses' attitudes, the thirteen-item Single Checking Administration of Medications Scale (SCAMS) was developed. We examined the psychometric properties of the SCAMS. Secondary analyses were conducted on data collected from 503 nurses across a large Australian health-care service. Analyses using exploratory and confirmatory factor analyses supported by structural equation modelling resulted in a valid twelve-item SCAMS containing two reliable subscales, the nine-item Attitudes towards single checking and three-item Advantages of single checking subscales. The SCAMS is recommended as a valid and reliable measure for monitoring nurses' attitudes to single checking prior to introducing single checking medications and after its implementation. © 2013 Wiley Publishing Asia Pty Ltd.

Differential Item Functioning Analysis Using Rasch Item Information Functions

ERIC Educational Resources Information Center

Wyse, Adam E.; Mapuranga, Raymond

2009-01-01

Differential item functioning (DIF) analysis is a statistical technique used for ensuring the equity and fairness of educational assessments. This study formulates a new DIF analysis method using the information similarity index (ISI). ISI compares item information functions when data fits the Rasch model. Through simulations and an international…

Development and preliminary psychometric properties of a well-being index for medical students.

PubMed

Dyrbye, Liselotte N; Szydlo, Daniel W; Downing, Steven M; Sloan, Jeff A; Shanafelt, Tait D

2010-01-27

Psychological distress is common among medical students but manifests in a variety of forms. Currently, no brief, practical tool exists to simultaneously evaluate these domains of distress among medical students. The authors describe the development of a subject-reported assessment (Medical Student Well-Being Index, MSWBI) intended to screen for medical student distress across a variety of domains and examine its preliminary psychometric properties. Relevant domains of distress were identified, items generated, and a screening instrument formed using a process of literature review, nominal group technique, input from deans and medical students, and correlation analysis from previously administered assessments. Eleven experts judged the clarity, relevance, and representativeness of the items. A Content Validity Index (CVI) was calculated. Interrater agreement was assessed using pair-wise percent agreement adjusted for chance agreement. Data from 2248 medical students who completed the MSWBI along with validated full-length instruments assessing domains of interest was used to calculate reliability and explore internal structure validity. Burnout (emotional exhaustion and depersonalization), depression, mental quality of life (QOL), physical QOL, stress, and fatigue were domains identified for inclusion in the MSWBI. Six of 7 items received item CVI-relevance and CVI-representativeness of >or=0.82. Overall scale CVI-relevance and CVI-representativeness was 0.94 and 0.91. Overall pair-wise percent agreement between raters was >or=85% for clarity, relevance, and representativeness. Cronbach's alpha was 0.68. Item by item percent pair-wise agreements and Phi were low, suggesting little overlap between items. The majority of MSWBI items had a >or=74% sensitivity and specificity for detecting distress within the intended domain. The results of this study provide evidence of reliability and content-related validity of the MSWBI. Further research is needed to assess

Development and preliminary psychometric properties of a well-being index for medical students

PubMed Central

2010-01-01

Background Psychological distress is common among medical students but manifests in a variety of forms. Currently, no brief, practical tool exists to simultaneously evaluate these domains of distress among medical students. The authors describe the development of a subject-reported assessment (Medical Student Well-Being Index, MSWBI) intended to screen for medical student distress across a variety of domains and examine its preliminary psychometric properties. Methods Relevant domains of distress were identified, items generated, and a screening instrument formed using a process of literature review, nominal group technique, input from deans and medical students, and correlation analysis from previously administered assessments. Eleven experts judged the clarity, relevance, and representativeness of the items. A Content Validity Index (CVI) was calculated. Interrater agreement was assessed using pair-wise percent agreement adjusted for chance agreement. Data from 2248 medical students who completed the MSWBI along with validated full-length instruments assessing domains of interest was used to calculate reliability and explore internal structure validity. Results Burnout (emotional exhaustion and depersonalization), depression, mental quality of life (QOL), physical QOL, stress, and fatigue were domains identified for inclusion in the MSWBI. Six of 7 items received item CVI-relevance and CVI-representativeness of ≥0.82. Overall scale CVI-relevance and CVI-representativeness was 0.94 and 0.91. Overall pair-wise percent agreement between raters was ≥85% for clarity, relevance, and representativeness. Cronbach's alpha was 0.68. Item by item percent pair-wise agreements and Phi were low, suggesting little overlap between items. The majority of MSWBI items had a ≥74% sensitivity and specificity for detecting distress within the intended domain. Conclusions The results of this study provide evidence of reliability and content-related validity of the MSWBI. Further

A Psychometric Evaluation of the Learning Styles Questionnaire: 40-Item Version

ERIC Educational Resources Information Center

Klein, Britt; McCall, Louise; Austin, David; Piterman, Leon

2007-01-01

Sixty-six English-speaking postgraduate distance-education medical students completed the Learning Styles Questionnaire (LSQ: 40-item version). This was completed while attending a residential workshop at the beginning of the semester, and 44 of these students completed the same LSQ questionnaire 5 months later at the completion of the semester.…

Assessing the Utility of Item Response Theory Models: Differential Item Functioning.

ERIC Educational Resources Information Center

Scheuneman, Janice Dowd

The current status of item response theory (IRT) is discussed. Several IRT methods exist for assessing whether an item is biased. Focus is on methods proposed by L. M. Rudner (1975), F. M. Lord (1977), D. Thissen et al. (1988) and R. L. Linn and D. Harnisch (1981). Rudner suggested a measure of the area lying between the two item characteristic…

Why do persons with bipolar disorder stop their medication?

PubMed

Devulapalli, Kavi K; Ignacio, Rosalinda V; Weiden, Peter; Cassidy, Kristin A; Williams, Tiffany D; Safavi, Roknedin; Blow, Frederic C; Sajatovic, Martha

2010-01-01

Non-adherence to maintenance medication regimens is a major problem, limiting outcomes for many persons with bipolar disorder. The aim of this paper is to determine the most relevant aspects of adherence attitudes in a sample of bipolar patients selected for problems with adherence behavior. Among a larger sample of bipolar disorder patients participating in a prospective follow-up study (N = 140), a subsample of patients were selected for non-adherent behavior defined as missing ≥ 30% of medication during the past month (n = 27; 19.3%). Adherence attitudes were assessed with the Rating of Medication Influences scale (ROMI), a self-reported attitudinal measure assessing reasons for and against adherence. Multiple logistic regression models for non-adherence vs. adherence were estimated with each of the 19 ROMI items in the model, while controlling for sex, age, ethnicity, education, duration of illness, and substance abuse. Mean score of ROMI items corresponding to reasons for treatment adherence was greater among adherent participants, whereas the mean score of ROMI items corresponding to reasons for treatment non-adherence was greater among nonadherent participants. The ROMI item identifying that the individual believes that medications are unnecessary had the strongest influence for non-adherence (p < 0.0001). This was followed by ROMI items corresponding to no perceived daily benefit (p = 0.0008), perceived change in appearance (p = 0.0057), and perceived interference with life goals (p = 0.0033). The ROMI item identifying fear of relapse was the strongest predictor for adherence (p = 0.0017). Non-adherent patients with bipolar disorder differ from adherent patients with bipolar disorder on reasons for adherence and non-adherence. Utilization of tools that evaluate medication treatment attitudes, such as the ROMI or similar measures, may assist clinicians in the selection of interventions that are most likely to modify future treatment adherence.

Effect of Clinically Discriminating, Evidence-Based Checklist Items on the Reliability of Scores from an Internal Medicine Residency OSCE

ERIC Educational Resources Information Center

Daniels, Vijay J.; Bordage, Georges; Gierl, Mark J.; Yudkowsky, Rachel

2014-01-01

Objective structured clinical examinations (OSCEs) are used worldwide for summative examinations but often lack acceptable reliability. Research has shown that reliability of scores increases if OSCE checklists for medical students include only clinically relevant items. Also, checklists are often missing evidence-based items that high-achieving…

Differential item functioning magnitude and impact measures from item response theory models.

PubMed

Kleinman, Marjorie; Teresi, Jeanne A

2016-01-01

Measures of magnitude and impact of differential item functioning (DIF) at the item and scale level, respectively are presented and reviewed in this paper. Most measures are based on item response theory models. Magnitude refers to item level effect sizes, whereas impact refers to differences between groups at the scale score level. Reviewed are magnitude measures based on group differences in the expected item scores and impact measures based on differences in the expected scale scores. The similarities among these indices are demonstrated. Various software packages are described that provide magnitude and impact measures, and new software presented that computes all of the available statistics conveniently in one program with explanations of their relationships to one another.

Comparing Tolerance of Ambiguity in Veterinary and Medical Students.

PubMed

Hancock, Jason; Hammond, Jennifer A; Roberts, Martin; Mattick, Karen

Current guidelines suggest that educators in both medical and veterinary professions should do more to ensure that students can tolerate ambiguity. Designing curricula to achieve this requires the ability to measure and understand differences in ambiguity tolerance among and within professional groups. Although scales have been developed to measure tolerance of ambiguity in both medical and veterinary professions, no comparative studies have been reported. We compared the tolerance of ambiguity of medical and veterinary students, hypothesizing that veterinary students would have higher tolerance of ambiguity, given the greater patient diversity and less well-established evidence base underpinning practice. We conducted a secondary analysis of questionnaire data from first- to fourth-year medical and veterinary students. Tolerance of ambiguity scores were calculated and compared using the TAMSAD scale (29 items validated for the medical student population), the TAVS scale (27 items validated for the veterinary student population), and a scale comprising the 22 items common to both scales. Using the TAMSAD and TAVS scales, medical students had a significantly higher mean tolerance of ambiguity score than veterinary students (56.1 vs. 54.1, p<.001 and 60.4 vs. 58.5, p=.002, respectively) but no difference was seen when only the 22 shared items were compared (56.1 vs. 57.2, p=.513). The results do not support our hypothesis and highlight that different findings can result when different tools are used. Medical students may have slightly higher tolerance of ambiguity than veterinary students, although this depends on the scale used.

Item Analyses of Memory Differences

PubMed Central

Salthouse, Timothy A.

2017-01-01

Objective Although performance on memory and other cognitive tests is usually assessed with a score aggregated across multiple items, potentially valuable information is also available at the level of individual items. Method The current study illustrates how analyses of variance with item as one of the factors, and memorability analyses in which item accuracy in one group is plotted as a function of item accuracy in another group, can provide a more detailed characterization of the nature of group differences in memory. Data are reported for two memory tasks, word recall and story memory, across age, ability, repetition, delay, and longitudinal contrasts. Results The item-level analyses revealed evidence for largely uniform differences across items in the age, ability, and longitudinal contrasts, but differential patterns across items in the repetition contrast, and unsystematic item relations in the delay contrast. Conclusion Analyses at the level of individual items have the potential to indicate the manner by which group differences in the aggregate test score are achieved. PMID:27618285

Designing P-Optimal Item Pools in Computerized Adaptive Tests with Polytomous Items

ERIC Educational Resources Information Center

Zhou, Xuechun

2012-01-01

Current CAT applications consist of predominantly dichotomous items, and CATs with polytomously scored items are limited. To ascertain the best approach to polytomous CAT, a significant amount of research has been conducted on item selection, ability estimation, and impact of termination rules based on polytomous IRT models. Few studies…

Communication training for advanced medical students improves information recall of medical laypersons in simulated informed consent talks--a randomized controlled trial.

PubMed

Werner, Anne; Holderried, Friederike; Schäffeler, Norbert; Weyrich, Peter; Riessen, Reimer; Zipfel, Stephan; Celebi, Nora

2013-02-01

Informed consent talks are mandatory before invasive interventions. However, the patients' information recall has been shown to be rather poor. We investigated, whether medical laypersons recalled more information items from a simulated informed consent talk after advanced medical students participated in a communication training aiming to reduce a layperson's cognitive load. Using a randomized, controlled, prospective cross-over-design, 30 5th and 6th year medical students were randomized into two groups. One group received communication training, followed by a comparison intervention (early intervention group, EI); the other group first received the comparison intervention and then communication training (late intervention group, LI). Before and after the interventions, the 30 medical students performed simulated informed consent talks with 30 blinded medical laypersons using a standardized set of information. We then recorded the number of information items the medical laypersons recalled. After the communication training both groups of medical laypersons recalled significantly more information items (EI: 41 ± 9% vs. 23 ± 9%, p < .0001, LI 49 ± 10% vs. 35 ± 6%, p < .0001). After the comparison intervention the improvement was modest and significant only in the LI (EI: 42 ± 9% vs. 40 ± 9%, p = .41, LI 35 ± 6% vs. 29 ± 9%, p = .016). Short communication training for advanced medical students improves information recall of medical laypersons in simulated informed consent talks.

Consensus on Quality Indicators of Postgraduate Medical E-Learning: Delphi Study

PubMed Central

Walsh, Kieran; Westerman, Michiel; Scheele, Fedde

2018-01-01

Background The progressive use of e-learning in postgraduate medical education calls for useful quality indicators. Many evaluation tools exist. However, these are diversely used and their empirical foundation is often lacking. Objective We aimed to identify an empirically founded set of quality indicators to set the bar for “good enough” e-learning. Methods We performed a Delphi procedure with a group of 13 international education experts and 10 experienced users of e-learning. The questionnaire started with 57 items. These items were the result of a previous literature review and focus group study performed with experts and users. Consensus was met when a rate of agreement of more than two-thirds was achieved. Results In the first round, the participants accepted 37 items of the 57 as important, reached no consensus on 20, and added 15 new items. In the second round, we added the comments from the first round to the items on which there was no consensus and added the 15 new items. After this round, a total of 72 items were addressed and, of these, 37 items were accepted and 34 were rejected due to lack of consensus. Conclusions This study produced a list of 37 items that can form the basis of an evaluation tool to evaluate postgraduate medical e-learning. This is, to our knowledge, the first time that quality indicators for postgraduate medical e-learning have been defined and validated. The next step is to create and validate an e-learning evaluation tool from these items. PMID:29699970

Librarian participation in expanding the pool of potential medical students.

PubMed

Guerrieri, Rose

2012-01-01

This article reports on the results of an exploratory survey to determine if librarians actively participate in medical school student recruiting programs. It looks specifically at what librarians are doing to assist with recruitment and what biomedical career resources their libraries offer. The survey link was e-mailed to all U.S. medical school library directors, who were asked to forward it to the appropriate librarian. Out of 113 medical schools, 68 (60%) responded to most questions. Forty-three (86%) of 50 item respondents do participate in such activities, and 29 (67%) of 43 item respondents have been doing so for more than five years. Thirty-two (64%) of 50 item respondents provide resources on biomedical careers in the libraries. Copyright © Taylor & Francis Group, LLC

Evolution of a Test Item

ERIC Educational Resources Information Center

Spaan, Mary

2007-01-01

This article follows the development of test items (see "Language Assessment Quarterly", Volume 3 Issue 1, pp. 71-79 for the article "Test and Item Specifications Development"), beginning with a review of test and item specifications, then proceeding to writing and editing of items, pretesting and analysis, and finally selection of an item for a…

Item Banking. ERIC/AE Digest.

ERIC Educational Resources Information Center

Rudner, Lawrence

This digest discusses the advantages and disadvantages of using item banks, and it provides useful information for those who are considering implementing an item banking project in their school districts. The primary advantage of item banking is in test development. Using an item response theory method, such as the Rasch model, items from multiple…

Effects of spacing of item repetitions in continuous recognition memory: does item retrieval difficulty promote item retention in older adults?

PubMed

Kılıç, Aslı; Hoyer, William J; Howard, Marc W

2013-01-01

BACKGROUND/STUDY CONTEXT: Older adults exhibit an age-related deficit in item memory as a function of the length of the retention interval, but older adults and young adults usually show roughly equivalent benefits due to the spacing of item repetitions in continuous memory tasks. The current experiment investigates the seemingly paradoxical effects of retention interval and spacing in young and older adults using a continuous recognition memory procedure. Fifty young adults and 52 older adults gave memory confidence ratings to words that were presented once (P1), twice (P2), or three times (P3), and the effects of the lag length and retention interval were assessed at P2 and at P3, respectively. Response times at P2 were disproportionately longer for older adults than for younger adults as a function of the number of items occurring between P1 and P2, suggestive of age-related loss in item memory. Ratings of confidence in memory responses revealed that older adults remembered fewer items at P2 with a high degree of certainty. Confidence ratings given at P3 suggested that young and older adults derived equivalent benefits from the spacing between P1 and P2. Findings of this study support theoretical accounts that suggest that recursive reminding and/or item retrieval difficulty promote item retention in older adults.

42 CFR 424.57 - Special payment rules for items furnished by DMEPOS suppliers and issuance of DMEPOS supplier...

Code of Federal Regulations, 2014 CFR

2014-10-01

... effort, and arterial oxygen saturation furnished in a sleep laboratory facility in which a technologist... inspiration and expiration. DMEPOS stands for durable medical equipment, prosthetics, orthotics and supplies... items means medical equipment and supplies as defined in section 1834(j)(5) of the Act. National...

42 CFR 424.57 - Special payment rules for items furnished by DMEPOS suppliers and issuance of DMEPOS supplier...

Code of Federal Regulations, 2012 CFR

2012-10-01

... effort, and arterial oxygen saturation furnished in a sleep laboratory facility in which a technologist... inspiration and expiration. DMEPOS stands for durable medical equipment, prosthetics, orthotics and supplies... items means medical equipment and supplies as defined in section 1834(j)(5) of the Act. National...

42 CFR 424.57 - Special payment rules for items furnished by DMEPOS suppliers and issuance of DMEPOS supplier...

Code of Federal Regulations, 2013 CFR

2013-10-01

... effort, and arterial oxygen saturation furnished in a sleep laboratory facility in which a technologist... inspiration and expiration. DMEPOS stands for durable medical equipment, prosthetics, orthotics and supplies... items means medical equipment and supplies as defined in section 1834(j)(5) of the Act. National...

A Procedure to Detect Item Bias Present Simultaneously in Several Items

DTIC Science & Technology

1991-04-25

exhibit a coherent and major biasing influence at the test level. In partic- ular, this can be true even if each individual item displays only a minor...response functions (IRFs) without the use of item parameter estimation algorithms when the sample size is too small for their use. Thissen, Steinberg...convention). A random sample of examinees is drawn from each group, and a test of N items is administered to them. Typically it is suspected that a

Developing an Interpretation of Item Parameters for Personality Items: Content Correlates of Parameter Estimates.

ERIC Educational Resources Information Center

Zickar, Michael J.; Ury, Karen L.

2002-01-01

Attempted to relate content features of personality items to item parameter estimates from the partial credit model of E. Muraki (1990) by administering the Adjective Checklist (L. Goldberg, 1992) to 329 undergraduates. As predicted, the discrimination parameter was related to the item subtlety ratings of personality items but the level of word…

Expertise sensitive item selection.

PubMed

Chow, P; Russell, H; Traub, R E

2000-12-01

In this paper we describe and illustrate a procedure for selecting items from a large pool for a certification test. The proposed procedure, which is intended to improve the alignment of the certification test with on-the-job performance, is based on an expertise sensitive index. This index for an item is the difference between the item's p values for experts and novices. An example is provided of the application of the index for selecting items to be used in certifying bakers.

Instructional Topics in Educational Measurement (ITEMS) Module: Using Automated Processes to Generate Test Items

ERIC Educational Resources Information Center

Gierl, Mark J.; Lai, Hollis

2013-01-01

Changes to the design and development of our educational assessments are resulting in the unprecedented demand for a large and continuous supply of content-specific test items. One way to address this growing demand is with automatic item generation (AIG). AIG is the process of using item models to generate test items with the aid of computer…

A 67-Item Stress Resilience item bank showing high content validity was developed in a psychosomatic sample.

PubMed

Obbarius, Nina; Fischer, Felix; Obbarius, Alexander; Nolte, Sandra; Liegl, Gregor; Rose, Matthias

2018-04-10

To develop the first item bank to measure Stress Resilience (SR) in clinical populations. Qualitative item development resulted in an initial pool of 131 items covering a broad theoretical SR concept. These items were tested in n=521 patients at a psychosomatic outpatient clinic. Exploratory and Confirmatory Factor Analysis (CFA), as well as other state-of-the-art item analyses and IRT were used for item evaluation and calibration of the final item bank. Out of the initial item pool of 131 items, we excluded 64 items (54 factor loading <.5, 4 residual correlations >.3, 2 non-discriminative Item Response Curves, 4 Differential Item Functioning). The final set of 67 items indicated sufficient model fit in CFA and IRT analyses. Additionally, a 10-item short form with high measurement precision (SE≤.32 in a theta range between -1.8 and +1.5) was derived. Both the SR item bank and the SR short form were highly correlated with an existing static legacy tool (Connor-Davidson Resilience Scale). The final SR item bank and 10-item short form showed good psychometric properties. When further validated, they will be ready to be used within a framework of Computer-Adaptive Tests for a comprehensive assessment of the Stress-Construct. Copyright © 2018. Published by Elsevier Inc.

42 CFR 424.57 - Special payment rules for items furnished by DMEPOS suppliers and issuance of DMEPOS supplier...

Code of Federal Regulations, 2011 CFR

2011-10-01

... effort, and arterial oxygen saturation furnished in a sleep laboratory facility in which a technologist... care products or services or both. DMEPOS stands for durable medical equipment, prosthetics, orthotics... categories. Medicare covered items means medical equipment and supplies as defined in section 1834(j)(5) of...

Designing an evaluation framework for WFME basic standards for medical education.

PubMed

Tackett, Sean; Grant, Janet; Mmari, Kristin

2016-01-01

To create an evaluation plan for the World Federation for Medical Education (WFME) accreditation standards for basic medical education. We conceptualized the 100 basic standards from "Basic Medical Education: WFME Global Standards for Quality Improvement: The 2012 Revision" as medical education program objectives. Standards were simplified into evaluable items, which were then categorized as inputs, processes, outputs and/or outcomes to generate a logic model and corresponding plan for data collection. WFME standards posed significant challenges to evaluation due to complex wording, inconsistent formatting and lack of existing assessment tools. Our resulting logic model contained 244 items. Standard B 5.1.1 separated into 24 items, the most for any single standard. A large proportion of items (40%) required evaluation of more than one input, process, output and/or outcome. Only one standard (B 3.2.2) was interpreted as requiring evaluation of a program outcome. Current WFME standards are difficult to use for evaluation planning. Our analysis may guide adaptation and revision of standards to make them more evaluable. Our logic model and data collection plan may be useful to medical schools planning an institutional self-review and to accrediting authorities wanting to provide guidance to schools under their purview.

The five item Barthel index

PubMed Central

Hobart, J; Thompson, A

2001-01-01

OBJECTIVES—Routine data collection is now considered mandatory. Therefore, staff rated clinical scales that consist of multiple items should have the minimum number of items necessary for rigorous measurement. This study explores the possibility of developing a short form Barthel index, suitable for use in clinical trials, epidemiological studies, and audit, that satisfies criteria for rigorous measurement and is psychometrically equivalent to the 10 item instrument.
METHODS—Data were analysed from 844 consecutive admissions to a neurological rehabilitation unit in London. Random half samples were generated. Short forms were developed in one sample (n=419), by selecting items with the best measurement properties, and tested in the other (n=418). For each of the 10 items of the BI, item total correlations and effect sizes were computed and rank ordered. The best items were defined as those with the lowest cross product of these rank orderings. The acceptability, reliability, validity, and responsiveness of three short form BIs (five, four, and three item) were determined and compared with the 10 item BI. Agreement between scores generated by short forms and 10 item BI was determined using intraclass correlation coefficients and the method of Bland and Altman.
RESULTS—The five best items in this sample were transfers, bathing, toilet use, stairs, and mobility. Of the three short forms examined, the five item BI had the best measurement properties and was psychometrically equivalent to the 10 item BI. Agreement between scores generated by the two measures for individual patients was excellent (ICC=0.90) but not identical (limits of agreement=1.84±3.84).
CONCLUSIONS—The five item short form BI may be a suitable outcome measure for group comparison studies in comparable samples. Further evaluations are needed. Results demonstrate a fundamental difference between assessment and measurement and the importance of incorporating psychometric methods in the

Computerized Adaptive Test (CAT) Applications and Item Response Theory Models for Polytomous Items

ERIC Educational Resources Information Center

Aybek, Eren Can; Demirtasli, R. Nukhet

2017-01-01

This article aims to provide a theoretical framework for computerized adaptive tests (CAT) and item response theory models for polytomous items. Besides that, it aims to introduce the simulation and live CAT software to the related researchers. Computerized adaptive test algorithm, assumptions of item response theory models, nominal response…

Item development process and analysis of 50 case-based items for implementation on the Korean Nursing Licensing Examination.

PubMed

Park, In Sook; Suh, Yeon Ok; Park, Hae Sook; Kang, So Young; Kim, Kwang Sung; Kim, Gyung Hee; Choi, Yeon-Hee; Kim, Hyun-Ju

2017-01-01

The purpose of this study was to improve the quality of items on the Korean Nursing Licensing Examination by developing and evaluating case-based items that reflect integrated nursing knowledge. We conducted a cross-sectional observational study to develop new case-based items. The methods for developing test items included expert workshops, brainstorming, and verification of content validity. After a mock examination of undergraduate nursing students using the newly developed case-based items, we evaluated the appropriateness of the items through classical test theory and item response theory. A total of 50 case-based items were developed for the mock examination, and content validity was evaluated. The question items integrated 34 discrete elements of integrated nursing knowledge. The mock examination was taken by 741 baccalaureate students in their fourth year of study at 13 universities. Their average score on the mock examination was 57.4, and the examination showed a reliability of 0.40. According to classical test theory, the average level of item difficulty of the items was 57.4% (80%-100% for 12 items; 60%-80% for 13 items; and less than 60% for 25 items). The mean discrimination index was 0.19, and was above 0.30 for 11 items and 0.20 to 0.29 for 15 items. According to item response theory, the item discrimination parameter (in the logistic model) was none for 10 items (0.00), very low for 20 items (0.01 to 0.34), low for 12 items (0.35 to 0.64), moderate for 6 items (0.65 to 1.34), high for 1 item (1.35 to 1.69), and very high for 1 item (above 1.70). The item difficulty was very easy for 24 items (below -2.0), easy for 8 items (-2.0 to -0.5), medium for 6 items (-0.5 to 0.5), hard for 3 items (0.5 to 2.0), and very hard for 9 items (2.0 or above). The goodness-of-fit test in terms of the 2-parameter item response model between the range of 2.0 to 0.5 revealed that 12 items had an ideal correct answer rate. We surmised that the low reliability of the

Selecting Items for Criterion-Referenced Tests.

ERIC Educational Resources Information Center

Mellenbergh, Gideon J.; van der Linden, Wim J.

1982-01-01

Three item selection methods for criterion-referenced tests are examined: the classical theory of item difficulty and item-test correlation; the latent trait theory of item characteristic curves; and a decision-theoretic approach for optimal item selection. Item contribution to the standardized expected utility of mastery testing is discussed. (CM)

Geriatric Anxiety Scale: item response theory analysis, differential item functioning, and creation of a ten-item short form (GAS-10).

PubMed

Mueller, Anne E; Segal, Daniel L; Gavett, Brandon; Marty, Meghan A; Yochim, Brian; June, Andrea; Coolidge, Frederick L

2015-07-01

The Geriatric Anxiety Scale (GAS; Segal et al. (Segal, D. L., June, A., Payne, M., Coolidge, F. L. and Yochim, B. (2010). Journal of Anxiety Disorders, 24, 709-714. doi:10.1016/j.janxdis.2010.05.002) is a self-report measure of anxiety that was designed to address unique issues associated with anxiety assessment in older adults. This study is the first to use item response theory (IRT) to examine the psychometric properties of a measure of anxiety in older adults. A large sample of older adults (n = 581; mean age = 72.32 years, SD = 7.64 years, range = 60 to 96 years; 64% women; 88% European American) completed the GAS. IRT properties were examined. The presence of differential item functioning (DIF) or measurement bias by age and sex was assessed, and a ten-item short form of the GAS (called the GAS-10) was created. All GAS items had discrimination parameters of 1.07 or greater. Items from the somatic subscale tended to have lower discrimination parameters than items on the cognitive or affective subscales. Two items were flagged for DIF, but the impact of the DIF was negligible. Women scored significantly higher than men on the GAS and its subscales. Participants in the young-old group (60 to 79 years old) scored significantly higher on the cognitive subscale than participants in the old-old group (80 years old and older). Results from the IRT analyses indicated that the GAS and GAS-10 have strong psychometric properties among older adults. We conclude by discussing implications and future research directions.

Asymptotic Standard Errors for Item Response Theory True Score Equating of Polytomous Items

ERIC Educational Resources Information Center

Cher Wong, Cheow

2015-01-01

Building on previous works by Lord and Ogasawara for dichotomous items, this article proposes an approach to derive the asymptotic standard errors of item response theory true score equating involving polytomous items, for equivalent and nonequivalent groups of examinees. This analytical approach could be used in place of empirical methods like…

MIMIC Methods for Assessing Differential Item Functioning in Polytomous Items

ERIC Educational Resources Information Center

Wang, Wen-Chung; Shih, Ching-Lin

2010-01-01

Three multiple indicators-multiple causes (MIMIC) methods, namely, the standard MIMIC method (M-ST), the MIMIC method with scale purification (M-SP), and the MIMIC method with a pure anchor (M-PA), were developed to assess differential item functioning (DIF) in polytomous items. In a series of simulations, it appeared that all three methods…

ESPACOMP Medication Adherence Reporting Guidelines (EMERGE): a reactive-Delphi study protocol.

PubMed

Helmy, R; Zullig, L L; Dunbar-Jacob, J; Hughes, D A; Vrijens, B; Wilson, I B; De Geest, S

2017-02-10

Medication adherence is fundamental to achieving optimal patient outcomes. Reporting research on medication adherence suffers from some issues-including conceptualisation, measurement and data analysis-that thwart its advancement. Using the ABC taxonomy for medication adherence as the conceptual basis, a steering committee of members of the European Society for Patient Adherence, COMpliance, and Persistence (ESPACOMP) launched an initiative to develop ESPACOMP Medication Adherence Reporting Guidelines (EMERGE). This paper is a protocol for a Delphi study that aims to build consensus among a group of topic experts regarding an item list that will support developing EMERGE. This study uses a reactive-Delphi design where a group of topic experts will be asked to rate the relevance and clarity of an initial list of items, in addition to suggesting further items and/or modifications of the initial items. The initial item list, generated by the EMERGE steering committee through a structured process, consists of 26 items distributed in 2 sections: 4 items representing the taxonomy-based minimum reporting criteria, and 22 items organised according to the common reporting sections. A purposive sample of experts will be selected from relevant disciplines and diverse geographical locations. Consensus will be achieved through predefined decision rules to keep, delete or modify the items. An iterative process of online survey rounds will be carried out until consensus is reached. An ethics approval was not required for the study according to the Swiss federal act on research involving human beings. The participating experts will be asked to give an informed consent. The results of this Delphi study will feed into EMERGE, which will be disseminated through peer-reviewed publications and presentations at conferences. Additionally, the steering committee will encourage their endorsement by registering the guidelines at the Enhancing the QUAlity and Transparency Of health Research

ESPACOMP Medication Adherence Reporting Guidelines (EMERGE): a reactive-Delphi study protocol

PubMed Central

Helmy, R; Zullig, L L; Dunbar-Jacob, J; Hughes, D A; Vrijens, B; Wilson, I B; De Geest, S

2017-01-01

Introduction Medication adherence is fundamental to achieving optimal patient outcomes. Reporting research on medication adherence suffers from some issues—including conceptualisation, measurement and data analysis—that thwart its advancement. Using the ABC taxonomy for medication adherence as the conceptual basis, a steering committee of members of the European Society for Patient Adherence, COMpliance, and Persistence (ESPACOMP) launched an initiative to develop ESPACOMP Medication Adherence Reporting Guidelines (EMERGE). This paper is a protocol for a Delphi study that aims to build consensus among a group of topic experts regarding an item list that will support developing EMERGE. Methods and analysis This study uses a reactive-Delphi design where a group of topic experts will be asked to rate the relevance and clarity of an initial list of items, in addition to suggesting further items and/or modifications of the initial items. The initial item list, generated by the EMERGE steering committee through a structured process, consists of 26 items distributed in 2 sections: 4 items representing the taxonomy-based minimum reporting criteria, and 22 items organised according to the common reporting sections. A purposive sample of experts will be selected from relevant disciplines and diverse geographical locations. Consensus will be achieved through predefined decision rules to keep, delete or modify the items. An iterative process of online survey rounds will be carried out until consensus is reached. Ethics and dissemination An ethics approval was not required for the study according to the Swiss federal act on research involving human beings. The participating experts will be asked to give an informed consent. The results of this Delphi study will feed into EMERGE, which will be disseminated through peer-reviewed publications and presentations at conferences. Additionally, the steering committee will encourage their endorsement by registering the guidelines at

Random Item IRT Models

ERIC Educational Resources Information Center

De Boeck, Paul

2008-01-01

It is common practice in IRT to consider items as fixed and persons as random. Both, continuous and categorical person parameters are most often random variables, whereas for items only continuous parameters are used and they are commonly of the fixed type, although exceptions occur. It is shown in the present article that random item parameters…

Ramsay-Curve Item Response Theory for the Three-Parameter Logistic Item Response Model

ERIC Educational Resources Information Center

Woods, Carol M.

2008-01-01

In Ramsay-curve item response theory (RC-IRT), the latent variable distribution is estimated simultaneously with the item parameters of a unidimensional item response model using marginal maximum likelihood estimation. This study evaluates RC-IRT for the three-parameter logistic (3PL) model with comparisons to the normal model and to the empirical…

Evaluation of Northwest University, Kano Post-UTME Test Items Using Item Response Theory

ERIC Educational Resources Information Center

Bichi, Ado Abdu; Hafiz, Hadiza; Bello, Samira Abdullahi

2016-01-01

High-stakes testing is used for the purposes of providing results that have important consequences. Validity is the cornerstone upon which all measurement systems are built. This study applied the Item Response Theory principles to analyse Northwest University Kano Post-UTME Economics test items. The developed fifty (50) economics test items was…

A Comprehensive List of Items to be Included on a Pediatric Drug Monograph

PubMed Central

Ito, Shinya; Woods, David; Nunn, Anthony J.; Taketomo, Carol; de Hoog, Matthijs; Offringa, Martin

2017-01-01

OBJECTIVES Children require special considerations for drug prescribing. Drug information summarized in a formulary containing drug monographs is essential for safe and effective prescribing. Currently, little is known about the information needs of those who prescribe and administer medicines to children. Our primary objective was to identify a list of important and relevant items to be included in a pediatric drug monograph. METHODS Following the establishment of an expert steering committee and an environmental scan of adult and pediatric formulary monograph items, 46 participants from 25 countries were invited to complete a 2-round Delphi survey. Questions regarding source of prescribing information and importance of items were recorded. An international consensus meeting to vote on and finalize the items list with the steering committee followed. RESULTS Pediatric formularies are most commonly the first resource consulted for information on medication used in children by 31 Delphi participants. After the Delphi rounds, 116 items were identified to be included in a comprehensive pediatric drug monograph, including general information, adverse drug reactions, dosages, precautions, drug-drug interactions, formulation, and drug properties. CONCLUSIONS Health care providers identified 116 monograph items as important for prescribing medicines for children by an international consensus-based process. This information will assist in setting standards for the creation of new pediatric drug monographs for international application and for those involved in pediatric formulary development. PMID:28337081

A Comprehensive List of Items to be Included on a Pediatric Drug Monograph.

PubMed

Kelly, Lauren E; Ito, Shinya; Woods, David; Nunn, Anthony J; Taketomo, Carol; de Hoog, Matthijs; Offringa, Martin

2017-01-01

Children require special considerations for drug prescribing. Drug information summarized in a formulary containing drug monographs is essential for safe and effective prescribing. Currently, little is known about the information needs of those who prescribe and administer medicines to children. Our primary objective was to identify a list of important and relevant items to be included in a pediatric drug monograph. Following the establishment of an expert steering committee and an environmental scan of adult and pediatric formulary monograph items, 46 participants from 25 countries were invited to complete a 2-round Delphi survey. Questions regarding source of prescribing information and importance of items were recorded. An international consensus meeting to vote on and finalize the items list with the steering committee followed. Pediatric formularies are most commonly the first resource consulted for information on medication used in children by 31 Delphi participants. After the Delphi rounds, 116 items were identified to be included in a comprehensive pediatric drug monograph, including general information, adverse drug reactions, dosages, precautions, drug-drug interactions, formulation, and drug properties. Health care providers identified 116 monograph items as important for prescribing medicines for children by an international consensus-based process. This information will assist in setting standards for the creation of new pediatric drug monographs for international application and for those involved in pediatric formulary development.

Assessment of medical residents' satisfaction.

PubMed

González-Martínez, José Francisco; García-García, José Antonio; Del Rosario Arnaud-Viñas, María; Arámbula-Morales, Enna Gabriela; Uriega-González Plata, Silvia; Mendoza-Guerrero, José Antonio

2011-01-01

Modern medical education is focused on students, and it is necessary to assess its level of satisfaction. A questionnaire was validated and we then conducted a study about the educational satisfaction level of medical residents of the Hospital General of Mexico. An observational, descriptive, cross-sectional and prospective study was conducted. A questionnaire of 21 items was validated and then applied to a representative sample of medical residents. Each item was evaluated with a scale from 0 to 10 and then gathered in groups: 0-5 = poor, 6-7 = average, 8 = good, 9 = very good, and 10 = excellent. Descriptive and inferential statistics were carried out using SPSS v.17.0. The questionnaire had internal validity with Cronbach's alpha >0.91 by item. Included in the study were 355 medical residents representing 37 different specialties. The performance perception of the ìheadî professors showed a wide heterogeneity: excellent (23.7%), very good (20.6%), good (16.9%), average (23.1%), poor (15.8%). Fourth-year residents and upward valued the educational performance higher (p = 0.001) as well as medical/surgical residents (p = 0.02). Intermediate-level residents valued the professor higher (p = 0.001), similar to students who were married or living with a partner (p <0.001). Upon contrasting the evaluation of the teacher's performance with the overall course performance, a linear, direct and significant correlation was obtained with Spearman's correlation coefficient = 0.78 and regression coefficient (p <0.001). We found a wide range of heterogeneity of results. Performance of the professors was the basic component to judge the quality of the residents' courses.

Using Differential Item Functioning Procedures to Explore Sources of Item Difficulty and Group Performance Characteristics.

ERIC Educational Resources Information Center

Scheuneman, Janice Dowd; Gerritz, Kalle

1990-01-01

Differential item functioning (DIF) methodology for revealing sources of item difficulty and performance characteristics of different groups was explored. A total of 150 Scholastic Aptitude Test items and 132 Graduate Record Examination general test items were analyzed. DIF was evaluated for males and females and Blacks and Whites. (SLD)

Correlates of a Single-Item Indicator Versus a Multi-Item Scale of Outness About Same-Sex Attraction

PubMed Central

Noor, Syed W.; Galos, Dylan L.; Simon Rosser, B. R.

2017-01-01

In this study, we investigated if a single-item indicator measured the degree to which people were open about their same-sex attraction (“out”) as accurately as a multi-item scale. For the multi-item scale, we used the Outness Inventory, which includes three subscales: family, world, and religion. We examined correlations between the single- and multi-item measures; between the single-item indicator and the subscales of the multi-item scale; and between the measures and internalized homonegativity, social attitudes towards homosexuality, and depressive symptoms. In addition, we calculated Tjur’s R2 as a measure of predictive power of the single-item indicator, multi-item scale, and subscales of the multi-item scale in predicting two health-related outcomes: depressive symptoms and condomless anal sex with multiple partners. There was a strong correlation between the single- and multi-item measures (r = 0.73). Furthermore, there were strong correlations between the single-item indicator and each subscale of the multi-item scale: family (r = 0.70), world (r = 0.77), and religion (r = 0.50). In addition, the correlations between the single-item indicator and internalized homonegativity (r = −0.63), social attitudes towards homosexuality (r = −0.38), and depression (r = −0.14) were higher than those between the multi-item scale and internalized homonegativity (r = −0.55), social attitudes towards homosexuality (r = −0.21), and depression (r = −0.13). Contrary to the premise that multi-item measures are superior to single-item measures, our collective findings indicate that the single-item indicator of outness performs better than the multi-item scale of outness. PMID:26292840

Development and assessment of floor and ceiling items for the PROMIS physical function item bank

PubMed Central

2013-01-01

Introduction Disability and Physical Function (PF) outcome assessment has had limited ability to measure functional status at the floor (very poor functional abilities) or the ceiling (very high functional abilities). We sought to identify, develop and evaluate new floor and ceiling items to enable broader and more precise assessment of PF outcomes for the NIH Patient-Reported-Outcomes Measurement Information System (PROMIS). Methods We conducted two cross-sectional studies using NIH PROMIS item improvement protocols with expert review, participant survey and focus group methods. In Study 1, respondents with low PF abilities evaluated new floor items, and those with high PF abilities evaluated new ceiling items for clarity, importance and relevance. In Study 2, we compared difficulty ratings of new floor items by low functioning respondents and ceiling items by high functioning respondents to reference PROMIS PF-10 items. We used frequencies, percentages, means and standard deviations to analyze the data. Results In Study 1, low (n = 84) and high (n = 90) functioning respondents were mostly White, women, 70 years old, with some college, and disability scores of 0.62 and 0.30. More than 90% of the 31 new floor and 31 new ceiling items were rated as clear, important and relevant, leaving 26 ceiling and 30 floor items for Study 2. Low (n = 246) and high (n = 637) functioning Study 2 respondents were mostly White, women, 70 years old, with some college, and Health Assessment Questionnaire (HAQ) scores of 1.62 and 0.003. Compared to difficulty ratings of reference items, ceiling items were rated to be 10% more to greater than 40% more difficult to do, and floor items were rated to be about 12% to nearly 90% less difficult to do. Conclusions These new floor and ceiling items considerably extend the measurable range of physical function at either extreme. They will help improve instrument performance in populations with broad functional ranges and those concentrated at

Communication training for advanced medical students improves information recall of medical laypersons in simulated informed consent talks – a randomized controlled trial

PubMed Central

2013-01-01

Background Informed consent talks are mandatory before invasive interventions. However, the patients’ information recall has been shown to be rather poor. We investigated, whether medical laypersons recalled more information items from a simulated informed consent talk after advanced medical students participated in a communication training aiming to reduce a layperson’s cognitive load. Methods Using a randomized, controlled, prospective cross-over-design, 30 5th and 6th year medical students were randomized into two groups. One group received communication training, followed by a comparison intervention (early intervention group, EI); the other group first received the comparison intervention and then communication training (late intervention group, LI). Before and after the interventions, the 30 medical students performed simulated informed consent talks with 30 blinded medical laypersons using a standardized set of information. We then recorded the number of information items the medical laypersons recalled. Results After the communication training both groups of medical laypersons recalled significantly more information items (EI: 41 ± 9% vs. 23 ± 9%, p < .0001, LI 49 ± 10% vs. 35 ± 6%, p < .0001). After the comparison intervention the improvement was modest and significant only in the LI (EI: 42 ± 9% vs. 40 ± 9%, p = .41, LI 35 ± 6% vs. 29 ± 9%, p = .016). Conclusion Short communication training for advanced medical students improves information recall of medical laypersons in simulated informed consent talks. PMID:23374907

Item-Writing Guidelines for Physics

ERIC Educational Resources Information Center

Regan, Tom

2015-01-01

A teacher learning how to write test questions (test items) will almost certainly encounter item-writing guidelines--lists of item-writing do's and don'ts. Item-writing guidelines usually are presented as applicable across all assessment settings. Table I shows some guidelines that I believe to be generally applicable and two will be briefly…

Item Response Data Analysis Using Stata Item Response Theory Package

ERIC Educational Resources Information Center

Yang, Ji Seung; Zheng, Xiaying

2018-01-01

The purpose of this article is to introduce and review the capability and performance of the Stata item response theory (IRT) package that is available from Stata v.14, 2015. Using a simulated data set and a publicly available item response data set extracted from Programme of International Student Assessment, we review the IRT package from…

Item Selection and Pre-equating with Empirical Item Characteristic Curves.

ERIC Educational Resources Information Center

Livingston, Samuel A.

An empirical item characteristic curve shows the probability of a correct response as a function of the student's total test score. These curves can be estimated from large-scale pretest data. They enable test developers to select items that discriminate well in the score region where decisions are made. A similar set of curves can be used to…

Assessing the Item Response Theory with Covariate (IRT-C) Procedure for Ascertaining Differential Item Functioning

ERIC Educational Resources Information Center

Tay, Louis; Vermunt, Jeroen K.; Wang, Chun

2013-01-01

We evaluate the item response theory with covariates (IRT-C) procedure for assessing differential item functioning (DIF) without preknowledge of anchor items (Tay, Newman, & Vermunt, 2011). This procedure begins with a fully constrained baseline model, and candidate items are tested for uniform and/or nonuniform DIF using the Wald statistic.…

Lack of security of networked medical equipment in radiology.

PubMed

Moses, Vinu; Korah, Ipeson

2015-02-01

OBJECTIVE. There are few articles in the literature describing the security and safety aspects of networked medical equipment in radiology departments. Most radiologists are unaware of the security issues. We review the security of the networked medical equipment of a typical radiology department. MATERIALS AND METHODS. All networked medical equipment in a radiology department was scanned for vulnerabilities with a port scanner and a network vulnerability scanner, and the vulnerabilities were classified using the Common Vulnerability Scoring System. A network sniffer was used to capture and analyze traffic on the radiology network for exposure of confidential patient data. We reviewed the use of antivirus software and firewalls on the networked medical equipment. USB ports and CD and DVD drives in the networked medical equipment were tested to see whether they allowed unauthorized access. Implementation of the virtual private network (VPN) that vendors use to access the radiology network was reviewed. RESULTS. Most of the networked medical equipment in our radiology department used vulnerable software with open ports and services. Of the 144 items scanned, 64 (44%) had at least one critical vulnerability, and 119 (83%) had at least one high-risk vulnerability. Most equipment did not encrypt traffic and allowed capture of confidential patient data. Of the 144 items scanned, two (1%) used antivirus software and three (2%) had a firewall enabled. The USB ports were not secure on 49 of the 58 (84%) items with USB ports, and the CD or DVD drive was not secure on 17 of the 31 (55%) items with a CD or DVD drive. One of three vendors had an insecure implementation of VPN access. CONCLUSION. Radiologists and the medical industry need to urgently review and rectify the security issues in existing networked medical equipment. We hope that the results of our study and this article also raise awareness among radiologists about the security issues of networked medical equipment.

Development and validation of the Medical Student Scholar-Ideal Mentor Scale (MSS-IMS).

PubMed

Sozio, Stephen M; Chan, Kitty S; Beach, Mary Catherine

2017-08-08

Programs encouraging medical student research such as Scholarly Concentrations (SC) are increasing nationally. However, there are few validated measures of mentoring quality tailored to medical students. We sought to modify and validate a mentoring scale for use in medical student research experiences. SC faculty created a scale evaluating how medical students assess mentors in the research setting. A validated graduate student scale of mentorship, the Ideal Mentor Scale, was modified by selecting 10 of the 34 original items most relevant for medical students and adding an item on project ownership. We administered this 11-item assessment to second year medical students in the Johns Hopkins University SC Program from 2011 to 2016, and performed exploratory factor analysis with oblique rotation to determine included items and subscales. We correlate overall mentoring quality scale and subscales with four student outcomes: 'very satisfied' with mentor, 'more likely' to do future research, project accepted at a national meeting, and highest SC faculty rating of student project. Five hundred ninety-eight students responded (87% response rate). After factor analysis, we eliminated three items producing a final scale of overall mentoring quality (8 items, Cronbach's alpha = 0.92) with three subscales: advocacy, responsiveness, and assistance. The overall mentoring quality scale was significantly associated with all four student outcomes, including mentor satisfaction: OR [(95% CI), p-value] 1.66 [(1.53-1.79), p < 0.001]; likelihood of future research: OR 1.06 [(1.03-1.09), p < 0.001]; abstract submission to national meetings: OR 1.05 [(1.02-1.08), p = 0.002]; and SC faculty rating of student projects: OR 1.08 [(1.03-1.14), p = 0.004]. Each subscale also correlated with overall mentor satisfaction, and the strongest relationship of each subscale was seen with 'mentor advocacy.' Mentor quality can be reliably measured and associates with important medical student

Age-related Differential Item Functioning for the Patient-Reported Outcomes Information System (PROMIS®) Physical Functioning Items.

PubMed

Paz, Sylvia H; Spritzer, Karen L; Morales, Leo S; Hays, Ron D

2013-03-29

To evaluate the equivalence of the PROMIS® wave 1 physical functioning item bank, by age (50 years or older versus 18-49). A total of 114 physical functioning items with 5 response choices were administered to English- (n=1504) and Spanish-language (n=640) adults. Item frequencies, means and standard deviations, item-scale correlations, and internal consistency reliability were estimated. Differential Item Functioning (DIF) by age was evaluated. Thirty of the 114 items were fagged for DIF based on an R-squared of 0.02 or above criterion. The expected total score was higher for those respondents who were 18-49 than those who were 50 or older. Those who were 50 years or older versus 18-49 years old with the same level of physical functioning responded differently to 30 of the 114 items in the PROMIS® physical functioning item bank. This study yields essential information about the equivalence of the physical functioning items in older versus younger individuals.

Can Item Analysis of MCQs Accomplish the Need of a Proper Assessment Strategy for Curriculum Improvement in Medical Education?

ERIC Educational Resources Information Center

Pawade, Yogesh R.; Diwase, Dipti S.

2016-01-01

Item analysis of Multiple Choice Questions (MCQs) is the process of collecting, summarizing and utilizing information from students' responses to evaluate the quality of test items. Difficulty Index (p-value), Discrimination Index (DI) and Distractor Efficiency (DE) are the parameters which help to evaluate the quality of MCQs used in an…

The Effect of the Position of an Item within a Test on the Item Difficulty Value.

ERIC Educational Resources Information Center

Rubin, Lois S.; Mott, David E. W.

An investigation of the effect on the difficulty value of an item due to position placement within a test was made. Using a 60-item operational test comprised of 5 subtests, 60 items were placed as experimental items on a number of spiralled test forms in three different positions (first, middle, last) within the subtest composed of like items.…

Validating and determining the weight of items used for evaluating clinical governance implementation based on analytic hierarchy process model.

PubMed

Hooshmand, Elaheh; Tourani, Sogand; Ravaghi, Hamid; Vafaee Najar, Ali; Meraji, Marziye; Ebrahimipour, Hossein

2015-04-08

The purpose of implementing a system such as Clinical Governance (CG) is to integrate, establish and globalize distinct policies in order to improve quality through increasing professional knowledge and the accountability of healthcare professional toward providing clinical excellence. Since CG is related to change, and change requires money and time, CG implementation has to be focused on priority areas that are in more dire need of change. The purpose of the present study was to validate and determine the significance of items used for evaluating CG implementation. The present study was descriptive-quantitative in method and design. Items used for evaluating CG implementation were first validated by the Delphi method and then compared with one another and ranked based on the Analytical Hierarchy Process (AHP) model. The items that were validated for evaluating CG implementation in Iran include performance evaluation, training and development, personnel motivation, clinical audit, clinical effectiveness, risk management, resource allocation, policies and strategies, external audit, information system management, research and development, CG structure, implementation prerequisites, the management of patients' non-medical needs, complaints and patients' participation in the treatment process. The most important items based on their degree of significance were training and development, performance evaluation, and risk management. The least important items included the management of patients' non-medical needs, patients' participation in the treatment process and research and development. The fundamental requirements of CG implementation included having an effective policy at national level, avoiding perfectionism, using the expertise and potentials of the entire country and the coordination of this model with other models of quality improvement such as accreditation and patient safety. © 2015 by Kerman University of Medical Sciences.

Validity of Single-Item Screening for Limited Health Literacy in English and Spanish Speakers.

PubMed

Bishop, Wendy Pechero; Craddock Lee, Simon J; Skinner, Celette Sugg; Jones, Tiffany M; McCallister, Katharine; Tiro, Jasmin A

2016-05-01

To evaluate 3 single-item screening measures for limited health literacy in a community-based population of English and Spanish speakers. We recruited 324 English and 314 Spanish speakers from a community research registry in Dallas, Texas, enrolled between 2009 and 2012. We used 3 screening measures: (1) How would you rate your ability to read?; (2) How confident are you filling out medical forms by yourself?; and (3) How often do you have someone help you read hospital materials? In analyses stratified by language, we used area under the receiver operating characteristic (AUROC) curves to compare each item with the validated 40-item Short Test of Functional Health Literacy in Adults. For English speakers, no difference was seen among the items. For Spanish speakers, "ability to read" identified inadequate literacy better than "help reading hospital materials" (AUROC curve = 0.76 vs 0.65; P = .019). The "ability to read" item performed the best, supporting use as a screening tool in safety-net systems caring for diverse populations. Future studies should investigate how to implement brief measures in safety-net settings and whether highlighting health literacy level influences providers' communication practices and patient outcomes.

Investigating the Impact of Item Parameter Drift for Item Response Theory Models with Mixture Distributions.

PubMed

Park, Yoon Soo; Lee, Young-Sun; Xing, Kuan

2016-01-01

This study investigates the impact of item parameter drift (IPD) on parameter and ability estimation when the underlying measurement model fits a mixture distribution, thereby violating the item invariance property of unidimensional item response theory (IRT) models. An empirical study was conducted to demonstrate the occurrence of both IPD and an underlying mixture distribution using real-world data. Twenty-one trended anchor items from the 1999, 2003, and 2007 administrations of Trends in International Mathematics and Science Study (TIMSS) were analyzed using unidimensional and mixture IRT models. TIMSS treats trended anchor items as invariant over testing administrations and uses pre-calibrated item parameters based on unidimensional IRT. However, empirical results showed evidence of two latent subgroups with IPD. Results also showed changes in the distribution of examinee ability between latent classes over the three administrations. A simulation study was conducted to examine the impact of IPD on the estimation of ability and item parameters, when data have underlying mixture distributions. Simulations used data generated from a mixture IRT model and estimated using unidimensional IRT. Results showed that data reflecting IPD using mixture IRT model led to IPD in the unidimensional IRT model. Changes in the distribution of examinee ability also affected item parameters. Moreover, drift with respect to item discrimination and distribution of examinee ability affected estimates of examinee ability. These findings demonstrate the need to caution and evaluate IPD using a mixture IRT framework to understand its effects on item parameters and examinee ability.

Investigating the Impact of Item Parameter Drift for Item Response Theory Models with Mixture Distributions

PubMed Central

Park, Yoon Soo; Lee, Young-Sun; Xing, Kuan

2016-01-01

This study investigates the impact of item parameter drift (IPD) on parameter and ability estimation when the underlying measurement model fits a mixture distribution, thereby violating the item invariance property of unidimensional item response theory (IRT) models. An empirical study was conducted to demonstrate the occurrence of both IPD and an underlying mixture distribution using real-world data. Twenty-one trended anchor items from the 1999, 2003, and 2007 administrations of Trends in International Mathematics and Science Study (TIMSS) were analyzed using unidimensional and mixture IRT models. TIMSS treats trended anchor items as invariant over testing administrations and uses pre-calibrated item parameters based on unidimensional IRT. However, empirical results showed evidence of two latent subgroups with IPD. Results also showed changes in the distribution of examinee ability between latent classes over the three administrations. A simulation study was conducted to examine the impact of IPD on the estimation of ability and item parameters, when data have underlying mixture distributions. Simulations used data generated from a mixture IRT model and estimated using unidimensional IRT. Results showed that data reflecting IPD using mixture IRT model led to IPD in the unidimensional IRT model. Changes in the distribution of examinee ability also affected item parameters. Moreover, drift with respect to item discrimination and distribution of examinee ability affected estimates of examinee ability. These findings demonstrate the need to caution and evaluate IPD using a mixture IRT framework to understand its effects on item parameters and examinee ability. PMID:26941699

Language-related differential item functioning between English and German PROMIS Depression items is negligible.

PubMed

Fischer, H Felix; Wahl, Inka; Nolte, Sandra; Liegl, Gregor; Brähler, Elmar; Löwe, Bernd; Rose, Matthias

2017-12-01

To investigate differential item functioning (DIF) of PROMIS Depression items between US and German samples we compared data from the US PROMIS calibration sample (n = 780), a German general population survey (n = 2,500) and a German clinical sample (n = 621). DIF was assessed in an ordinal logistic regression framework, with 0.02 as criterion for R 2 -change and 0.096 for Raju's non-compensatory DIF. Item parameters were initially fixed to the PROMIS Depression metric; we used plausible values to account for uncertainty in depression estimates. Only four items showed DIF. Accounting for DIF led to negligible effects for the full item bank as well as a post hoc simulated computer-adaptive test (< 0.1 point on the PROMIS metric [mean = 50, standard deviation =10]), while the effect on the short forms was small (< 1 point). The mean depression severity (43.6) in the German general population sample was considerably lower compared to the US reference value of 50. Overall, we found little evidence for language DIF between US and German samples, which could be addressed by either replacing the DIF items by items not showing DIF or by scoring the short form in German samples with the corrected item parameters reported. Copyright © 2016 John Wiley & Sons, Ltd.

Measuring stigma after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Stigma item bank and short form.

PubMed

Kisala, Pamela A; Tulsky, David S; Pace, Natalie; Victorson, David; Choi, Seung W; Heinemann, Allen W

2015-05-01

To develop a calibrated item bank and computer adaptive test (CAT) to assess the effects of stigma on health-related quality of life in individuals with spinal cord injury (SCI). Grounded-theory based qualitative item development methods, large-scale item calibration field testing, confirmatory factor analysis, and item response theory (IRT)-based psychometric analyses. Five SCI Model System centers and one Department of Veterans Affairs medical center in the United States. Adults with traumatic SCI. SCI-QOL Stigma Item Bank A sample of 611 individuals with traumatic SCI completed 30 items assessing SCI-related stigma. After 7 items were iteratively removed, factor analyses confirmed a unidimensional pool of items. Graded Response Model IRT analyses were used to estimate slopes and thresholds for the final 23 items. The SCI-QOL Stigma item bank is unique not only in the assessment of SCI-related stigma but also in the inclusion of individuals with SCI in all phases of its development. Use of confirmatory factor analytic and IRT methods provide flexibility and precision of measurement. The item bank may be administered as a CAT or as a 10-item fixed-length short form and can be used for research and clinical applications.

The effects of relative food item size on optimal tooth cusp sharpness during brittle food item processing

PubMed Central

Berthaume, Michael A.; Dumont, Elizabeth R.; Godfrey, Laurie R.; Grosse, Ian R.

2014-01-01

Teeth are often assumed to be optimal for their function, which allows researchers to derive dietary signatures from tooth shape. Most tooth shape analyses normalize for tooth size, potentially masking the relationship between relative food item size and tooth shape. Here, we model how relative food item size may affect optimal tooth cusp radius of curvature (RoC) during the fracture of brittle food items using a parametric finite-element (FE) model of a four-cusped molar. Morphospaces were created for four different food item sizes by altering cusp RoCs to determine whether optimal tooth shape changed as food item size changed. The morphospaces were also used to investigate whether variation in efficiency metrics (i.e. stresses, energy and optimality) changed as food item size changed. We found that optimal tooth shape changed as food item size changed, but that all optimal morphologies were similar, with one dull cusp that promoted high stresses in the food item and three cusps that acted to stabilize the food item. There were also positive relationships between food item size and the coefficients of variation for stresses in food item and optimality, and negative relationships between food item size and the coefficients of variation for stresses in the enamel and strain energy absorbed by the food item. These results suggest that relative food item size may play a role in selecting for optimal tooth shape, and the magnitude of these selective forces may change depending on food item size and which efficiency metric is being selected. PMID:25320068

Do continuing medical education articles foster shared decision making?

PubMed

Labrecque, Michel; Lafortune, Valérie; Lajeunesse, Judith; Lambert-Perrault, Anne-Marie; Manrique, Hermes; Blais, Johanne; Légaré, France

2010-01-01

Defined as reviews of clinical aspects of a specific health problem published in peer-reviewed and non-peer-reviewed medical journals, offered without charge, continuing medical education (CME) articles form a key strategy for translating knowledge into practice. This study assessed CME articles for mention of evidence-based information on benefits and harms of available treatment and/or preventive options that are deemed essential for shared decision making (SDM) to occur in clinical practice. Articles were selected from 5 medical journals that publish CME articles and are provided free of charge to primary-care physicians of the Province of Quebec, Canada. Two individuals independently scored each article with the use of a 10-item checklist based on the International Patient Decision Aid Standards. In case of discrepancy, the item score was established by team consensus. Scores were added to produce a total article score ranging from 0 (no item present) to 10 (all items present). Thirty articles (6 articles per journal) were selected. Total article scores ranged from 1 to 9, with a mean (+/- SD) of 3.1 +/- 2.0 (95% confidence interval 2.8-4.3). Health conditions and treatment options were the items most frequently discussed in the articles; next came treatment benefits. Possible harms, the use of the same denominators for benefits and harms, and methods to facilitate the communication of benefits and harms to patients were almost never described. No significant differences between journals were observed. The CME articles evaluated did not include the evidence-based information necessary to foster SDM in clinical practice. Peer-reviewed and non-peer-reviewed medical journals should require CME articles to include this type of information.

Applying Bayesian Item Selection Approaches to Adaptive Tests Using Polytomous Items

ERIC Educational Resources Information Center

Penfield, Randall D.

2006-01-01

This study applied the maximum expected information (MEI) and the maximum posterior-weighted information (MPI) approaches of computer adaptive testing item selection to the case of a test using polytomous items following the partial credit model. The MEI and MPI approaches are described. A simulation study compared the efficiency of ability…

Optimal Item Selection with Credentialing Examinations.

ERIC Educational Resources Information Center

Hambleton, Ronald K.; And Others

The study compared two promising item response theory (IRT) item-selection methods, optimal and content-optimal, with two non-IRT item selection methods, random and classical, for use in fixed-length certification exams. The four methods were used to construct 20-item exams from a pool of approximately 250 items taken from a 1985 certification…

Using Automatic Item Generation to Meet the Increasing Item Demands of High-Stakes Educational and Occupational Assessment

ERIC Educational Resources Information Center

Arendasy, Martin E.; Sommer, Markus

2012-01-01

The use of new test administration technologies such as computerized adaptive testing in high-stakes educational and occupational assessments demands large item pools. Classic item construction processes and previous approaches to automatic item generation faced the problems of a considerable loss of items after the item calibration phase. In this…

Detecting Differential Item Discrimination (DID) and the Consequences of Ignoring DID in Multilevel Item Response Models

ERIC Educational Resources Information Center

Lee, Woo-yeol; Cho, Sun-Joo

2017-01-01

Cross-level invariance in a multilevel item response model can be investigated by testing whether the within-level item discriminations are equal to the between-level item discriminations. Testing the cross-level invariance assumption is important to understand constructs in multilevel data. However, in most multilevel item response model…

Electromagnetic pulse (EMP), Part I: Effects on field medical equipment.

PubMed

Vandre, R H; Klebers, J; Tesche, F M; Blanchard, J P

1993-04-01

The electromagnetic pulse (EMP) from a high-altitude nuclear detonation has the potential to cover an area as large as the continental United States with damaging levels of EMP radiation. In this study, two of seven items of medical equipment were damaged by an EMP simulator. Computer circuit analysis of 17 different items showed that 11 of the 17 items would be damaged by current surges on the power cords, while two would be damaged by current surges on external leads. This research showed that a field commander can expect approximately 65% of his electronic medical equipment to be damaged by a single nuclear detonation as far as 2,200 km away.

Memorandum "Open Metadata". Open Access to Documentation Forms and Item Catalogs in Healthcare.

PubMed

Dugas, M; Jöckel, K-H; Friede, T; Gefeller, O; Kieser, M; Marschollek, M; Ammenwerth, E; Röhrig, R; Knaup-Gregori, P; Prokosch, H-U

2015-01-01

At present, most documentation forms and item catalogs in healthcare are not accessible to the public. This applies to assessment forms of routine patient care as well as case report forms (CRFs) of clinical and epidemiological studies. On behalf of the German chairs for Medical Informatics, Biometry and Epidemiology six recommendations to developers and users of documentation forms in healthcare were developed. Open access to medical documentation forms could substantially improve information systems in healthcare and medical research networks. Therefore these forms should be made available to the scientific community, their use should not be unduly restricted, they should be published in a sustainable way using international standards and sources of documentation forms should be referenced in scientific publications.

Expansion of a physical function item bank and development of an abbreviated form for clinical research.

PubMed

Bode, Rita K; Lai, Jin-shei; Dineen, Kelly; Heinemann, Allen W; Shevrin, Daniel; Von Roenn, Jamie; Cella, David

2006-01-01

We expanded an existing 33-item physical function (PF) item bank with a sufficient number of items to enable computerized adaptive testing (CAT). Ten items were written to expand the bank and the new item pool was administered to 295 people with cancer. For this analysis of the new pool, seven poorly performing items were identified for further examination. This resulted in a bank with items that define an essentially unidimensional PF construct, cover a wide range of that construct, reliably measure the PF of persons with cancer, and distinguish differences in self-reported functional performance levels. We also developed a 5-item (static) assessment form ("BriefPF") that can be used in clinical research to express scores on the same metric as the overall bank. The BriefPF was compared to the PF-10 from the Medical Outcomes Study SF-36. Both short forms significantly differentiated persons across functional performance levels. While the entire bank was more precise across the PF continuum than either short form, there were differences in the area of the continuum in which each short form was more precise: the BriefPF was more precise than the PF-10 at the lower functional levels and the PF-10 was more precise than the BriefPF at the higher levels. Future research on this bank will include the development of a CAT version, the PF-CAT.

26 CFR 1.213-1 - Medical, dental, etc., expenses.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 3 2012-04-01 2012-04-01 false Medical, dental, etc., expenses. 1.213-1 Section... (CONTINUED) INCOME TAXES (CONTINUED) Additional Itemized Deductions for Individuals § 1.213-1 Medical, dental... (including nurses' board where paid by the taxpayer), medical, laboratory, surgical, dental and other...

26 CFR 1.213-1 - Medical, dental, etc., expenses.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 3 2014-04-01 2014-04-01 false Medical, dental, etc., expenses. 1.213-1 Section... (CONTINUED) INCOME TAXES (CONTINUED) Additional Itemized Deductions for Individuals § 1.213-1 Medical, dental... (including nurses' board where paid by the taxpayer), medical, laboratory, surgical, dental and other...

26 CFR 1.213-1 - Medical, dental, etc., expenses.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 3 2013-04-01 2013-04-01 false Medical, dental, etc., expenses. 1.213-1 Section... (CONTINUED) INCOME TAXES (CONTINUED) Additional Itemized Deductions for Individuals § 1.213-1 Medical, dental... (including nurses' board where paid by the taxpayer), medical, laboratory, surgical, dental and other...

Development and Initial Validation of the Medical Fear Survey-Short Version

ERIC Educational Resources Information Center

Olatunji, Bunmi O.; Ebesutani, Chad; Sawchuk, Craig N.; McKay, Dean; Lohr, Jeffrey M.; Kleinknecht, Ronald A.

2012-01-01

The present investigation employs item response theory (IRT) to develop an abbreviated Medical Fear Survey (MFS). Application of IRT analyses in Study 1 (n = 931) to the original 50-item MFS resulted in a 25-item shortened version. Examination of the location parameters also resulted in a reduction of the Likert-type scaling of the MFS by removing…

The Communicative Participation Item Bank (CPIB): Item bank calibration and development of a disorder-generic short form

PubMed Central

Baylor, Carolyn; Yorkston, Kathryn; Eadie, Tanya; Kim, Jiseon; Chung, Hyewon; Amtmann, Dagmar

2015-01-01

Purpose The purpose of this study was to calibrate the items for the Communicative Participation Item Bank (CPIB) using Item Response Theory (IRT). One overriding objective was to examine if the IRT item parameters would be consistent across different diagnostic groups, thereby allowing creation of a disorder-generic instrument. The intended outcomes were the final item bank and a short form ready for clinical and research applications. Methods Self-report data were collected from 701 individuals representing four diagnoses: multiple sclerosis, Parkinson’s disease, amyotrophic lateral sclerosis and head and neck cancer. Participants completed the CPIB and additional self-report questionnaires. CPIB data were analyzed using the IRT Graded Response Model (GRM). Results The initial set of 94 candidate CPIB items were reduced to an item bank of 46 items demonstrating unidimensionality, local independence, good item fit, and good measurement precision. Differential item function (DIF) analyses detected no meaningful differences across diagnostic groups. A 10-item, disorder-generic short form was generated. Conclusions The CPIB provides speech-language pathologists with a unidimensional, self-report outcomes measurement instrument dedicated to the construct of communicative participation. This instrument may be useful to clinicians and researchers wanting to implement measures of communicative participation in their work. PMID:23816661

Item-specific processing reduces false memories.

PubMed

McCabe, David P; Presmanes, Alison G; Robertson, Chuck L; Smith, Anderson D

2004-12-01

We examined the effect of item-specific and relational encoding instructions on false recognition in two experiments in which the DRM paradigm was used (Deese, 1959; Roediger & McDermott, 1995). Type of encoding (item-specific or relational) was manipulated between subjects in Experiment 1 and within subjects in Experiment 2. Decision-based explanations (e.g., the distinctiveness heuristic) predict reductions in false recognition in between-subjects designs, but not in within-subjects designs, because they are conceptualized as global shifts in decision criteria. Memory-based explanations predict reductions in false recognition in both designs, resulting from enhanced recollection of item-specific details. False recognition was reduced following item-specific encoding instructions in both experiments, favoring a memory-based explanation. These results suggest that providing unique cues for the retrieval of individual studied items results in enhanced discrimination between those studied items and critical lures. Conversely, enhancing the similarity of studied items results in poor discrimination among items within a particular list theme. These results are discussed in terms of the item-specific/ relational framework (Hunt & McDaniel, 1993).

Audio Adapted Assessment Data: Does the Addition of Audio to Written Items Modify the Item Calibration?

ERIC Educational Resources Information Center

Snyder, James

2010-01-01

This dissertation research examined the changes in item RIT calibration that occurred when adding audio to a set of currently calibrated RIT items and then placing these new items as field test items in the modified assessments on the NWEA MAP test platform. The researcher used test results from over 600 students in the Poway School District in…

Measuring stigma after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Stigma item bank and short form

PubMed Central

Kisala, Pamela A.; Tulsky, David S.; Pace, Natalie; Victorson, David; Choi, Seung W.; Heinemann, Allen W.

2015-01-01

Objective To develop a calibrated item bank and computer adaptive test (CAT) to assess the effects of stigma on health-related quality of life in individuals with spinal cord injury (SCI). Design Grounded-theory based qualitative item development methods, large-scale item calibration field testing, confirmatory factor analysis, and item response theory (IRT)-based psychometric analyses. Setting Five SCI Model System centers and one Department of Veterans Affairs medical center in the United States. Participants Adults with traumatic SCI. Main Outcome Measures SCI-QOL Stigma Item Bank Results A sample of 611 individuals with traumatic SCI completed 30 items assessing SCI-related stigma. After 7 items were iteratively removed, factor analyses confirmed a unidimensional pool of items. Graded Response Model IRT analyses were used to estimate slopes and thresholds for the final 23 items. Conclusions The SCI-QOL Stigma item bank is unique not only in the assessment of SCI-related stigma but also in the inclusion of individuals with SCI in all phases of its development. Use of confirmatory factor analytic and IRT methods provide flexibility and precision of measurement. The item bank may be administered as a CAT or as a 10-item fixed-length short form and can be used for research and clinical applications. PMID:26010973

Adult Attachment Ratings (AAR): an item response theory analysis.

PubMed

Pilkonis, Paul A; Kim, Yookyung; Yu, Lan; Morse, Jennifer Q

2014-01-01

The Adult Attachment Ratings (AAR) include 3 scales for anxious, ambivalent attachment (excessive dependency, interpersonal ambivalence, and compulsive care-giving), 3 for avoidant attachment (rigid self-control, defensive separation, and emotional detachment), and 1 for secure attachment. The scales include items (ranging from 6-16 in their original form) scored by raters using a 3-point format (0 = absent, 1 = present, and 2 = strongly present) and summed to produce a total score. Item response theory (IRT) analyses were conducted with data from 414 participants recruited from psychiatric outpatient, medical, and community settings to identify the most informative items from each scale. The IRT results allowed us to shorten the scales to 5-item versions that are more precise and easier to rate because of their brevity. In general, the effective range of measurement for the scales was 0 to +2 SDs for each of the attachment constructs; that is, from average to high levels of attachment problems. Evidence for convergent and discriminant validity of the scales was investigated by comparing them with the Experiences of Close Relationships-Revised (ECR-R) scale and the Kobak Attachment Q-sort. The best consensus among self-reports on the ECR-R, informant ratings on the ECR-R, and expert judgments on the Q-sort and the AAR emerged for anxious, ambivalent attachment. Given the good psychometric characteristics of the scale for secure attachment, however, this measure alone might provide a simple alternative to more elaborate procedures for some measurement purposes. Conversion tables are provided for the 7 scales to facilitate transformation from raw scores to IRT-calibrated (theta) scores.

A Mixed Effects Randomized Item Response Model

ERIC Educational Resources Information Center

Fox, J.-P.; Wyrick, Cheryl

2008-01-01

The randomized response technique ensures that individual item responses, denoted as true item responses, are randomized before observing them and so-called randomized item responses are observed. A relationship is specified between randomized item response data and true item response data. True item response data are modeled with a (non)linear…

Item Response Theory with Covariates (IRT-C): Assessing Item Recovery and Differential Item Functioning for the Three-Parameter Logistic Model

ERIC Educational Resources Information Center

Tay, Louis; Huang, Qiming; Vermunt, Jeroen K.

2016-01-01

In large-scale testing, the use of multigroup approaches is limited for assessing differential item functioning (DIF) across multiple variables as DIF is examined for each variable separately. In contrast, the item response theory with covariate (IRT-C) procedure can be used to examine DIF across multiple variables (covariates) simultaneously. To…

41 CFR 102-36.435 - How do we identify Munitions List Items (MLIs)/Commerce Control List Items (CCLIs) requiring...

Code of Federal Regulations, 2013 CFR

2013-07-01

... Munitions List Items (MLIs)/Commerce Control List Items (CCLIs) requiring demilitarization? 102-36.435... Personal Property Whose Disposal Requires Special Handling Munitions List Items/commerce Control List Items (mlis/cclis) § 102-36.435 How do we identify Munitions List Items (MLIs)/Commerce Control List Items...

41 CFR 102-36.435 - How do we identify Munitions List Items (MLIs)/Commerce Control List Items (CCLIs) requiring...

Code of Federal Regulations, 2012 CFR

2012-01-01

... Munitions List Items (MLIs)/Commerce Control List Items (CCLIs) requiring demilitarization? 102-36.435... Personal Property Whose Disposal Requires Special Handling Munitions List Items/commerce Control List Items (mlis/cclis) § 102-36.435 How do we identify Munitions List Items (MLIs)/Commerce Control List Items...

41 CFR 102-36.435 - How do we identify Munitions List Items (MLIs)/Commerce Control List Items (CCLIs) requiring...

Code of Federal Regulations, 2011 CFR

2011-01-01

... Munitions List Items (MLIs)/Commerce Control List Items (CCLIs) requiring demilitarization? 102-36.435... Personal Property Whose Disposal Requires Special Handling Munitions List Items/commerce Control List Items (mlis/cclis) § 102-36.435 How do we identify Munitions List Items (MLIs)/Commerce Control List Items...

41 CFR 102-36.435 - How do we identify Munitions List Items (MLIs)/Commerce Control List Items (CCLIs) requiring...

Code of Federal Regulations, 2014 CFR

2014-01-01

... Munitions List Items (MLIs)/Commerce Control List Items (CCLIs) requiring demilitarization? 102-36.435... Personal Property Whose Disposal Requires Special Handling Munitions List Items/commerce Control List Items (mlis/cclis) § 102-36.435 How do we identify Munitions List Items (MLIs)/Commerce Control List Items...

41 CFR 102-36.435 - How do we identify Munitions List Items (MLIs)/Commerce Control List Items (CCLIs) requiring...

Code of Federal Regulations, 2010 CFR

2010-07-01

... Munitions List Items (MLIs)/Commerce Control List Items (CCLIs) requiring demilitarization? 102-36.435... Personal Property Whose Disposal Requires Special Handling Munitions List Items/commerce Control List Items (mlis/cclis) § 102-36.435 How do we identify Munitions List Items (MLIs)/Commerce Control List Items...

Ramsay-Curve Differential Item Functioning

ERIC Educational Resources Information Center

Woods, Carol M.

2011-01-01

Differential item functioning (DIF) occurs when an item on a test, questionnaire, or interview has different measurement properties for one group of people versus another, irrespective of true group-mean differences on the constructs being measured. This article is focused on item response theory based likelihood ratio testing for DIF (IRT-LR or…

Planning New Medical Library Buildings: an Annotated Checklist with Selected References

PubMed Central

Martin, Jess A.

1969-01-01

Special attention is paid to several planning essentials for new medical library buildings. These should be covered in the program of requirements that appears as item six on the checklist. The checklist assumes that the decision to build a new medical library has been made and that monies have been allocated for that purpose. References pertaining to the checklist items are provided along with a suggested timetable for achieving each, based on the author's own experiences. PMID:5823509

41 CFR 102-36.430 - May we dispose of excess Munitions List Items (MLIs)/Commerce Control List Items (CCLIs)?

Code of Federal Regulations, 2013 CFR

2013-07-01

... Munitions List Items (MLIs)/Commerce Control List Items (CCLIs)? 102-36.430 Section 102-36.430 Public... Disposal Requires Special Handling Munitions List Items/commerce Control List Items (mlis/cclis) § 102-36.430 May we dispose of excess Munitions List Items (MLIs)/Commerce Control List Items (CCLIs)? You may...

41 CFR 102-36.430 - May we dispose of excess Munitions List Items (MLIs)/Commerce Control List Items (CCLIs)?

Code of Federal Regulations, 2012 CFR

2012-01-01

... Munitions List Items (MLIs)/Commerce Control List Items (CCLIs)? 102-36.430 Section 102-36.430 Public... Disposal Requires Special Handling Munitions List Items/commerce Control List Items (mlis/cclis) § 102-36.430 May we dispose of excess Munitions List Items (MLIs)/Commerce Control List Items (CCLIs)? You may...

41 CFR 102-36.430 - May we dispose of excess Munitions List Items (MLIs)/Commerce Control List Items (CCLIs)?

Code of Federal Regulations, 2014 CFR

2014-01-01

... Munitions List Items (MLIs)/Commerce Control List Items (CCLIs)? 102-36.430 Section 102-36.430 Public... Disposal Requires Special Handling Munitions List Items/commerce Control List Items (mlis/cclis) § 102-36.430 May we dispose of excess Munitions List Items (MLIs)/Commerce Control List Items (CCLIs)? You may...

41 CFR 102-36.430 - May we dispose of excess Munitions List Items (MLIs)/Commerce Control List Items (CCLIs)?

Code of Federal Regulations, 2011 CFR

2011-01-01

... Munitions List Items (MLIs)/Commerce Control List Items (CCLIs)? 102-36.430 Section 102-36.430 Public... Disposal Requires Special Handling Munitions List Items/commerce Control List Items (mlis/cclis) § 102-36.430 May we dispose of excess Munitions List Items (MLIs)/Commerce Control List Items (CCLIs)? You may...

41 CFR 102-36.430 - May we dispose of excess Munitions List Items (MLIs)/Commerce Control List Items (CCLIs)?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Munitions List Items (MLIs)/Commerce Control List Items (CCLIs)? 102-36.430 Section 102-36.430 Public... Disposal Requires Special Handling Munitions List Items/commerce Control List Items (mlis/cclis) § 102-36.430 May we dispose of excess Munitions List Items (MLIs)/Commerce Control List Items (CCLIs)? You may...

Effects of Anchor Item Methods on the Detection of Differential Item Functioning within the Family of Rasch Models

ERIC Educational Resources Information Center

Wang, Wen-Chung

2004-01-01

Scale indeterminacy in analysis of differential item functioning (DIF) within the framework of item response theory can be resolved by imposing 3 anchor item methods: the equal-mean-difficulty method, the all-other anchor item method, and the constant anchor item method. In this article, applicability and limitations of these 3 methods are…

Unidimensional Interpretations for Multidimensional Test Items

ERIC Educational Resources Information Center

Kahraman, Nilufer

2013-01-01

This article considers potential problems that can arise in estimating a unidimensional item response theory (IRT) model when some test items are multidimensional (i.e., show a complex factorial structure). More specifically, this study examines (1) the consequences of model misfit on IRT item parameter estimates due to unintended minor item-level…

Validation of Single-Item Screening Measures for Provider Burnout in a Rural Health Care Network.

PubMed

Waddimba, Anthony C; Scribani, Melissa; Nieves, Melinda A; Krupa, Nicole; May, John J; Jenkins, Paul

2016-06-01

We validated three single-item measures for emotional exhaustion (EE) and depersonalization (DP) among rural physician/nonphysician practitioners. We linked cross-sectional survey data (on provider demographics, satisfaction, resilience, and burnout) with administrative information from an integrated health care network (1 academic medical center, 6 community hospitals, 31 clinics, and 19 school-based health centers) in an eight-county underserved area of upstate New York. In total, 308 physicians and advanced-practice clinicians completed a self-administered, multi-instrument questionnaire (65.1% response rate). Significant proportions of respondents reported high EE (36.1%) and DP (9.9%). In multivariable linear mixed models, scores on EE/DP subscales of the Maslach Burnout Inventory were regressed on each single-item measure. The Physician Work-Life Study's single-item measure (classifying 32.8% of respondents as burning out/completely burned out) was correlated with EE and DP (Spearman's ρ = .72 and .41, p < .0001; Kruskal-Wallis χ(2) = 149.9 and 56.5, p < .0001, respectively). In multivariable models, it predicted high EE (but neither low EE nor low/high DP). EE/DP single items were correlated with parent subscales (Spearman's ρ = .89 and .81, p < .0001; Kruskal-Wallis χ(2) = 230.98 and 197.84, p < .0001, respectively). In multivariable models, the EE item predicted high/low EE, whereas the DP item predicted only low DP. Therefore, the three single-item measures tested varied in effectiveness as screeners for EE/DP dimensions of burnout. © The Author(s) 2015.

Effect of clinically discriminating, evidence-based checklist items on the reliability of scores from an Internal Medicine residency OSCE.

PubMed

Daniels, Vijay J; Bordage, Georges; Gierl, Mark J; Yudkowsky, Rachel

2014-10-01

Objective structured clinical examinations (OSCEs) are used worldwide for summative examinations but often lack acceptable reliability. Research has shown that reliability of scores increases if OSCE checklists for medical students include only clinically relevant items. Also, checklists are often missing evidence-based items that high-achieving learners are more likely to use. The purpose of this study was to determine if limiting checklist items to clinically discriminating items and/or adding missing evidence-based items improved score reliability in an Internal Medicine residency OSCE. Six internists reviewed the traditional checklists of four OSCE stations classifying items as clinically discriminating or non-discriminating. Two independent reviewers augmented checklists with missing evidence-based items. We used generalizability theory to calculate overall reliability of faculty observer checklist scores from 45 first and second-year residents and predict how many 10-item stations would be required to reach a Phi coefficient of 0.8. Removing clinically non-discriminating items from the traditional checklist did not affect the number of stations (15) required to reach a Phi of 0.8 with 10 items. Focusing the checklist on only evidence-based clinically discriminating items increased test score reliability, needing 11 stations instead of 15 to reach 0.8; adding missing evidence-based clinically discriminating items to the traditional checklist modestly improved reliability (needing 14 instead of 15 stations). Checklists composed of evidence-based clinically discriminating items improved the reliability of checklist scores and reduced the number of stations needed for acceptable reliability. Educators should give preference to evidence-based items over non-evidence-based items when developing OSCE checklists.

An Item-Driven Adaptive Design for Calibrating Pretest Items. Research Report. ETS RR-14-38

ERIC Educational Resources Information Center

Ali, Usama S.; Chang, Hua-Hua

2014-01-01

Adaptive testing is advantageous in that it provides more efficient ability estimates with fewer items than linear testing does. Item-driven adaptive pretesting may also offer similar advantages, and verification of such a hypothesis about item calibration was the main objective of this study. A suitability index (SI) was introduced to adaptively…

The Positive Role of Professionalism and Ethics Training in Medical Education: A Comparison of Medical Student and Resident Perspectives

ERIC Educational Resources Information Center

Roberts, Laura Weiss; Hammond, Katherine A. Green; Geppert, Cynthia M. A.; Warner, Teddy D.

2004-01-01

Objective: To assess the perspectives and preferences of medical students and residents regarding professionalism and ethics education. Methods: A new written survey with 124 items (scale: "strongly disagree" = 1, "strongly agree" = 9) was sent to all medical students (n = 308) and PGY 1-3 residents (n = 233) at one academic center. Results: Of…

Demand Characteristics of Multiple-Choice Items.

ERIC Educational Resources Information Center

Diamond, James J.; Williams, David V.

Thirteen graduate students were asked to indicate for each of 24 multiple-choice items whether the item tested "recall of specific information," a "higher order skill," or "don't know." The students were also asked to state their general basis for judging the items. The 24 items had been previously classified according to Bloom's cognitive-skills…

Measurement invariance of the Depression Anxiety Stress Scales-21 across medical student genders

PubMed Central

Jafari, Peyman; Nozari, Farnoosh; Ahrari, Forooghosadat

2017-01-01

Objectives This study aimed to assess whether male and female Iranian medical students perceived the meaning of the items in the Depression Anxiety Stress Scales-21 consistently. Methods A convenience sample of 783 preclinical medical students from the first to sixth semester was invited to this cross-sectional study. Of the 477 respondents, 238 were male and 239 were female. All participants completed the Persian version of the Depression Anxiety Stress Scales-21. The graded response model was used to assess measurement invariance of the instrument across the gender groups. Categorical confirmatory factor analysis was used to evaluate the construct validity of the measure. Moreover, internal consistency was assessed via Cronbach's Alpha. Results Statistically significant differential item functioning was flagged for just item 6 in the depression subscales (c2=6.5, df=1, p=0.011). However, removing or retaining the item 6 in the stress subscale did not change our findings significantly, when we compared stress scores across two genders. The results of categorical confirmatory factor analysis supported the fit of the three-factor model of Depression Anxiety Stress Scales-21. Moreover, Cronbach’s alpha was greater than 0.7 in depression, anxiety and stress subscales. Conclusions This study revealed that Depression Anxiety Stress Scales-21 is an invariant measure across male and female medical students. Hence, this reliable and valid instrument can be used for meaningful comparison of distress scores between medical student genders. Gender comparisons of medical students’ psychological profiles provide a better insight into gender influences on the outcome of medical education and medical practice.  PMID:28362630

Measurement invariance of the Depression Anxiety Stress Scales-21 across medical student genders.

PubMed

Jafari, Peyman; Nozari, Farnoosh; Ahrari, Forooghosadat; Bagheri, Zahra

2017-03-30

This study aimed to assess whether male and female Iranian medical students perceived the meaning of the items in the Depression Anxiety Stress Scales-21 consistently. A convenience sample of 783 preclinical medical students from the first to sixth semester was invited to this cross-sectional study. Of the 477 respondents, 238 were male and 239 were female. All participants completed the Persian version of the Depression Anxiety Stress Scales-21. The graded response model was used to assess measurement invariance of the instrument across the gender groups. Categorical confirmatory factor analysis was used to evaluate the construct validity of the measure. Moreover, internal consistency was assessed via Cronbach's Alpha. Statistically significant differential item functioning was flagged for just item 6 in the depression subscales (c 2 =6.5, df=1, p=0.011). However, removing or retaining the item 6 in the stress subscale did not change our findings significantly, when we compared stress scores across two genders. The results of categorical confirmatory factor analysis supported the fit of the three-factor model of Depression Anxiety Stress Scales-21. Moreover, Cronbach's alpha was greater than 0.7 in depression, anxiety and stress subscales. This study revealed that Depression Anxiety Stress Scales-21 is an invariant measure across male and female medical students. Hence, this reliable and valid instrument can be used for meaningful comparison of distress scores between medical student genders. Gender comparisons of medical students' psychological profiles provide a better insight into gender influences on the outcome of medical education and medical practice.

The Malaysia DREEM: perceptions of medical students about the learning environment in a medical school in Malaysia

PubMed Central

Al-Naggar, Redhwan A; Abdulghani, Mahfoudh; Osman, Muhamed T; Al-Kubaisy, Waqar; Daher, Aqil Mohammad; Nor Aripin, Khairun Nain Bin; Assabri, Ali; Al-Hidabi, Dawood A; Ibrahim, Mohamed Izham B Mohamed; Al-Rofaai, Ahmed; Ibrahim, Hisham S; Al-Talib, Hassanain; Al-Khateeb, Alyaa; Othman, Gamil Qasem; Abdulaziz, Qaid Ali; Chinna, Karuthan; Bobryshev, Yuri V

2014-01-01

Background Students’ perceptions of their learning environment, by defining its strengths and weaknesses, are important for continuous improvement of the educational environments and curriculum. Therefore, the aim of this study was to explore students’ perceptions of their learning environment, among medical students in Malaysia. Various aspects of the education environment were compared between year levels and sex. Methods This cross-sectional study was conducted at the Management and Science University, Shah Alam, Malaysia in 2012. A total number of 438 medical students participated in this study, and the response rate was 87.6%. Data were analyzed using SPSS. Comparisons of the mean scores of Dundee Ready Education Environment Measure (DREEM) subscales were calculated. The t-test was used to determine statistically significant differences. Results The majority of the study participants were female, Malay, and from year 3 (68.7%, 65.3%, and 55.7%; respectively). Analysis of each of the 50 items of the DREEM inventory showed that 47 items scored ranged between 2.00 and 3.00, and three items scored below 2.00. These were identified as problem areas in this medical school that are required to be critically addressed. The overall score showed that the medical students’ perceptions were positive. The students’ perception toward educational environment was positive for all five DREEM subscales. Conclusion The study found that, in general, the perceptions of the participants about the learning environment were positive. Nevertheless, the study also found there is a need for curriculum improvement in this school and identified priority areas for such improvement. PMID:24959093

The Malaysia DREEM: perceptions of medical students about the learning environment in a medical school in Malaysia.

PubMed

Al-Naggar, Redhwan A; Abdulghani, Mahfoudh; Osman, Muhamed T; Al-Kubaisy, Waqar; Daher, Aqil Mohammad; Nor Aripin, Khairun Nain Bin; Assabri, Ali; Al-Hidabi, Dawood A; Ibrahim, Mohamed Izham B Mohamed; Al-Rofaai, Ahmed; Ibrahim, Hisham S; Al-Talib, Hassanain; Al-Khateeb, Alyaa; Othman, Gamil Qasem; Abdulaziz, Qaid Ali; Chinna, Karuthan; Bobryshev, Yuri V

2014-01-01

Students' perceptions of their learning environment, by defining its strengths and weaknesses, are important for continuous improvement of the educational environments and curriculum. Therefore, the aim of this study was to explore students' perceptions of their learning environment, among medical students in Malaysia. Various aspects of the education environment were compared between year levels and sex. This cross-sectional study was conducted at the Management and Science University, Shah Alam, Malaysia in 2012. A total number of 438 medical students participated in this study, and the response rate was 87.6%. Data were analyzed using SPSS. Comparisons of the mean scores of Dundee Ready Education Environment Measure (DREEM) subscales were calculated. The t-test was used to determine statistically significant differences. The majority of the study participants were female, Malay, and from year 3 (68.7%, 65.3%, and 55.7%; respectively). Analysis of each of the 50 items of the DREEM inventory showed that 47 items scored ranged between 2.00 and 3.00, and three items scored below 2.00. These were identified as problem areas in this medical school that are required to be critically addressed. The overall score showed that the medical students' perceptions were positive. The students' perception toward educational environment was positive for all five DREEM subscales. The study found that, in general, the perceptions of the participants about the learning environment were positive. Nevertheless, the study also found there is a need for curriculum improvement in this school and identified priority areas for such improvement.

17 CFR 260.7a-16 - Inclusion of items, differentiation between items and answers, omission of instructions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 17 Commodity and Securities Exchanges 3 2012-04-01 2012-04-01 false Inclusion of items, differentiation between items and answers, omission of instructions. 260.7a-16 Section 260.7a-16 Commodity and... INDENTURE ACT OF 1939 Formal Requirements § 260.7a-16 Inclusion of items, differentiation between items and...

17 CFR 260.7a-16 - Inclusion of items, differentiation between items and answers, omission of instructions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 17 Commodity and Securities Exchanges 4 2014-04-01 2014-04-01 false Inclusion of items, differentiation between items and answers, omission of instructions. 260.7a-16 Section 260.7a-16 Commodity and... INDENTURE ACT OF 1939 Formal Requirements § 260.7a-16 Inclusion of items, differentiation between items and...

17 CFR 260.7a-16 - Inclusion of items, differentiation between items and answers, omission of instructions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 17 Commodity and Securities Exchanges 3 2013-04-01 2013-04-01 false Inclusion of items, differentiation between items and answers, omission of instructions. 260.7a-16 Section 260.7a-16 Commodity and... INDENTURE ACT OF 1939 Formal Requirements § 260.7a-16 Inclusion of items, differentiation between items and...

17 CFR 260.7a-16 - Inclusion of items, differentiation between items and answers, omission of instructions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 17 Commodity and Securities Exchanges 3 2011-04-01 2011-04-01 false Inclusion of items, differentiation between items and answers, omission of instructions. 260.7a-16 Section 260.7a-16 Commodity and... INDENTURE ACT OF 1939 Formal Requirements § 260.7a-16 Inclusion of items, differentiation between items and...

17 CFR 260.7a-16 - Inclusion of items, differentiation between items and answers, omission of instructions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Inclusion of items, differentiation between items and answers, omission of instructions. 260.7a-16 Section 260.7a-16 Commodity and... INDENTURE ACT OF 1939 Formal Requirements § 260.7a-16 Inclusion of items, differentiation between items and...

Comparing Methods for Item Analysis: The Impact of Different Item-Selection Statistics on Test Difficulty

ERIC Educational Resources Information Center

Jones, Andrew T.

2011-01-01

Practitioners often depend on item analysis to select items for exam forms and have a variety of options available to them. These include the point-biserial correlation, the agreement statistic, the B index, and the phi coefficient. Although research has demonstrated that these statistics can be useful for item selection, no research as of yet has…

The Effects of Test Length and Sample Size on Item Parameters in Item Response Theory

ERIC Educational Resources Information Center

Sahin, Alper; Anil, Duygu

2017-01-01

This study investigates the effects of sample size and test length on item-parameter estimation in test development utilizing three unidimensional dichotomous models of item response theory (IRT). For this purpose, a real language test comprised of 50 items was administered to 6,288 students. Data from this test was used to obtain data sets of…

Developing and evaluating innovative items for the NCLEX: Part 2, item characteristics and cognitive processing.

PubMed

Wendt, Anne; Harmes, J Christine

2009-01-01

This article is a continuation of the research on the development and evaluation of innovative item formats for the NCLEX examinations that was published in the March/April 2009 edition of Nurse Educator. The authors discuss the innovative item templates and evaluate the statistical characteristics and level of cognitive processing required to answer the examination items.

Approximation Preserving Reductions among Item Pricing Problems

NASA Astrophysics Data System (ADS)

Hamane, Ryoso; Itoh, Toshiya; Tomita, Kouhei

When a store sells items to customers, the store wishes to determine the prices of the items to maximize its profit. Intuitively, if the store sells the items with low (resp. high) prices, the customers buy more (resp. less) items, which provides less profit to the store. So it would be hard for the store to decide the prices of items. Assume that the store has a set V of n items and there is a set E of m customers who wish to buy those items, and also assume that each item i ∈ V has the production cost di and each customer ej ∈ E has the valuation vj on the bundle ej ⊆ V of items. When the store sells an item i ∈ V at the price ri, the profit for the item i is pi = ri - di. The goal of the store is to decide the price of each item to maximize its total profit. We refer to this maximization problem as the item pricing problem. In most of the previous works, the item pricing problem was considered under the assumption that pi ≥ 0 for each i ∈ V, however, Balcan, et al. [In Proc. of WINE, LNCS 4858, 2007] introduced the notion of “loss-leader, ” and showed that the seller can get more total profit in the case that pi < 0 is allowed than in the case that pi < 0 is not allowed. In this paper, we derive approximation preserving reductions among several item pricing problems and show that all of them have algorithms with good approximation ratio.

42 CFR 102.80 - Calculation of medical benefits.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Calculation of medical benefits. 102.80 Section 102.80 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES SMALLPOX... medical items and services that are reasonable and necessary to diagnose or treat a smallpox vaccine...

42 CFR 102.80 - Calculation of medical benefits.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Calculation of medical benefits. 102.80 Section 102.80 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES SMALLPOX... medical items and services that are reasonable and necessary to diagnose or treat a smallpox vaccine...

42 CFR 102.80 - Calculation of medical benefits.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Calculation of medical benefits. 102.80 Section 102.80 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES SMALLPOX... medical items and services that are reasonable and necessary to diagnose or treat a smallpox vaccine...

Which Statistic Should Be Used to Detect Item Preknowledge When the Set of Compromised Items Is Known?

PubMed

Sinharay, Sandip

2017-09-01

Benefiting from item preknowledge is a major type of fraudulent behavior during educational assessments. Belov suggested the posterior shift statistic for detection of item preknowledge and showed its performance to be better on average than that of seven other statistics for detection of item preknowledge for a known set of compromised items. Sinharay suggested a statistic based on the likelihood ratio test for detection of item preknowledge; the advantage of the statistic is that its null distribution is known. Results from simulated and real data and adaptive and nonadaptive tests are used to demonstrate that the Type I error rate and power of the statistic based on the likelihood ratio test are very similar to those of the posterior shift statistic. Thus, the statistic based on the likelihood ratio test appears promising in detecting item preknowledge when the set of compromised items is known.

Portuguese Medical Students' Knowledge and Attitudes Towards Homosexuality.

PubMed

Lopes, Lucas; Gato, Jorge; Esteves, Manuel

2016-11-01

Lesbian, gay, bisexual and transgender people still face discrimination in healthcare environments and physicians often report lack of knowledge on this population's specific healthcare needs. In fact, recommendations have been put forward to include lesbian, gay, bisexual and transgender health in medical curricula. This study aimed to explore factors associated with medical students' knowledge and attitudes towards homosexuality in different years of the medical course. An anonymous online-based questionnaire was sent to all medical students enrolled at the Faculty of Medicine - University of Porto, Portugal, in December 2015. The questionnaire included socio-demographic questions, the Multidimensional Scale of Attitudes Toward Lesbians and Gay Men (27 items) and a Homosexuality Knowledge Questionnaire (17 items). Descriptive statistics, ANOVAs, Chi-square tests and Pearson's correlations were used in the analysis. A total of 489 completed responses was analyzed. Male gender, religiosity and absence of lesbian, gay or bisexual friends were associated with more negative attitudes towards homosexuality. Attitudinal scores did not correlate with advanced years in medical course or contact with lesbian, gay or bisexual patients. Students aiming to pursue technique-oriented specialties presented higher scores in the 'Modern Heterosexism' subscale than students seeking patient-oriented specialties. Although advanced years in medical course correlated significantly with higher knowledge scores, items related with lesbian, gay or bisexual health showed the lowest percentage of correct answers. There seems to be a lack of exploration of medical students' personal attitudes towards lesbians and gay men, and also a lack of knowledge on lesbian, gay or bisexual specific healthcare needs. This study highlights the importance of inclusive undergraduate curriculum development in order to foster quality healthcare.

Factoring handedness data: I. Item analysis.

PubMed

Messinger, H B; Messinger, M I

1995-12-01

Recently in this journal Peters and Murphy challenged the validity of factor analyses done on bimodal handedness data, suggesting instead that right- and left-handers be studied separately. But bimodality may be avoidable if attention is paid to Oldfield's questionnaire format and instructions for the subjects. Two characteristics appear crucial: a two-column LEFT-RIGHT format for the body of the instrument and what we call Oldfield's Admonition: not to indicate strong preference for handedness item, such as write, unless "... the preference is so strong that you would never try to use the other hand unless absolutely forced to...". Attaining unimodality of an item distribution would seem to overcome the objections of Peters and Murphy. In a 1984 survey in Boston we used Oldfield's ten-item questionnaire exactly as published. This produced unimodal item distributions. With reflection of the five-point item scale and a logarithmic transformation, we achieved a degree of normalization for the items. Two surveys elsewhere based on Oldfield's 20-item list but with changes in the questionnaire format and the instructions, yielded markedly different item distributions with peaks at each extreme and sometimes in the middle as well.

[Medical manuscripts in the library of the Deontology Department of the Ankara University Medical School].

PubMed

Arda, B

1998-01-01

At every academical platform on medical history and its instruction, lack of Turkish medical historiography is mainly emphasized. There are two main factors determining the situation: 1-There isn't any comprehensive Turkish medical history textbook. 2-There are difficulties in reaching the primary sources in this field. Everybody agrees with the importance of reaching medical manuscripts easily and reading and evaluating them in medical history. For this reason, it is important to know where we can find them. In this article, medical manuscripts which are available in the library of the Deontology Department of Ankara University Medical School are introduced. The manuscripts have been listed in alphabetical order of the authors' name. The bibliographic items, such as the size, writing style, and type of paper used, are mentioned.

Restricted interests and teacher presentation of items.

PubMed

Stocco, Corey S; Thompson, Rachel H; Rodriguez, Nicole M

2011-01-01

Restricted and repetitive behavior (RRB) is more pervasive, prevalent, frequent, and severe in individuals with autism spectrum disorders (ASDs) than in their typical peers. One subtype of RRB is restricted interests in items or activities, which is evident in the manner in which individuals engage with items (e.g., repetitious wheel spinning), the types of items or activities they select (e.g., preoccupation with a phone book), or the range of items or activities they select (i.e., narrow range of items). We sought to describe the relation between restricted interests and teacher presentation of items. Overall, we observed 5 teachers interacting with 2 pairs of students diagnosed with an ASD. Each pair included 1 student with restricted interests. During these observations, teachers were free to present any items from an array of 4 stimuli selected by experimenters. We recorded student responses to teacher presentation of items and analyzed the data to determine the relation between teacher presentation of items and the consequences for presentation provided by the students. Teacher presentation of items corresponded with differential responses provided by students with ASD, and those with restricted preferences experienced a narrower array of items.

Measuring psychological trauma after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Psychological Trauma item bank and short form

PubMed Central

Kisala, Pamela A.; Victorson, David; Pace, Natalie; Heinemann, Allen W.; Choi, Seung W.; Tulsky, David S.

2015-01-01

Objective To describe the development and psychometric properties of the SCI-QOL Psychological Trauma item bank and short form. Design Using a mixed-methods design, we developed and tested a Psychological Trauma item bank with patient and provider focus groups, cognitive interviews, and item response theory based analytic approaches, including tests of model fit, differential item functioning (DIF) and precision. Setting We tested a 31-item pool at several medical institutions across the United States, including the University of Michigan, Kessler Foundation, Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital and the James J. Peters/Bronx Veterans Administration hospital. Participants A total of 716 individuals with SCI completed the trauma items Results The 31 items fit a unidimensional model (CFI=0.952; RMSEA=0.061) and demonstrated good precision (theta range between 0.6 and 2.5). Nine items demonstrated negligible DIF with little impact on score estimates. The final calibrated item bank contains 19 items Conclusion The SCI-QOL Psychological Trauma item bank is a psychometrically robust measurement tool from which a short form and a computer adaptive test (CAT) version are available. PMID:26010967

The medial temporal lobes distinguish between within-item and item-context relations during autobiographical memory retrieval.

PubMed

Sheldon, Signy; Levine, Brian

2015-12-01

During autobiographical memory retrieval, the medial temporal lobes (MTL) relate together multiple event elements, including object (within-item relations) and context (item-context relations) information, to create a cohesive memory. There is consistent support for a functional specialization within the MTL according to these relational processes, much of which comes from recognition memory experiments. In this study, we compared brain activation patterns associated with retrieving within-item relations (i.e., associating conceptual and sensory-perceptual object features) and item-context relations (i.e., spatial relations among objects) with respect to naturalistic autobiographical retrieval. We developed a novel paradigm that cued participants to retrieve information about past autobiographical events, non-episodic within-item relations, and non-episodic item-context relations with the perceptuomotor aspects of retrieval equated across these conditions. We used multivariate analysis techniques to extract common and distinct patterns of activity among these conditions within the MTL and across the whole brain, both in terms of spatial and temporal patterns of activity. The anterior MTL (perirhinal cortex and anterior hippocampus) was preferentially recruited for generating within-item relations later in retrieval whereas the posterior MTL (posterior parahippocampal cortex and posterior hippocampus) was preferentially recruited for generating item-context relations across the retrieval phase. These findings provide novel evidence for functional specialization within the MTL with respect to naturalistic memory retrieval. © 2015 Wiley Periodicals, Inc.

Examining Multiple Sources of Differential Item Functioning on the Clinician & Group CAHPS® Survey

PubMed Central

Rodriguez, Hector P; Crane, Paul K

2011-01-01

Objective To evaluate psychometric properties of a widely used patient experience survey. Data Sources English-language responses to the Clinician & Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS®) survey (n = 12,244) from a 2008 quality improvement initiative involving eight southern California medical groups. Methods We used an iterative hybrid ordinal logistic regression/item response theory differential item functioning (DIF) algorithm to identify items with DIF related to patient sociodemographic characteristics, duration of the physician–patient relationship, number of physician visits, and self-rated physical and mental health. We accounted for all sources of DIF and determined its cumulative impact. Principal Findings The upper end of the CG-CAHPS® performance range is measured with low precision. With sensitive settings, some items were found to have DIF. However, overall DIF impact was negligible, as 0.14 percent of participants had salient DIF impact. Latinos who spoke predominantly English at home had the highest prevalence of salient DIF impact at 0.26 percent. Conclusions The CG-CAHPS® functions similarly across commercially insured respondents from diverse backgrounds. Consequently, previously documented racial and ethnic group differences likely reflect true differences rather than measurement bias. The impact of low precision at the upper end of the scale should be clarified. PMID:22092021

Managing a Test Item Bank on a Microcomputer: Can It Help You and Your Students?

ERIC Educational Resources Information Center

Peterson, Julian A.; Meister, Lynn L.

1983-01-01

Describes a test item bank developed by the Association for Medical School Departments of Biochemistry (Texas). Programs (written in Pascal) allow self-evaluation by interactive student access to questions randomly selected from a chosen category. Potential users of the system (having student, manager, and instructor modes) are invited to contact…

Managing the Navy’s Infectious Medical Waste

DTIC Science & Technology

1992-08-04

pasteur pipetes, broken glass, scalpel blades) which have come into contact with infectious agents during use in patient care or in medical , research...concerned patients with a responsible method of disposal of their syringes. 4.8 Proposed Federal Legislation On June 22, 1992, American Medical News reported...disposal point for non- medically related wastes which required special handling. These wastes included such items as confiscated marijuana , sensitive

Differential item functioning of the patient-reported outcomes information system (PROMIS®) pain interference item bank by language (Spanish versus English).

PubMed

Paz, Sylvia H; Spritzer, Karen L; Reise, Steven P; Hays, Ron D

2017-06-01

About 70% of Latinos, 5 years old or older, in the United States speak Spanish at home. Measurement equivalence of the PROMIS ® pain interference (PI) item bank by language of administration (English versus Spanish) has not been evaluated. A sample of 527 adult Spanish-speaking Latinos completed the Spanish version of the 41-item PROMIS ® pain interference item bank. We evaluate dimensionality, monotonicity and local independence of the Spanish-language items. Then we evaluate differential item functioning (DIF) using ordinal logistic regression with item response theory scores estimated from DIF-free "anchor" items. One of the 41 items in the Spanish version of the PROMIS ® PI item bank was identified as having significant uniform DIF. English- and Spanish-speaking subjects with the same level of pain interference responded differently to 1 of the 41 items in the PROMIS ® PI item bank. This item was not retained due to proprietary issues. The original English language item parameters can be used when estimating PROMIS ® PI scores.

Durable medical equipment recycling: a pilot program.

PubMed

Wright, Aaron J

2012-01-01

Our unfunded trauma patients often lack the access to adequate health care services and equipment after hospital discharge. We have developed and implemented a pilot program to provide reclaimed durable medical equipment to medically indigent trauma patients. Our program includes the reuse of items such as front-wheeled walkers, bedside commodes, shower chairs, crutches, and canes.

Conditional recall and the frequency effect in the serial recall task: an examination of item-to-item associativity.

PubMed

Miller, Leonie M; Roodenrys, Steven

2012-11-01

The frequency effect in short-term serial recall is influenced by the composition of lists. In pure lists, a robust advantage in the recall of high-frequency (HF) words is observed, yet in alternating mixed lists, HF and low-frequency (LF) words are recalled equally well. It has been argued that the preexisting associations between all list items determine a single, global level of supportive activation that assists item recall. Preexisting associations between items are assumed to be a function of language co-occurrence; HF-HF associations are high, LF-LF associations are low, and mixed associations are intermediate in activation strength. This account, however, is based on results when alternating lists with equal numbers of HF and LF words were used. It is possible that directional association between adjacent list items is responsible for the recall patterns reported. In the present experiment, the recall of three forms of mixed lists-those with equal numbers of HF and LF items and pure lists-was examined to test the extent to which item-to-item associations are present in serial recall. Furthermore, conditional probabilities were used to examine more closely the evidence for a contribution, since correct-in-position scoring may mask recall that is dependent on the recall of prior items. The results suggest that an item-to-item effect is clearly present for early but not late list items, and they implicate an additional factor, perhaps the availability of resources at output, in the recall of late list items.

Caries Risk Assessment Item Importance

PubMed Central

Chaffee, B.W.; Featherstone, J.D.B.; Gansky, S.A.; Cheng, J.; Zhan, L.

2016-01-01

Caries risk assessment (CRA) is widely recommended for dental caries management. Little is known regarding how practitioners use individual CRA items to determine risk and which individual items independently predict clinical outcomes in children younger than 6 y. The objective of this study was to assess the relative importance of pediatric CRA items in dental providers’ decision making regarding patient risk and in association with clinically evident caries, cross-sectionally and longitudinally. CRA information was abstracted retrospectively from electronic patient records of children initially aged 6 to 72 mo at a university pediatric dentistry clinic (n = 3,810 baseline; n = 1,315 with follow-up). The 17-item CRA form included caries risk indicators, caries protective items, and clinical indicators. Conditional random forests classification trees were implemented to identify and assign variable importance to CRA items independently associated with baseline high-risk designation, baseline evident tooth decay, and follow-up evident decay. Thirteen individual CRA items, including all clinical indicators and all but 1 risk indicator, were independently and statistically significantly associated with student/resident providers’ caries risk designation. Provider-assigned baseline risk category was strongly associated with follow-up decay, which increased from low (20.4%) to moderate (30.6%) to high/extreme risk patients (68.7%). Of baseline CRA items, before adjustment, 12 were associated with baseline decay and 7 with decay at follow-up; however, in the conditional random forests models, only the clinical indicators (evident decay, dental plaque, and recent restoration placement) and 1 risk indicator (frequent snacking) were independently and statistically significantly associated with future disease, for which baseline evident decay was the strongest predictor. In this predominantly high-risk population under caries-preventive care, more individual CRA items

Patients and Medical Statistics

PubMed Central

Woloshin, Steven; Schwartz, Lisa M; Welch, H Gilbert

2005-01-01

BACKGROUND People are increasingly presented with medical statistics. There are no existing measures to assess their level of interest or confidence in using medical statistics. OBJECTIVE To develop 2 new measures, the STAT-interest and STAT-confidence scales, and assess their reliability and validity. DESIGN Survey with retest after approximately 2 weeks. SUBJECTS Two hundred and twenty-four people were recruited from advertisements in local newspapers, an outpatient clinic waiting area, and a hospital open house. MEASURES We developed and revised 5 items on interest in medical statistics and 3 on confidence understanding statistics. RESULTS Study participants were mostly college graduates (52%); 25% had a high school education or less. The mean age was 53 (range 20 to 84) years. Most paid attention to medical statistics (6% paid no attention). The mean (SD) STAT-interest score was 68 (17) and ranged from 15 to 100. Confidence in using statistics was also high: the mean (SD) STAT-confidence score was 65 (19) and ranged from 11 to 100. STAT-interest and STAT-confidence scores were moderately correlated (r=.36, P<.001). Both scales demonstrated good test–retest repeatability (r=.60, .62, respectively), internal consistency reliability (Cronbach's α=0.70 and 0.78), and usability (individual item nonresponse ranged from 0% to 1.3%). Scale scores correlated only weakly with scores on a medical data interpretation test (r=.15 and .26, respectively). CONCLUSION The STAT-interest and STAT-confidence scales are usable and reliable. Interest and confidence were only weakly related to the ability to actually use data. PMID:16307623

Medical terminology: Its size and typology.

PubMed

Kucharz, Eugeniusz Józef

2015-01-01

Medical terminology is one of the largest specialized terminologies and is estimated to contain over 250,000 items. Classification of medical terminology into six categories is proposed. The categories are as the following: (A) medical terms that are a part of general basic lexicon of average native speaker (0.02-0.03 % of all terms), (B) specialized medical terms known by average physician (about 45 % of all terms), (C) highly-specialized terms of subspecialties (about 15 % of all terms) (D) medical terms that primarily belong to other terminologies (e.g. biological, chemical, physical, statistical) (about 20 % of all terms), (E) medical slang (0.04-0.05 % of all terms), and (F) pharmaceutical terminology (about 20 % of all terms).

Item response theory - A first approach

NASA Astrophysics Data System (ADS)

Nunes, Sandra; Oliveira, Teresa; Oliveira, Amílcar

2017-07-01

The Item Response Theory (IRT) has become one of the most popular scoring frameworks for measurement data, frequently used in computerized adaptive testing, cognitively diagnostic assessment and test equating. According to Andrade et al. (2000), IRT can be defined as a set of mathematical models (Item Response Models - IRM) constructed to represent the probability of an individual giving the right answer to an item of a particular test. The number of Item Responsible Models available to measurement analysis has increased considerably in the last fifteen years due to increasing computer power and due to a demand for accuracy and more meaningful inferences grounded in complex data. The developments in modeling with Item Response Theory were related with developments in estimation theory, most remarkably Bayesian estimation with Markov chain Monte Carlo algorithms (Patz & Junker, 1999). The popularity of Item Response Theory has also implied numerous overviews in books and journals, and many connections between IRT and other statistical estimation procedures, such as factor analysis and structural equation modeling, have been made repeatedly (Van der Lindem & Hambleton, 1997). As stated before the Item Response Theory covers a variety of measurement models, ranging from basic one-dimensional models for dichotomously and polytomously scored items and their multidimensional analogues to models that incorporate information about cognitive sub-processes which influence the overall item response process. The aim of this work is to introduce the main concepts associated with one-dimensional models of Item Response Theory, to specify the logistic models with one, two and three parameters, to discuss some properties of these models and to present the main estimation procedures.

Recommendations to improve the positive and negative syndrome scale (PANSS) based on item response theory.

PubMed

Levine, Stephen Z; Rabinowitz, Jonathan; Rizopoulos, Dimitris

2011-08-15

The adequacy of the Positive and Negative Syndrome Scale (PANSS) items in measuring symptom severity in schizophrenia was examined using Item Response Theory (IRT). Baseline PANSS assessments were analyzed from two multi-center clinical trials of antipsychotic medication in chronic schizophrenia (n=1872). Generally, the results showed that the PANSS (a) item ratings discriminated symptom severity best for the negative symptoms; (b) has an excess of "Severe" and "Extremely severe" rating options; and (c) assessments are more reliable at medium than very low or high levels of symptom severity. Analysis also showed that the detection of statistically and non-statistically significant differences in treatment were highly similar for the original and IRT-modified PANSS. In clinical trials of chronic schizophrenia, the PANSS appears to require the following modifications: fewer rating options, adjustment of 'Lack of judgment and insight', and improved severe symptom assessment. 2011 Elsevier Ltd. All rights reserved.

‘Forget me (not)?’ – Remembering Forget-Items Versus Un-Cued Items in Directed Forgetting

PubMed Central

Zwissler, Bastian; Schindler, Sebastian; Fischer, Helena; Plewnia, Christian; Kissler, Johanna M.

2015-01-01

Humans need to be able to selectively control their memories. This capability is often investigated in directed forgetting (DF) paradigms. In item-method DF, individual items are presented and each is followed by either a forget- or remember-instruction. On a surprise test of all items, memory is then worse for to-be-forgotten items (TBF) compared to to-be-remembered items (TBR). This is thought to result mainly from selective rehearsal of TBR, although inhibitory mechanisms also appear to be recruited by this paradigm. Here, we investigate whether the mnemonic consequences of a forget instruction differ from the ones of incidental encoding, where items are presented without a specific memory instruction. Four experiments were conducted where un-cued items (UI) were interspersed and recognition performance was compared between TBR, TBF, and UI stimuli. Accuracy was encouraged via a performance-dependent monetary bonus. Experiments varied the number of items and their presentation speed and used either letter-cues or symbolic cues. Across all experiments, including perceptually fully counterbalanced variants, memory accuracy for TBF was reduced compared to TBR, but better than for UI. Moreover, participants made consistently fewer false alarms and used a very conservative response criterion when responding to TBF stimuli. Thus, the F-cue results in active processing and reduces false alarm rate, but this does not impair recognition memory beyond an un-cued baseline condition, where only incidental encoding occurs. Theoretical implications of these findings are discussed. PMID:26635657

Depression and stigma in medical students at a private medical college.

PubMed

Vankar, Jagdish R; Prabhakaran, Anusha; Sharma, Himanshu

2014-07-01

This study aimed to assess prevalence rate of depression and perceptions regarding stigma associated with depression amongst medical students. A cross-sectional survey was conducted amongst 331 undergraduate medical students at a private medical college in Gujarat. Data was collected, which comprised of socio-demographic details, Patient Health Questionnaire (PHQ-9), and a 22-item semi-structured questionnaire to assess personal, perceived, and help-seeking stigma. Univariate analysis and chi-square tests were used to test for association between variables. Overall prevalence of depression was found to be 64%. Highest level of depression was seen in first year. Moderate to severe depression was found in 26.6% students. 73.3% students felt that having depression would negatively affect their education, and 52.3% saw depression as a sign of personal weakness. Females more strongly believed that students would not want to work with a depressed student (50.9% v/s 36.2%) and that if depressed, they would be unable to complete medical college responsibilities (61.9% v/s 44.1%). With increasing academic year, there was increase in stigma about disclosing depression to friends (P = 0.0082) and increase in stigma about working with a depressed student (P = 0.0067). Depressed students felt more strongly than non-depressed students on 10 items of the stigma questionnaire. High stigma exists among students about the causation of depression, and there exists an environment in which students discriminate fellow colleagues based on the presence of depression. This raises need for increasing awareness and support from peers and faculty.

Computerized Adaptive Testing with Item Clones. Research Report.

ERIC Educational Resources Information Center

Glas, Cees A. W.; van der Linden, Wim J.

To reduce the cost of item writing and to enhance the flexibility of item presentation, items can be generated by item-cloning techniques. An important consequence of cloning is that it may cause variability on the item parameters. Therefore, a multilevel item response model is presented in which it is assumed that the item parameters of a…

Investigating Separate and Concurrent Approaches for Item Parameter Drift in 3PL Item Response Theory Equating

ERIC Educational Resources Information Center

Arce-Ferrer, Alvaro J.; Bulut, Okan

2017-01-01

This study examines separate and concurrent approaches to combine the detection of item parameter drift (IPD) and the estimation of scale transformation coefficients in the context of the common item nonequivalent groups design with the three-parameter item response theory equating. The study uses real and synthetic data sets to compare the two…

Exploring the Relevance of Items in the Communicative Participation Item Bank (CPIB) for Individuals With Hearing Loss

PubMed Central

Baylor, Carolyn R.; Birch, Kristen; Yorkston, Kathryn M.

2017-01-01

Purpose The Communicative Participation Item Bank (CPIB) was developed to evaluate participation restrictions in communication situations for individuals with speech and language disorders. This study evaluated the potential relevance of CPIB items for individuals with hearing loss. Method Cognitive interviews were conducted with 17 adults with a range of treated and untreated hearing loss, who responded to 46 items. Interviews were continued until saturation was reached and prevalent trends emerged. A focus group was also conducted with 3 experienced audiologists to seek their views on the CPIB. Analysis of data included qualitative and quantitative approaches. Results The majority of the items were applicable to individuals with hearing loss; however, 12 items were identified as potentially not relevant. This was largely attributed to the items' focus on speech production rather than hearing. The results from the focus group were in agreement for a majority of items. Conclusions The next step in validating the CPIB for individuals with hearing loss is a psychometric analysis on a large sample. Possible outcomes could be that the CPIB is considered valid in its entirety or the creation of a new questionnaire or a hearing loss–specific short form with a subset of items is necessary. PMID:28114665

Introduction to an open source internet-based testing program for medical student examinations.

PubMed

Lee, Yoon-Hwan

2009-12-20

The author developed a freely available open source internet-based testing program for medical examination. PHP and Java script were used as the programming language and postgreSQL as the database management system on an Apache web server and Linux operating system. The system approach was that a super user inputs the items, each school administrator inputs the examinees' information, and examinees access the system. The examinee's score is displayed immediately after examination with item analysis. The set-up of the system beginning with installation is described. This may help medical professors to easily adopt an internet-based testing system for medical education.

Development and validation of a professionalism assessment scale for medical students

PubMed Central

Klemenc-Ketis, Zalika; Vrecko, Helena

2014-01-01

Objectives To develop and validate a scale for the assess-ment of professionalism in medical students based on students' perceptions of and attitudes towards professional-ism in medicine. Methods This was a mixed methods study with under-graduate medical students. Two focus groups were carried out with 12 students, followed by a transcript analysis (grounded theory method with open coding). Then, a 3-round Delphi with 20 family medicine experts was carried out. A psychometric assessment of the scale was performed with a group of 449 students. The items of the Professional-ism Assessment Scale could be answered on a five-point Likert scale. Results After the focus groups, the first version of the PAS consisted of 56 items and after the Delphi study, 30 items remained. The final sample for quantitative study consisted of 122 students (27.2% response rate). There were 95 (77.9%) female students in the sample. The mean age of the sample was 22.1 ± 2.1 years. After the principal component analysis, we removed 8 items and produced the final version of the PAS (22 items). The Cronbach's alpha of the scale was 0.88. Factor analysis revealed three factors: empathy and humanism, professional relationships and development and responsibility. Conclusions The new Professionalism Assessment Scale proved to be valid and reliable. It can be used for the assessment of professionalism in undergraduate medical students. PMID:25382090

76 FR 60474 - Commercial Item Handbook

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-29

... DEPARTMENT OF DEFENSE Defense Acquisition Regulations System Commercial Item Handbook AGENCY.... SUMMARY: DoD has updated its Commercial Item Handbook. The purpose of the Handbook is to help acquisition personnel develop sound business strategies for procuring commercial items. DoD is seeking industry input on...

Developing an Item Bank to Measure Quality of Life in Individuals With Glaucoma, and the Results of the Interview With Patients: The Effect of Visual Function, Visual Field Progression Rate, Medical, and Surgical Treatments on Quality of Life.

PubMed

Matsuura, Masato; Hirasawa, Kazunori; Hirasawa, Hiroyo; Yanagisawa, Mieko; Murata, Hiroshi; Mayama, Chihiro; Asaoka, Ryo

2017-02-01

To construct a new item bank to measure quality of life (QOL) in glaucoma patients and to evaluate glaucoma patients' QOL using the item bank. An item bank of questions was generated through a literature review of QOL instruments useful for glaucoma patients. Using this item bank, a cognitive survey was performed on 203 patients with glaucoma (112 males and 91 females, 61.9±11.9 y old; mean±SD). The results were then analyzed using the Rasch analysis, and the Rasch-derived disability scores were predicted using linear modelling and the following clinical parameters: age, mean total deviation (mTD) in superior and inferior visual field (mTDsup/mTDinf), mTD progression rate, better visual acuity, worse visual acuity, number of eye drops administered per day, number of trabeculectomy procedures experienced in both eyes. A total of 23 questionnaires of QOL in glaucoma patients were identified resulting in an item bank of 187 questions related to the following tasks: reading/writing, walking, going out, eating and driving (direct disability) as well as questions concerned with worry/anxiety, social participation, and physical symptoms (indirect disability). In the optimal model for direct disability, age and mTDinf were identified as significant predictors, whereas number of eye drops administered per day and number of trabeculectomy experienced were included in the optimal model for indirect disability. A new item bank to measure QOL in glaucoma patients was developed and evaluated. Age and mTDinf were found to be related to direct disability while medical and surgical treatments were related to indirect disability.

Work-family conflicts and subsequent sleep medication among women and men: a longitudinal registry linkage study.

PubMed

Lallukka, T; Arber, S; Laaksonen, M; Lahelma, E; Partonen, T; Rahkonen, O

2013-02-01

Work and family are two key domains of life among working populations. Conflicts between paid work and family life can be detrimental to sleep and other health-related outcomes. This study examined longitudinally the influence of work-family conflicts on subsequent sleep medication. Questionnaire data were derived from the Helsinki Health Study mail surveys in 2001-2002 (2929 women, 793 men) of employees aged 40-60 years. Data concerning sleep medication were derived from the Finnish Social Insurance Institution's registers covering all prescribed medication from 1995 to 2007. Four items measured whether job responsibilities interfered with family life (work to family conflicts), and four items measured whether family responsibilities interfered with work (family to work conflicts). Cox proportional hazard models were fitted, adjusting for age, sleep medication five years before baseline, as well as various family- and work-related covariates. During a five-year follow-up, 17% of women and 10% of men had at least one purchase of prescribed sleep medication. Among women, family to work conflicts were associated with sleep medication over the following 5 years after adjustment for age and prior medication. The association remained largely unaffected after adjusting for family-related and work-related covariates. Work to family conflicts were also associated with subsequent sleep medication after adjustment for age and prior medication. The association attenuated after adjustment for work-related factors. No associations could be confirmed among men. Thus reasons for men's sleep medication likely emerge outside their work and family lives. Concerning individual items, strain-based ones showed stronger associations with sleep medication than more concrete time-based items. In conclusion, in particular family to work conflicts, but also work to family conflicts, are clear determinants of women's sleep medication. Copyright © 2012 Elsevier Ltd. All rights reserved.

Generalized Full-Information Item Bifactor Analysis

PubMed Central

Cai, Li; Yang, Ji Seung; Hansen, Mark

2011-01-01

Full-information item bifactor analysis is an important statistical method in psychological and educational measurement. Current methods are limited to single group analysis and inflexible in the types of item response models supported. We propose a flexible multiple-group item bifactor analysis framework that supports a variety of multidimensional item response theory models for an arbitrary mixing of dichotomous, ordinal, and nominal items. The extended item bifactor model also enables the estimation of latent variable means and variances when data from more than one group are present. Generalized user-defined parameter restrictions are permitted within or across groups. We derive an efficient full-information maximum marginal likelihood estimator. Our estimation method achieves substantial computational savings by extending Gibbons and Hedeker’s (1992) bifactor dimension reduction method so that the optimization of the marginal log-likelihood only requires two-dimensional integration regardless of the dimensionality of the latent variables. We use simulation studies to demonstrate the flexibility and accuracy of the proposed methods. We apply the model to study cross-country differences, including differential item functioning, using data from a large international education survey on mathematics literacy. PMID:21534682

The Relationship between Personality Styles of Sociotropy and Autonomy With Suicidal Tendency in Medical Students

PubMed Central

Raeisei, Ahmadali; Mojahed, Azizollah; Bakhshani, Nour-Mohammad

2015-01-01

The research aim was investigating the relationship between personality styles of autonomy and sociotropy, and suicidal behavior at Zahedan University of medical sciences’ medical students. This was a descriptive correlational study. The population consisted of all medical students at Zahedan University of Medical Sciences internship period 2002-2003. The number of samples was 102 patients, including 47 males and 55 females. To collect information, the personal style inventory (PSI) with 48 items. Twenty four items to assess sociotropy, 24 items to assess autonomy, and to measure suicide the suicidal subscale (MMPI) with 21 items were used. The two scales had the content validity and for the reliability used Cronbach α. So the reliability of the personality styles is 0.84 and the reliability of the suicidal subscales is 0.83. Data were analyzed using Pearson’s correlation methods. The results showed that there is an inverse and significant relation between autonomic style and trends of suicide in men (P = 0.02, r = -0.43), but no association between sociotropy and suicidal tendencies were observed in men. There was no significant relationship between autonomy and sociotropy personality styles and tendency towards suicide in women. PMID:25948467

Building clinical data groups for electronic medical record in China.

PubMed

Tu, Haibo; Yu, Yingtao; Yang, Peng; Tang, Xuejun; Hu, Jianping; Rao, Keqin; Pan, Feng; Xu, Yongyong; Liu, Danhong

2012-04-01

This article aims at building clinical data groups for Electronic Medical Records (EMR) in China. These data groups can be reused as basic information units in building the medical sheets of Electronic Medical Record Systems (EMRS) and serve as part of its implementation guideline. The results were based on medical sheets, the forms that are used in hospitals, which were collected from hospitals. To categorize the information in these sheets into data groups, we adopted the Health Level 7 Clinical Document Architecture Release 2 Model (HL7 CDA R2 Model). The regulations and legal documents concerning health informatics and related standards in China were implemented. A set of 75 data groups with 452 data elements was created. These data elements were atomic items that comprised the data groups. Medical sheet items contained clinical records information and could be described by standard data elements that exist in current health document protocols. These data groups match different units of the CDA model. Twelve data groups with 87 standardized data elements described EMR headers, and 63 data groups with 405 standardized data elements constituted the body. The later 63 data groups in fact formed the sections of the model. The data groups had two levels. Those at the first level contained both the second level data groups and the standardized data elements. The data groups were basically reusable information units that served as guidelines for building EMRS and that were used to rebuild a medical sheet and serve as templates for the clinical records. As a pilot study of health information standards in China, the development of EMR data groups combined international standards with Chinese national regulations and standards, and this was the most critical part of the research. The original medical sheets from hospitals contain first hand medical information, and some of their items reveal the data types characteristic of the Chinese socialist national health system

7 CFR 2902.5 - Item designation.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., USDA will use life cycle cost information only from tests using the BEES analytical method. (c... availability of such items and the economic and technological feasibility of using such items, including life cycle costs. USDA will gather information on individual products within an item and extrapolate that...

Ipsative imputation for a 15-item Geriatric Depression Scale in community-dwelling elderly people.

PubMed

Imai, Hissei; Furukawa, Toshiaki A; Kasahara, Yoriko; Ishimoto, Yasuko; Kimura, Yumi; Fukutomi, Eriko; Chen, Wen-Ling; Tanaka, Mire; Sakamoto, Ryota; Wada, Taizo; Fujisawa, Michiko; Okumiya, Kiyohito; Matsubayashi, Kozo

2014-09-01

Missing data are inevitable in almost all medical studies. Imputation methods using the probabilistic model are common, but they cannot impute individual data and require special software. In contrast, the ipsative imputation method, which substitutes the missing items by the mean of the remaining items within the individual, is easy and does not need any special software, but it can provide individual scores. The aim of the present study was to evaluate the validity of the ipsative imputation method using data involving the 15-item Geriatric Depression Scale. Participants were community-dwelling elderly individuals (n = 1178). A structural equation model was constructed. The model fit indexes were calculated to assess the validity of the imputation method when it is used for individuals who were missing 20% of data or less and 40% of data or less, depending on whether we assumed that their correlation coefficients were the same as the dataset with no missing items. Finally, we compared path coefficients of the dataset imputed by ipsative imputation with those by multiple imputation. When compared with the assumption that the datasets differed, all of the model fit indexes were better under the assumption that the dataset without missing data is the same as that that was missing 20% of data or less. However, by the same assumption, the model fit indexes were worse in the dataset that was missing 40% of data or less. The path coefficients of the dataset imputed by ipsative imputation and by multiple imputation were compatible with each other if the proportion of missing items was 20% or less. Ipsative imputation appears to be a valid imputation method and can be used to impute data in studies using the 15-item Geriatric Depression Scale, if the percentage of its missing items is 20% or less. © 2014 The Authors. Psychogeriatrics © 2014 Japanese Psychogeriatric Society.

Positive attitudes towards psychiatry among Chinese medical students.

PubMed

Williams, Joshua A; Liu, Ni; Afzal, Khalid; Cooper, Brian; Sherer, Renslow; Morgan, Ivy; Dong, Hongmei

2014-02-01

Increasingly positive attitudes have been reported among young people in China towards mental illness, but little is known about Chinese medical students' attitudes towards psychiatry, psychiatric services and patients. We administered a bilingual survey to Wuhan University medical students in the final years of their clinical training. Primary outcomes were composite scores on a 21-item attitudes toward psychiatry (ATP) survey and the number of correct responses to diagnostic questions following a series of three clinical case vignettes. Mean composite score on the ATP items was 78/105 (SD = 9.6), representing overall positive attitudes among the students. Female gender and having learned about more psychiatric disorders were positively associated with a higher mean ATP score and remained so after adjustment for relevant covariates. Chinese medical students reported positive attitudes towards psychiatry, openness with regard to psychiatric services, and respect for psychiatric patients. Learning about a broad spectrum of psychiatric diagnoses and greater clinical contact with patients may improve overall attitudes of Chinese medical students towards psychiatry and their ability to make accurate diagnoses.

The 4-Item Negative Symptom Assessment (NSA-4) Instrument: A Simple Tool for Evaluating Negative Symptoms in Schizophrenia Following Brief Training.

PubMed

Alphs, Larry; Morlock, Robert; Coon, Cheryl; van Willigenburg, Arjen; Panagides, John

2010-07-01

Objective. To assess the ability of mental health professionals to use the 4-item Negative Symptom Assessment instrument, derived from the Negative Symptom Assessment-16, to rapidly determine the severity of negative symptoms of schizophrenia.Design. Open participation.Setting. Medical education conferences.Participants. Attendees at two international psychiatry conferences.Measurements. Participants read a brief set of the 4-item Negative Symptom Assessment instructions and viewed a videotape of a patient with schizophrenia. Using the 1 to 6 4-item Negative Symptom Assessment severity rating scale, they rated four negative symptom items and the overall global negative symptoms. These ratings were compared with a consensus rating determination using frequency distributions and Chi-square tests for the proportion of participant ratings that were within one point of the expert rating.Results. More than 400 medical professionals (293 physicians, 50% with a European practice, and 55% who reported past utilization of schizophrenia ratings scales) participated. Between 82.1 and 91.1 percent of the 4-items and the global rating determinations by the participants were within one rating point of the consensus expert ratings. The differences between the percentage of participant rating scores that were within one point versus the percentage that were greater than one point different from those by the consensus experts was significant (p<0.0001). Participants rating of negative symptoms using the 4-item Negative Symptom Assessment did not generally differ among the geographic regions of practice, the professional credentialing, or their familiarity with the use of schizophrenia symptom rating instruments.Conclusion. These findings suggest that clinicians from a variety of geographic practices can, after brief training, use the 4-item Negative Symptom Assessment effectively to rapidly assess negative symptoms in patients with schizophrenia.

Criterion-Referenced Test Items for Welding.

ERIC Educational Resources Information Center

Davis, Diane, Ed.

This test item bank on welding contains test questions based upon competencies found in the Missouri Welding Competency Profile. Some test items are keyed for multiple competencies. These criterion-referenced test items are designed to work with the Vocational Instructional Management System. Questions have been statistically sampled and validated…

Item Analysis in Introductory Economics Testing.

ERIC Educational Resources Information Center

Tinari, Frank D.

1979-01-01

Computerized analysis of multiple choice test items is explained. Examples of item analysis applications in the introductory economics course are discussed with respect to three objectives: to evaluate learning; to improve test items; and to help improve classroom instruction. Problems, costs and benefits of the procedures are identified. (JMD)

Generalized Full-Information Item Bifactor Analysis

ERIC Educational Resources Information Center

Cai, Li; Yang, Ji Seung; Hansen, Mark

2011-01-01

Full-information item bifactor analysis is an important statistical method in psychological and educational measurement. Current methods are limited to single-group analysis and inflexible in the types of item response models supported. We propose a flexible multiple-group item bifactor analysis framework that supports a variety of…

A Review of the Effects on IRT Item Parameter Estimates with a Focus on Misbehaving Common Items in Test Equating

PubMed Central

Michaelides, Michalis P.

2010-01-01

Many studies have investigated the topic of change or drift in item parameter estimates in the context of item response theory (IRT). Content effects, such as instructional variation and curricular emphasis, as well as context effects, such as the wording, position, or exposure of an item have been found to impact item parameter estimates. The issue becomes more critical when items with estimates exhibiting differential behavior across test administrations are used as common for deriving equating transformations. This paper reviews the types of effects on IRT item parameter estimates and focuses on the impact of misbehaving or aberrant common items on equating transformations. Implications relating to test validity and the judgmental nature of the decision to keep or discard aberrant common items are discussed, with recommendations for future research into more informed and formal ways of dealing with misbehaving common items. PMID:21833230

A Review of the Effects on IRT Item Parameter Estimates with a Focus on Misbehaving Common Items in Test Equating.

PubMed

Michaelides, Michalis P

2010-01-01

Many studies have investigated the topic of change or drift in item parameter estimates in the context of item response theory (IRT). Content effects, such as instructional variation and curricular emphasis, as well as context effects, such as the wording, position, or exposure of an item have been found to impact item parameter estimates. The issue becomes more critical when items with estimates exhibiting differential behavior across test administrations are used as common for deriving equating transformations. This paper reviews the types of effects on IRT item parameter estimates and focuses on the impact of misbehaving or aberrant common items on equating transformations. Implications relating to test validity and the judgmental nature of the decision to keep or discard aberrant common items are discussed, with recommendations for future research into more informed and formal ways of dealing with misbehaving common items.

Medical technology at home: safety-related items in technical documentation.

PubMed

Hilbers, Ellen S M; de Vries, Claudette G J C A; Geertsma, Robert E

2013-01-01

This study aimed to investigate the technical documentation of manufacturers on issues of safe use of their device in a home setting. Three categories of equipment were selected: infusion pumps, ventilators, and dialysis systems. Risk analyses, instructions for use, labels, and post market surveillance procedures were requested from manufacturers. Additionally, they were asked to fill out a questionnaire on collection of field experience, on incidents, and training activities. Specific risks of device operation by lay users in a home setting were incompletely addressed in the risk analyses. A substantial number of user manuals were designed for professionals, rather than for patients or lay carers. Risk analyses and user information often showed incomplete coherence. Post market surveillance was mainly based on passive collection of field experiences. Manufacturers of infusion pumps, ventilators, and dialysis systems pay insufficient attention to the specific risks of use by lay persons in home settings. It is expected that this conclusion is also applicable for other medical equipment for treatment at home. Manufacturers of medical equipment for home use should pay more attention to use errors, lay use and home-specific risks in design, risk analysis, and user information. Field experiences should be collected more actively. Coherence between risk analysis and user information should be improved. Notified bodies should address these aspects in their assessment. User manuals issued by institutions supervising a specific home therapy should be drawn up in consultation with the manufacturer.

A Comparison of the 27-Item and 12-Item Intolerance of Uncertainty Scales

ERIC Educational Resources Information Center

Khawaja, Nigar G.; Yu, Lai Ngo Heidi

2010-01-01

The 27-item Intolerance of Uncertainty Scale (IUS) has become one of the most frequently used measures of Intolerance of Uncertainty. More recently, an abridged, 12-item version of the IUS has been developed. The current research used clinical (n = 50) and non-clinical (n = 56) samples to examine and compare the psychometric properties of both…

Detecting Gender Bias Through Test Item Analysis

NASA Astrophysics Data System (ADS)

González-Espada, Wilson J.

2009-03-01

Many physical science and physics instructors might not be trained in pedagogically appropriate test construction methods. This could lead to test items that do not measure what they are intended to measure. A subgroup of these items might show bias against some groups of students. This paper describes how the author became aware of potentially biased items against females in his examinations, which led to the exploration of fundamental issues related to item validity, gender bias, and differential item functioning, or DIF. A brief discussion of DIF in the context of university courses, as well as practical suggestions to detect possible gender-biased items, follows.

Ubiquitous testing using tablets: its impact on medical student perceptions of and engagement in learning.

PubMed

Kim, Kyong-Jee; Hwang, Jee-Young

2016-03-01

Ubiquitous testing has the potential to affect medical education by enhancing the authenticity of the assessment using multimedia items. This study explored medical students' experience with ubiquitous testing and its impact on student learning. A cohort (n=48) of third-year students at a medical school in South Korea participated in this study. The students were divided into two groups and were given different versions of 10 content-matched items: one in text version (the text group) and the other in multimedia version (the multimedia group). Multimedia items were delivered using tablets. Item response analyses were performed to compare item characteristics between the two versions. Additionally, focus group interviews were held to investigate the students' experiences of ubiquitous testing. The mean test score was significantly higher in the text group. Item difficulty and discrimination did not differ between text and multimedia items. The participants generally showed positive responses on ubiquitous testing. Still, they felt that the lectures that they had taken in preclinical years did not prepare them enough for this type of assessment and clinical encounters during clerkships were more helpful. To be better prepared, the participants felt that they needed to engage more actively in learning in clinical clerkships and have more access to multimedia learning resources. Ubiquitous testing can positively affect student learning by reinforcing the importance of being able to understand and apply knowledge in clinical contexts, which drives students to engage more actively in learning in clinical settings.

47 CFR 32.7600 - Extraordinary items.

Code of Federal Regulations, 2010 CFR

2010-10-01

... items, if reported other than as extraordinary items. (c) This account shall be charged or credited and Account 4070, Income taxes—accrued, shall be credited or charged for all current income tax effects (Federal, state and local) of extraordinary items. (d) This account shall also be charged or credited, as...

Computerized Numerical Control Test Item Bank.

ERIC Educational Resources Information Center

Reneau, Fred; And Others

This guide contains 285 test items for use in teaching a course in computerized numerical control. All test items were reviewed, revised, and validated by incumbent workers and subject matter instructors. Items are provided for assessing student achievement in such aspects of programming and planning, setting up, and operating machines with…

Effects of age on negative subsequent memory effects associated with the encoding of item and item-context information.

PubMed

Mattson, Julia T; Wang, Tracy H; de Chastelaine, Marianne; Rugg, Michael D

2014-12-01

It has consistently been reported that "negative" subsequent memory effects--lower study activity for later remembered than later forgotten items--are attenuated in older individuals. The present functional magnetic resonance imaging study investigated whether these findings extend to subsequent memory effects associated with successful encoding of item-context information. Older (n = 25) and young (n = 17) subjects were scanned while making 1 of 2 encoding judgments on a series of pictures. Memory was assessed for the study item and, for items judged old, the item's encoding task. Both memory judgments were made using confidence ratings, permitting item and source memory strength to be unconfounded and source confidence to be equated across age groups. Replicating prior findings, negative item effects in regions of the default mode network in young subjects were reversed in older subjects. Negative source effects, however, were invariant with respect to age and, in both age groups, the magnitude of the effects correlated with source memory performance. It is concluded that negative item effects do not reflect processes necessary for the successful encoding of item-context associations in older subjects. Negative source effects, in contrast, appear to reflect the engagement of processes that are equally important for successful episodic encoding in older and younger individuals. © The Author 2013. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Influence of the wording of evaluation items on outcome-based evaluation results for large-group teaching in anatomy, biochemistry and legal medicine.

PubMed

Anders, Sven; Pyka, Katharina; Mueller, Tjark; von Streinbuechel, Nicole; Raupach, Tobias

2016-11-01

Student learning outcome is an important dimension of teaching quality in undergraduate medical education. Measuring an increase in knowledge during teaching requires repetitive objective testing which is usually not feasible. As an alternative, student learning outcome can be calculated from student self-ratings. Comparative self-assessment (CSA) gain reflects the performance difference before and after teaching, adjusted for initial knowledge. It has been shown to be a valid proxy measure of actual learning outcome derived from objective tests. However, student self-ratings are prone to a number of confounding factors. In the context of outcome-based evaluation, the wording of self-rating items is crucial to the validity of evaluation results. This randomized trial assessed whether including qualifiers in these statements impacts on student ratings and CSA gain. First-year medical students self-rated their initial (then-test) and final (post-test) knowledge for lectures in anatomy, biochemistry and legal medicine, respectively, and 659 questionnaires were retrieved. Six-point scales were used for self-ratings with 1 being the most positive option. Qualifier use did not affect then-test ratings but was associated with slightly less favorable post-test ratings. Consecutively, mean CSA gain was smaller for items containing qualifiers than for items lacking qualifiers (50.6±15.0% vs. 56.3±14.6%, p=0.079). The effect was more pronounced (Cohen's d=0.82) for items related to anatomy. In order to increase fairness of outcome-based evaluation and increase the comparability of CSA gain data across subjects, medical educators should agree on a consistent approach (qualifiers for all items or no qualifiers at all) when drafting self-rating statements for outcome-based evaluation. Copyright © 2016 Elsevier GmbH. All rights reserved.

Negative effects of item repetition on source memory.

PubMed

Kim, Kyungmi; Yi, Do-Joon; Raye, Carol L; Johnson, Marcia K

2012-08-01

In the present study, we explored how item repetition affects source memory for new item-feature associations (picture-location or picture-color). We presented line drawings varying numbers of times in Phase 1. In Phase 2, each drawing was presented once with a critical new feature. In Phase 3, we tested memory for the new source feature of each item from Phase 2. Experiments 1 and 2 demonstrated and replicated the negative effects of item repetition on incidental source memory. Prior item repetition also had a negative effect on source memory when different source dimensions were used in Phases 1 and 2 (Experiment 3) and when participants were explicitly instructed to learn source information in Phase 2 (Experiments 4 and 5). Importantly, when the order between Phases 1 and 2 was reversed, such that item repetition occurred after the encoding of critical item-source combinations, item repetition no longer affected source memory (Experiment 6). Overall, our findings did not support predictions based on item predifferentiation, within-dimension source interference, or general interference from multiple traces of an item. Rather, the findings were consistent with the idea that prior item repetition reduces attention to subsequent presentations of the item, decreasing the likelihood that critical item-source associations will be encoded.

Examination of Polytomous Items' Psychometric Properties According to Nonparametric Item Response Theory Models in Different Test Conditions

ERIC Educational Resources Information Center

Sengul Avsar, Asiye; Tavsancil, Ezel

2017-01-01

This study analysed polytomous items' psychometric properties according to nonparametric item response theory (NIRT) models. Thus, simulated datasets--three different test lengths (10, 20 and 30 items), three sample distributions (normal, right and left skewed) and three samples sizes (100, 250 and 500)--were generated by conducting 20…

Exploring Item Characteristics That Are Related to the Difficulty of TOEFL Dialogue Items. Research Reports. RR-79. RR-04-11

ERIC Educational Resources Information Center

Kostin, Irene

2004-01-01

The purpose of this study is to explore the relationship between a set of item characteristics and the difficulty of TOEFL[R] dialogue items. Identifying characteristics that are related to item difficulty has the potential to improve the efficiency of the item-writing process The study employed 365 TOEFL dialogue items, which were coded on 49…

Examination of the PROMIS upper extremity item bank.

PubMed

Hung, Man; Voss, Maren W; Bounsanga, Jerry; Crum, Anthony B; Tyser, Andrew R

Clinical measurement. The psychometric properties of the PROMIS v1.2 UE item bank were tested on various samples prior to its release, but have not been fully evaluated among the orthopaedic population. This study assesses the performance of the UE item bank within the UE orthopaedic patient population. The UE item bank was administered to 1197 adult patients presenting to a tertiary orthopaedic clinic specializing in hand and UE conditions and was examined using traditional statistics and Rasch analysis. The UE item bank fits a unidimensional model (outfit MNSQ range from 0.64 to 1.70) and has adequate reliabilities (person = 0.84; item = 0.82) and local independence (item residual correlations range from -0.37 to 0.34). Only one item exhibits gender differential item functioning. Most items target low levels of function. The UE item bank is a useful clinical assessment tool. Additional items covering higher functions are needed to enhance validity. Supplemental testing is recommended for patients at higher levels of function until more high function UE items are developed. 2c. Copyright © 2016 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

31 CFR 561.327 - Food, medicine, and medical devices.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Food, medicine, and medical devices... REGULATIONS General Definitions § 561.327 Food, medicine, and medical devices. (a) The term food means items...-grade gelatin powder, and peptones and their derivatives. (b) The term medicine has the same meaning...

Psychometric Consequences of Subpopulation Item Parameter Drift

ERIC Educational Resources Information Center

Huggins-Manley, Anne Corinne

2017-01-01

This study defines subpopulation item parameter drift (SIPD) as a change in item parameters over time that is dependent on subpopulations of examinees, and hypothesizes that the presence of SIPD in anchor items is associated with bias and/or lack of invariance in three psychometric outcomes. Results show that SIPD in anchor items is associated…

Adaptable Learning Assistant for Item Bank Management

ERIC Educational Resources Information Center

Nuntiyagul, Atorn; Naruedomkul, Kanlaya; Cercone, Nick; Wongsawang, Damras

2008-01-01

We present PKIP, an adaptable learning assistant tool for managing question items in item banks. PKIP is not only able to automatically assist educational users to categorize the question items into predefined categories by their contents but also to correctly retrieve the items by specifying the category and/or the difficulty level. PKIP adapts…

Exploratory Item Classification Via Spectral Graph Clustering

PubMed Central

Chen, Yunxiao; Li, Xiaoou; Liu, Jingchen; Xu, Gongjun; Ying, Zhiliang

2017-01-01

Large-scale assessments are supported by a large item pool. An important task in test development is to assign items into scales that measure different characteristics of individuals, and a popular approach is cluster analysis of items. Classical methods in cluster analysis, such as the hierarchical clustering, K-means method, and latent-class analysis, often induce a high computational overhead and have difficulty handling missing data, especially in the presence of high-dimensional responses. In this article, the authors propose a spectral clustering algorithm for exploratory item cluster analysis. The method is computationally efficient, effective for data with missing or incomplete responses, easy to implement, and often outperforms traditional clustering algorithms in the context of high dimensionality. The spectral clustering algorithm is based on graph theory, a branch of mathematics that studies the properties of graphs. The algorithm first constructs a graph of items, characterizing the similarity structure among items. It then extracts item clusters based on the graphical structure, grouping similar items together. The proposed method is evaluated through simulations and an application to the revised Eysenck Personality Questionnaire. PMID:29033476

Location Indices for Ordinal Polytomous Items Based on Item Response Theory. Research Report. ETS RR-15-20

ERIC Educational Resources Information Center

Ali, Usama S.; Chang, Hua-Hua; Anderson, Carolyn J.

2015-01-01

Polytomous items are typically described by multiple category-related parameters; situations, however, arise in which a single index is needed to describe an item's location along a latent trait continuum. Situations in which a single index would be needed include item selection in computerized adaptive testing or test assembly. Therefore single…

Real and Artificial Differential Item Functioning

ERIC Educational Resources Information Center

Andrich, David; Hagquist, Curt

2012-01-01

The literature in modern test theory on procedures for identifying items with differential item functioning (DIF) among two groups of persons includes the Mantel-Haenszel (MH) procedure. Generally, it is not recognized explicitly that if there is real DIF in some items which favor one group, then as an artifact of this procedure, artificial DIF…

Skylab medical experiments altitude test crew observations.

NASA Technical Reports Server (NTRS)

Bobko, K. J.

1973-01-01

The paper deals with the crew's observations during training and the SMEAT 56-day test. Topics covered include the crew's adaptation to the SMEAT environment and medical experiments protocol. Personal observations are made of daily activities surrounding the medical experiments hardware, Skylab clothing, supplementary activities, recreational equipment, food, and waste management. An assessment of these items and their contributions to the Skylab flight program is made.

Few items in the thyroid-related quality of life instrument ThyPRO exhibited differential item functioning.

PubMed

Watt, Torquil; Groenvold, Mogens; Hegedüs, Laszlo; Bonnema, Steen Joop; Rasmussen, Åse Krogh; Feldt-Rasmussen, Ulla; Bjorner, Jakob Bue

2014-02-01

To evaluate the extent of differential item functioning (DIF) within the thyroid-specific quality of life patient-reported outcome measure, ThyPRO, according to sex, age, education and thyroid diagnosis. A total of 838 patients with benign thyroid diseases completed the ThyPRO questionnaire (84 five-point items, 13 scales). Uniform and nonuniform DIF were investigated using ordinal logistic regression, testing for both statistical significance and magnitude (∆R(2) > 0.02). Scale level was estimated by the sum score, after purification. Twenty instances of DIF in 17 of the 84 items were found. Eight according to diagnosis, where the goiter scale was the one most affected, possibly due to differing perceptions in patients with auto-immune thyroid diseases compared to patients with simple goiter. Eight DIFs according to age were found, of which 5 were in positively worded items, which younger patients were more likely to endorse; one according to gender: women were more likely to report crying, and three according to educational level. The vast majority of DIF had only minor influence on the scale scores (0.1-2.3 points on the 0-100 scales), but two DIF corresponded to a difference of 4.6 and 9.8, respectively. Ordinal logistic regression identified DIF in 17 of 84 items. The potential impact of this on the present scales was low, but items displaying DIF could be avoided when developing abbreviated scales, where the potential impact of DIF (due to fewer items) will be larger.

Validation of a general measure of treatment satisfaction, the Treatment Satisfaction Questionnaire for Medication (TSQM), using a national panel study of chronic disease

PubMed Central

Atkinson, Mark J; Sinha, Anusha; Hass, Steven L; Colman, Shoshana S; Kumar, Ritesh N; Brod, Meryl; Rowland, Clayton R

2004-01-01

Background The objective of this study was to develop and psychometrically evaluate a general measure of patients' satisfaction with medication, the Treatment Satisfaction Questionnaire for Medication (TSQM). Methods The content and format of 55 initial questions were based on a formal conceptual framework, an extensive literature review, and the input from three patient focus groups. Patient interviews were used to select the most relevant questions for further evaluation (n = 31). The psychometric performance of items and resulting TSQM scales were examined using eight diverse patient groups (arthritis, asthma, major depression, type I diabetes, high cholesterol, hypertension, migraine, and psoriasis) recruited from a national longitudinal panel study of chronic illness (n = 567). Participants were then randomized to complete the test items using one of two alternate scaling methods (Visual Analogue vs. Likert-type). Results A factor analysis (principal component extraction with varimax rotation) of specific items revealed three factors (Eigenvalues > 1.7) explaining 75.6% of the total variance; namely Side effects (4 items, 28.4%, Cronbach's Alpha = .87), Effectiveness (3 items, 24.1%, Cronbach's Alpha = .85), and Convenience (3 items, 23.1%, Cronbach's Alpha = .87). A second factor analysis of more generally worded items yielded a Global Satisfaction scale (3 items, Eigenvalue = 2.3, 79.1%, Cronbach's Alpha = .85). The final four scales possessed good psychometric properties, with the Likert-type scaling method performing better than the VAS approach. Significant differences were found on the TSQM by the route of medication administration (oral, injectable, topical, inhalable), level of illness severity, and length of time on medication. Regression analyses using the TSQM scales accounted for 40–60% of variation in patients' ratings of their likelihood to persist with their current medication. Conclusion The TSQM is a psychometrically sound and valid measure

Chronic disease management items in general practice: a population-based study of variation in claims by claimant characteristics.

PubMed

Douglas, Kirsty A; Yen, Laurann E; Korda, Rosemary J; Kljakovic, Marjan; Glasgow, Nicholas J

2011-08-15

To describe how Medical Benefits Schedule (MBS) chronic disease (CD) item claims vary by sociodemographic and health characteristics in people with heart disease, asthma or diabetes. A cross-sectional analysis of linked unit-level MBS and survey data from the first 102,934 participants enrolled in the 45 and Up Study, a large-scale cohort study in New South Wales, who completed the baseline survey between January 2006 and July 2008. Claim for any general practitioner CD item within 18 months before enrolment, ascertained from MBS records. The proportion of individuals making claims for MBS CD items was 18.5% for asthma, 22.3% for heart disease, and 44.9% for diabetes. Associations between participant characteristics and a claim for a CD item showed similar patterns across the three diseases. For heart disease and asthma, people most likely to claim a CD item were women, older, of low income and education levels, with multiple chronic conditions, fair or poor self-rated health, obesity and low physical activity levels. The pattern of claims was slightly different for participants with diabetes in that there was no significant association with number of chronic conditions, smoking or physical activity. Many individuals with self-reported CD do not claim CD items. People with diabetes and individuals with greatest need based on health, socioeconomic and lifestyle risk factors are the most likely to claim CD items.

Validation of the MOS Social Support Survey 6-item (MOS-SSS-6) measure with two large population-based samples of Australian women.

PubMed

Holden, Libby; Lee, Christina; Hockey, Richard; Ware, Robert S; Dobson, Annette J

2014-12-01

This study aimed to validate a 6-item 1-factor global measure of social support developed from the Medical Outcomes Study Social Support Survey (MOS-SSS) for use in large epidemiological studies. Data were obtained from two large population-based samples of participants in the Australian Longitudinal Study on Women's Health. The two cohorts were aged 53-58 and 28-33 years at data collection (N = 10,616 and 8,977, respectively). Items selected for the 6-item 1-factor measure were derived from the factor structure obtained from unpublished work using an earlier wave of data from one of these cohorts. Descriptive statistics, including polychoric correlations, were used to describe the abbreviated scale. Cronbach's alpha was used to assess internal consistency and confirmatory factor analysis to assess scale validity. Concurrent validity was assessed using correlations between the new 6-item version and established 19-item version, and other concurrent variables. In both cohorts, the new 6-item 1-factor measure showed strong internal consistency and scale reliability. It had excellent goodness-of-fit indices, similar to those of the established 19-item measure. Both versions correlated similarly with concurrent measures. The 6-item 1-factor MOS-SSS measures global functional social support with fewer items than the established 19-item measure.

Item Response Modeling with Sum Scores

ERIC Educational Resources Information Center

Johnson, Timothy R.

2013-01-01

One of the distinctions between classical test theory and item response theory is that the former focuses on sum scores and their relationship to true scores, whereas the latter concerns item responses and their relationship to latent scores. Although item response theory is often viewed as the richer of the two theories, sum scores are still…

Vegetable, Sauce, and Bakery Item Production Guides Prepared for Walter Reed Army Medical Center

DTIC Science & Technology

1981-01-01

this report were found to be acceptable throughout 60 days of storage at 0°F (-17.8°C). CHEESE ITEM5 Cheese Noodle Loaf Cheese Potato Casserole...Macaroni and Cheese Welsh Rarebit CHEESE NOODLE LOAF Yield: 100 portions Ingredients Each portion: 6 oz (170 g) Pounds Grams Procedure... Noodles , egg Water, boiling Salt - 5.00 2,270 25.00 11,350 0.13 57 0.50 227 0.50 227 0.T5 3kl 6.00 2,72U 1.75 795 3.75 1,702 8.60 3,90*+ 0.01 2

Reading the medical record. I. Analysis of physicians' ways of reading the medical record.

PubMed

Nygren, E; Henriksson, P

1992-01-01

Physicians were interviewed about their routines in everyday use of the medical record. From the interviews, we conclude that the medical record is a well functioning working instrument for the experienced physician. Using the medical record as a basis for decision making involves interpretation of format, layout and other textural features of the type-written data. Interpretation of these features provides effective guidance in the process of searching, reading and assessing the relevance of different items of information in the record. It seems that this is a skill which is an integrated part of diagnostic expertise. This skill plays an important role in decision making based on the large amount of information about a patient, which is exhibited to the reader in the medical record. This finding has implications for the design of user interfaces for reading computerized medical records.

Impact of IRT item misfit on score estimates and severity classifications: an examination of PROMIS depression and pain interference item banks.

PubMed

Zhao, Yue

2017-03-01

In patient-reported outcome research that utilizes item response theory (IRT), using statistical significance tests to detect misfit is usually the focus of IRT model-data fit evaluations. However, such evaluations rarely address the impact/consequence of using misfitting items on the intended clinical applications. This study was designed to evaluate the impact of IRT item misfit on score estimates and severity classifications and to demonstrate a recommended process of model-fit evaluation. Using secondary data sources collected from the Patient-Reported Outcome Measurement Information System (PROMIS) wave 1 testing phase, analyses were conducted based on PROMIS depression (28 items; 782 cases) and pain interference (41 items; 845 cases) item banks. The identification of misfitting items was assessed using Orlando and Thissen's summed-score item-fit statistics and graphical displays. The impact of misfit was evaluated according to the agreement of both IRT-derived T-scores and severity classifications between inclusion and exclusion of misfitting items. The examination of the presence and impact of misfit suggested that item misfit had a negligible impact on the T-score estimates and severity classifications with the general population sample in the PROMIS depression and pain interference item banks, implying that the impact of item misfit was insignificant. Findings support the T-score estimates in the two item banks as robust against item misfit at both the group and individual levels and add confidence to the use of T-scores for severity diagnosis in the studied sample. Recommendations on approaches for identifying item misfit (statistical significance) and assessing the misfit impact (practical significance) are given.

Vegetable parenting practices scale. Item response modeling analyses

PubMed Central

Chen, Tzu-An; O’Connor, Teresia; Hughes, Sheryl; Beltran, Alicia; Baranowski, Janice; Diep, Cassandra; Baranowski, Tom

2015-01-01

Objective To evaluate the psychometric properties of a vegetable parenting practices scale using multidimensional polytomous item response modeling which enables assessing item fit to latent variables and the distributional characteristics of the items in comparison to the respondents. We also tested for differences in the ways item function (called differential item functioning) across child’s gender, ethnicity, age, and household income groups. Method Parents of 3–5 year old children completed a self-reported vegetable parenting practices scale online. Vegetable parenting practices consisted of 14 effective vegetable parenting practices and 12 ineffective vegetable parenting practices items, each with three subscales (responsiveness, structure, and control). Multidimensional polytomous item response modeling was conducted separately on effective vegetable parenting practices and ineffective vegetable parenting practices. Results One effective vegetable parenting practice item did not fit the model well in the full sample or across demographic groups, and another was a misfit in differential item functioning analyses across child’s gender. Significant differential item functioning was detected across children’s age and ethnicity groups, and more among effective vegetable parenting practices than ineffective vegetable parenting practices items. Wright maps showed items only covered parts of the latent trait distribution. The harder- and easier-to-respond ends of the construct were not covered by items for effective vegetable parenting practices and ineffective vegetable parenting practices, respectively. Conclusions Several effective vegetable parenting practices and ineffective vegetable parenting practices scale items functioned differently on the basis of child’s demographic characteristics; therefore, researchers should use these vegetable parenting practices scales with caution. Item response modeling should be incorporated in analyses of parenting

Introduction to an Open Source Internet-Based Testing Program for Medical Student Examinations

PubMed Central

2009-01-01

The author developed a freely available open source internet-based testing program for medical examination. PHP and Java script were used as the programming language and postgreSQL as the database management system on an Apache web server and Linux operating system. The system approach was that a super user inputs the items, each school administrator inputs the examinees' information, and examinees access the system. The examinee's score is displayed immediately after examination with item analysis. The set-up of the system beginning with installation is described. This may help medical professors to easily adopt an internet-based testing system for medical education. PMID:20046457

Do Images Influence Assessment in Anatomy? Exploring the Effect of Images on Item Difficulty and Item Discrimination

ERIC Educational Resources Information Center

Vorstenbosch, Marc A. T. M.; Klaassen, Tim P. F. M.; Kooloos, Jan G. M.; Bolhuis, Sanneke M.; Laan, Roland F. J. M.

2013-01-01

Anatomists often use images in assessments and examinations. This study aims to investigate the influence of different types of images on item difficulty and item discrimination in written assessments. A total of 210 of 460 students volunteered for an extra assessment in a gross anatomy course. This assessment contained 39 test items grouped in…

Oral anticancer agent medication adherence by outpatients.

PubMed

Kimura, Michio; Usami, Eiseki; Iwai, Mina; Nakao, Toshiya; Yoshimura, Tomoaki; Mori, Hiromi; Sugiyama, Tadashi; Teramachi, Hitomi

2014-11-01

In the present study, medication adherence and factors affecting adherence were examined in patients taking oral anticancer agents. In June 2013, 172 outpatients who had been prescribed oral anticancer agents by Ogaki Municipal Hospital (Ogaki, Gifu, Japan) completed a questionnaire survey, with answers rated on a five-point Likert scale. The factors that affect medication adherence were evaluated using a customer satisfaction (CS) analysis. For patients with good and insufficient adherence to medication, the median ages were 66 years (range, 21-85 years) and 73 years (range, 30-90 years), respectively (P=0.0004), while the median dosing time was 131 days (range, 3-3,585 days) and 219 days (24-3,465 days), respectively (P=0.0447). In 36.0% (62 out of 172) of the cases, there was insufficient medication adherence; 64.5% of those cases (40 out of 62) showed good medication compliance (4-5 point rating score). However, these patients did not fully understand the effects or side-effects of the drugs, giving a score of three points or less. The percentage of patients with good medication compliance was 87.2% (150 out of 172). Through the CS analysis, three items, the interest in the drug, the desire to consult about the drug and the condition of the patient, were extracted as items for improvement. Overall, the medication compliance of the patients taking the oral anticancer agents was good, but the medication adherence was insufficient. To improve medication adherence, a better understanding of the effectiveness and necessity of drugs and their side-effects is required. In addition, the interest of patients in their medication should be encouraged and intervention should be tailored to the condition of the patient. These steps should lead to improved medication adherence.

Developing Multidimensional Likert Scales Using Item Factor Analysis: The Case of Four-Point Items

ERIC Educational Resources Information Center

Asún, Rodrigo A.; Rdz-Navarro, Karina; Alvarado, Jesús M.

2016-01-01

This study compares the performance of two approaches in analysing four-point Likert rating scales with a factorial model: the classical factor analysis (FA) and the item factor analysis (IFA). For FA, maximum likelihood and weighted least squares estimations using Pearson correlation matrices among items are compared. For IFA, diagonally weighted…

Measuring self-esteem after spinal cord injury: Development, validation and psychometric characteristics of the SCI-QOL Self-esteem item bank and short form.

PubMed

Kalpakjian, Claire Z; Tate, Denise G; Kisala, Pamela A; Tulsky, David S

2015-05-01

To describe the development and psychometric properties of the Spinal Cord Injury-Quality of Life (SCI-QOL) Self-esteem item bank. Using a mixed-methods design, we developed and tested a self-esteem item bank through the use of focus groups with individuals with SCI and clinicians with expertise in SCI, cognitive interviews, and item-response theory-(IRT) based analytic approaches, including tests of model fit, differential item functioning (DIF) and precision. We tested a pool of 30 items at several medical institutions across the United States, including the University of Michigan, Kessler Foundation, the Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital, and the James J. Peters/Bronx Department of Veterans Affairs hospital. A total of 717 individuals with SCI completed the self-esteem items. A unidimensional model was observed (CFI=0.946; RMSEA=0.087) and measurement precision was good (theta range between -2.7 and 0.7). Eleven items were flagged for DIF; however, effect sizes were negligible with little practical impact on score estimates. The final calibrated item bank resulted in 23 retained items. This study indicates that the SCI-QOL Self-esteem item bank represents a psychometrically robust measurement tool. Short form items are also suggested and computer adaptive tests are available.

Can items used in 4-year-old well-child visits predict children's health and school outcomes?

PubMed

Smithers, Lisa G; Chittleborough, Catherine R; Stocks, Nigel; Sawyer, Michael G; Lynch, John W

2014-08-01

To examine whether items comprising a preschool well-child check for use by family doctors in Australia with 4-5-year old children predicts health and academic outcomes at 6-7 years. The well-child check includes mandatory (anthropometry, eye/vision, ear/hearing, dental, toileting, allergy problems) and non-mandatory (processed food consumption, low physical activity, motor, behaviour/mood problems) items. The predictive validity of mandatory and non-mandatory items measured at 4-5 years was examined using data from the Longitudinal Study of Australian Children. Outcomes at 6-7 years included overweight/obesity, asthma, health care/medication needs, general health, mental health problems, quality of life, teacher-reported mathematics and literacy ability (n = 2,280-2,787). Weight or height >90th centile at 4-5 years predicted overweight/obesity at 6-7 years with 60% sensitivity, 79% specificity and 40% positive predictive value (PPV). Mood/behaviour problems at 4-5 predicted mental health problems at 6-7 years with 86% sensitivity, 40% specificity and 8% PPV. Non-mandatory items improved the discrimination between children with and without mental health problems at 6-7 years (area under the receiver operating characteristic curve 0.75 compared with 0.69 for mandatory items only), but was weak for most outcomes. Items used in a well-child health check were moderate predictors of overweight/obesity and mental health problems at 6-7 years, but poor predictors of other health and academic outcomes.

Development and validation of the FertiMed questionnaire assessing patients' experiences with hormonal fertility medication.

PubMed

Lankreijer, K; D'Hooghe, T; Sermeus, W; van Asseldonk, F P M; Repping, S; Dancet, E A F

2016-08-01

Can a valid and reliable questionnaire be developed to assess patients' experiences with all of the characteristics of hormonal fertility medication valued by them? The FertiMed questionnaire is a valid and reliable tool that assesses patients' experiences with all medication characteristics valued by them and that can be used for all hormonal fertility medications, irrespective of their route of administration. Hormonal fertility medications cause emotional strain and differ in their dosage regime and route of administration, although they often have comparable effectiveness. Medication experiences of former patients would be informative for medication choices. A recent literature review showed that there is no trustworthy tool to compare patients' experiences of medications with differing routes of administration, regarding all medication characteristics which patients value. The items of the new FertiMed questionnaire were generated by literature review and 23 patient interviews. In 2013, 411 IVF-patients were asked to retrospectively complete the FertiMed questionnaire to assess 1 out of the 8 different medications used for ovarian stimulation, induction of pituitary quiescence, ovulation triggering or luteal support. In total, 276 patients (on average 35 per medication) from 2 university fertility clinics (Belgium, the Netherlands) completed the FertiMed questionnaire (67% response rate). The FertiMed questionnaire questioned whether items were valued by patients and whether these items were experienced while using the assessed medication. Hence, the final outcome 'Experiences with Valued Aspects Scores' (EVAS) combined importance and experience ratings. The content and face validity, reliability, feasibility and discriminative potential of the FertiMed questionnaire were tested and changes were made accordingly. Patient interviews defined 51 items relevant to seven medication characteristics previously proved to be important to patients. Item analysis deleted

Identification of technical item flaws leads to improvement of the quality of single best Multiple Choice Questions.

PubMed

Fayyaz Khan, Humaira; Farooq Danish, Khalid; Saeed Awan, Azra; Anwar, Masood

2013-05-01

The purpose of the study was to identify technical item flaws in the multiple choice questions submitted for the final exams for the years 2009, 2010 and 2011. This descriptive analytical study was carried out in Islamic International Medical College (IIMC). The Data was collected from the MCQ's submitted by the faculty for the final exams for the year 2009, 2010 and 2011. The data was compiled and evaluated by a three member assessment committee. The data was analyzed for frequency and percentages the categorical data was analyzed by chi-square test. Overall percentage of flawed item was 67% for the year 2009 of which 21% were for testwiseness and 40% were for irrelevant difficulty. In year 2010 the total item flaws were 36% and 11% testwiseness and 22% were for irrelevant difficulty. The year 2011 data showed decreased overall flaws of 21%. The flaws of testwisness were 7%, irrelevant difficulty were 11%. Technical item flaws are frequently encountered during MCQ construction, and the identification of flaws leads to improved quality of the single best MCQ's.

Sources of influence on medical practice

PubMed Central

Fernandez, L. A.; Martin, J. M.; del Castillo, J. d. D. L.; Gaspar, O. S.; Millan, J. I.; Lozano, M. J.; Keenoy, E. D.

2000-01-01

OBJECTIVES—To explore the opinion of general practitioners on the importance and legitimacy of sources of influence on medical practice.
METHODS—General practitioners (n=723) assigned to Primary Care Teams (PCTs) in two Spanish regions were randomly selected to participate in this study. A self administered questionnaire was sent by mail and collected by hand. The dependent variable collected the opinion on different sources that exert influence on medical practice. Importance was measured with a 9 item scale while legitimacy was evaluated with 16 items measured with a 1 to 7 point Likert scale.
RESULTS—The most important and legitimate sources of influence according to general practitioners were: training courses and scientific articles, designing self developed protocols and discussing with colleagues. The worst evaluated were: financial incentives and the role played by the pharmaceutical industry.
CONCLUSIONS—The development of medical practice is determined by many factors, grouped around three big areas: organisational setting, professional system and social setting. The medical professional system is the one considered as being the most important and legitimate by general practitioners. Other strategies of influence, considered to be very important by the predominant management culture (financial incentives), are not considered to be so by general practitioners. These results, however, are not completely reliable as regards the real network of influences existing in medical practice, which reflect instead different "value systems".


Keywords: primary health care; physicians' practice patterns; medical practice management; physicians' incentive plans PMID:10890875

Assessment of Differential Item Functioning in Testlet-Based Items Using the Rasch Testlet Model

ERIC Educational Resources Information Center

Wang, Wen-Chung; Wilson, Mark

2005-01-01

This study presents a procedure for detecting differential item functioning (DIF) for dichotomous and polytomous items in testlet-based tests, whereby DIF is taken into account by adding DIF parameters into the Rasch testlet model. Simulations were conducted to assess recovery of the DIF and other parameters. Two independent variables, test type…

CPI revision provides more accuracy in the medical care services component.

PubMed

Ford, I K; Sturm, P

1988-04-01

This revision, as in the past, enabled the Bureau to update medical care service expenditure weights in the CPI, including a more complete allocation of health insurance premiums. Instead of keeping the portion of premiums that go to benefits under health insurance, the expenditure weight for each benefit category has been added to the appropriate out-of-pocket expense. The unpublished health insurance item represents only the retained earnings portion of premiums paid by households. The specific item categories included in medical care services have also been updated and expanded. A study conducted during the developmental phase of the revision indicated that the Bureau should expand the eligible priced rates for physicians in the CPI to include not only the "self-pay" rate, but also other categories of payment as well. Another study indicated that the direct pricing of health insurance is not feasible because of the difficulty of factoring out from premium changes the effect of utilization levels and modified coverage. In pricing medical care service items, as with other item categories in the CPI, BLS attempts to exclude from price movement the effect of quality changes. However, some quality changes are difficult to assess or are not readily identified, for example, a change in the ratio of nurses to patients, and such changes may be reflected as part of the price change movement in the CPI.

Preferred reporting items for studies mapping onto preference-based outcome measures: The MAPS statement.

PubMed

Petrou, Stavros; Rivero-Arias, Oliver; Dakin, Helen; Longworth, Louise; Oppe, Mark; Froud, Robert; Gray, Alastair

2015-08-01

'Mapping' onto generic preference-based outcome measures is increasingly being used as a means of generating health utilities for use within health economic evaluations. Despite publication of technical guides for the conduct of mapping research, guidance for the reporting of mapping studies is currently lacking. The MAPS (MApping onto Preference-based measures reporting Standards) statement is a new checklist, which aims to promote complete and transparent reporting of mapping studies. The primary audiences for the MAPS statement are researchers reporting mapping studies, the funders of the research, and peer reviewers and editors involved in assessing mapping studies for publication.A de novo list of 29 candidate reporting items and accompanying explanations was created by a working group comprised of six health economists and one Delphi methodologist. Following a two-round, modified Delphi survey with representatives from academia, consultancy, health technology assessment agencies and the biomedical journal editorial community, a final set of 23 items deemed essential for transparent reporting, and accompanying explanations, was developed. The items are contained in a user friendly 23 item checklist. They are presented numerically and categorised within six sections, namely: (i) title and abstract; (ii) introduction; (iii) methods; (iv) results; (v) discussion; and (vi) other. The MAPS statement is best applied in conjunction with the accompanying MAPS explanation and elaboration document.It is anticipated that the MAPS statement will improve the clarity, transparency and completeness of reporting of mapping studies. To facilitate dissemination and uptake, the MAPS statement is being co-published by eight health economics and quality of life journals, and broader endorsement is encouraged. The MAPS working group plans to assess the need for an update of the reporting checklist in five years' time.This statement was published jointly in Applied Health Economics

Findings from the ISMP Medication Safety Self-Assessment for hospitals.

PubMed

Smetzer, Judy L; Vaida, Allen J; Cohen, Michael R; Tranum, Diane; Pittman, Mary A; Armstrong, Carl W

2003-11-01

Hospital medication practices should be assessed, awareness of the characteristics of a safe medication system heightened, and baseline data to identify national priorities established. A cross-sectional survey of U.S. hospitals (N = 6,180) was conducted in May 2000. The survey instrument contained 194 self-assessment items organized into 20 core characteristics and 10 larger domains. Hospitals were asked to voluntarily submit their confidential assessment data to the Institute for Safe Medication Practices (ISMP) for aggregate analysis. A weighting structure was applied to the individual items and used to calculate core characteristic scores, domain scores, and overall self-assessment scores. These scores were then compared to identify areas most in need of improvement. The 1,435 participating hospitals scored highest in domains related to drug storage and distribution; environmental factors; infusion pumps; and medication labeling, packaging, and nomenclature issues. These hospitals scored lowest in domains related to accessible patient information, communication of medication orders, patient education, and quality processes such as double-check systems and organizational culture. Enormous opportunities exist to improve medication safety, especially in domains related to culture, information management, and communication.

Medical emergencies on board commercial airlines: is documentation as expected?

PubMed Central

2012-01-01

Introduction The purpose of this study was to perform a descriptive, content-based analysis on the different forms of documentation for in-flight medical emergencies that are currently provided in the emergency medical kits on board commercial airlines. Methods Passenger airlines in the World Airline Directory were contacted between March and May 2011. For each participating airline, sample in-flight medical emergency documentation forms were obtained. All items in the sample documentation forms were subjected to a descriptive analysis and compared to a sample "medical incident report" form published by the International Air Transport Association (IATA). Results A total of 1,318 airlines were contacted. Ten airlines agreed to participate in the study and provided a copy of their documentation forms. A descriptive analysis revealed a total of 199 different items, which were summarized into five sub-categories: non-medical data (63), signs and symptoms (68), diagnosis (26), treatment (22) and outcome (20). Conclusions The data in this study illustrate a large variation in the documentation of in-flight medical emergencies by different airlines. A higher degree of standardization is preferable to increase the data quality in epidemiologic aeromedical research in the future. PMID:22397530

[A methodological approach to assessing the quality of medical health information on its way from science to the mass media].

PubMed

Serong, Julia; Anhäuser, Marcus; Wormer, Holger

2015-01-01

A current research project deals with the question of how the quality of medical health information changes on its way from the academic journal via press releases to the news media. In an exploratory study a sample of 30 news items has been selected stage-by-stage from an adjusted total sample of 1,695 journalistic news items on medical research in 2013. Using a multidimensional set of criteria the news items as well as the corresponding academic articles, abstracts and press releases are examined by science journalists and medical experts. Together with a content analysis of the expert assessments, it will be verified to what extent established quality standards for medical journalism can be applied to medical health communication and public relations or even to studies and abstracts as well. Copyright © 2015. Published by Elsevier GmbH.

Ubiquitous testing using tablets: its impact on medical student perceptions of and engagement in learning

PubMed Central

Kim, Kyong-Jee; Hwang, Jee-Young

2016-01-01

Purpose: Ubiquitous testing has the potential to affect medical education by enhancing the authenticity of the assessment using multimedia items. This study explored medical students’ experience with ubiquitous testing and its impact on student learning. Methods: A cohort (n=48) of third-year students at a medical school in South Korea participated in this study. The students were divided into two groups and were given different versions of 10 content-matched items: one in text version (the text group) and the other in multimedia version (the multimedia group). Multimedia items were delivered using tablets. Item response analyses were performed to compare item characteristics between the two versions. Additionally, focus group interviews were held to investigate the students’ experiences of ubiquitous testing. Results: The mean test score was significantly higher in the text group. Item difficulty and discrimination did not differ between text and multimedia items. The participants generally showed positive responses on ubiquitous testing. Still, they felt that the lectures that they had taken in preclinical years did not prepare them enough for this type of assessment and clinical encounters during clerkships were more helpful. To be better prepared, the participants felt that they needed to engage more actively in learning in clinical clerkships and have more access to multimedia learning resources. Conclusion: Ubiquitous testing can positively affect student learning by reinforcing the importance of being able to understand and apply knowledge in clinical contexts, which drives students to engage more actively in learning in clinical settings. PMID:26838569

Professionalism Deficits among Medical Students: Models of Identification and Intervention

ERIC Educational Resources Information Center

Bennett, Aurora J.; Roman, Brenda; Arnold, Lesley M.; Kay, Jerald; Goldenhar, Linda M.

2005-01-01

Objective: This study compares the instruments and interventions utilized to identify and remediate unprofessional behaviors in medical students across U.S. psychiatry clerkships. Methods: A 20-item questionnaire was distributed to 120 psychiatry clerkship directors and directors of medical student education, in the U.S., inquiring into the…

[Pilot study of dementia medication compliance conducted among pharmacists providing home visits which evaluates the degree of drug compliance, as defined by numerous attributes, between patients at home and patients in a medical facility].

PubMed

Nanaumi, Yoko; Matoba, Shunya; Onda, Mitsuko; Tanaka, Rie; Tsubota, Kenichi; Mukai, Yusuke; Sakurai, Hidehiko; Hayase, Yukitoshi; Arakawa, Yukio

2012-01-01

A survey was conducted among pharmacists providing "home-visit guidance on drug management" to patients taking medication for dementia. Factors related to medication adherence among patients and pharmacists' acquisition of patient information were then verified. The survey items were: (1) patient attributes (degree of care received, bed-ridden, family composition, and living environment); (2) the person controlling medications; (3) drug storage method and location; (4) dispensing method; (5) patient management of visiting nurses; (6) patient management of visiting physician; (7) details of pharmacist's home-visit guidance; (8) medication adherence; (9) five items related to cognitive function (short-term memory, autonomous judgment, fluctuations in level of consciousness, excitation and loss of orientation, understanding); and (10) ten items related of ADL (mobility in bed, transferring, mobility within the home or outdoors, dressing upper/lower body, eating, toilet use, individual hygiene, bathing). The t test was used to verify the number of items of patient information concerning cognitive function and physical function that pharmacists could acquire at a visit. It was suggested that pharmacists were able to acquire more patient information (①cognitive function and ②ADL) when they visited patients cared for at home, compared to facility residents (①p=0.008, ② p=0.006). Thus, it was suggested that there is a latent risk concerning the pharmacist's ability to discover problems with administration of medications among facility residents. These findings demonstrate that it is essential for pharmacists to be more proactive about providing home-visit guidance.

Relationship between item difficulty and discrimination indices in true/false-type multiple choice questions of a para-clinical multidisciplinary paper.

PubMed

Sim, Si-Mui; Rasiah, Raja Isaiah

2006-02-01

This paper reports the relationship between the difficulty level and the discrimination power of true/false-type multiple-choice questions (MCQs) in a multidisciplinary paper for the para-clinical year of an undergraduate medical programme. MCQ items in papers taken from Year II Parts A, B and C examinations for Sessions 2001/02, and Part B examinations for 2002/03 and 2003/04, were analysed to obtain their difficulty indices and discrimination indices. Each paper consisted of 250 true/false items (50 questions of 5 items each) on topics drawn from different disciplines. The questions were first constructed and vetted by the individual departments before being submitted to a central committee, where the final selection of the MCQs was made, based purely on the academic judgement of the committee. There was a wide distribution of item difficulty indices in all the MCQ papers analysed. Furthermore, the relationship between the difficulty index (P) and discrimination index (D) of the MCQ items in a paper was not linear, but more dome-shaped. Maximal discrimination (D = 51% to 71%) occurred with moderately easy/difficult items (P = 40% to 74%). On average, about 38% of the MCQ items in each paper were "very easy" (P > or =75%), while about 9% were "very difficult" (P <25%). About two-thirds of these very easy/difficult items had "very poor" or even negative discrimination (D < or =20%). MCQ items that demonstrate good discriminating potential tend to be moderately difficult items, and the moderately-to-very difficult items are more likely to show negative discrimination. There is a need to evaluate the effectiveness of our MCQ items.

Differential item functioning of the Geriatric Depression Scale in an Asian population.

PubMed

Broekman, B F P; Nyunt, S Z; Niti, M; Jin, A Z; Ko, S M; Kumar, R; Fones, C S L; Ng, T P

2008-06-01

The Geriatric Depression Scale (GDS) is widely used for screening and assessment of major depressive disorder (MDD). Screening scales are often culture-specific and should be evaluated for item response bias (synonymously differential item functioning, DIF) before use in clinical practice and research in a different population. In this study, we examined DIF associated with age, gender, ethnicity and chronic illness in a heterogeneous Asian population in Singapore. The GDS-15 and Structured Clinical Interview for DSM-IV diagnosis of MDD were independently administered by interviewers on 4253 non-institutionalized community living elderly subjects aged 60 years and above who were users of social service agencies. Multiple Indicator Multiple Cause latent variable modelling was used to identify DIF. We found evidence of significant DIF associated with age, gender, ethnicity and chronic illness for 8 items: dropped many activities and interests, afraid something bad is going to happen, prefer staying home to going out, more problems with memory than most, think it is (not) wonderful to be alive, feel pretty worthless, feel (not) full of energy, feel that situation is hopeless. The smaller number of minority Indian and Malay subjects and the self-report of chronic medical illnesses. In a heterogeneous mix of respondents in Singapore, eight items of the GDS-15 showed DIF for age, gender, ethnicity and chronic illness. The awareness and identification of DIF in the GDS-15 provides a rational basis for its use in diverse population groups and guiding the derivation of abbreviated scales.

The Impact of Item Position Change on Item Parameters and Common Equating Results under the 3PL Model

ERIC Educational Resources Information Center

Meyers, Jason L.; Murphy, Stephen; Goodman, Joshua; Turhan, Ahmet

2012-01-01

Operational testing programs employing item response theory (IRT) applications benefit from of the property of item parameter invariance whereby item parameter estimates obtained from one sample can be applied to other samples (when the underlying assumptions are satisfied). In theory, this feature allows for applications such as computer-adaptive…

Measuring anxiety after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Anxiety item bank and linkage with GAD-7.

PubMed

Kisala, Pamela A; Tulsky, David S; Kalpakjian, Claire Z; Heinemann, Allen W; Pohlig, Ryan T; Carle, Adam; Choi, Seung W

2015-05-01

To develop a calibrated item bank and computer adaptive test to assess anxiety symptoms in individuals with spinal cord injury (SCI), transform scores to the Patient Reported Outcomes Measurement Information System (PROMIS) metric, and create a statistical linkage with the Generalized Anxiety Disorder (GAD)-7, a widely used anxiety measure. Grounded-theory based qualitative item development methods; large-scale item calibration field testing; confirmatory factor analysis; graded response model item response theory analyses; statistical linking techniques to transform scores to a PROMIS metric; and linkage with the GAD-7. Setting Five SCI Model System centers and one Department of Veterans Affairs medical center in the United States. Participants Adults with traumatic SCI. Spinal Cord Injury-Quality of Life (SCI-QOL) Anxiety Item Bank Seven hundred sixteen individuals with traumatic SCI completed 38 items assessing anxiety, 17 of which were PROMIS items. After 13 items (including 2 PROMIS items) were removed, factor analyses confirmed unidimensionality. Item response theory analyses were used to estimate slopes and thresholds for the final 25 items (15 from PROMIS). The observed Pearson correlation between the SCI-QOL Anxiety and GAD-7 scores was 0.67. The SCI-QOL Anxiety item bank demonstrates excellent psychometric properties and is available as a computer adaptive test or short form for research and clinical applications. SCI-QOL Anxiety scores have been transformed to the PROMIS metric and we provide a method to link SCI-QOL Anxiety scores with those of the GAD-7.

Development of the PROMIS nicotine dependence item banks.

PubMed

Shadel, William G; Edelen, Maria Orlando; Tucker, Joan S; Stucky, Brian D; Hansen, Mark; Cai, Li

2014-09-01

Nicotine dependence is a core construct important for understanding cigarette smoking and smoking cessation behavior. This article describes analyses conducted to develop and evaluate item banks for assessing nicotine dependence among daily and nondaily smokers. Using data from a sample of daily (N = 4,201) and nondaily (N =1,183) smokers, we conducted a series of item factor analyses, item response theory analyses, and differential item functioning analyses (according to gender, age, and race/ethnicity) to arrive at a unidimensional set of nicotine dependence items for daily and nondaily smokers. We also evaluated performance of short forms (SFs) and computer adaptive tests (CATs) to efficiently assess dependence. A total of 32 items were included in the Nicotine Dependence item banks; 22 items are common across daily and nondaily smokers, 5 are unique to daily smokers, and 5 are unique to nondaily smokers. For both daily and nondaily smokers, the Nicotine Dependence item banks are strongly unidimensional, highly reliable (reliability = 0.97 and 0.97, respectively), and perform similarly across gender, age, and race/ethnicity groups. SFs common to daily and nondaily smokers consist of 8 and 4 items (reliability = 0.91 and 0.81, respectively). Results from simulated CATs showed that dependence can be assessed with very good precision for most respondents using fewer than 6 items adaptively selected from the item banks. Nicotine dependence on cigarettes can be assessed on the basis of these item banks via one of the SFs, by using CATs, or through a tailored set of items selected for a specific research purpose. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Underestimating numerosity of items in visual search tasks.

PubMed

Cassenti, Daniel N; Kelley, Troy D; Ghirardelli, Thomas G

2010-10-01

Previous research on numerosity judgments addressed attended items, while the present research addresses underestimation for unattended items in visual search tasks. One potential cause of underestimation for unattended items is that estimates of quantity may depend on viewing a large portion of the display within foveal vision. Another theory follows from the occupancy model: estimating quantity of items in greater proximity to one another increases the likelihood of an underestimation error. Three experimental manipulations addressed aspects of underestimation for unattended items: the size of the distracters, the distance of the target from fixation, and whether items were clustered together. Results suggested that the underestimation effect for unattended items was best explained within a Gestalt grouping framework.

Generalizability in Item Response Modeling

ERIC Educational Resources Information Center

Briggs, Derek C.; Wilson, Mark

2007-01-01

An approach called generalizability in item response modeling (GIRM) is introduced in this article. The GIRM approach essentially incorporates the sampling model of generalizability theory (GT) into the scaling model of item response theory (IRT) by making distributional assumptions about the relevant measurement facets. By specifying a random…

[What is the purpose of the German Aptitude Test for Medical Studies (TMS)?].

PubMed

Kadmon, Guni; Kirchner, Anna; Duelli, Roman; Resch, Franz; Kadmon, Martina

2012-01-01

The German Aptitude Test for Medical Studies (TMS) was implemented in 2007. 12,194 persons registered for this test in 2011, which represents a 91% increase over 2007. The male/female ratio remained constant at 38:62. Its reliability among applicants to Heidelberg Medical Faculty was confirmed by Cronbach's α (≥ 0.75) and inter-item correlation (≥ 0.25, p < 10(-7)). The TMS contains nine items; using factor analysis these were allocated to the two components verbal-mathematical and spatial-figural ability. The verbal-mathematical items moderately correlate with the German Baccalaureate GPA (r = 0.33), while the spatial-figural items do not correlate (r = 0.07). Thus, the TMS is an admission instrument that appraise different cognitive abilities than the GPA. For the admission of students to our faculty their TMS scores are weighted at 39%, which has resulted in a diversification of our student cohorts. Copyright © 2011. Published by Elsevier GmbH.

Caregiver perspective on pediatric attention-deficit/hyperactivity disorder: medication satisfaction and symptom control

PubMed Central

Fridman, Moshe; Banaschewski, Tobias; Sikirica, Vanja; Quintero, Javier; Erder, M Haim; Chen, Kristina S

2017-01-01

The caregiver perspective on pediatric attention-deficit/hyperactivity disorder (ADHD) study (CAPPA) was a web-based, cross-sectional survey of caregivers of children and adolescents (6–17 years of age) with ADHD and was conducted in 10 European countries. CAPPA included caregiver assessments of global medication satisfaction, global symptom control, and satisfaction with ADHD medication attributes. Overall, 2,326 caregiver responses indicated that their child or adolescent was currently receiving ADHD medication and completed the “off medication” assessment required for inclusion in the present analyses. Responses to the single-item global medication satisfaction question indicated that 88% were satisfied (moderately satisfied to very satisfied) with current medication and 18% were “very satisfied” on the single-item question. Responses to the single-item global symptom control question indicated that 47% and 19% of caregivers considered their child or adolescent’s symptoms to be “controlled” or “very well controlled”, respectively. Significant variations in response to the questions of medication satisfaction and symptom control were observed between countries. The correlation between the global medication satisfaction and global symptom control questions was 0.677 (P<0.001). Global medication satisfaction was significantly correlated (P<0.001) with all assessed medication attributes, with the highest correlations observed for symptom control (r=0.601) and effect duration (r=0.449). Correlations of medication attributes with global symptom control were generally lower than with global medication satisfaction but were all statistically significant (P<0.001). CAPPA medication satisfaction and symptom control were also significantly correlated (P<0.001) with symptom control as based on the ADHD-Rating Scale-IV symptom score and the number of bad days per month when on medication. In conclusion, caregiver responses in this European sample suggest

Does medical students' clinical performance affect their actual performance during medical internship?

PubMed

Han, Eui-Ryoung; Chung, Eun-Kyung

2016-02-01

This study examines the relationship between the clinical performance of medical students and their performance as doctors during their internships. This retrospective study involved 63 applicants to a residency programme conducted at the Chonnam National University Hospital, South Korea, in November 2012. We compared the performance of the applicants during their internship with the clinical performance of the applicants during their fourth year of medical school. The performance of the applicants as interns was periodically evaluated by the faculty of each department, while the clinical performance of the applicants as fourth year medical students was assessed using the Clinical Performance Examination (CPX) and the Objective Structured Clinical Examination (OSCE). The performance of the applicants as interns was positively correlated with their clinical performance as fourth year medical students, as measured by CPX and OSCE. The performance of the applicants as interns was moderately correlated with the patient-physician interactions items addressing communication and interpersonal skills in the CPX. The clinical performance of medical students during their fourth year in medical school was related to their performance as medical interns. Medical students should be trained to develop good clinical skills, through actual encounters with patients or simulated encounters using manikins, so that they are able to become competent doctors. Copyright © Singapore Medical Association.

Item selection via Bayesian IRT models.

PubMed

Arima, Serena

2015-02-10

With reference to a questionnaire that aimed to assess the quality of life for dysarthric speakers, we investigate the usefulness of a model-based procedure for reducing the number of items. We propose a mixed cumulative logit model, which is known in the psychometrics literature as the graded response model: responses to different items are modelled as a function of individual latent traits and as a function of item characteristics, such as their difficulty and their discrimination power. We jointly model the discrimination and the difficulty parameters by using a k-component mixture of normal distributions. Mixture components correspond to disjoint groups of items. Items that belong to the same groups can be considered equivalent in terms of both difficulty and discrimination power. According to decision criteria, we select a subset of items such that the reduced questionnaire is able to provide the same information that the complete questionnaire provides. The model is estimated by using a Bayesian approach, and the choice of the number of mixture components is justified according to information criteria. We illustrate the proposed approach on the basis of data that are collected for 104 dysarthric patients by local health authorities in Lecce and in Milan. Copyright © 2014 John Wiley & Sons, Ltd.

41 CFR 101-30.701-1 - Item reduction study.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 41 Public Contracts and Property Management 2 2011-07-01 2007-07-01 true Item reduction study. 101....7-Item Reduction Program § 101-30.701-1 Item reduction study. Item reduction study means the study... so identified, a replacement item shall be proposed. The result of item reduction studies will...

41 CFR 101-30.701-1 - Item reduction study.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Item reduction study. 101....7-Item Reduction Program § 101-30.701-1 Item reduction study. Item reduction study means the study... so identified, a replacement item shall be proposed. The result of item reduction studies will...

Detection of Differential Item Functioning Using the Lasso Approach

ERIC Educational Resources Information Center

Magis, David; Tuerlinckx, Francis; De Boeck, Paul

2015-01-01

This article proposes a novel approach to detect differential item functioning (DIF) among dichotomously scored items. Unlike standard DIF methods that perform an item-by-item analysis, we propose the "LR lasso DIF method": logistic regression (LR) model is formulated for all item responses. The model contains item-specific intercepts,…

Multidimensional CAT Item Selection Methods for Domain Scores and Composite Scores with Item Exposure Control and Content Constraints

ERIC Educational Resources Information Center

Yao, Lihua

2014-01-01

The intent of this research was to find an item selection procedure in the multidimensional computer adaptive testing (CAT) framework that yielded higher precision for both the domain and composite abilities, had a higher usage of the item pool, and controlled the exposure rate. Five multidimensional CAT item selection procedures (minimum angle;…

Automatic Association of News Items.

ERIC Educational Resources Information Center

Carrick, Christina; Watters, Carolyn

1997-01-01

Discussion of electronic news delivery systems and the automatic generation of electronic editions focuses on the association of related items of different media type, specifically photos and stories. The goal is to be able to determine to what degree any two news items refer to the same news event. (Author/LRW)

Item response theory analysis of the life orientation test-revised: age and gender differential item functioning analyses.

PubMed

Steca, Patrizia; Monzani, Dario; Greco, Andrea; Chiesi, Francesca; Primi, Caterina

2015-06-01

This study is aimed at testing the measurement properties of the Life Orientation Test-Revised (LOT-R) for the assessment of dispositional optimism by employing item response theory (IRT) analyses. The LOT-R was administered to a large sample of 2,862 Italian adults. First, confirmatory factor analyses demonstrated the theoretical conceptualization of the construct measured by the LOT-R as a single bipolar dimension. Subsequently, IRT analyses for polytomous, ordered response category data were applied to investigate the items' properties. The equivalence of the items across gender and age was assessed by analyzing differential item functioning. Discrimination and severity parameters indicated that all items were able to distinguish people with different levels of optimism and adequately covered the spectrum of the latent trait. Additionally, the LOT-R appears to be gender invariant and, with minor exceptions, age invariant. Results provided evidence that the LOT-R is a reliable and valid measure of dispositional optimism. © The Author(s) 2014.

What side effects are problematic for patients prescribed antipsychotic medication? The Maudsley Side Effects (MSE) measure for antipsychotic medication.

PubMed

Wykes, T; Evans, J; Paton, C; Barnes, T R E; Taylor, D; Bentall, R; Dalton, B; Ruffell, T; Rose, D; Vitoratou, S

2017-10-01

Capturing service users' perspectives can highlight additional and different concerns to those of clinicians, but there are no up to date, self-report psychometrically sound measures of side effects of antipsychotic medications. Aim To develop a psychometrically sound measure to identify antipsychotic side effects important to service users, the Maudsley Side Effects (MSE) measure. An initial item bank was subjected to a Delphi exercise (n = 9) with psychiatrists and pharmacists, followed by service user focus groups and expert panels (n = 15) to determine item relevance and language. Feasibility and comprehensive psychometric properties were established in two samples (N43 and N50). We investigated whether we could predict the three most important side effects for individuals from their frequency, severity and life impact. MSE is a 53-item measure with good reliability and validity. Poorer mental and physical health, but not psychotic symptoms, was related to side-effect burden. Seventy-nine percent of items were chosen as one of the three most important effects. Severity, impact and distress only predicted 'putting on weight' which was more distressing, more severe and had more life impact in those for whom it was most important. MSE is a self-report questionnaire that identifies reliably the side-effect burden as experienced by patients. Identifying key side effects important to patients can act as a starting point for joint decision making on the type and the dose of medication.

Measuring self-esteem after spinal cord injury: Development, validation and psychometric characteristics of the SCI-QOL Self-esteem item bank and short form

PubMed Central

Kalpakjian, Claire Z.; Tate, Denise G.; Kisala, Pamela A.; Tulsky, David S.

2015-01-01

Objective To describe the development and psychometric properties of the Spinal Cord Injury-Quality of Life (SCI-QOL) Self-esteem item bank. Design Using a mixed-methods design, we developed and tested a self-esteem item bank through the use of focus groups with individuals with SCI and clinicians with expertise in SCI, cognitive interviews, and item-response theory- (IRT) based analytic approaches, including tests of model fit, differential item functioning (DIF) and precision. Setting We tested a pool of 30 items at several medical institutions across the United States, including the University of Michigan, Kessler Foundation, the Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital, and the James J. Peters/Bronx Department of Veterans Affairs hospital. Participants A total of 717 individuals with SCI completed the self-esteem items. Results A unidimensional model was observed (CFI = 0.946; RMSEA = 0.087) and measurement precision was good (theta range between −2.7 and 0.7). Eleven items were flagged for DIF; however, effect sizes were negligible with little practical impact on score estimates. The final calibrated item bank resulted in 23 retained items. Conclusion This study indicates that the SCI-QOL Self-esteem item bank represents a psychometrically robust measurement tool. Short form items are also suggested and computer adaptive tests are available. PMID:26010972

Development and psychometric characteristics of the SCI-QOL Ability to Participate and Satisfaction with Social Roles and Activities item banks and short forms.

PubMed

Heinemann, Allen W; Kisala, Pamela A; Hahn, Elizabeth A; Tulsky, David S

2015-05-01

To develop a spinal cord injury (SCI)-focused version of PROMIS and Neuro-QOL social domain item banks; evaluate the psychometric properties of items developed for adults with SCI; and report information to facilitate clinical and research use. We used a mixed-methods design to develop and evaluate Ability to Participate in Social Roles and Activities and Satisfaction with Social Roles and Activities items. Focus groups helped define the constructs; cognitive interviews helped revise items; and confirmatory factor analysis and item response theory methods helped calibrate item banks and evaluate differential item functioning related to demographic and injury characteristics. Five SCI Model System sites and one Veterans Administration medical center. The calibration sample consisted of 641 individuals; a reliability sample consisted of 245 individuals residing in the community. A subset of 27 Ability to Participate and 35 Satisfaction items demonstrated good measurement properties and negligible differential item functioning related to demographic and injury characteristics. The SCI-specific measures correlate strongly with the PROMIS and Neuro-QOL versions. Ten item short forms correlate >0.96 with the full banks. Variable-length CATs with a minimum of 4 items, variable-length CATs with a minimum of 8 items, fixed-length CATs of 10 items, and the 10-item short forms demonstrate construct coverage and measurement error that is comparable to the full item bank. The Ability to Participate and Satisfaction with Social Roles and Activities CATs and short forms demonstrate excellent psychometric properties and are suitable for clinical and research applications.

Key Factors for Providing Appropriate Medical Care in Secondary School Athletics: Athletic Training Services and Budget

PubMed Central

Wham, George S.; Saunders, Ruth; Mensch, James

2010-01-01

Abstract Context: Research suggests that appropriate medical care for interscholastic athletes is frequently lacking. However, few investigators have examined factors related to care. Objective: To examine medical care provided by interscholastic athletics programs and to identify factors associated with variations in provision of care. Design: Cross-sectional study. Setting: Mailed and e-mailed survey. Patients or Other Participants: One hundred sixty-six South Carolina high schools. Intervention(s): The 132-item Appropriate Medical Care Assessment Tool (AMCAT) was developed and pilot tested. It included 119 items assessing medical care based on the Appropriate Medical Care for Secondary School-Age Athletes (AMCSSAA) Consensus Statement and Monograph (test-retest reliability: r  =  0.89). Also included were items assessing potential influences on medical care. Presence, source, and number of athletic trainers; school size; distance to nearest medical center; public or private status; sports medicine supply budget; and varsity football regional championships served as explanatory variables, whereas the school setting, region of state, and rate of free or reduced lunch qualifiers served as control variables. Main Outcome Measure(s): The Appropriate Care Index (ACI) score from the AMCAT provided a quantitative measure of medical care and served as the response variable. The ACI score was determined based on a school's response to items relating to AMCSSAA guidelines. Results: Regression analysis revealed associations with ACI score for athletic training services and sports medicine supply budget (both P < .001) when controlling for the setting, region, and rate of free or reduced lunch qualifiers. These 2 variables accounted for 30% of the variance in ACI score (R2  =  0.302). Post hoc analysis showed differences between ACI score based on the source of the athletic trainer and the size of the sports medicine supply budget. Conclusions: The AMCAT offers an

Science Library of Test Items. Volume Nineteen. A Collection of Multiple Choice Test Items Relating Mainly to Geology.

ERIC Educational Resources Information Center

New South Wales Dept. of Education, Sydney (Australia).

As one in a series of test item collections developed by the Assessment and Evaluation Unit of the Directorate of Studies, items are made available to teachers for the construction of unit tests or term examinations or as a basis for class discussion. Each collection was reviewed for content validity and reliability. The test items meet syllabus…

Science Library of Test Items. Volume Seventeen. A Collection of Multiple Choice Test Items Relating Mainly to Biology.

ERIC Educational Resources Information Center

New South Wales Dept. of Education, Sydney (Australia).

As one in a series of test item collections developed by the Assessment and Evaluation Unit of the Directorate of Studies, items are made available to teachers for the construction of unit tests or term examinations or as a basis for class discussion. Each collection was reviewed for content validity and reliability. The test items meet syllabus…

Science Library of Test Items. Volume Eighteen. A Collection of Multiple Choice Test Items Relating Mainly to Chemistry.

ERIC Educational Resources Information Center

New South Wales Dept. of Education, Sydney (Australia).

As one in a series of test item collections developed by the Assessment and Evaluation Unit of the Directorate of Studies, items are made available to teachers for the construction of unit tests or term examinations or as a basis for class discussion. Each collection was reviewed for content validity and reliability. The test items meet syllabus…

Air medical transport: what the family wants to know.

PubMed

Fultz, J H; McKee, J L; Zalaznik, F R; Kidd, P S

1993-01-01

The needs of family members of intensive care unit patients are well-documented, but there is little published about the specific needs of family members of air medical patients. This study was devised to identify family member's information needs regarding air medical transport. Using a descriptive correlational design, 100 family members of air medical patients completed a 14-item Likert-format questionnaire. Each item addressed an information need and asked how important the information was to the family member and how much of this information they received. The information needs most frequently ranked as very important related to the patient's condition, the patient's admitting unit at the receiving hospital, and being able to see the patient prior to flight. Information most frequently received by the family related to the patient's condition. Flight crews need to be cognizant of families' needs and develop ways to improve communication with the family to meet those needs.

Expected role of medical technologists in diabetes mellitus education teams.

PubMed

Kotani, Kazuhiko; Imazato, Takahiro; Anzai, Keizo

2015-06-01

The expected role of medical technologists within diabetes mellitus education teams was surveyed. In addition to items regarding laboratory examinations and results themselves, good communication with patients and education team members was highly required. When medical technologists sufficiently follow this role, it would aid patients to cope with life with diabetes mellitus.

48 CFR 235.071 - Export-controlled items.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Export-controlled items..., DEPARTMENT OF DEFENSE SPECIAL CATEGORIES OF CONTRACTING RESEARCH AND DEVELOPMENT CONTRACTING 235.071 Export-controlled items. For requirements regarding access to export-controlled items, see Subpart 204.73. [73 FR...

Feed mechanism and method for feeding minute items

DOEpatents

Stringer, Timothy Kent; Yerganian, Simon Scott

2012-11-06

A feeding mechanism and method for feeding minute items, such as capacitors, resistors, or solder preforms. The mechanism is adapted to receive a plurality of the randomly-positioned and randomly-oriented extremely small or minute items, and to isolate, orient, and position the items in a specific repeatable pickup location wherefrom they may be removed for use by, for example, a computer-controlled automated assembly machine. The mechanism comprises a sliding shelf adapted to receive and support the items; a wiper arm adapted to achieve a single even layer of the items; and a pushing arm adapted to push the items into the pickup location. The mechanism can be adapted for providing the items with a more exact orientation, and can also be adapted for use in a liquid environment.

Feed mechanism and method for feeding minute items

DOEpatents

Stringer, Timothy Kent [Bucyrus, KS; Yerganian, Simon Scott [Lee's Summit, MO

2009-10-20

A feeding mechanism and method for feeding minute items, such as capacitors, resistors, or solder preforms. The mechanism is adapted to receive a plurality of the randomly-positioned and randomly-oriented extremely small or minute items, and to isolate, orient, and position one or more of the items in a specific repeatable pickup location wherefrom they may be removed for use by, for example, a computer-controlled automated assembly machine. The mechanism comprises a sliding shelf adapted to receive and support the items; a wiper arm adapted to achieve a single even layer of the items; and a pushing arm adapted to push the items into the pickup location. The mechanism can be adapted for providing the items with a more exact orientation, and can also be adapted for use in a liquid environment.

Development of an instrument to measure medical students' perceptions of the assessment environment: initial validation.

PubMed

Sim, Joong Hiong; Tong, Wen Ting; Hong, Wei-Han; Vadivelu, Jamuna; Hassan, Hamimah

2015-01-01

Assessment environment, synonymous with climate or atmosphere, is multifaceted. Although there are valid and reliable instruments for measuring the educational environment, there is no validated instrument for measuring the assessment environment in medical programs. This study aimed to develop an instrument for measuring students' perceptions of the assessment environment in an undergraduate medical program and to examine the psychometric properties of the new instrument. The Assessment Environment Questionnaire (AEQ), a 40-item, four-point (1=Strongly Disagree to 4=Strongly Agree) Likert scale instrument designed by the authors, was administered to medical undergraduates from the authors' institution. The response rate was 626/794 (78.84%). To establish construct validity, exploratory factor analysis (EFA) with principal component analysis and varimax rotation was conducted. To examine the internal consistency reliability of the instrument, Cronbach's α was computed. Mean scores for the entire AEQ and for each factor/subscale were calculated. Mean AEQ scores of students from different academic years and sex were examined. Six hundred and eleven completed questionnaires were analysed. EFA extracted four factors: feedback mechanism (seven items), learning and performance (five items), information on assessment (five items), and assessment system/procedure (three items), which together explained 56.72% of the variance. Based on the four extracted factors/subscales, the AEQ was reduced to 20 items. Cronbach's α for the 20-item AEQ was 0.89, whereas Cronbach's α for the four factors/subscales ranged from 0.71 to 0.87. Mean score for the AEQ was 2.68/4.00. The factor/subscale of 'feedback mechanism' recorded the lowest mean (2.39/4.00), whereas the factor/subscale of 'assessment system/procedure' scored the highest mean (2.92/4.00). Significant differences were found among the AEQ scores of students from different academic years. The AEQ is a valid and reliable

Memory for Items and Relationships among Items Embedded in Realistic Scenes: Disproportionate Relational Memory Impairments in Amnesia

PubMed Central

Hannula, Deborah E.; Tranel, Daniel; Allen, John S.; Kirchhoff, Brenda A.; Nickel, Allison E.; Cohen, Neal J.

2014-01-01

Objective The objective of this study was to examine the dependence of item memory and relational memory on medial temporal lobe (MTL) structures. Patients with amnesia, who either had extensive MTL damage or damage that was relatively restricted to the hippocampus, were tested, as was a matched comparison group. Disproportionate relational memory impairments were predicted for both patient groups, and those with extensive MTL damage were also expected to have impaired item memory. Method Participants studied scenes, and were tested with interleaved two-alternative forced-choice probe trials. Probe trials were either presented immediately after the corresponding study trial (lag 1), five trials later (lag 5), or nine trials later (lag 9) and consisted of the studied scene along with a manipulated version of that scene in which one item was replaced with a different exemplar (item memory test) or was moved to a new location (relational memory test). Participants were to identify the exact match of the studied scene. Results As predicted, patients were disproportionately impaired on the test of relational memory. Item memory performance was marginally poorer among patients with extensive MTL damage, but both groups were impaired relative to matched comparison participants. Impaired performance was evident at all lags, including the shortest possible lag (lag 1). Conclusions The results are consistent with the proposed role of the hippocampus in relational memory binding and representation, even at short delays, and suggest that the hippocampus may also contribute to successful item memory when items are embedded in complex scenes. PMID:25068665

Parameter Estimation in Rasch Models for Examinee-Selected Items

ERIC Educational Resources Information Center

Liu, Chen-Wei; Wang, Wen-Chung

2017-01-01

The examinee-selected-item (ESI) design, in which examinees are required to respond to a fixed number of items in a given set of items (e.g., choose one item to respond from a pair of items), always yields incomplete data (i.e., only the selected items are answered and the others have missing data) that are likely nonignorable. Therefore, using…

Applying Hierarchical Model Calibration to Automatically Generated Items.

ERIC Educational Resources Information Center

Williamson, David M.; Johnson, Matthew S.; Sinharay, Sandip; Bejar, Isaac I.

This study explored the application of hierarchical model calibration as a means of reducing, if not eliminating, the need for pretesting of automatically generated items from a common item model prior to operational use. Ultimately the successful development of automatic item generation (AIG) systems capable of producing items with highly similar…

7 CFR 65.220 - Processed food item.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 3 2011-01-01 2011-01-01 false Processed food item. 65.220 Section 65.220 Agriculture..., PEANUTS, AND GINSENG General Provisions Definitions § 65.220 Processed food item. Processed food item... other covered commodity or other substantive food component (e.g., chocolate, breading, tomato sauce...

7 CFR 65.220 - Processed food item.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 3 2014-01-01 2014-01-01 false Processed food item. 65.220 Section 65.220 Agriculture..., PEANUTS, AND GINSENG General Provisions Definitions § 65.220 Processed food item. Processed food item... other covered commodity or other substantive food component (e.g., chocolate, breading, tomato sauce...

7 CFR 65.220 - Processed food item.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 3 2012-01-01 2012-01-01 false Processed food item. 65.220 Section 65.220 Agriculture..., PEANUTS, AND GINSENG General Provisions Definitions § 65.220 Processed food item. Processed food item... other covered commodity or other substantive food component (e.g., chocolate, breading, tomato sauce...

7 CFR 65.220 - Processed food item.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 3 2013-01-01 2013-01-01 false Processed food item. 65.220 Section 65.220 Agriculture..., PEANUTS, AND GINSENG General Provisions Definitions § 65.220 Processed food item. Processed food item... other covered commodity or other substantive food component (e.g., chocolate, breading, tomato sauce...

7 CFR 65.220 - Processed food item.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 3 2010-01-01 2010-01-01 false Processed food item. 65.220 Section 65.220 Agriculture..., PEANUTS, AND GINSENG General Provisions Definitions § 65.220 Processed food item. Processed food item... other covered commodity or other substantive food component (e.g., chocolate, breading, tomato sauce...

Automatic Item Generation of Probability Word Problems

ERIC Educational Resources Information Center

Holling, Heinz; Bertling, Jonas P.; Zeuch, Nina

2009-01-01

Mathematical word problems represent a common item format for assessing student competencies. Automatic item generation (AIG) is an effective way of constructing many items with predictable difficulties, based on a set of predefined task parameters. The current study presents a framework for the automatic generation of probability word problems…

Linking Item Parameters to a Base Scale

ERIC Educational Resources Information Center

Kang, Taehoon; Petersen, Nancy S.

2012-01-01

This paper compares three methods of item calibration--concurrent calibration, separate calibration with linking, and fixed item parameter calibration--that are frequently used for linking item parameters to a base scale. Concurrent and separate calibrations were implemented using BILOG-MG. The Stocking and Lord in "Appl Psychol Measure"…

7 CFR 2902.5 - Item designation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... additionally will not designate items for preferred procurement that are determined to have mature markets. USDA will determine mature market status by whether the item had significant national market penetration in 1972. ...

Modeling Local Item Dependence in Cloze and Reading Comprehension Test Items Using Testlet Response Theory

ERIC Educational Resources Information Center

Baghaei, Purya; Ravand, Hamdollah

2016-01-01

In this study the magnitudes of local dependence generated by cloze test items and reading comprehension items were compared and their impact on parameter estimates and test precision was investigated. An advanced English as a foreign language reading comprehension test containing three reading passages and a cloze test was analyzed with a…

Does medical students’ clinical performance affect their actual performance during medical internship?

PubMed Central

Han, Eui-Ryoung; Chung, Eun-Kyung

2016-01-01

INTRODUCTION This study examines the relationship between the clinical performance of medical students and their performance as doctors during their internships. METHODS This retrospective study involved 63 applicants of a residency programme conducted at Chonnam National University Hospital, South Korea, in November 2012. We compared the performance of the applicants during their internship with their clinical performance during their fourth year of medical school. The performance of the applicants as interns was periodically evaluated by the faculty of each department, while their clinical performance as fourth-year medical students was assessed using the Clinical Performance Examination (CPX) and the Objective Structured Clinical Examination (OSCE). RESULTS The performance of the applicants as interns was positively correlated with their clinical performance as fourth-year medical students, as measured by the CPX and OSCE. The performance of the applicants as interns was moderately correlated with the patient-physician interaction items addressing communication and interpersonal skills in the CPX. CONCLUSION The clinical performance of medical students during their fourth year in medical school was related to their performance as medical interns. Medical students should be trained to develop good clinical skills through actual encounters with patients or simulated encounters using manikins, to enable them to become more competent doctors. PMID:26768172

Development of an assay of seven biochemical items, HbA1c, and hematocrit using a small amount of blood collected from the fingertip.

PubMed

Shinya, Sugimoto; Masaru, Akimoto; Akira, Hayakawa; Eisaku, Hokazono; Susumu, Osawa

2012-01-18

Lifestyle-related diseases in Japan account for 30% of the entire medical expenditure of the country and cause 60% of all deaths. For the prevention of lifestyle-related diseases, medical examination by laboratory tests on metabolic syndrome is important. To undertake examination by collection of blood from a fingertip, we developed the "Well Kit". About 65 μl of blood collected from a fingertip was diluted with buffer solution, which contained two internal standard materials. The kit also separated corpuscles and diluted plasma with a special filter. It measured the obtained diluted plasma using the JCA-BM2250. This measurement system was evaluated for the quantitative analysis of 8 items. The uncertainties of tested items of this measurement system were 1.7% to 6.4%. The coefficients of correlation of all tested items between this measurement value and the venous plasma sample value were 0.876-0.991, and hematocrit was 0.958. This system for testing blood collected from a fingertip is simple to use and can be applied in testing for metabolic syndrome. In addition, this testing system is useful in the medical examination of the personal healthcare and inhabitants. Copyright © 2011 Elsevier B.V. All rights reserved.

Agriculture Library of Test Items.

ERIC Educational Resources Information Center

Sutherland, Duncan, Ed.

As one in a series of test item collections developed by the Assessment and Evaluation Unit of the Directorate of Studies, items of value from past tests are made available to teachers for the construction of unit tests, term examinations or as a basis for class discussion. Each collection is reviewed for content validity and reliability. The test…

Item Response Theory Equating Using Bayesian Informative Priors.

ERIC Educational Resources Information Center

de la Torre, Jimmy; Patz, Richard J.

This paper seeks to extend the application of Markov chain Monte Carlo (MCMC) methods in item response theory (IRT) to include the estimation of equating relationships along with the estimation of test item parameters. A method is proposed that incorporates estimation of the equating relationship in the item calibration phase. Item parameters from…

10 CFR 835.605 - Labeling items and containers.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Labeling items and containers. 835.605 Section 835.605... items and containers. Except as provided at § 835.606, each item or container of radioactive material... information to permit individuals handling, using, or working in the vicinity of the items or containers to...

Statistical Approaches to the Study of Item Difficulty.

ERIC Educational Resources Information Center

Olson, John F.; And Others

Traditionally, item difficulty has been defined in terms of the performance of examinees. For test development purposes, a more useful concept would be some kind of intrinsic item difficulty, defined in terms of the item's content, context, or characteristics and the task demands set by the item. In this investigation, the measurement literature…

An Evaluation of "Intentional" Weighting of Extended-Response or Constructed-Response Items in Tests with Mixed Item Types.

ERIC Educational Resources Information Center

Ito, Kyoko; Sykes, Robert C.

This study investigated the practice of weighting a type of test item, such as constructed response, more than other types of items, such as selected response, to compute student scores for a mixed-item type of test. The study used data from statewide writing field tests in grades 3, 5, and 8 and considered two contexts, that in which a single…

Measuring depression after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Depression item bank and linkage with PHQ-9.

PubMed

Tulsky, David S; Kisala, Pamela A; Kalpakjian, Claire Z; Bombardier, Charles H; Pohlig, Ryan T; Heinemann, Allen W; Carle, Adam; Choi, Seung W

2015-05-01

To develop a calibrated spinal cord injury-quality of life (SCI-QOL) item bank, computer adaptive test (CAT), and short form to assess depressive symptoms experienced by individuals with SCI, transform scores to the Patient Reported Outcomes Measurement Information System (PROMIS) metric, and create a crosswalk to the Patient Health Questionnaire (PHQ)-9. We used grounded-theory based qualitative item development methods, large-scale item calibration field testing, confirmatory factor analysis, item response theory (IRT) analyses, and statistical linking techniques to transform scores to a PROMIS metric and to provide a crosswalk with the PHQ-9. Five SCI Model System centers and one Department of Veterans Affairs medical center in the United States. Adults with traumatic SCI. Spinal Cord Injury--Quality of Life (SCI-QOL) Depression Item Bank Individuals with SCI were involved in all phases of SCI-QOL development. A sample of 716 individuals with traumatic SCI completed 35 items assessing depression, 18 of which were PROMIS items. After removing 7 non-PROMIS items, factor analyses confirmed a unidimensional pool of items. We used a graded response IRT model to estimate slopes and thresholds for the 28 retained items. The SCI-QOL Depression measure correlated 0.76 with the PHQ-9. The SCI-QOL Depression item bank provides a reliable and sensitive measure of depressive symptoms with scores reported in terms of general population norms. We provide a crosswalk to the PHQ-9 to facilitate comparisons between measures. The item bank may be administered as a CAT or as a short form and is suitable for research and clinical applications.

Criterion-Referenced Test Items for Small Engines.

ERIC Educational Resources Information Center

Herd, Amon

This notebook contains criterion-referenced test items for testing students' knowledge of small engines. The test items are based upon competencies found in the Missouri Small Engine Competency Profile. The test item bank is organized in 18 sections that cover the following duties: shop procedures; tools and equipment; fasteners; servicing fuel…

Item-Based Top-N Recommendation Algorithms

DTIC Science & Technology

2003-01-20

basket of items, utilized by many e-commerce sites, cannot take advantage of pre-computed user-to-user similarities. Finally, even though the...not discriminate between items that are present in frequent itemsets and items that are not, while still maintaining the computational advantages of...453219 0.02% 7.74 ccard 42629 68793 398619 0.01% 9.35 ecommerce 6667 17491 91222 0.08% 13.68 em 8002 1648 769311 5.83% 96.14 ml 943 1682 100000 6.31

Medical Equipment Used to Support Operations in Southwest Asia

DTIC Science & Technology

2009-09-30

services. USCENTCOM Medical Logistics Management In February 2006, the Chairman of the Joint Chiefs of Staff designated the U.S. Army Medical...Microbiology Psychiatry/Mental Health Pediatrics Radiology* Prosthesis Trauma Surgery (General, Orthopedic, Urologic, Obstetrics and Gynecology... automated capability to manage equipment assets from the time a customer starts the research for an equipment item to the point at which the equipment

Curriculum Type as a Differentiating Factor in Medical Licensing Examinations.

ERIC Educational Resources Information Center

Shen, Linjun

This study assessed the effects of the type of medical curriculum on differential item functioning (DIF) and group differences at the test level in Level 1 of the Comprehensive Osteopathic Medical Licensing Examinations (COMLEX). The study also explored the relationship of the DIF and group differences at the test level. There are generally two…

Item Response Theory Using Hierarchical Generalized Linear Models

ERIC Educational Resources Information Center

Ravand, Hamdollah

2015-01-01

Multilevel models (MLMs) are flexible in that they can be employed to obtain item and person parameters, test for differential item functioning (DIF) and capture both local item and person dependence. Papers on the MLM analysis of item response data have focused mostly on theoretical issues where applications have been add-ons to simulation…

A Review of Classical Methods of Item Analysis.

ERIC Educational Resources Information Center

French, Christine L.

Item analysis is a very important consideration in the test development process. It is a statistical procedure to analyze test items that combines methods used to evaluate the important characteristics of test items, such as difficulty, discrimination, and distractibility of the items in a test. This paper reviews some of the classical methods for…

Modeling Item-Position Effects within an IRT Framework

ERIC Educational Resources Information Center

Debeer, Dries; Janssen, Rianne

2013-01-01

Changing the order of items between alternate test forms to prevent copying and to enhance test security is a common practice in achievement testing. However, these changes in item order may affect item and test characteristics. Several procedures have been proposed for studying these item-order effects. The present study explores the use of…

Impact of the Chronic Care Model on medication adherence when patients perceive cost as a barrier.

PubMed

Mackey, Katherine; Parchman, Michael L; Leykum, Luci K; Lanham, Holly J; Noël, Polly H; Zeber, John E

2012-07-01

Cost burdens represent a significant barrier to medication adherence among chronically ill patients, yet financial pressures may be mitigated by clinical or organizational factors, such as treatment aligned with the Chronic Care Model (CCM). This study examines how perceptions of chronic illness care attenuate the relationship between adherence and cost burden. Surveys were administered to patients at 40 small community-based primary care practices. Medication adherence was assessed using the 4-item Morisky scale, while five cost-related items documented recent pharmacy restrictions. CCM experiences were assessed via the 20-item Patient Assessment of Chronic Illness Care (PACIC). Nested random effects models determined if chronic care perceptions modified the association between medication adherence and cost-related burden. Of 1823 respondents reporting diabetes and other chronic diseases, one-quarter endorsed intrapersonal adherence barriers, while 23% restricted medication due of cost. Controlling for age and health status, the relationship between medication cost and CCM with adherence was significant; including PACIC scores attenuated cost-related problems patients with adequate or problematic adherence behavior. Patients experiencing treatment more consistent with the CCM reported better adherence and lower cost-related burden. Fostering highly activated patients and shared clinical decision making may help alleviate medication cost pressures and improve adherence. Published by Elsevier Ltd.

Generating constrained randomized sequences: item frequency matters.

PubMed

French, Robert M; Perruchet, Pierre

2009-11-01

All experimental psychologists understand the importance of randomizing lists of items. However, randomization is generally constrained, and these constraints-in particular, not allowing immediately repeated items-which are designed to eliminate particular biases, frequently engender others. We describe a simple Monte Carlo randomization technique that solves a number of these problems. However, in many experimental settings, we are concerned not only with the number and distribution of items but also with the number and distribution of transitions between items. The algorithm mentioned above provides no control over this. We therefore introduce a simple technique that uses transition tables for generating correctly randomized sequences. We present an analytic method of producing item-pair frequency tables and item-pair transitional probability tables when immediate repetitions are not allowed. We illustrate these difficulties and how to overcome them, with reference to a classic article on word segmentation in infants. Finally, we provide free access to an Excel file that allows users to generate transition tables with up to 10 different item types, as well as to generate appropriately distributed randomized sequences of any length without immediately repeated elements. This file is freely available from http://leadserv.u-bourgogne.fr/IMG/xls/TransitionMatrix.xls.

Electronics. Criterion-Referenced Test (CRT) Item Bank.

ERIC Educational Resources Information Center

Davis, Diane, Ed.

This document contains 519 criterion-referenced multiple choice and true or false test items for a course in electronics. The test item bank is designed to work with both the Vocational Instructional Management System (VIMS) and the Vocational Administrative Management System (VAMS) in Missouri. The items are grouped into 15 units covering the…

Comparison of children's fears of medical experiences across two cultures.

PubMed

Mahat, Ganga; Scoloveno, Mary Ann; Cannella, Barbara

2004-01-01

This study examined the self-reported fears of school-age children living in the United States and in Nepal. Thirty school-age children from each country, matched by sex and age, participated in this study. The revised version of the Child Medical Fear Scale was used to identify medical fears of children. Among 17 feared items, the result showed getting a shot to be the most feared item reported by both groups. Nepalese children reported higher fear scores than did American children. It also was found that there was a significant difference in fear scores between Nepalese boys and girls, with girls reporting higher fear scores than boys. There was no difference in fear scores between American boys and girls. The findings of this study are important to nurse practitioners in understanding children's fears of medical experiences across different cultures. Nurses can support children in dealing with their fears of medical experiences by recognizing these fears and taking into consideration the child's family, sex, and culture when planning care. Nursing implications are discussed.

Towards the integration of medical informatics education for clinicians into the medical curriculum.

PubMed

Lungeanu, Diana; Tractenberg, Rochelle E; Bersan, Otilia S; Mihalas, George I

2009-01-01

In the context of an existing first year, one-semester mandatory course of medical informatics (MI) for medical students, we tested an interactive teaching approach in parallel with the traditional academic program. After six semesters (at the beginning of the clinical stage) we collected feedback from the former students in the two parallel programs (with anonymous questionnaires comprising both subjectively-rated items and open-ended questions). We conclude that an introductory course on information and communication technology and information skills can be useful at the beginning of the medical curriculum, while an interactive, problem-based-learning-type MI course should be included during the clinical stage. Early development of these skills, and their use/utility across the curriculum, are important aspects of integrating MI education into clinical training.

Rasch Measurement and Item Banking: Theory and Practice.

ERIC Educational Resources Information Center

Nakamura, Yuji

The Rasch Model is an item response theory, one parameter model developed that states that the probability of a correct response on a test is a function of the difficulty of the item and the ability of the candidate. Item banking is useful for language testing. The Rasch Model provides estimates of item difficulties that are meaningful,…

Emotional disorders among medical students in a Malaysian private medical school.

PubMed

Zaid, Z A; Chan, S C; Ho, J J

2007-10-01

A study was done between December 2005 and January 2006 to determine the prevalence of emotional disorders among medical students in a private medical school in Ipoh, Perak, Malaysia and to determine the demographical characteristics, contributing factors and the key person consulted for emotional problems. Medical students in the private medical school completed the 12-item English version of the General Health Questionnaire (GHQ-12) and a demographical questionnaire. A cut-off point of 3/4 for the GHQ was used to determine negative and positive scores for emotional disorders. Out of 292 medical students, 86.6 percent completed the questionnaires. A total of 117 students (46.2 percent) were found to have emotional disorders. There was no significant association of ethnicity, gender, age group, number of examinations sat, examination performances, past medical conditions and relationships with parents, siblings, course-mates and lecturers with positive GHQ scores. A significant association, however, was found between positive GHQ scores for emotional disorders and the year of study, pressure faced due to examinations, and not having a love relationship. 39 percent of the students stated friends as their main preference for consultation of any emotional problem. The prevalence of emotional disorders among medical students was high. Further studies and diagnostic measures are recommended, including a more systematic screening and counselling programme by the medical school for early diagnosis and treatment to prevent complications.

A Balance Sheet for Educational Item Banking.

ERIC Educational Resources Information Center

Hiscox, Michael D.

Educational item banking presents observers with a considerable paradox. The development of test items from scratch is viewed as wasteful, a luxury in times of declining resources. On the other hand, item banking has failed to become a mature technology despite large amounts of money and the efforts of talented professionals. The question of which…

Measuring Student Learning with Item Response Theory

ERIC Educational Resources Information Center

Lee, Young-Jin; Palazzo, David J.; Warnakulasooriya, Rasil; Pritchard, David E.

2008-01-01

We investigate short-term learning from hints and feedback in a Web-based physics tutoring system. Both the skill of students and the difficulty and discrimination of items were determined by applying item response theory (IRT) to the first answers of students who are working on for-credit homework items in an introductory Newtonian physics…

Promoting Cold-Start Items in Recommender Systems

PubMed Central

Liu, Jin-Hu; Zhou, Tao; Zhang, Zi-Ke; Yang, Zimo; Liu, Chuang; Li, Wei-Min

2014-01-01

As one of the major challenges, cold-start problem plagues nearly all recommender systems. In particular, new items will be overlooked, impeding the development of new products online. Given limited resources, how to utilize the knowledge of recommender systems and design efficient marketing strategy for new items is extremely important. In this paper, we convert this ticklish issue into a clear mathematical problem based on a bipartite network representation. Under the most widely used algorithm in real e-commerce recommender systems, the so-called item-based collaborative filtering, we show that to simply push new items to active users is not a good strategy. Interestingly, experiments on real recommender systems indicate that to connect new items with some less active users will statistically yield better performance, namely, these new items will have more chance to appear in other users' recommendation lists. Further analysis suggests that the disassortative nature of recommender systems contributes to such observation. In a word, getting in-depth understanding on recommender systems could pave the way for the owners to popularize their cold-start products with low costs. PMID:25479013

Promoting cold-start items in recommender systems.

PubMed

Liu, Jin-Hu; Zhou, Tao; Zhang, Zi-Ke; Yang, Zimo; Liu, Chuang; Li, Wei-Min

2014-01-01

As one of the major challenges, cold-start problem plagues nearly all recommender systems. In particular, new items will be overlooked, impeding the development of new products online. Given limited resources, how to utilize the knowledge of recommender systems and design efficient marketing strategy for new items is extremely important. In this paper, we convert this ticklish issue into a clear mathematical problem based on a bipartite network representation. Under the most widely used algorithm in real e-commerce recommender systems, the so-called item-based collaborative filtering, we show that to simply push new items to active users is not a good strategy. Interestingly, experiments on real recommender systems indicate that to connect new items with some less active users will statistically yield better performance, namely, these new items will have more chance to appear in other users' recommendation lists. Further analysis suggests that the disassortative nature of recommender systems contributes to such observation. In a word, getting in-depth understanding on recommender systems could pave the way for the owners to popularize their cold-start products with low costs.

Mixed-Format Test Score Equating: Effect of Item-Type Multidimensionality, Length and Composition of Common-Item Set, and Group Ability Difference

ERIC Educational Resources Information Center

Wang, Wei

2013-01-01

Mixed-format tests containing both multiple-choice (MC) items and constructed-response (CR) items are now widely used in many testing programs. Mixed-format tests often are considered to be superior to tests containing only MC items although the use of multiple item formats leads to measurement challenges in the context of equating conducted under…

Private sector involvement in times of armed conflict: What are the constraints for trading medical equipment?

PubMed

Schmidt, Georg

Today, healthcare facilities are highly dependent on the private sector to keep their medical equipment functioning. Moreover, private sector involvement becomes particularly important for the supply of spare parts and consumables. However, in times of armed conflict, the capacity of the corporate world appears to be seriously hindered. Subsequently, this study researches the influence of armed conflict on the private medical equipment sector. This study follows a qualitative approach by conducting 19 interviews with representatives of the corporate world in an active conflict zone. A semistructured interview guide, consisting of 10 questions, was used to examine the constraints of this sector. The results reveal that the lack of skilled personnel, complicated importation procedures, and a decrease in financial capacity are the major constraints faced by private companies dealing in medical equipment in conflict zones. Even when no official sanctions and embargoes for medical items exist, constraints for trading medical equipment are clearly recognizable. Countries at war would benefit from a centralized structure that deals with the importation procedures for medical items, to assist local companies in their purchasing procedures. A high degree of adaption is needed to continue operating, despite the emerging constraints of armed conflict. Future studies might research the constraints for manufacturers outside the conflict to export medical items to the country of war.

Negative affect impairs associative memory but not item memory.

PubMed

Bisby, James A; Burgess, Neil

2013-12-17

The formation of associations between items and their context has been proposed to rely on mechanisms distinct from those supporting memory for a single item. Although emotional experiences can profoundly affect memory, our understanding of how it interacts with different aspects of memory remains unclear. We performed three experiments to examine the effects of emotion on memory for items and their associations. By presenting neutral and negative items with background contexts, Experiment 1 demonstrated that item memory was facilitated by emotional affect, whereas memory for an associated context was reduced. In Experiment 2, arousal was manipulated independently of the memoranda, by a threat of shock, whereby encoding trials occurred under conditions of threat or safety. Memory for context was equally impaired by the presence of negative affect, whether induced by threat of shock or a negative item, relative to retrieval of the context of a neutral item in safety. In Experiment 3, participants were presented with neutral and negative items as paired associates, including all combinations of neutral and negative items. The results showed both above effects: compared to a neutral item, memory for the associate of a negative item (a second item here, context in Experiments 1 and 2) is impaired, whereas retrieval of the item itself is enhanced. Our findings suggest that negative affect impairs associative memory while recognition of a negative item is enhanced. They support dual-processing models in which negative affect or stress impairs hippocampal-dependent associative memory while the storage of negative sensory/perceptual representations is spared or even strengthened.

Non-ignorable missingness item response theory models for choice effects in examinee-selected items.

PubMed

Liu, Chen-Wei; Wang, Wen-Chung

2017-11-01

Examinee-selected item (ESI) design, in which examinees are required to respond to a fixed number of items in a given set, always yields incomplete data (i.e., when only the selected items are answered, data are missing for the others) that are likely non-ignorable in likelihood inference. Standard item response theory (IRT) models become infeasible when ESI data are missing not at random (MNAR). To solve this problem, the authors propose a two-dimensional IRT model that posits one unidimensional IRT model for observed data and another for nominal selection patterns. The two latent variables are assumed to follow a bivariate normal distribution. In this study, the mirt freeware package was adopted to estimate parameters. The authors conduct an experiment to demonstrate that ESI data are often non-ignorable and to determine how to apply the new model to the data collected. Two follow-up simulation studies are conducted to assess the parameter recovery of the new model and the consequences for parameter estimation of ignoring MNAR data. The results of the two simulation studies indicate good parameter recovery of the new model and poor parameter recovery when non-ignorable missing data were mistakenly treated as ignorable. © 2017 The British Psychological Society.

Measuring the ICF components of impairment, activity limitation and participation restriction: an item analysis using classical test theory and item response theory

PubMed Central

Pollard, Beth; Dixon, Diane; Dieppe, Paul; Johnston, Marie

2009-01-01

Background The International Classification of Functioning, Disability and Health (ICF) proposes three main health outcomes, Impairment (I), Activity Limitation (A) and Participation Restriction (P), but good measures of these constructs are needed The aim of this study was to use both Classical Test Theory (CTT) and Item Response Theory (IRT) methods to carry out an item analysis to improve measurement of these three components in patients having joint replacement surgery mainly for osteoarthritis (OA). Methods A geographical cohort of patients about to undergo lower limb joint replacement was invited to participate. Five hundred and twenty four patients completed ICF items that had been previously identified as measuring only a single ICF construct in patients with osteoarthritis. There were 13 I, 26 A and 20 P items. The SF-36 was used to explore the construct validity of the resultant I, A and P measures. The CTT and IRT analyses were run separately to identify items for inclusion or exclusion in the measurement of each construct. The results from both analyses were compared and contrasted. Results Overall, the item analysis resulted in the removal of 4 I items, 9 A items and 11 P items. CTT and IRT identified the same 14 items for removal, with CTT additionally excluding 3 items, and IRT a further 7 items. In a preliminary exploration of reliability and validity, the new measures appeared acceptable. Conclusion New measures were developed that reflect the ICF components of Impairment, Activity Limitation and Participation Restriction for patients with advanced arthritis. The resulting Aberdeen IAP measures (Ab-IAP) comprising I (Ab-I, 9 items), A (Ab-A, 17 items), and P (Ab-P, 9 items) met the criteria of conventional psychometric (CTT) analyses and the additional criteria (information and discrimination) of IRT. The use of both methods was more informative than the use of only one of these methods. Thus combining CTT and IRT appears to be a valuable tool in

Attitudes of Medical Students and Residents toward Care of the Elderly

ERIC Educational Resources Information Center

Muangpaisan, Weerasak; Intalapapron, Somboon; Assantachai, Prasert

2008-01-01

The research reported in this article examined attitudes toward the care of the elderly between and among medical students and residents in training. Data were collected with a 16-item attitude questionnaire. Participants were medical students in their introduction period (prior to clinical experience) and residents of the Department of Internal…

Science Library of Test Items. Volume Two.

ERIC Educational Resources Information Center

New South Wales Dept. of Education, Sydney (Australia).

The second volume of test items in the Science Library of Test Items is intended as a resource to assist teachers in implementing and evaluating science courses in the first 4 years of Australian secondary school. The items were selected from questions submitted to the School Certificate Development Unit by teachers in New South Wales. Only the…

Ethnic Group Bias in Intelligence Test Items.

ERIC Educational Resources Information Center

Scheuneman, Janice

In previous studies of ethnic group bias in intelligence test items, the question of bias has been confounded with ability differences between the ethnic group samples compared. The present study is based on a conditional probability model in which an unbiased item is defined as one where the probability of a correct response to an item is the…

A Case Study on an Item Writing Process: Use of Test Specifications, Nature of Group Dynamics, and Individual Item Writers' Characteristics

ERIC Educational Resources Information Center

Kim, Jiyoung; Chi, Youngshin; Huensch, Amanda; Jun, Heesung; Li, Hongli; Roullion, Vanessa

2010-01-01

This article discusses a case study on an item writing process that reflects on our practical experience in an item development project. The purpose of the article is to share our lessons from the experience aiming to demystify item writing process. The study investigated three issues that naturally emerged during the project: how item writers use…

A 7-item version of the fatigue severity scale has better psychometric properties among HIV-infected adults: an application of a Rasch model.

PubMed

Lerdal, Anners; Kottorp, Anders; Gay, Caryl; Aouizerat, Bradley E; Portillo, Carmen J; Lee, Kathryn A

2011-11-01

To examine the psychometric properties of the 9-item Fatigue Severity Scale (FSS) using a Rasch model application. A convenience sample of HIV-infected adults was recruited, and a subset of the sample was assessed at 6-month intervals for 2 years. Socio-demographic, clinical, and symptom data were collected by self-report questionnaires. CD4 T-cell count and viral load measures were obtained from medical records. The Rasch analysis included 316 participants with 698 valid questionnaires. FSS item 2 did not advanced monotonically, and items 1 and 2 did not show acceptable goodness-of-fit to the Rasch model. A reduced FSS 7-item version demonstrated acceptable goodness-of-fit and explained 61.2% of the total variance in the scale. In the FSS-7 item version, no uniform Differential Item Functioning was found in relation to time of evaluation or to any of the socio-demographic or clinical variables. This study demonstrated that the FSS-7 has better psychometric properties than the FSS-9 in this HIV sample and that responses to the different items are comparable over time and unrelated to socio-demographic and clinical variables.