Development and Psychometric Evaluation of a Caregiver Survey to Assess Family-Centered Care in the Emergency Department.

OBJECTIVE: To develop and evaluate the psychometric properties of a family caregiver-reported survey that assesses family-centeredness of care in the context of pediatric emergency department (ED) encounters. METHODS: We created a caregiver-reported scale, incorporated content expert feedback, and iteratively revised it based on cognitive interviews with caregivers. We then field tested the scale in a survey with caregivers. We dichotomized items using top-box scoring and obtained a summary score per respondent. Using a sample of 191 caregivers recruited from 9 EDs, we analyzed internal consistency reliability, dimensionality via item response theory modeling, and convergent validity with the ED Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. RESULTS: Feedback from the 9 experts led us to remove 4 items. We conducted 16 cognitive interviews and revised the survey in 4 rounds. An 11-item survey was field tested. Mean (standard deviation) respondent 11-item summary score was 77.2 (26.6). We removed 2 items given inconsistent response patterns, poor variability, and poor internal consistency, which increased coefficient alpha from 0.85 to 0.88 for the final scale. A multidimensional model fit the data best, but factor scores correlated strongly with summary scores, suggesting the latter are sufficient for quality improvement and future research. Regarding convergent validity, adjusted partial correlation between our scale's 9-item summary score and the ED CAHPS summary score was 0.75 (95% confidence interval 0.67-0.81). CONCLUSIONS: Psychometric analyses demonstrated strong item performance, reliability, and convergent validity for the 9-item scale. This survey can be used to assess family-centered care in the ED for research and quality improvement purposes.

Five-Minute Cognitive Test as A New Quick Screening of Cognitive Impairment in The Elderly.

This study aims to develop a new evaluation method for quickly and conveniently screening cognitive impairment in the elderly. The five-minute cognitive test (FCT) was designed to capture deficits in five domains of cognitive abilities, including episodic memory, language fluency, time orientation, visuospatial function, and executive function. Subsequently, FCT efficiencies in differentiating normally cognitive ability from cognitive impairment were explored and compared with that of the Mini-Mental Status Evaluation (MMSE). Equipercentile equating method was utilized to create a crosswalk between scores of the FCT and MMSE. Further, the association of scores of the FCT and MMSE with hippocampal volumes was investigated. There were 241 subjects aged 60 years or above enrolled in this study, including 107 adults with cognitive abilities in normal range, 107 patients with mild cognitive impairment (MCI), and 27 patients with mild Alzheimer disease (AD). The AUC of FCT for detection of cognitive impairment (MCI and mild AD) was 0.885 (95% CI 0.838 to 0.922). The sensitivity and specificity of FCT for the diagnosis of cognitive impairment were 80.6% and 84.11 %, respectively. FCT's diagnostic performance was superior to that of MMSE in the same cohort. Mean completion time of FCT was 339.9 ± 67.7 seconds (5-6 min). In addition, a conversion table between scores on the FCT and MMSE was created. Further, the FCT scores were positively correlated with hippocampal volumes. The FCT is a novel, reliable, and valid cognitive screening test for the detection of dementia at early stages.

Linking With External Covariates: Examining Accuracy by Anchor Type, Test Length, Ability Difference, and Sample Size.

Research has recently demonstrated the use of multiple anchor tests and external covariates to supplement or substitute for common anchor items when linking and equating with nonequivalent groups. This study examines the conditions under which external covariates improve linking and equating accuracy, with internal and external anchor tests of varying lengths and groups of differing abilities. Pseudo forms of a state science test were equated within a resampling study where sample size ranged from 1,000 to 10,000 examinees and anchor tests ranged in length from eight to 20 items, with reading and math scores included as covariates. Frequency estimation linking with an anchor test and external covariate was found to produce the most accurate results under the majority of conditions studied. Practical applications of linking with anchor tests and covariates are discussed.

Person-Fit as an Index of Inattentive Responding: A Comparison of Methods Using Polytomous Survey Data.

Self-report measures are vulnerable to response biases that can degrade the accuracy of conclusions drawn from results. In low-stakes measures, inattentive or careless responding can be especially problematic. A variety of a priori and post hoc methods exist for detecting these aberrant response patterns. Previous research indicates that nonparametric person-fit statistics tend to be the most accurate post hoc method for detecting inattentive responding on measures with dichotomous outcomes. This study investigated the accuracy and impact on model fit of parametric and nonparametric person-fit statistics in detecting inattentive responding with polytomous response scales. Receiver operating curve (ROC) analysis was used to determine the accuracy of each detection metric, and confirmatory factor analysis (CFA) fit indices were used to examine the impact of using person-fit statistics to identify inattentive respondents. ROC analysis showed the nonparametric H T statistic offered the most area under the curve when predicting a proxy for inattentive responding. The CFA fit indices showed the impact of using the person-fit statistics largely depends on the purpose (and cutoff) for using the person-fit statistics. Implications for using person-fit statistics to identify inattentive responders are discussed further.

Statistical equating with measures of oral reading fluency.

Recent research on curriculum-based measurement of oral reading fluency has revealed important issues in current passage development procedures, highlighting how dissimilar passages are problematic for monitoring student progress. The purpose of this paper is to describe statistical equating as an option for achieving equivalent scores across non-parallel reading passages. The psychometric and design properties of words-correct scores are examined, and the requirements of traditional equating methods are discussed. Simulated and empirical words-correct scores are used to demonstrate the steps in the equating process and the situations in which each method is most appropriate.