1,720,981 research outputs found
Validation of the German Day-to-Day Impact of Vaginal Aging (DIVA) Questionnaire in Peri- and Postmenopausal Women.
Get PDFBACKGROUND
The Day-to-Day Impact of Vaginal Aging (DIVA) questionnaire is a validated patient-reported outcome measure (PROM) capturing the impacts of vaginal symptoms in postmenopausal women.
AIM
We aimed to psychometrically validate the German version of the DIVA questionnaire.
METHODS
Data was collected online and by paper-pencil. We ran confirmatory factor analyses to confirm the a priori four-factor structure of the DIVA. Internal consistency was calculated using Cronbach's alpha. Correlations with other outcome measures such as the Patient Health Questionnaire-4 (PHQ-4), the SF-12 SOEP (socio-economic panel) version and self-created anchor questions were calculated regarding convergent validity. Known groups regarding age, home country and disease severity were analyzed. Test-retest reliability after 1 week and responsiveness after 4 weeks were only descriptively assessed due to low sample sizes.
MAIN OUTCOME MEASURES
The DIVA questionnaire, the Menopause Rating Scale (MRS II), the PHQ-4 and the SF-12 SOEP version were the main outcome measures.
RESULTS
185 postmenopausal women reporting vaginal complaints participated in the survey. The mode of administration did not influence the severity of vaginal symptoms. The four-factor structure of the DIVA could be confirmed and the model fit indicated sufficient structural validity. Furthermore, strong internal consistency in all of the DIVA domains was found. Regarding convergent validity, no hypothesis has failed completely. The results regarding known-groups validity were mostly in line with our a priori hypotheses. Descriptive evidence for sufficient test-retest reliability and responsiveness was given, however, the sample size for the assessment of those two measurement properties was low.
CONCLUSION
This study supports the excellent structural validity, internal consistency and construct validity of the German version of the DIVA questionnaire. It can be recommended for the assessment of the impacts of vaginal symptoms in postmenopausal women in future clinical GSM trials. Gabes M, Stute P, Apfelbacher C. Validation of the German Day-to-Day Impact of Vaginal Aging (DIVA) Questionnaire in Peri- and Postmenopausal Women. Sex Med 2021;9:100382
Appearance in acne: an often-overlooked concept
Get PDFAcne is one of the most common skin conditions affecting all age groups, especially adolescents and young adults.1 The transition into adulthood is a crucial period of development including many changes and challenges, such as professional progress, making and strengthening relationships and forming one's personal identity.2 Having visible acne impedes these developmental tasks and, in the absence of a cure, affected people must learn to live with their skin condition. Effective treatments are therefore essential. In order to measure efficacy of different treatments, well‐developed and validated patient‐reported outcome measures should be available and capture improvements from the patient's perspective.3 Being an important outcome of acne treatments, appearance should be measured in every clinical trial. What is more important for an affected patient, especially for adolescents and young adults, than how their skin, acne and acne scars look and improve? Because appearance is in the eye of the beholder, a self‐report is needed to capture this concept. There are some acne‐specific measures available, but they often overlook this subjective concept. In this issue of the BJD, Klassen et al. dared to develop a new instrument filling this gap, the ACNE‐Q.4 Addressing the concept appearance comprehensively, this measure is novel. An important criterion to ensure good quality of the development of a measure is a patient‐oriented approach. Patients as well as different healthcare providers were involved in the whole development process. Three top‐level domains with several major and minor themes emerged. Feedback of clinical experts was obtained and cognitive interviews with affected patients were conducted to assess content validity of the scales according to the COSMIN criteria.5 Modern psychometric analyses using the Rasch Measurement Theory were performed to identify items with poor fit and different measurement properties of the ACNE‐Q, such as structural validity, internal consistency, test–retest reliability and construct validity, were assessed. The study is limited to the North American population. However, a large sample size (n = 256) recruited from two countries and different settings, i.e. hospital and community dermatology clinics, was involved in the validation study. Although the ACNE‐Q is quite long, with 73 items in seven scales, it is a comprehensive and promising measure that can be used in clinical practice and research to measure appearance and appearance‐related distress and symptoms. This study lays the ground for future studies on the validation and feasibility of the ACNE‐Q
The 'Chronic Itch Burden Scale' : giving patients with chronic pruritus a voice
Get PDFProjekt DEAL 202
Patient-reported outcome measures beim Genitourinary Syndrome of Menopause (GSM): systematische Übersichtsarbeit, Validierung des „Day-to-Day Impact of Vaginal Aging (DIVA) Questionnaire“ und Exploration der urologischen Komponente des GSM
Get PDFDas Genitourinary Syndrome of Menopause (GSM) zeigt deutliche Auswirkungen auf das Leben von betroffenen Frauen. Durch die hohe Prävalenz der Beschwerden unter postmenopausalen Frauen und die Tatsache, dass urogenitale Beschwerden entgegen vieler Annahmen von alleine nicht wieder verschwinden, ist weiterhin eine große klinische Forschungsaktivität in diesem Bereich zu erwarten.
In der systematischen Übersichtsarbeit wurden insgesamt vier patient-reported outcome measures (PROMs) identifiziert, von denen zwei für die Verwendung in künftigen klinischen GSM-Studien gemäß den COSMIN-Richtlinien empfohlen werden konnten. Nur beim Day-to-Day Impact of Vaginal Aging (DIVA) Questionnaire wurde die Zielpopulation, postmenopausale Frauen mit vulvovaginaler Atrohphie bzw. dem GSM, bei dessen Entwicklung miteinbezogen.
Aus diesem Grund wurde eine weitere Validierungsstudie mit der deutschen Version des DIVA durchgeführt, bei der mehrere exzellente Messeigenschaften des DIVA bestätigt werden konnten. Durch die erstmalige Verwendung der probabilistischen Testtheorie konnte nun noch ein komplett neuer Blick auf die einzelnen Items sowie auf die Antwortoptionen geworfen werden, um die Multidimensionalität des DIVA aufzuzeigen und den ohnehin schon sehr hochwertigen DIVA in seiner Qualität weiter zu verbessern. Zudem resultierte aus diesen Ergebnissen eine „verfeinerte“ Version des deutschen DIVA, die ebenfalls mehrere exzellente Messeigenschaften zeigen konnte. Der DIVA kann guten Gewissens weiterhin in klinischen Studien verwendet werden und auch die deutsche Version des DIVA liefert reliable und valide Ergebnisse.
Da der DIVA nur Items zu der genitalen und sexuellen Komponente des GSM enthält, wurde die urologische Komponente in einer qualitativen Untersuchung genauer exploriert. Es zeigte sich, dass auch urologische Beschwerden als Teil des GSM negative Auswirkungen auf das Leben von betroffenen Frauen haben und urogenitale Beschwerden im Rahmen der Menopause generell ein immer noch stark tabuisiertes Thema darstellen. Diese qualitative Studie legte offen, dass es auch einer PROM bedarf, die die Auswirkungen der urologischen Komponente des GSM erfasst, da der DIVA dieser Anforderung nicht gerecht wird. Darauf sollte sich künftige Forschung fokussieren, gemäß dem Motto „Qualität vor Quantität“
Are existing quality-of-life instruments in cutaneous T-cell lymphoma of sufficient quality?
Get PDFCutaneous T-cell lymphoma (CTCL) is a rare type of non-Hodgkin lymphoma. However, non-Hodgkin lymphoma is ranked as the seventh most common cancer in the USA.1 In CTCL, mutated T cells migrate to the skin, and lesions on the skin tend to appear. Mycosis fungoides (MF) and Sézary syndrome (SS) are the most prevalent forms of CTCL.2 Pruritus, one of the most prominent symptoms of the disease, often leads to scratching, which in turns causes painful skin and can lead to disfigurement of affected patients. This negatively impacts their quality of life (QoL).3
Instruments measuring QoL are of great interest as they capture the patient’s perspective. Their use in clinical trials is increasingly recognized by regulatory authorities, clinicians and patients because they help to indicate whether the impact of an intervention is comprehensively assessed.4
In this issue of the BJD, Bhat et al.5 use qualitative research to assess the impact of CTCL on patients’ daily lives and to identify the most meaningful aspects in assessing QoL in CTCL. This is achieved by evaluating existing QoL instruments (generic, skin specific and disease specific). Generic instruments (e.g. the 36-Item Short-Form Health Survey) and skin-specific instruments (e.g. the Dermatology Life Quality Index) cannot capture CTCL-specific constructs. However, the only existing CTCL-specific measure, the MF/SS-CTCL instrument, did not include patients with advanced-stage disease in either the development or validation.6
In their study, Bhat et al. included patients at all stages of the disease. This assessment across various severity stages is novel. Eighteen semistructured interviews revealed three major themes: clinical symptoms, psychological and social functioning, and the salient treatment burden. Existing QoL instruments were screened for relevant patient concerns identified in the interviews. In particular, individual clinical symptoms, concerns about appearance and problems with sleep were not adequately represented in either generic or skin-specific instruments, or in the only existing CTCL-specific QoL measure. For this reason, there is currently no available QoL instrument of sufficient quality in CTCL.
Qualitative research involving affected patients, as performed by the authors, is the gold standard for the development of a promising patient-reported outcome measure. Without patient input, the content validity of a new instrument can be questioned. Only patients are able to judge the impact of their disease, their feelings and their treatment burden. For this reason, this study including interviews with patients with variations in severity represents an excellent starting point for the development of a new, comprehensive, disease-specific QoL instrument of sufficient quality for patients with CTCL.Projekt DEAL 202
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Driving simulation: the effects of interactivity and presentation setting
Get PDFBackground: Driving simulators are established tools used for different research purposes. Either head-mounted displays (HMDs) or monitors are applied. However, the extent to which the setting (HMD vs monitors) or the interactivity in driving (active behaviour as a driver or passive behaviour as a co-driver) influences the experience of presence, realism or simulator sickness is not yet entirely clear.
Objective: We aimed to compare different conditions to assess the influence of interactivity and presentation setting on the experience of presence, realism, and simulator sickness. Further, different driving performance parameters (e.g., speed perception or sign detection) were aimed to be assessed between the two settings.
Methods: Ninety participants were recruited. This was an experimental study (2 × 2 within-between-subject design) with interactivity as within-subject factor (2 levels: active vs passive) and setting as between-subject factor (2 levels: HMD vs monitors). As driving scenarios, we selected four specific driving maneuvers that we assume would affect driving behaviour differently depending on the setting. Differences in the experience of presence as well as in the development of simulator sickness were assessed using standardised questionnaires.
Results: There was no difference between the two settings regarding presence, realism or simulator sickness. Regarding interactivity, presence was significantly higher in the active compared to the passive condition. The most prominent difference between the two settings was found in the sign detection task where participants wearing an HMD performed worse.
Conclusion: The choice of interactivity appears to have a stronger effect on the experience of presence than the setting. Sign detection was worse in the HMD setting probably due to the lower display resolution. These results are relevant for the interpretation of driving simulator studies and the implementation of future studies
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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