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  • 1.
    Bing-Jonsson, Pia Cecilie
    et al.
    University of South-Eastern Norway, Norway.
    Boman, Erika
    Åland University of Applied Sciences, Finland.
    Melin, Jeanette
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology. University of Gothenburg, Sweden.
    The Ms. Olsen test: Measurement properties of a short test of nursing staffs' competence in clinical decision-making2021In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 77, no 10, p. 4268-4278Article in journal (Refereed)
    Abstract [en]

    AIMS: To assess the measurement properties of the Ms. Olsen test for registered nurses and assistant nurses, respectively, and suggest cut-off points between competence levels. DESIGN: Cross-sectional study. The results were analysed by implementing the Rasch Measurement Theory. METHODS: Nursing staff working in various health care settings participated (n = 757). To measure the competence of nursing staff in clinical decision-making, a 19-item scale from the Nursing Older People-Competence Evaluation Tool-the 'Ms. Olsen test'-was used. Data were collected in October 2017, 2018 and 2019. RESULTS: The Ms. Olsen test showed reasonably good measurement properties for registered nurses and assistant nurses respectively. Results show slightly better measurement properties for registered nurses than for assistant nurses. The cut-off for registered nurses, 0.62, corresponds to managing approximately two-thirds of the items while, for assistant nurses, the cut-off of 0.01 corresponds to managing approximately half of the items. CONCLUSION: The Ms. Olsen test is a short (7- to 10-min) test measuring competence in clinical decision-making among nursing staff working in older people nursing. Despite reasonably good measurement properties, this should be considered an initial validation in the development of a short test for assessing clinical decision-making among nursing staff in various health care setting. IMPACT: Several scales aiming to measure nursing competence have been developed over the last decade, but measurement properties (beyond classical test theory) are seldom evaluated, few scales concern other staff groups than registered nurses and few scales have proposed or established cut-offs for safe practice. The Ms. Olsen test is a short test of clinical decision-making that demonstrates reasonably good measurement properties. Cut-off points for registered nurses and assistant nurses were established. The Ms. Olsen test may be used to measure and evaluate competence in clinical decision-making among nursing staff working in older people nursing and educational settings.

  • 2.
    Cano, Stefan
    et al.
    Modus Outcomes, UK.
    Pendrill, Leslie
    RISE - Research Institutes of Sweden (2017-2019), Safety and Transport, Measurement Science and Technology.
    Melin, Jeanette
    RISE - Research Institutes of Sweden (2017-2019), Safety and Transport, Measurement Science and Technology.
    Fisher, William
    University of California, USA.
    Towards consensus measurement standards for patient-centered outcomes2019In: Measurement, Vol. 141, p. 62-69Article in journal (Refereed)
    Abstract [en]

    Patient centered outcomes pertain to a patient's beliefs, opinions and needs in conjunction with a clinician's medical expertise and assessment. The rise of patient-centered outcome (PCO) measurement parallels increased interest in patient-centered care. PCO measures offer the opportunity for more meaningful measurement of health outcomes informative enough to guide treatment decisions. However, it has been suggested that, for practical and scientific reasons, existing PCO measures are currently not capable of delivering the kind of quality assured measurement required for high-stakes decision making. Potential solutions include: addressing the lack of units in PCO measurement through recourse to mathematical models devised to define meaningful, invariant, and additive units of measurement with known uncertainties; establishing coordinated international networks of key stakeholders guided by five principles (i.e., collaboration, alignment, integration, innovation and communication); better use of technology leveraging measurement through item banks linking PCO reports via common items, common patients, or specification equations based in strong explanatory theory. And finally ensuring PCO measurement always is associated with: (1) a clear definition of the measurand in regards to the intended clinical use; (2) a clear definition of the clinically allowable error of measurement; (3) international cooperation and consensus to navigate the complexities of the development of metrologically sound reference measurement systems; and (4) continued clinical validation of newly calibrated measures. In this article, we illustrate the principles to improve PCO measures with examples from breast cancer, vision-related patient-reported outcome measures, and dementia clinician-reported and performance outcome measures.

  • 3.
    Danielsson, Louise
    et al.
    University of Gothenburg, Sweden; Angered Hospital, Sweden.
    Elfström, Magnus
    Mälardalen University, Sweden.
    Galan Henche, Javier
    Angered Hospital, Sweden.
    Melin, Jeanette
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Measurement properties of the Swedish clinical outcomes in routine evaluation outcome measures (CORE-OM): Rasch analysis and short version for depressed and anxious out-patients in a multicultural area2022In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 20, no 1, p. 30-Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: The Swedish version of the patient-reported Clinical Outcomes in Routine Evaluation Outcome Measures (CORE-OM) has demonstrated high reliability and acceptable convergent validity in explanatory factor analyses. However, the fundamental scale properties have not yet been validated according to item response theory. The aim of this study was to analyze the measurement properties of the Swedish CORE-OM in a cohort of psychiatric out-patients with depression and anxiety in a multicultural area and to explore combinations of items based on shorter versions of the scale (CORE-10, CORE-6D) to improve measurement properties. METHODS: Data from CORE-OM assessments of 337 patients were analyzed using Rasch analysis. The patients had a mean age of 30 ± 14 years, the majority were women (72%). Requirements for measurement properties were checked: overall model fit, item fit residuals, targeting, internal consistency, differential item functioning and thresholds. Sensitivity to change was also analyzed. RESULTS: The CORE-OM showed high internal consistency (person separation index = 0.947) and adequate targeting, but there was overall model misfit (item trait interaction χ2 = 917.53, p < 0.001), indication of local dependency, and differential item functioning in 9 items. The risk items showed problems with disordered thresholds. The emotional component of the shorter CORE-6D showed the best fit for our sample. Adding 3 items to include depressive and trauma-related content resulted in a unidimensional 8-item set with acceptable reliability, model fit, targeting and sensitivity to change. CONCLUSION: For out-patients with diagnosed depression or anxiety in a multicultural area, the Swedish CORE-OM showed high internal consistency, but also validity problems. Based on the shorter CORE-6D version, a unidimensional 8-item set could be an alternative brief measure of psychological distress for this population, but further validity studies are required. Qualitative studies exploring the CORE-OM items in non-native speakers are also warranted. © 2022. The Author(s).

  • 4.
    Dannapfel, Petra
    et al.
    Linköping University, Sweden.
    Thomas, Kristin
    Linköping University, Sweden.
    Chakhunashvili, Alexander
    Karolinska University Hospital, Sweden.
    Melin, Jeanette
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Trolle Lagerros, Ylva
    Karolinska Institute, Sweden; Stockholm Health Services, Sweden.
    A Self-help Tool to Facilitate Implementation of eHealth Initiatives in Health Care (E-Ready): Formative Evaluation2022In: JMIR Formative Research, E-ISSN 2561-326X, Vol. 6, no 1, article id e17568Article in journal (Refereed)
    Abstract [en]

    Background: eHealth interventions have the potential to increase the efficiency and effectiveness of health care. However, research has shown that implementing eHealth in routine health care practice is difficult. Organizational readiness to change has been shown to be central to successful implementation. This paper describes the development and formative evaluation of a generic self-help tool, E-Ready, designed to be used by managers, project leaders, or others responsible for implementation in a broad range of health care settings. Objective: The aim of this study is to develop and evaluate a tool that could facilitate eHealth implementation in, for example, health care. Methods: A first version of the tool was generated based on implementation theory (E-Ready 1.0). A formative evaluation was undertaken through expert panels (n=15), cognitive interviews (n=17), and assessment of measurement properties on E-Ready items from 3 different workplaces (n=165) using Rasch analyses. E-Ready 1.0 was also field tested among the target population (n=29). Iterative revisions were conducted during the formative evaluation process, and E-Ready 2.0 was generated. Results: The E-Ready Tool consists of a readiness assessment survey and a hands-on manual. The survey measures perceived readiness for change (willingness and capability) at individual and collective levels: perceived conditions for change at the workplace, perceived individual conditions for change, perceived support and engagement among management, perceived readiness among colleagues, perceived consequences on status quo, and perceived workplace attitudes. The manual contains a brief introduction, instructions on how to use the tool, information on the themes of E-Ready, instructions on how to create an implementation plan, brief advice for success, and tips for further reading on implementation theory. Rasch analyses showed overall acceptable measurement properties in terms of fit validity. The subscale Individual conditions for change (3 items) had the lowest person reliability (0.56), whereas Perceived consequences on status quo (5 items) had the highest person reliability (0.87). Conclusions: E-Ready 2.0 is a new self-help tool to guide implementation targeting health care provider readiness and engagement readiness ahead of eHealth initiatives in, for example, health care settings. E-Ready can be improved further to capture additional aspects of implementation; improvements can also be made by evaluating the tool in a larger sample. 

  • 5.
    Fisher Jr, William Paul
    et al.
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Melin, Jeanette
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Möller, Charlotta
    RISE Research Institutes of Sweden, Built Environment, System Transition and Service Innovation.
    Metrology for climate-neutral cities2021Report (Other academic)
    Abstract [en]

    We propose in this report decisive and constructive responses to critical appraisals of the Agenda 2030, the Sustainable Development Goals, and the EU taxonomy. The lack of transparency and accountability plaguing these vitally important efforts can be rectified by means of systematic implementations of the art and science of measurement modelling informed by metrological principles. The aforementioned documents’ vague and all-inclusive language fails to assign responsibilities or aid in goal achievement, but can be replaced with systems of measurements that are effectively and efficiently, meaningfully and usefully, integrated with management objectives. When measurements are welldesigned, managing goals and objectives becomes seamlessly integrated with measurement. Measuring instruments should map the domain of interest, allowing users to locate where they are relative to where they were, where they want to go, and what to do next. But for this to happen, the intention to measure in this way must be acted on. Then, incomparable ordinal ratings and scores must be replaced with qualityassured quantity values. And disconnected reporting systems must be coordinated and aligned. Most importantly, taking the trouble to create fluidly manageable measures makes it possible to identify and harness human-powered energy sources for driving sustainable change, for ramping up efforts to the global scale that must be achieved if we are to succeed in transforming our systems. Entrepreneurs and innovators need scientifically rigorous, meaningful, useful, and convenient tools if they are to succeed in imagining, designing, and deploying effective responses to the pressing challenges we face. Our recommendations are formulated in direct response to criticisms that have been directed at the Agenda 2030 and the EU Taxonomy concerning the transparency, comparability, and accountability of the proposed goals for sustainable development. Neither the goals themselves nor the urgency of the need to address them are at issue. The concern is rather with the means by which those goals may be achieved, and the effectiveness of those means. The solutions we propose in this document are complex but manageable—just as the problems we face are also complex but manageable. We have no intention of providing a panacea, or a one-size-fits-all solution. There is nothing automatic or easy about what needs to be done. This report is only a first step. We provide it in the hope of provoking more of those concerned to take a fresh look at what might be possible. We tap readily available, longstanding, well-established, proven ideas not previously brought together for close consideration. But far from expecting or even hoping that our recommendations will be taken up and followed to the letter, we instead fervently pray for playful experimentation and constructive debate. Our goal, perhaps more than anything else, is to encourage a broader scope for the imagination of possible solutions. Imaginations today seem overly bound within the constraints of assumptions that actually—and perversely—contribute to perpetuating the problems we face. We will count our efforts successful if we manage to shake some minds free from those constraints. In this spirit, we look forward to engaging soon in productive collaborations with any and all who are interested.

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    fulltext
  • 6.
    Gellerstedt, Martin
    et al.
    University of Skövde, Sweden; University West, Sweden.
    Melin, Jeanette
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology. University of Gothenburg, Sweden.
    Johansson, Victoria
    University West, Sweden.
    Angenete, Eva
    University of Gothenburg, Sweden; Sahlgrenska University Hospital, Sweden.
    Are patients willing to take a more active role? Questionnaires to measure patients' willingness to be empowered.2022In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 105, no 3, p. 741-749Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: One crucial prerequisite for increased patient empowerment is the willingness among patients to take a more active role. The aim of this study was to develop questionnaires for measuring a patient's willingness to be empowered in general and by using e-health.

    METHODS: The study was based on a random sample from an online panel. The 800 responders were Swedish citizens and reflected the internet-using population in Sweden regarding age, gender, income, and education. The measurement properties were evaluated according to the Rasch Measurement Theory.

    RESULTS: The analyses showed two questionnaires with adequate fit to the basic measurement model and with high reliability (PSI 0.84 and 0.89, respectively).

    CONCLUSION: We conclude that this study generated two questionnaires with an intuitive order of items illustrating an understandable progression of willingness to be empowered in general as well as for e-health.

    PRACTICE IMPLICATIONS: The suggested questionnaires are valuable tools supporting the effort to tailor empowerment strategies to meet the patient's willingness. Questionnaires will also be valuable for evaluating strategies for supporting willingness, studying factors related to willingness and potential inequalities due to e.g. varying digital literacy, and for enabling identification of patient stereotypes using cluster analyses.

  • 7.
    Johansson, Magnus
    et al.
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Svensson, Hanna
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Melin, Jeanette
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Mätning av mjuka värden - hur får vi bra beslutsunderlag?2021Report (Other academic)
    Abstract [sv]

    I en tidigare SHIC-rapport presenterades hur kvalitetssäkrade mätningar för sociala och hälsomässiga värden kan utvecklasoch bör hanteras. Denna rapport visar hur mätkvalitet påverkar möjligheter att tolka resultat av mätningar och vilka kravsom bör ställs på mätverktyg i form av enkäter.Med hjälp av kvalitetssäkrade mätningar kan vi på ett tillförlitligt sätt mäta och jämföra nyttan av insatser, tjänster ochprodukter, även gällande mjuka sociala och hälsomässiga värden – som upplevelser, förmågor och egenskaper. Sådanamätningar kan utgöra centrala underlag för beslutsfattande kopplat till ekonomiska, sociala och hälsomässiga utfall, ochmedför alltid vissa mätosäkerheter som behöver beaktas.För att kunna bedöma kvaliteten på mätverktyg och mätdata behöver vi efterfråga och förstå några nyckelbegrepp utifrånmättekniska analyser. Som praktisk och verklighetsnära förankring kommer vi att använda ett exempel relaterat tillpsykosocial arbetsmiljö; med andra ord de psykologiska och sociala aspekterna av arbetsmiljön, exempelvis upplevelserav hur samarbetet med kollegor fungerar. Exemplet utgår från ett tänkt samband mellan psykosocial arbetsmiljö,medarbetarengagemang och sjukfrånvaro.

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    fulltext
  • 8.
    Karlsson, Simon
    et al.
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Harris, Kathryn L
    RISE Research Institutes of Sweden, Bioeconomy and Health, Material and Surface Design.
    Melin, Jeanette
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Lahne, Jacob
    Virginia Polytechnic Institute and State University, USA.
    Wolfson, Julia
    John Hopkins University, USA.
    Collier, Elizabeth S
    RISE Research Institutes of Sweden, Bioeconomy and Health, Material and Surface Design. Linköping University, Sweden.
    An evaluation and shortening of the Cooking and Food Provisioning Action Scale (CAFPAS) using item response theory2023In: Food Quality and Preference, ISSN 0950-3293, E-ISSN 1873-6343, Vol. 108, article id 104880Article in journal (Refereed)
    Abstract [en]

    The Cooking and Food Provisioning Action Scale (CAFPAS) is a 28-item validated tool for measuring food agency, a latent construct representing an individual's ability to make and achieve food-preparation and -provisioning goals. Here, key measurement parameters (targeting, threshold ordering, item fit, unidimensionality, differential item functioning, local dependency, and person reliability) of the CAFPAS are evaluated using a specific case of item response theory, Rasch analysis, on data from a development sample (N = 1853; 910 from Sweden; 943 from the US). Winsteps (v.5.1.7) is used for this analysis. The similarity of the Swedish version of the CAFPAS to the original is also assessed. Based on an iterative assessment of the measurement properties with different combinations of items in the development sample, ways to shorten the CAFPAS without jeopardizing construct validity or person reliability are examined. After removing items that do not fit the Rasch model, or that appear redundant in relation to other items, an 11-item version (CAFPAS-short) is suggested and tested using further Rasch analysis on both the development sample and an additional US-based validation sample (N = 1457). Scores of cooking confidence and attitudes are then modelled with measures from the CAFPAS and CAFPAS-short using frequentist and Bayesian analysis. Results suggest that the CAFPAS-short performs similarly to the full-length version, and potential future improvements to the CAFPAS are discussed. This study represents a successful application of item response theory to investigate and shorten a psychometric scale, reducing cognitive load on participants in studies using the CAFPAS whilst minimizing loss of data reliability. © 2023 The Author(s)

  • 9.
    Linden, Karolina
    et al.
    University of Gothenburg, Sweden.
    Berg, Marie
    University of Gothenburg, Sweden; Sahlgrenska University Hospital, Sweden.
    Sparud-Lundin, Carolina
    University of Gothenburg, Sweden.
    Adolfsson, Annsofie
    Örebro University, Sweden.
    Melin, Jeanette
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Initial validation of the diabetes and breastfeeding management questionnaire (DBM-Q)2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 9, article id 3044Article in journal (Refereed)
    Abstract [en]

    Women with pre-gestational diabetes face additional challenges after birth as they struggle with breastfeeding and managing unpredictable blood glucose levels. The aim of this study is to validate the Diabetes and Breastfeeding Management Questionnaire (DBM-Q). In total, 142 mothers with type 1 diabetes mellitus answered the questionnaire, which initially consisted of 11 items. The response rate was 82.5% (n = 128) at two months, and 88.4% (n = 137) at six months postpartum. The measurement properties of the Diabetes and Breastfeeding Management Questionnaire were tested according to the Rasch measurement theory (RMT). One item showed both disordered thresholds and several model misfits and was removed. Two items showed disordered thresholds which were resolved by collapsing response categories. This resulted in a 10-item questionnaire with all the fit residuals within the range of +2.5, minor significant differential item functioning, well-targeted items and a person separation index of 0.73. Evaluating the DBM-Q according to the RMT is a strength, as it evaluates data against strict measurement criteria. This study provides an initial validation of the questionnaire. The DBM-Q shows good measurement properties for measuring diabetes and breastfeeding management postpartum in women with pre-gestational diabetes. Further studies are needed to identify cutoffs for when professional support is needed. © 2020 by the authors.

  • 10.
    Melin, Jeanette
    et al.
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology. University of Gothenburg, Sweden; Sahlgrenska University Hospital, Sweden.
    Axwalter, Emelie
    University of Gothenburg, Sweden; Sahlgrenska University Hospital, Sweden.
    Åhrén, Gunilla
    University of Gothenburg, Sweden; Sahlgrenska University Hospital, Sweden.
    Sunnerhagen, Katharina
    University of Gothenburg, Sweden; Sahlgrenska University Hospital, Sweden.
    Lundgren-Nilsson, Åsa
    University of Gothenburg, Sweden; Sahlgrenska University Hospital, Sweden.
    Wangdell, Johanna
    University of Gothenburg, Sweden; Sahlgrenska University Hospital, Sweden.
    Research priorities to enhance life for people with spinal cord injury: a Swedish priority setting partnership2023In: Spinal Cord, ISSN 1362-4393, E-ISSN 1476-5624Article in journal (Refereed)
    Abstract [en]

    Study design: Mixed-method consensus development project. Objective: To identify the top ten research priorities for spinal cord injury (SCI). Setting: Nationwide in Sweden in 2021–22. Methods: The PSP process proposed by the James Lind Alliance was used. It comprises two main phases: question identification and priority selection. People living with SCI, relatives of people with SCI as well as health professionals and personal care assistants working with people with SCI were included. Results: In the first phase, 242 respondents provided 431 inputs addressing potentially unanswered questions. Of these, 128 were beyond the scope of this study. The remaining 303 were merged to formulate 57 questions. The literature review found one question answered, so 56 questions proceeded to the prioritisation. In the second phase, the interim prioritisation survey, 276 respondents ranked the 56 questions. The top 24 questions then proceeded to the final prioritisation workshop, at which 23 participants agreed on the top ten priorities. Conclusions: This paper reveals issues that people living with SCI, relatives of people with SCI as well as health professionals and personal care assistants working with people with SCI find difficult to get answered. The top-priority questions for people living with SCI in Sweden concern specialist SCI care and rehabilitation, followed by a number of questions addressing physical health. Other topics, from the 56 key questions include Mental health, Ageing with SCI, Community support and personal care assistance, and Body functions. This result can guide researchers to design appropriate studies relevant to people with SCI. Sponsorship: The project was funded by the Gothenburg Competence Centre for Spinal Cord Injury and the Swedish Association for Survivors of Accident and Injury (RTP). [Figure not available: see fulltext.]. © 2023, The Author(s).

  • 11.
    Melin, Jeanette
    et al.
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Bonn, Stephanie
    Karolinska Institutet, Sweden.
    Pendrill, Leslie
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Trolle Lagerros, Ylva
    Karolinska Institutet, Sweden.
    A Questionnaire for Assessing User Satisfaction With Mobile Health Apps: Development Using Rasch Measurement Theory2020In: JMIR mhealth and uhealth, E-ISSN 2291-5222, Vol. 8, no 5, article id e15909Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Mobile health (mHealth) apps offer great opportunities to deliver large-scale, cost-efficient digital solutions for implementing lifestyle changes. Furthermore, many mHealth apps act as medical devices. Yet, there is little research on how to assess user satisfaction with an mHealth solution. OBJECTIVE: This study presents the development of the mHealth Satisfaction Questionnaire and evaluates its measurement properties. METHODS: Respondents who took part in the Health Integrator Study and were randomized to use the Health Integrator smartphone app for lifestyle changes (n=112), with and without additional telephone coaching, rated their satisfaction with the app using the new 14-item mHealth Satisfaction Questionnaire. The ratings were given on a 5-point Likert scale and measurement properties were evaluated using Rasch measurement theory (RMT). RESULTS: Optimal scoring was reached when response options 2, 3, and 4 were collapsed, giving three response categories. After omitting two items that did not fit into the scale, fit residuals were within, or close to, the recommended range of ±2.5. There was no differential item functioning between intervention group, age group, or sex. The Person Separation Index was 0.79, indicating that the scale's ability to discriminate correctly between person leniency was acceptable for group comparisons but not for individual evaluations. The scale did not meet the criterion of unidimensionality; 16.1% (18/112) of the respondents were outside the desired range of -1.96 to 1.96. In addition, several items showed local dependency and three underlying dimensions emerged: negative experiences, positive experiences, and lifestyle consequences of using the mHealth solution. CONCLUSIONS: In times where mHealth apps and digital solutions are given more attention, the mHealth Satisfaction Questionnaire provides a new possibility to measure user satisfaction to ensure usability and improve development of new apps. Our study is one of only a few cases where RMT has been used to evaluate the usability of such an instrument. There is, though, a need for further development of the mHealth Satisfaction Questionnaire, including the addition of more items and consideration of further response options. The mHealth Satisfaction Questionnaire should also be evaluated in a larger sample and with other mHealth apps and in other contexts. TRIAL REGISTRATION: ClinicalTrials.gov NCT03579342; http://clinicaltrials.gov/ct2/show/NCT03579342. ©Jeanette Melin, Stephanie Erika Bonn, Leslie Pendrill, Ylva Trolle Lagerros. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 26.05.2020.

  • 12.
    Melin, Jeanette
    et al.
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Cano, S. J.
    Modus Outcomes, UK.
    Flöel, A.
    University Medicine Greifswald, Germany; German Center for Neurodegenerative Diseases, Germany.
    Göschel, L.
    Charité Universitätsmedizin Berlin, Germany.
    Pendrill, Leslie
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Construct specification equations: ‘Recipes’ for certified reference materials in cognitive measurement2021In: Measurement: Sensors, ISSN 2665-9174, Vol. 18, article id 100290Article in journal (Refereed)
    Abstract [en]

    Construct specification equations (CSEs), providing a comprehensive understanding of the construct purported to be measured and how a collection of items works together causally, are candidate ‘recipes for certified reference materials’ (CRM). Analogous to the role of CRMs in areas such as chemistry and material properties, CSEs appear to provide metrological traceability in the human sciences. In this work we illustrate how memory test items, Rasch Measurement Theory (RMT) and CSEs can be brought together to help ‘tell a clearer story’ about memory decline that links language- and cultural-free items (blocks, digits) to more complex word recall. Combining different test items to form novel cognitive metrics, done carefully so not jeopardize validity and to enhance coherence in item design and purpose, is guided by entropy-based equivalence criteria identified in the CSEs. The novel NeuroMET Memory Metric may enable better-informed high stakes decision-making and more efficient and valid cognitive assessment.

  • 13.
    Melin, Jeanette
    et al.
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Cano, S. J.
    Modus Outcomes Ltd, UK.
    Flöel, A.
    German Center for Neurodegenerative Diseases, Germany; University Medicine Greifswald, Germany.
    Göschel, L.
    Universitätsmedizin Berlin, Germany.
    Pendrill, Leslie
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Metrological advancements in cognitive measurement: A worked example with the NeuroMET memory metric providing more reliability and efficiency2023In: Measurement: Sensors, ISSN 2665-9174, Vol. 25, article id 100658Article in journal (Refereed)
    Abstract [en]

    Better metrics of cognition can be formed by carefully combining selected items from legacy short-term memory tests so as to enhance coherence in item design while not jeopardizing validity. In this paper, we report on how Rasch Measurement Theory and Construct specification equations (CSE) have been brought together when composing the NeuroMET Memory Metric (NMM). The NMM is guided by: i) entropy-based equivalence criteria; ii) a comprehensive understanding of the construct purported to be measured; and iii) how a collection of items works together. CSEs play a major role in ensuring the metrological legitimacy of the NMM in a way analogous to certified reference materials in more established areas of metrology. The resulting NMM for short-term memory recall has up to a five-fold reduction in measurement uncertainties for memory ability compared with an individual legacy test, and the entropy-based CSEs should enable more efficient and valid assessment. © 2022 The Authors

  • 14.
    Melin, Jeanette
    et al.
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Cano, S. J.
    Modus Outcomes Ltd, UK.
    Gillman, A.
    Modus Outcomes Ltd, UK.
    Marquis, S.
    Modus Outcomes LCC, UK.
    Flöel, A.
    University Medicine Greifswald, Germany; DZNE German Center for Neurodegenerative Diseases, Germany.
    Göschel, L
    Freie Universität Berlin, Germany; Humboldt Universität zu Berlin, Germany.
    Pendrill, Leslie
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Traceability and comparability through crosswalks with the NeuroMET Memory Metric2023In: Scientific Reports, E-ISSN 2045-2322, Vol. 13, no 1, article id 5179Article in journal (Refereed)
    Abstract [en]

    Accurate assessment of memory ability for persons on the continuum of Alzheimer’s disease (AD) is vital for early diagnosis, monitoring of disease progression and evaluation of new therapies. However, currently available neuropsychological tests suffer from a lack of standardization and metrological quality assurance. Improved metrics of memory can be created by carefully combining selected items from legacy short-term memory tests, whilst at the same time retaining validity, and reducing patient burden. In psychometrics, this is known as “crosswalks” to link items empirically. The aim of this paper is to link items from different types of memory tests. Memory test data were collected from the European EMPIR NeuroMET and the SmartAge studies recruited at Charité Hospital (Healthy controls n = 92; Subjective cognitive decline n = 160; Mild cognitive impairment n = 50; and AD n = 58; age range 55–87). A bank of items (n = 57) was developed based on legacy short-term memory items (i.e., Corsi Block Test, Digit Span Test, Rey’s Auditory Verbal Learning Test, Word Learning Lists from the CERAD test battery and Mini Mental State Examination; MMSE). The NeuroMET Memory Metric (NMM) is a composite metric that comprises 57 dichotomous items (right/wrong). We previously reported on a preliminary item bank to assess memory based on immediate recall, and have now demonstrated direct comparability of measurements generated from the different legacy tests. We created crosswalks between the NMM and the legacy tests and between the NMM and the full MMSE using Rasch analysis (RUMM2030) and produced two conversion tables. Measurement uncertainties for estimates of person memory ability with the NMM across the full span were smaller than all individual legacy tests, which demonstrates the added value of the NMM. Comparisons with one (MMSE) of the legacy tests showed however higher measurement uncertainties of the NMM for people with a very low memory ability (raw score ≤ 19). The conversion tables developed through crosswalks in this paper provide clinicians and researchers with a practical tool to: (i) compensate for ordinality in raw scores, (ii) ensure traceability to make reliable and valid comparisons when measuring person ability, and (iii) enable comparability between test results from different legacy tests. © 2023, The Author(s).

  • 15.
    Melin, Jeanette
    et al.
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Cano, S. J.
    Modus Outcomes, UK.
    Göschel, L.
    Charité Universitätsmedizin Berlin, Germany.
    Fillmer, A.
    PTB Physikalisch-Technische Bundesanstalt, Germany.
    Lehmann, S.
    Univ Montpellier, France.
    Hirtz, C.
    Univ Montpellier, France.
    Flöel, A.
    University Medicine Greifswald, Germany; German Center for Neurodegenerative Diseases, Germany.
    Pendrill, Leslie
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Metrological references for person ability in memory tests2021In: Measurement: Sensors, ISSN 2665-9174, Vol. 18, article id 100289Article in journal (Refereed)
    Abstract [en]

    To ensure reliable diagnosis and treatment consistently throughout healthcare, metrological quality assurance is essential. There are, however, many observations in the social sciences and healthcare, such as the memory tests studied here, which have been ‘claimed’ to be measurements but in fact have not been fully metrologically legitimated. We have already argued in favour of extending traditional metrological underlying principles to cover social measurements, including the development of construct specification equations (CSE) considered as ‘recipes for certified reference materials (CRM)’ for traceability, analogous to CRMs in metrology in chemistry. Although the CSE approach has to date been used mostly to explain and validate test item attributes, this paper turns to focus on causal explanations of person characteristics. We describe methods and preliminary results developed in the European EMPIR NeuroMET projects, which may be used for providing quality assured measurement of disease progression and treatment benefits for patients with neurodegenerative conditions. 

  • 16.
    Melin, Jeanette
    et al.
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Cano, Stefan
    Modus Outcomes, UK.
    Flöel, Agnes
    University Medicine Greifswald, UK; German Center for Neurodegenerative Diseases, UK.
    Göschel, Laura
    Universitätsmedizin Berlin as a Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; NeuroCure Clinical Research Center, Charité—Universitätsmedizin Berlin as a Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany.
    Pendrill, Leslie
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    The Role of Entropy in Construct Specification Equations (CSE) to Improve the Validity of Memory Tests: Extension to Word Lists2022In: Entropy, E-ISSN 1099-4300, Vol. 24, no 7, article id 934Article in journal (Refereed)
    Abstract [en]

    Metrological methods for word learning list tests can be developed with an information theoretical approach extending earlier simple syntax studies. A classic Brillouin entropy expression is applied to the analysis of the Rey’s Auditory Verbal Learning Test RAVLT (immediate recall), where more ordered tasks—with less entropy—are easier to perform. The findings from three case studies are described, including 225 assessments of the NeuroMET2 cohort of persons spanning a cognitive spectrum from healthy older adults to patients with dementia. In the first study, ordinality in the raw scores is compensated for, and item and person attributes are separated with the Rasch model. In the second, the RAVLT IR task difficulty, including serial position effects (SPE), particularly Primacy and Recency, is adequately explained (Pearson’s correlation = 0.80) with construct specification equations (CSE). The third study suggests multidimensionality is introduced by SPE, as revealed through goodness-of-fit statistics of the Rasch analyses. Loading factors common to two kinds of principal component analyses (PCA) for CSE formulation and goodness-of-fit logistic regressions are identified. More consistent ways of defining and analysing memory task difficulties, including SPE, can maintain the unique metrological properties of the Rasch model and improve the estimates and understanding of a person’s memory abilities on the path towards better-targeted and more fit-for-purpose diagnostics. © 2022 by the authors. 

  • 17.
    Melin, Jeanette
    et al.
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Cano, Stefan
    ModusOutcomes, UK.
    Göschel, Laura
    Universitätsmedizin, Germany.
    Flöel, Agnes
    University Medicine Greifswald, Germany; German Centre for Neurodegenerative Diseases, Germany.
    Pendrill, Leslie
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    NeuroMET Memory Metric: Improving accuracy and comparability with crosswalks2023In: Alzheimer’s & Dementia: Translational Research & Clinical Interventions, E-ISSN 2352-8737, Vol. 19, no S4, article id e063924Article in journal (Refereed)
    Abstract [en]

    Background: The ability to measure, track over time, and compare memory ability for people with neurodegeneration is important. However, currently, full comparability of memory test data is limited by a lack of quality assurance of memory measurements. At AAIC 2021, we presented a preliminary item bank to assess memory, composed by selecting items from legacy tests according to metrological principles through use of the Rasch model and with item equivalence based on entropy. Method: Here, we demonstrate direct comparability of measurements generated from different tests, with the new NeuroMET Memory Metric comprising 87 selected items for task difficulty from: the Corsi Block Test, Digit Span Test, Rey’s Auditory Verbal Learning Test, Word Learning List from the CERAD test battery and the Mini Mental State Examination. Data were collected from the European EMPIR NeuroMET and the SmartAge studies recruited at Charité Hospital (Healthy controls n = 92; Subjective cognitive decline n = 160; Mild Cognitive Impairment n = 50; and Alzheimer’s Disease n = 58; age range 55-87). Results: The Rasch analysis showed well-targeted items for all participants’ abilities; good fit to the measurement model, with 83 items (95%) having fit residuals within the expected range and satisfactory unidimensionality, and item reliability of 0.96. The full item bank comprising 87 short-term memory items gave a person reliability of 0.85. Subsequently, a conversion table was created linking the raw scores from the legacy tests to the common NeuroMET Memory Metric and to individual legacy tests. Conclusion: Legacy memory tests have previously proven useful in clinical practice and research, and will continue to be used, but have to date been metrologically limited. The provided conversion table, linking these legacy memory tests to a metrologically assured scale, viz., the NeuroMET memory metric, remedies this deficiency. The NeuroMET memory metric will be included in the first ever prototype of a metrological validated app used to deliver memory tests. Clinicians and researchers will be able to select sets of items to produce data, via a scoring algorithm for transforming patient responses to measures, in a common frame of reference.

  • 18.
    Melin, Jeanette
    et al.
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Cano, Stefan
    Modus Outcomes, UK.
    Pendrill, Leslie
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    The role of entropy in construct specification equations (CSE) to improve the validity of memory tests2021In: Entropy, E-ISSN 1099-4300, Vol. 23, no 2, article id 212Article in journal (Refereed)
    Abstract [en]

    Commonly used rating scales and tests have been found lacking reliability and validity, for example in neurodegenerative diseases studies, owing to not making recourse to the inherent ordinality of human responses, nor acknowledging the separability of person ability and item difficulty parameters according to the well-known Rasch model. Here, we adopt an information theory approach, particularly extending deployment of the classic Brillouin entropy expression when explaining the difficulty of recalling non-verbal sequences in memory tests (i.e., Corsi Block Test and Digit Span Test): a more ordered task, of less entropy, will generally be easier to perform. Construct specification equations (CSEs) as a part of a methodological development, with entropy-based variables dominating, are found experimentally to explain (r =√R2 = 0.98) and predict the construct of task difficulty for short-term memory tests using data from the NeuroMET (n = 88) and Gothenburg MCI (n = 257) studies. We propose entropy-based equivalence criteria, whereby different tasks (in the form of items) from different tests can be combined, enabling new memory tests to be formed by choosing a bespoke selection of items, leading to more efficient testing, improved reliability (reduced uncertainties) and validity. This provides opportunities for more practical and accurate measurement in clinical practice, research and trials. © 2021 by the authors.

  • 19.
    Melin, Jeanette
    et al.
    RISE - Research Institutes of Sweden (2017-2019), Safety and Transport, Measurement Science and Technology.
    Fornazar, Robin
    University of Gothenburg, Sweden.
    Spångfors, Martin
    Lund University, Sweden; Kristianstad Hospital, Sweden.
    Pendrill, Leslie
    RISE - Research Institutes of Sweden (2017-2019), Safety and Transport, Measurement Science and Technology.
    Rasch analysis of the Patient Participation in Rehabilitation Questionnaire (PPRQ)2020In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 26, no 1, p. 248-255Article in journal (Refereed)
    Abstract [en]

    Objective: To evaluate the Patient Participation in Rehabilitation Questionnaire (PPRQ) according to Rasch measurement theory. Method: Five hundred twenty-two post-discharge patients from a neurological rehabilitation unit were included. The PPRQ questionnaire comprises 20 items rated by a cohort of 522 patients about their experiences of participating in rehabilitation. The measurement properties of the PPRQ were evaluated by Rasch analysis of the responses. Results: The Rasch analysis of 20 items showed some major misfits, particularly three items addressing the involvement of family members. After removing those items, the model fit improved and no significant DIF remained. Despite improvements, person values (−2.96 to 4.86 logits) were not fully matched by the item values (−0.61 to 0.77 logits). Neither did the t test for unidimensionality meet the criterion of 5%, and local dependency was present. The unidimensionality and local dependency could, however, be accommodated for by four testlets. Conclusion: The PPRQ-17 showed that a ruler with a reasonable and clinical hierarchy can be constructed, although the expectations of dimensionality and local dependency need to be evaluated further. Despite room for further development, PPRQ-17 nevertheless shows improved measurement precision in terms of patient leniency compared with previous evaluations with classical test theory. In turn, this can play a crucial role when comparing different rehabilitation programs and planning tailored care development activities.

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  • 20.
    Melin, Jeanette
    et al.
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology. University of Gothenburg, Sweden.
    Fors, Andreas
    University of Gothenburg, Sweden; Region Västra Götaland, Sweden.
    Jakobsson, Sofie
    University of Gothenburg, Sweden.
    Krabbe, David
    Sahlgrenska University Hospital, Sweden; University of Gothenburg, Sweden.
    Björkman, Ida
    University of Gothenburg, Sweden.
    Self-Efficacy to Manage Chronic Disease (SEMCD) scale: translation and evaluation of measurement properties for a swedish version2023In: Archives of Public Health, ISSN 0778-7367, E-ISSN 2049-3258, Vol. 81, no 1, article id 2Article in journal (Refereed)
    Abstract [en]

    Background: Reinforcing self-efficacy in patients is important in person-centered care; therefore, reliable and valid measures of a person’s self-efficacy is of clinical relevance. A questionnaire suitable for self-efficacy and patient engagement that is not limited to a particular condition is the Self-efficacy to Manage Chronic Disease (SEMCD). This study aims to evaluate the measurement properties of a Swedish translation of the SEMCD with a Rasch analysis. Methods: The translation and cultural adaptation of the SEMCD was performed according to the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) recommendations. Self-reported data was collected from two cohorts: patients with pituitary tumors (n = 86) and patients on sick leave due to common mental disorders (n = 209). Measurement properties were evaluated with a Rasch analysis in RUMM2030. Results: The original six-item SEMCD did not fit to a unidimensional scale. Two items, item 5 and item 6, deviated both statistically and conceptually and were removed. A four-item solution, the SEMCD-4 with collapsed thresholds for mid-range response options, showed good targeting and unidimensionality, no item misfit, and a reliability of 0.83. Conclusion: In a Swedish context with a mix of patients with pituitary tumors or common mental disorders, SEMCD-4 showed satisfactory measurement properties. Thus, SEMCD-4 could be used to identify patient self-efficacy in long-term illnesses. This knowledge about patient self-efficacy may be of importance to tailor person-centered support based on each patient´s resources, needs and goals. © 2023, The Author(s).

  • 21.
    Melin, Jeanette
    et al.
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology. Swedish Defence University, Sweden.
    Fridberg, Helena
    Umeå University, Sweden.
    Ekvall Hansson, Eva
    Lund University, Sweden.
    Smedberg, Daniel
    Skåne University Hospital, Sweden.
    Pendrill, Leslie
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Exploring a New Application of Construct Specification Equations (CSEs) and Entropy: A Pilot Study with Balance Measurements2023In: Entropy, E-ISSN 1099-4300, Vol. 25, no 6, article id 940Article in journal (Refereed)
    Abstract [en]

    Both construct specification equations (CSEs) and entropy can be used to provide a specific, causal, and rigorously mathematical conceptualization of item attributes in order to provide fit-for-purpose measurements of person abilities. This has been previously demonstrated for memory measurements. It can also be reasonably expected to be applicable to other kinds of measures of human abilities and task difficulty in health care, but further exploration is needed about how to incorporate qualitative explanatory variables in the CSE formulation. In this paper we report two case studies exploring the possibilities of advancing CSE and entropy to include human functional balance measurements. In case study I, physiotherapists have formulated a CSE for balance task difficulty by principal component regression of empirical balance task difficulty values from Berg’s Balance Scale transformed using the Rasch model. In case study II, four balance tasks of increasing difficulty due to diminishing bases of support and vision were briefly investigated in relation to entropy as a measure of the amount of information and order as well as physical thermodynamics. The pilot study has explored both methodological and conceptual possibilities and concerns to be considered in further work. The results should not be considered as fully comprehensive or absolute, but rather open up for further discussion and investigations to advance measurements of person balance ability in clinical practice, research, and trials. © 2023 by the authors.

  • 22.
    Melin, Jeanette
    et al.
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology. Swedish Defence University, Sweden.
    Göschel, Laura
    Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany.
    Hagell, Peter
    Kristianstad University, Sweden.
    Westergren, Albert
    Kristianstad University, Sweden.
    Flöel, Agnes
    University Medicine Greifswald, Germany; DZNE German Center for Neurodegenerative Diseases, Germany.
    Pendrill, Leslie
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Forward and Backward Recalling Sequences in Spatial and Verbal Memory Tasks: What Do We Measure?2023In: Entropy, E-ISSN 1099-4300, Vol. 25, no 5, article id 813Article in journal (Refereed)
    Abstract [en]

    There are different views in the literature about the number and inter-relationships of cognitive domains (such as memory and executive function) and a lack of understanding of the cognitive processes underlying these domains. In previous publications, we demonstrated a methodology for formulating and testing cognitive constructs for visuo-spatial and verbal recall tasks, particularly for working memory task difficulty where entropy is found to play a major role. In the present paper, we applied those insights to a new set of such memory tasks, namely, backward recalling block tapping and digit sequences. Once again, we saw clear and strong entropy-based construct specification equations (CSEs) for task difficulty. In fact, the entropy contributions in the CSEs for the different tasks were of similar magnitudes (within the measurement uncertainties), which may indicate a shared factor in what is being measured with both forward and backward sequences, as well as visuo-spatial and verbal memory recalling tasks more generally. On the other hand, the analyses of dimensionality and the larger measurement uncertainties in the CSEs for the backward sequences suggest that caution is needed when attempting to unify a single unidimensional construct based on forward and backward sequences with visuo-spatial and verbal memory tasks.

  • 23.
    Melin, Jeanette
    et al.
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology. University of Gothenburg, Sweden.
    Lundin, A.
    Karolinska Institute, Sweden.
    Johansson, Magnus
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    An off-target scale limits the utility of Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS) as a measure of well-being in public health surveys2022In: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 202, p. 43-48Article in journal (Refereed)
    Abstract [en]

    Objectives: To assess the utility and measurement properties for the well-being scale Short Warwick–Edinburgh Mental Well-Being Scale (SWEMWBS) in a Swedish general population survey. Study design: A cross-sectional survey study. Methods: Data were retrieved from the 2018 public health survey in Stockholm County, containing a random sample of 22 856 persons stratified to be representative for the municipalities and districts within the region. The data were analyzed according to Rasch Measurement Theory. Results: Person attribute values are positively skewed (mean 2.32, SD 1.85), with wide gaps in the item threshold attribute values. Overall item fit statistics were acceptable, and person measurement separation reliability was 0.83, indicating three statistically distinct ranges in the estimated well-being values. Conclusion: While the SWEMWBS items indicated acceptable fit to the Rasch measurement model, targeting of items to sample is skewed toward lower levels of well-being, and there is a ceiling effect. Thus, we suggest a careful reconsideration of SWEMWBS as a tool for use in general public health surveys, especially for assessing change over time and group differences, as there are large measurement uncertainties for the majority of cases when the population as a whole is sampled. We encourage revisions applying a coherent and comprehensive ordinal construct theory for well-being to fill the gaps in the upper end of the SWEMWBS scales' item thresholds. The addition of more challenging items would improve targeting for population-based surveys, increase reliability, and provide more actionable information that could be useful in improving individuals' well-being. © 2021 The Authors

  • 24.
    Melin, Jeanette
    et al.
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Möllerberg, Marie-Louise
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Svensson, Hanna
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Johansson, Magnus
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Korsell, Nicklas
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Karlsson, Simon
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Preuter, Marit
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Pendrill, Leslie
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    A sustainable organization for measurement quality assurance of category based measurements: Tasked with coordinating and ensuring reliable and comparable measurements of experiences, feelings, behaviours and abilities2023Report (Other academic)
    Abstract [en]

    Why?

    Society's need for knowledge about experiences, feelings, behaviours and abilities is increasing. It is important to know how people and society feel or how a product or service is perceived, and to be able to compare how these change over time and between different areas, for example when making decisions about priorities, efforts and effects. In order for measurements of experiences, feelings, behaviours and abilities to be useful and provide reliable data, quality-assured measurement is required for socalled category based measurements1. It is therefore necessary that basic measurement principles are applied, which is often not the case today in this field. For the physical quantities (length, mass, time, etc.) there has long been an internationally established measurement quality infrastructure. In Sweden, it is mainly RISE as the National Metrological Institute which, through its national measurement sites, is responsible for ensuring access to quality-assured and traceable measurements for society. However, the corresponding measurement quality infrastructure is so far missing for category based measurements.

    What?

    RISE has been working for several years to develop methodology and working methods for measurement quality assurance of experiences, feelings, behaviours and abilities. Through dialogue over several years with actors at various levels, including in health care and academia, it has emerged that there is a great need for support for this development. RISE has therefore produced a first draft of a possible sustainable organization for measurement quality assurance of category based measurements. A national centre for quality assurance of category based measurements would be tasked with coordinating and ensuring reliable and comparable measurements of experiences, feelings, behaviours and abilities. Such infrastructural support must make methodologies available to enable quality assurance for category based measurements. The organization must meet society's need for support by offering services based on internationally accepted metrological principles and scientific methods, as well as adopting a neutral and independent role.

    How?

    We have humility about the fact that it is a long process to establish an organization for category based measurements and that it needs to happen through a dynamic and iterative development in co-creation with the actors involved. We look forward to continuing to develop ideas and revise the proposal in dialogue in the coming years. It is also important to start a dialogue together with relevant actors about how the implementation of the organization can take place in the future.

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  • 25.
    Melin, Jeanette
    et al.
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Möllerberg, Marie-Louise
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Svensson, Hanna
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Johansson, Magnus
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Korsell, Nicklas
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Karlsson, Simon
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Preuter, Marit
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Pendrill, Leslie
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    En hållbar organisering för mätkvalitetssäkring av kategoribaserade mätningar: Med uppdrag att samordna och säkerställa tillförlitliga och jämförbara mätningar av upplevelser, känslor, beteenden och förmågor2023Report (Other academic)
    Abstract [sv]

    Varför?

    Samhällets behov av kunskap om upplevelser, känslor, beteenden och förmågor ökar. Det är viktigt att veta hur personer och samhället mår eller hur en produkt eller tjänst upplevs samt att kunna jämföra hur detta förändras över tid och mellan olika områden, för att exempelvis fatta beslut om prioriteringar, insatser och effekter. För att mätningar av upplevelser, känslor, beteenden och förmågor ska vara användbara och ge tillförlitliga underlag krävs kvalitetssäkrad mätteknik för s.k. kategoribaserade mätningar. Det är alltså nödvändigt att grundläggande mättekniska principer tillämpas, vilket ofta inte är fallet i dag inom detta område. För de fysikaliska storheterna (längd, massa, tid etc.) finns sedan länge en internationellt etablerad mätkvalitetsinfrastruktur. I Sverige är det huvudsakligen RISE som Nationellt Metrologiskt Institut som genom sina riksmätplatser ansvarar för att säkerställa tillgång till kvalitetssäkrade och spårbara mätningar för samhället. Motsvarande mätkvalitetsinfrastruktur saknas dock för kategoribaserade mätningar.

    Vad?

    RISE arbetar sedan flera år för att utveckla metoder och arbetssätt för mätkvalitetssäkring av upplevelser, känslor, beteenden och förmågor. Genom dialoger med aktörer på olika nivåer, bland annat inom hälso- och sjukvården och akademin, som pågått under flera års tid har det framkommit att det finns ett stort behov av stöd för denna utveckling. RISE har därför tagit fram ett första utkast för en möjlig hållbar organisering för mätkvalitetssäkring av kategoribaserade mätningar. Ett nationellt centrum för mätkvalitetssäkring av kategoribaserade mätningar skulle ha i uppdrag att samordna och säkerställa tillförlitliga och jämförbara mätningar av upplevelser, känslor, beteenden och förmågor. Ett sådant infrastrukturellt stöd ska tillgängliggöra metodiker för att möjliggöra mätkvalitetssäkring för kategoribaserade mätningar. Organiseringen ska möta samhällets behov av stöd genom att erbjuda tjänster baserade på internationellt vedertagna mättekniska principer och vetenskapliga metoder samt ha en neutral och oberoende roll.

    Hur?

    Det finns en stor ödmjukhet kring att det är en lång process att etablera en organisering för kategoribaserade mätningar och att det behöver ske genom en dynamisk och iterativ utveckling i samskapande med berörda aktörer. Vi ser fram emot att fortsätta utveckla tankar och revidera förslaget i dialog under kommande år. Det är också viktigt att påbörja en dialog tillsammans med relevanta aktörer om hur implementeringen av organiseringen kan ske i framtiden.

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  • 26.
    Melin, Jeanette
    et al.
    RISE - Research Institutes of Sweden (2017-2019), Safety and Transport, Measurement Science and Technology. University of Gothenburg, Sweden.
    Nordin, Åsa
    University of Gothenburg, Sweden.
    Feldthusen, Caroline
    University of Gothenburg, Sweden.
    Danielsson, Louise
    University of Gothenburg, Sweden; Angered hospital, Sweden.
    Goal-setting in physiotherapy: exploring a person-centered perspective.2019In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040Article in journal (Refereed)
    Abstract [en]

    Objective: To analyze definitions and related requirements, processes, and operationalization of person-centered goal-setting in the physiotherapy research literature; to discuss those findings in relation to underlying principles of person-centeredness; and to provide an initial framework for how person-centered goal-setting could be conceptualized and operationalized in physiotherapy. Methods: A literature search was conducted in the databases: CINAHL, PubMed, PEDro, PsycINFO, REHABdata and Scopus. A content analysis was performed on how person-centered goal-setting was described. Results: A total of 21 articles were included in the content analysis. Five categories were identified: 1) Understanding goals that are meaningful to the patients; 2) Setting goals in collaboration; 3) Facing challenges with person-centered goal-setting; 4) Developing skills by experiences and education; and 5) Changing interaction and reflective practice. These categories were abstracted into two higher-ordered interlaced themes: 1) To seek mutual understanding of what is meaningful to the patient; and 2) To refine physiotherapy interaction skills, which we suggest would be useful for further conceptualization. Conclusion: In this analysis, we interpreted person-centered goal-setting in physiotherapy as a process of interaction toward a mutual understanding of what is meaningful to the patient. Future research may explore how to integrate mindful listening, embodied interaction and continuous ethical reflection with different assessments and treatment methods.

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  • 27.
    Melin, Jeanette
    et al.
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Pendrill, Leslie
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    A Novel Metrological Approach to a More Consistent Way of Defining and Analyzing Memory Task Difficulty in Word Learning List Tests with Repeated Trials2022In: Proceedings - 4th RaPID Workshop: Resources and Processing of Linguistic, Para-Linguistic and Extra-Linguistic Data from People with Various Forms of Cognitive/Psychiatric/Developmental Impairments, as part of the 13th Edition of the Language Resources and Evaluation Conference, LREC 2022, European Language Resources Association (ELRA) , 2022, p. 17-21Conference paper (Refereed)
    Abstract [en]

    New candidate diagnostics for cognitive decline and dementia have recently been proposed based on effects such as primacy and recency in word learning memory list tests. The diagnostic value is, however, currently limited by the multiple ways in which raw scores, and in particular these serial position effects (SPE), have been defined and analyzed to date. In this work, we build on previous analyses taking a metrological approach to the 10-item word learning list. We show i) how the variation in task difficulty reduces successively for trials 2 and 3, ii) how SPE change with repeated trials as predicted with our entropy-based theory, and iii) how possibilities to separate cohort members according to cognitive health status are limited. These findings mainly depend on the test design itself: A test with only 10 words, where SPE do not dominate over trials, requires more challenging words to increase the variation in task difficulty, and in turn to challenge the test persons. The work is novel and also contributes to the endeavour to develop for more consistent ways of defining and analyzing memory task difficulty, and in turn opens up for more practical and accurate measurement in clinical practice, research and trials.

  • 28.
    Melin, Jeanette
    et al.
    RISE - Research Institutes of Sweden, Safety and Transport, Measurement Science and Technology.
    Pendrill, Leslie
    RISE - Research Institutes of Sweden, Safety and Transport, Measurement Science and Technology.
    Innovative measurements for improved diagnosis and management of neurodegenerative diseases2019Conference paper (Other academic)
    Abstract [en]

    Development of novel therapies for Alzheimer’s Disease (AD) is constrained by the lack of available methods for preclinical diagnosis, despite extensive research on biomarker identification. The EMPIR NeuroMET project unites National Measurement Laboratories, clinicians and academics, to overcome limitations in measurement methods and provide a better understanding of how to improve, combine and analyse measurements in AD diagnosis and treatment. Comparability through SI (System of International Units) traceability and uncertainty analysis is an, as yet, unmet requirement for regulatory approval of biomarkers, patient centred outcome measures, clinical thresholds and new therapeutic drugs. We will report on:

    • Multimodal statistical analysis on blood, CSF and saliva biomarkers data from the NeuroMET cohort generated by using mass spectroscopy and immunoassay platforms, including a novel immunoassay approach to overcome matrix effects when relative quantification is not sensitive enough. A new digital PCR approach was developed to assess microRNAs quantities in blood to compare with established biomarkers.
    • Progress towards the development of mass spectrometry reference measurement procedures traceable to the SI for t-tau and α-synuclein in cerebrospinal fluids.
    • Development of ultrahigh field Magnetic Resonance Imaging and Spectroscopy protocols for increased spatial and spectral resolution and decreased uncertainty, and their application to the NeuroMET cohort.
    • Improved cognitive assessment protocols, with improved metrological evaluation of cognitive performance scores and the development of construct specification equations for various cognitive protocols and biomarkers.
    • Potential relationships between volumes of AD-related brain structures and neurometabolite concentrations with measured cognitive function.

    Improved reference methods to underpin the production of calibrators and improve measurement comparability of established biomarkers has the potential to further the understanding of AD and boost research for disease modifying therapies.

  • 29.
    Melin, Jeanette
    et al.
    RISE - Research Institutes of Sweden, Safety and Transport, Measurement Science and Technology.
    Pendrill, Leslie
    RISE - Research Institutes of Sweden, Safety and Transport, Measurement Science and Technology.
    Quality assurance of cognitive assessments and other categorical data2019Conference paper (Other academic)
    Abstract [en]

    Did you ever wonder how to account for biases such as ceiling eects in your (cognitive) data?

    Metrological quality assurance of human-based responses is in its infancy and analyzing categorial data and other human responses is challenging. However, there is a need to tackle those challenges to ensure that decisions about health care are made correctly. Quality assured comparability, interoperability and decision-making can successfully be done by applying sound metrological approaches to enable traceability as well as stressing declaration of measurement uncertainties. In the seminar, we present metrological approaches to ensure quality assurance of categorical data,such as cognitive assessments and other human-reported responses. This is followed by a hands-onworkshop where you are welcome to bring your own or freely available data for analyses.

  • 30.
    Melin, Jeanette
    et al.
    RISE - Research Institutes of Sweden, Safety and Transport, Measurement Science and Technology.
    Pendrill, Leslie
    RISE - Research Institutes of Sweden, Safety and Transport, Measurement Science and Technology.
    Cano, Stefan
    Modus Outcome, Uk.
    NeuroMET Memory Metric version 0.12019Conference paper (Other academic)
    Abstract [en]

    Alongside a lack clinically validated, minimally invasive diagnostic tools for early diagnosis and/or monitoring of disease progression in Alzheimer’s Disease (AD), there are no sound metrological assessment protocols and measurements for cognition, nor measurement comparability through SI (System of International Units), traceability and uncertainty for regulatory approval of biomarkers. As part of the on-going EMPIR HLT04 NeuroMET project in which several national metrology institutes work together with clinicians and academics to overcome specific measurement issues to improve diagnosis and disease progression, we describe here the justification for and development of the ‘NeuroMET Memory Metric’ (version 0.1).

    Re-examination of traditional widely used ‘legacy’ cognitive assessment protocols using invariant measurement theory aims at more accurately capturing the patient’s cognitive ability and improving the analysis of correlations with various AD biomarkers. Two principal elements provide sound metrological underpinnings: (i) a correct formulation of a measurement model; and (ii) proper handling of the ordinal cognitive data. In turn, this enables formulation of novel construct specification equations for patient cognitive ability as a function of diverse biomarkers (e.g., in plasma, CSF and saliva together with MRI/MRS data) as well as for cognitive task difficult as a function of test design.

    To further improve the accuracy in patient’s cognitive ability work is now in progress to develop a NeuroMET Memory Metric based on legacy cognitive assessments (e.g., MMSE, Corsi Block Test, Digital Span Test). This work can be ascribed a level-5 construct theory. This means the realization of more fit-for-purpose, better targeted and better administered cognitive measurement systems. It will also enable traceable calibration of both additional cognitive tasks as well as the effects of intervention (or disease progression) on the cognitive ability of each individual patient.

  • 31.
    Pendrill, Leslie
    et al.
    RISE - Research Institutes of Sweden.
    Cano, Stefan
    Modus Outcomes plc, UK.
    Kobe, Theresa
    Charité - University Medicine Berlin, Germany.
    Melin, Jeanette
    Fillmer, Ariane
    Physikalisch-Technische Bundesanstalt, Germany.
    Restitution of ability and difficulty from decision-making: The metrology of human-based perceptions2018In: Measurement at the Crossroads: History,philosophy and sociology of measurement, Paris, 2018Conference paper (Refereed)
    Abstract [en]

    Fundamental reappraisal of metrology, beyond superficial analogies with traditional measurement instruments, is needed if ordinal properties – such as ‘counted fractions’ (bounded by zero and one), performance metrics for ability tests, customer satisfaction, etc - are to be included in an extended quantity calculus for a new SI. Regarding a human being (or other ‘probe’) as a Measurement Instrument with Rasch measurement theory (i.e., postulating a Generalised Linear Model link function z = θ – δ, of a ‘probe’ attribute θ and a ‘target’ attribute δ) not only handles ordinal properties of the measurement system response, Psuccess, but also attribute separability in restitution; essential to underpinning measurement traceability and uncertainty. Examples from person-centred care (e.g., of Alzheimer ’s disease patients) will demonstrate causal Rasch models relating task difficulty and patient ability to explanatory variables such as test sequence entropy and brain atrophy, thereby enabling novel certified reference materials for traceability.

  • 32.
    Pendrill, Leslie
    et al.
    RISE - Research Institutes of Sweden, Safety and Transport, Measurement Science and Technology.
    Melin, Jeanette
    RISE - Research Institutes of Sweden, Safety and Transport, Measurement Science and Technology.
    Measuring counted fractions in healthcare2019In: TMQ Techniques, Methodologies and Quality, ISSN 2183-0940, no NÚMERO ESPECIAL, p. 60-69Article in journal (Refereed)
    Abstract [en]

    In establishing metrological quality assurance in healthcare, one major hurdle is the correct treatment ofordinal data typical of questionnaires, performance tests and other categorical data collected widely in care.Despite being known well over a century, there are still many examples of measurements in healthcare – forexample, (i) on-line tables of percentage performance indicators (e.g. fraction of patients seeing a doctorwithin seven days) and (ii) correlation plots for Alzheimer sufferers of cognitive scores against biomarkerconcentration – where the ‘counted fraction’ distortion of scales is not compensated for. The Rasch form ofgeneralised linear model not only handles counted fraction ordinality but also enables separation of objectand instrument attributes (such as task difficulty and patient ability) essential for metrological restitutionin measurement systems in healthcare. A perspective is given of a new kind of certified reference materialemploying causal Rasch models in terms of construct specification equations for metrological item bankingin the social sciences. This is part of the response to a recent call for: ‘a new international body to bringtogether metrology, psychometrics, philosophy, and clinical management to support the global comparabilityand equivalence of measurement results in patient centred outcome measurement to improve healthcare’.

  • 33.
    Pendrill, Leslie
    et al.
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology.
    Melin, Jeanette
    RISE Research Institutes of Sweden, Safety and Transport, Measurement Technology. Swedish Defence University, Sweden.
    Stavelin, Anne
    Noklus The Norwegian Organisation for Quality Improvement of Laboratory Examinations, Norway.
    Nordin, Gunnar
    Equalis, Sweden.
    Modernising Receiver Operating Characteristic (ROC) Curves †2023In: Algorithms, E-ISSN 1999-4893, Vol. 16, no 5, article id 253Article in journal (Refereed)
    Abstract [en]

    The justification for making a measurement can be sought in asking what decisions are based on measurement, such as in assessing the compliance of a quality characteristic of an entity in relation to a specification limit, SL. The relative performance of testing devices and classification algorithms used in assessing compliance is often evaluated using the venerable and ever popular receiver operating characteristic (ROC). However, the ROC tool has potentially all the limitations of classic test theory (CTT) such as the non-linearity, effects of ordinality and confounding task difficulty and instrument ability. These limitations, inherent and often unacknowledged when using the ROC tool, are tackled here for the first time with a modernised approach combining measurement system analysis (MSA) and item response theory (IRT), using data from pregnancy testing as an example. The new method of assessing device ability from separate Rasch IRT regressions for each axis of ROC curves is found to perform significantly better, with correlation coefficients with traditional area-under-curve metrics of at least 0.92 which exceeds that of linearised ROC plots, such as Linacre’s, and is recommended to replace other approaches for device assessment. The resulting improved measurement quality of each ROC curve achieved with this original approach should enable more reliable decision-making in conformity assessment in many scenarios, including machine learning, where its use as a metric for assessing classification algorithms has become almost indispensable.

  • 34.
    Pendrill, Leslie
    et al.
    RISE - Research Institutes of Sweden, Safety and Transport, Measurement Science and Technology.
    Quaglia, Milena
    Laboratory of the Government Chemist Limited, UK.
    Cano, Stefan
    Modus Outcomes, UK.
    Melin, Jeanette
    RISE - Research Institutes of Sweden, Safety and Transport, Measurement Science and Technology.
    Innovative measurements forimproved diagnosis and management of neurodegenerative diseases – EMPIRNeuroMet 15HLT042017Conference paper (Refereed)
    Abstract [en]

    Background: Neurodegeneration is an incurable, debilitating process which presents a growing medical and economic challenge due to our aging population. Alzheimer’s disease is one of the most common neurodegenerative diseases. Objectives: Currently, there are no minimally invasive diagnostic tools which allow for early diagnosis or monitoring of the progression of disease in patients. Methods: The European EMPIR NeuroMet 15HLT04 project (2016 – 9) is helping to address these objectives by exploring innovative techniques for early diagnosis and monitoring, based on non-invasive magnetic resonance imaging approaches, and developing improved clinical assessment protocols focused on monitoring declining cognitive functions. Results: As a case study, the person-centred measurement of cognitive ability is examined, where better analysis of correlations with brain atrophy is enabled thanks to the Rasch metrological approach. A new model of the metrology of ordinal data, including performance metrics and restitution is presented. Conclusions: An example is given of how the Rasch invariant measure theory can improve contemporary studies of possible correlations between neurodegeneration in patients suffering from Alzheimer’s disease – specifically failing cognitive ability – and brain atrophy. It is the first time to our knowledge that the known distortions - revealed by the Rasch psychometric model - of measurement scales in common clinical instruments for cognitive assessment have been corrected for in correlation studies. Possibilities of higher resolution and more reliable clinical decisions open up. Acknowledgments The European Metrology Programme for Innovation & Research (EMPIR, Horizon2020, Art. 185) is jointly funded by the EMPIR participating countries within EURAMET (www.euramet.org) and the European Union in this EMPIR 15 HLT04 NeuroMet project (coordinator: LGC (UK)). Thanks are due, particularly, to Members of the EMPIR NeuroMet consortium. PROJECT WEBSITE http://www.lgcgroup.com/our-science/national-measurement-laboratory/european-metrology-programme-for-innovation-and-re/neuromet/#.WRHEO2dYrcs

  • 35.
    Quaglia, Milena
    et al.
    LGC, UK.
    Bellotti, Vittorio
    University College London, UK.
    Cano, Stefan
    Modus Outcomes, UK.
    Cyrar, Adam
    LGC, UK.
    Deane, Katherine
    University East Anglia, UK.
    Divieto, Carla
    Istituto Nazionale di Ricerca Metrologica, Italy.
    Fillmer, Ariane
    PTB Physikalisch-Technische Bundesanstalt, Germany.
    Giangrande, Chiara
    Laboratoire National de Métrologie et d'Essais, France.
    Köbe, Theresa
    Humboldt-Universität zu Berlin, Germany; Berlin Institute of Health, Germany.
    Lehmann, Sylvain
    CHU Montpellier, France.
    Melin, Jeanette
    RISE - Research Institutes of Sweden (2017-2019), Safety and Transport, Measurement Science and Technology.
    Pang, Susan
    LGC, UK.
    Parkes, Helen
    LGC, UK.
    Pendrill, Leslie
    RISE - Research Institutes of Sweden (2017-2019), Safety and Transport, Measurement Science and Technology.
    Better Measurement for Improved Diagnosis and Management of Alzheimer's Disease: Update on the Empir Neuromet Project2018In: Alzheimer's & Dementia: Journal of the Alzheimer's Association, ISSN 1552-5260, E-ISSN 1552-5279, Vol. 14, p. P759-P760, article id 7Article in journal (Other academic)
    Abstract [en]

    The development of novel therapies for Alzheimer’s Disease (AD) is constrained by the lack of available methods for preclinical diagnosis, despite extensive research on biomarker identification. Here, we present an update of progress from EMPIR NeuroMET, a project combining diverse expertise from five National Measurement Institutes (NMIs), with clinicians and academics, to overcome limitations in measurement methods in neurodegenerative disease diagnosis and treatment.

1 - 35 of 35
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