2.50
Hdl Handle:
http://hdl.handle.net/10755/154740
Type:
Presentation
Title:
Establishing Content Validity for the Osteoporosis Risk Assessment Tool
Abstract:
Establishing Content Validity for the Osteoporosis Risk Assessment Tool
Conference Sponsor:Sigma Theta Tau International
Conference Year:2002
Conference Date:July, 2002
Author:Wynd, Christine, PhD
P.I. Institution Name:University of Akron
Title:Professor
Objective: The objective of this study was to establish content validity for a newly developed Osteoporosis Risk Assessment Tool, or ORAT, an instrument developed for assessing potential osteoporosis risk in adult females. Design: A methodological study design was used to evaluate the psychometrics of instrument development. This paper describes the process used to establish content validity for the ORAT. Population, Sample, Setting, Years: The ORAT is intended for use with a population of adult females. A sample of 745 adult women evaluated predictive utility for the tool; however, this paper describes the first step in establishing content validity for the ORAT. Therefore, a panel of eight experts actually constituted the sample for this portion of the psychometric study. The experts were selected based on their clinical and research expertise in osteoporosis and they represented both the nursing and medical disciplines. Additionally, there was broad geographic representation from experts living across the United States in order to account for differences in colloquial terms that could affect instrument comprehension by many diverse groups. Expert panel responses were collected between 1999-2000. Concept or Variables Studied: Construction of the ORAT began with a thorough literature review to identify the domain of content regarding osteoporosis risk. The current state of the science was assessed and 23 variables, or risk factors, were included in the original tool: age, gender, race; history of fractures, kidney stones, thyroid disease and thyroid hormone replacement therapy; previous diagnosis of osteoporosis; previous bone densitometry measurements; age at onset of menopause; use of estrogen, steroids, heparin, cyclosporine, antacids, barbiturates; family history of fractures; use of calcium supplements; daily consumption of caffeine, alcohol, servings of calcium-rich foods; smoking history; and the amount of weight-bearing exercises performed per week. Methods: A Likert-like relevance rating scale allowed experts to rate each separate ORAT item. Expert responses were then used to analyze percent agreement through determination of the Content Validity Index (CVI). Additionally, expert response agreement was subjected to a kappa coefficient of agreement to confirm results. Experts also provided qualitative comments and recommendations that assisted in revision of item wording and strengthened the ORAT's ability to assess osteoporosis risk. Findings: The CVI for the entire ORAT resulted in 65% agreement and the kappa coefficient was equal to 0.0394 (p=.5000), indicating the need for revisions to strengthen content validity. Fifteen ORAT items received adequate validity at 100% agreement. Eight items were deemed to require revision or elimination as they achieved ratings of 57% to 86% agreement and individual kappa coefficients of 0.467 or below. Conclusions: A final 15 items remained in the ORAT after all qualitative and quantitative analyses were reviewed. The most significant, suggested revisions for strengthening the tool included an emphasis on variables of age, weight, previous fractures occurring after age 40, estrogen replacement therapy after the onset of menopause, and current smoking status. A new ORAT-II is currently being developed through additional pilot testing. Implications: Osteoporosis is reaching epidemic status in the United States today as well as in other places throughout the world. The Osteoporosis Risk Assessment Tool is being developed to provide a more cost efficient mechanism for screening women with potential for osteoporosis risk. Existing diagnostic tools include bone mineral density measurements (BMD) that are very expensive and therefore not recommended for mass screening. Following extensive psychometric testing and improvements, the ORAT is proposed as a screening device for evaluating women with osteoporosis risk potential and supporting their referral for more definitive diagnostic procedures.

Repository Posting Date:
26-Oct-2011
Date of Publication:
Jul-2002
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleEstablishing Content Validity for the Osteoporosis Risk Assessment Toolen_GB
dc.identifier.urihttp://hdl.handle.net/10755/154740-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Establishing Content Validity for the Osteoporosis Risk Assessment Tool</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2002</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">July, 2002</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Wynd, Christine, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Akron</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Professor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">cwynd@uakron.edu</td></tr><tr><td colspan="2" class="item-abstract">Objective: The objective of this study was to establish content validity for a newly developed Osteoporosis Risk Assessment Tool, or ORAT, an instrument developed for assessing potential osteoporosis risk in adult females. Design: A methodological study design was used to evaluate the psychometrics of instrument development. This paper describes the process used to establish content validity for the ORAT. Population, Sample, Setting, Years: The ORAT is intended for use with a population of adult females. A sample of 745 adult women evaluated predictive utility for the tool; however, this paper describes the first step in establishing content validity for the ORAT. Therefore, a panel of eight experts actually constituted the sample for this portion of the psychometric study. The experts were selected based on their clinical and research expertise in osteoporosis and they represented both the nursing and medical disciplines. Additionally, there was broad geographic representation from experts living across the United States in order to account for differences in colloquial terms that could affect instrument comprehension by many diverse groups. Expert panel responses were collected between 1999-2000. Concept or Variables Studied: Construction of the ORAT began with a thorough literature review to identify the domain of content regarding osteoporosis risk. The current state of the science was assessed and 23 variables, or risk factors, were included in the original tool: age, gender, race; history of fractures, kidney stones, thyroid disease and thyroid hormone replacement therapy; previous diagnosis of osteoporosis; previous bone densitometry measurements; age at onset of menopause; use of estrogen, steroids, heparin, cyclosporine, antacids, barbiturates; family history of fractures; use of calcium supplements; daily consumption of caffeine, alcohol, servings of calcium-rich foods; smoking history; and the amount of weight-bearing exercises performed per week. Methods: A Likert-like relevance rating scale allowed experts to rate each separate ORAT item. Expert responses were then used to analyze percent agreement through determination of the Content Validity Index (CVI). Additionally, expert response agreement was subjected to a kappa coefficient of agreement to confirm results. Experts also provided qualitative comments and recommendations that assisted in revision of item wording and strengthened the ORAT's ability to assess osteoporosis risk. Findings: The CVI for the entire ORAT resulted in 65% agreement and the kappa coefficient was equal to 0.0394 (p=.5000), indicating the need for revisions to strengthen content validity. Fifteen ORAT items received adequate validity at 100% agreement. Eight items were deemed to require revision or elimination as they achieved ratings of 57% to 86% agreement and individual kappa coefficients of 0.467 or below. Conclusions: A final 15 items remained in the ORAT after all qualitative and quantitative analyses were reviewed. The most significant, suggested revisions for strengthening the tool included an emphasis on variables of age, weight, previous fractures occurring after age 40, estrogen replacement therapy after the onset of menopause, and current smoking status. A new ORAT-II is currently being developed through additional pilot testing. Implications: Osteoporosis is reaching epidemic status in the United States today as well as in other places throughout the world. The Osteoporosis Risk Assessment Tool is being developed to provide a more cost efficient mechanism for screening women with potential for osteoporosis risk. Existing diagnostic tools include bone mineral density measurements (BMD) that are very expensive and therefore not recommended for mass screening. Following extensive psychometric testing and improvements, the ORAT is proposed as a screening device for evaluating women with osteoporosis risk potential and supporting their referral for more definitive diagnostic procedures.<br/><br/></td></tr></table>en_GB
dc.date.available2011-10-26T13:14:24Z-
dc.date.issued2002-07en_GB
dc.date.accessioned2011-10-26T13:14:24Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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