Validity and reliability of telephone administration of the patient-specific functional scale for the assessment of recovery from snakebite envenomation.
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2019-12-13
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Abstract
OBJECTIVES:Although more than 1.8 million people survive snakebite envenomation each year, their recovery is understudied. Obtaining long-term follow-up is challenging in both high- and low-resource settings. The Patient-Specific Functional Scale (PSFS) is an easily administered, well-accepted patient-reported outcome that is validated for assessing limb recovery from snakebite envenomation. We studied whether the PSFS is valid and reliable when administered by telephone. METHODS:This is a secondary analysis of data from a randomized clinical trial. We analyzed the results of PSFS collected in-person on days 3, 7, 14, 21, and 28 and by telephone on days 10, 17, and 24. We assessed the following scale psychometric properties: (a) content validity (ceiling and floor effects), (b) internal structure and consistency (Cronbach's alpha), and (c) temporal and external validity using Intraclass Correlation Coefficient (ICC). Temporal stability was assessed using Spearman's correlation coefficient and agreement between adjacent in-person and telephonic assessments with Cohen's kappa. Bland Altman analysis was used to assess differential bias in low and high score results. RESULTS:Data from 74 patients were available for analysis. Floor effects were seen in the early post-injury time points (median: 3 (IQR: 0, 5) at 3 days post-enrollment) and ceiling effects in the late time points (median: 9 (IQR: 8, 10). Internal consistency was good to excellent with both in-person (Cronbach α: 0.91 (95%CI 0.88, 0.95)) and telephone administration (0.81 (0.73, 0.89). Temporal stability was also good (ICC: 0.83 (0.72, 0.89) in-person, 0.80 (0.68, 0.88) telephone). A strong linear correlation was found between in-person and telephone administration (Spearman's ρ: 0.83 (CI: 0.78, 0.84), consistency was assessed as excellent (Cohen's κ 0.81 (CI: 0.78, 0.84), and Bland Altman analysis showed no systematic bias. CONCLUSIONS:Telephone administration of the PSFS provides valid, reliable, and consistent data for the assessment of recovery from snakebite envenomation.
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Theophanous, Rebecca G, Joao Ricardo Nickenig Vissoci, Fan Hui Wen, S Michelle Griffin, Victoria E Anderson, Michael E Mullins, Nicklaus P Brandehoff, Eugenia B Quackenbush, et al. (2019). Validity and reliability of telephone administration of the patient-specific functional scale for the assessment of recovery from snakebite envenomation. PLoS neglected tropical diseases, 13(12). p. e0007935. 10.1371/journal.pntd.0007935 Retrieved from https://hdl.handle.net/10161/19913.
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Rebecca George Theophanous
Rebecca Theophanous, MD, MHSc, FAEMUS is an Emergency Ultrasound Faculty at Duke University Hospital and the Durham VA Healthcare System.
She is actively involved with clinical ultrasound education, teaching residents and students on shift, performing weekly ultrasound image review, presenting monthly advanced ultrasound talks, and teaching at monthly resident simulation sessions.
Her first-author publications investigate the diagnostic utility and accuracy of 3D ultrasound for assessing ocular complaints, and she developed a point-of-care ultrasound implementation intervention for VA clinicians (funded by an SAEMF/AEUS grant in 2022-2023). Furthermore, she completed a Master of Health Sciences degree through Duke’s Clinical Research Training Program and served as site PI for the Reason3 POCUS in cardiac arrest trial. Her recent SAEM ARMED MedEd studies involve implementation and testing of POCUS simulation-training methods (nerve block training funded by SAEMF), resident and faculty development, and POCUS competency testing.
Dr. Theophanous leads as an AAEM-EUS councilor and SCUF Education fellowship curriculum subcommittee lead. She has presented both didactic and research-based talks at national conferences and has experience writing POCUS guidelines and policy on her hospital’s POCUS taskforce. Finally, she is a reviewer for multiple medical journals, including for the Journal of Ultrasound in Medicine.
Charles J. Gerardo
Dr. Gerardo is Professor and Chair for the Department of Emergency Medicine. He graduated with honors from Stanford University with a Bachelor’s of Science in Biology, and received his MD degree from University of California, Davis. He went on to complete his residency training in Emergency Medicine at Loma Linda University Medical Center. He completed his Masters of Health Sciences from the Duke University Clinical Research and Training Program. In 2000, he joined Emergency Medicine faculty at Duke University and has served in numerous educational, research and administrative leadership roles. His current research focuses on US and global snake envenomation using a variety of methodologies from transitional science and clinical trials to machine learning and implementation science. He has over 90 peer reviewed publications and book chapters, and is published in JAMA, PLOS Medicine, Annals of Emergency Medicine, Academic Emergency Medicine and Clinical Toxicology.
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