Validity and reliability of telephone administration of the patient-specific functional scale for the assessment of recovery from snakebite envenomation.

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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10.1371/journal.pntd.0007935

Publication Info

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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Theophanous

Rebecca George Theophanous

Associate Professor of Emergency Medicine

Rebecca Theophanous, MD, MHSc is an Emergency Ultrasound Faculty at Duke University Hospital and the Durham VA Healthcare System. Her research involves identifying facilitators and barriers to implementation of a new emergency ultrasound program at the Durham VAHCS and its impact on clinical care for future dissemination. She is also studying 3DUS technology at Duke as an innovative bedside tool and training ED providers on ultrasound. Her academic interests include medical education, with a focus on ultrasound and critical care.


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