Equipercentile linking of the Sheehan Disability Scale and the World Health Organization Assessment Schedule 2.0 scales in people with mental disorders

BACKGROUND

The Sheehan Disability Scale (SDS) and the World Health Organization Disability Assessment Scale (WHODAS 2.0) have been widely used to measure functional impairment and disability. To ensure that the scores from these two scales are practically exchangeable across diseases, therapies, and care programmes, the current study aimed to examine the linkage of the WHODAS 2.0 with the SDS and develop a simple and reliable conversion table for the two scales in people with mental disorders.

METHODS

A total of 798 patients (mean age = 36.1, SD = 12.7) were recruited from outpatient clinics of the Institute of Mental Health, and the Community Wellness Clinic in Singapore. Using a single-group design, an equipercentile equating method with log-linear smoothing was used to establish a conversion table from the SDS to the WHODAS 2.0 and vice versa.

RESULTS

The conversion table showed that the scores were consistent for the entire range of scores when the scores were converted either from the SDS to the WHODAS 2.0 or from the WHODAS 2.0 to the SDS. The agreement between the WHODAS 2.0's raw and converted scores and SDS's raw and converted scores were interpreted as good with intraclass correlation coefficient of 0.711 and 0.725, respectively.

CONCLUSION

This study presents a simple and reliable method for converting the SDS scores to the WHODAS 2.0 scores and vice versa, enabling interchangeable use of data across these two disability measures.

Establishing a common metric for physical function: Linking SARC-F and PROMIS® physical function

INTRODUCTION

Aligned with the increasing need for standardized assessment of physical function in older individuals with cancer and other conditions, several patient-reported outcome measures (PROMs) have been developed and published. The aim of this study is to link the Strength, Assistance with walking, Rising from a chair, Climbing stairs, and Falls questionnaire (SARC-F), and the Patient-Reported Outcomes Measurement Information System® (PROMIS®) Physical Function Short Form 8c (PROMIS PF 8c), and make their scores convertible, in order to expand the use of both instruments in research and inform clinicians and researchers about the interchangeability of critical cut-off scores.

MATERIALS AND METHODS

The sample included 300 participants recruited from an online panel. Participants were included if they had received a cancer diagnosis from a clinician and reported receiving anti-cancer treatment. We conducted five linking procedures and selected an optimal one to generate the crosswalk table between the two measures.

RESULTS

The linked T scores of all five methods showed acceptably small mean differences from the observed T scores, and the standard deviation (SD), and root-mean-squared deviation (RMSD) of the differences were generally similar across all methods. After comparing across all statistics, the Stocking-Lord approach was considered as the optimal approach to compute the crosswalk table for converting SARC-F raw scores to PROMIS PF 8c scores. The crosswalk table shows that the SARC-F cut-off value of 4 between healthy versus symptomatic with a corresponding score of 37 fell in the range of moderate physical function limitation from 30 to 39 on the PROMI PF 8c T score metric.

DISCUSSION

The linkage in this study has potential for improving clinical and research activities for people with cancer and perhaps others with a similar range of physical function. It facilitates the interpretability in scores of both measures on a common metric anchored on general population for further group-level analysis. Researchers can use this crosswalk to harmonize data collected from either instrument without requiring all cohorts to administer the same instrument for a prospective data collection or retrospective data analysis purpose or for a cross-study effectiveness study.

A unidirectional mapping of ICD-8 to ICD-10 codes, for harmonized longitudinal analysis of diseases

Periodic revisions of the international classification of diseases (ICD) ensure that the classification reflects new practices and knowledge; however, this complicates retrospective research as diagnoses are coded in different versions. For longitudinal disease trajectory studies, a crosswalk is an essential tool and a comprehensive mapping between ICD-8 and ICD-10 has until now been lacking. In this study, we map all ICD-8 morbidity codes to ICD-10 in the expanded Danish ICD version. We mapped ICD-8 codes to ICD-10, using a many-to-one system inspired by general equivalence mappings such that each ICD-8 code maps to a single ICD-10 code. Each ICD-8 code was manually and unidirectionally mapped to a single ICD-10 code based on medical setting and context. Each match was assigned a score (1 of 4 levels) reflecting the quality of the match and, if applicable, a "flag" signalling choices made in the mapping. We provide the first complete mapping of the 8596 ICD-8 morbidity codes to ICD-10 codes. All Danish ICD-8 codes representing diseases were mapped and 5106 (59.4%) achieved the highest consistency score. Only 334 (3.9%) of the ICD-8 codes received the lowest mapping consistency score. The mapping provides a scaffold for translation of ICD-8 to ICD-10, which enable longitudinal disease studies back to and 1969 in Denmark and to 1965 internationally with further adaption.

Spatial-temporal distribution and pedestrian exposure assessment of size-fractionated particles on crosswalk of urban intersection

Vehicles tend to produce more pollutants especially particles at an urban intersection than other segments. Meanwhile, pedestrians at an intersection are inevitably exposed to high particle level and suffered from the health problem. Especially, some particles can deposit in different thoracic areas of the respiratory system and cause serious health problems. Hence, in this paper, the particles from 0.3 to 10 μm in 16 channels were measured to compare the spatio-temporal characteristics of them on the crosswalk and the roadside. Based on the roadside of fixed measurements, submicron particles (< 1 μm) are discovered to have a high relation with traffic signal and exhibit a bimodal distribution pattern in the green phase. On the crosswalk of mobile measurements, submicron particles present decreasing trend along the crosswalk while crossing. Additionally, mobile measurements were conducted across six time intervals that correspond to different pedestrian's journey when passing the crosswalk. The results showed that all size particles in the first three journeys present high concentrations than that in other journeys. Furthermore, pedestrian exposure to all 16 channel particles was assessed. The total and regional deposition fractions of these particles in different sizes and age groups are determined. What ought to be paid attention to is that these real-world measurement results contribute to advancing the understanding of pedestrian exposure to size-fractionated particles on crosswalk and assisting the pedestrian to make better informed choice so as to limit particle exposure in these pollution hotspots.

Development of a mapping function ("crosswalk") for the conversion of scores between the Oswestry Disability Index (ODI) and the Core Outcome Measures Index (COMI)

INTRODUCTION

The Oswestry Disability Index (ODI) and the Core Outcome Measures Index (COMI) are two commonly used self-rating outcome instruments in patients with lumbar spinal disorders. No formal crosswalk between them exists that would otherwise allow the scores of one to be interpreted in terms of the other. We aimed to create such a mapping function.

METHODS

We performed a secondary analysis of ODI and COMI data previously collected from 3324 patients (57 ± 17y; 60.3% female) at baseline and 1y after surgical or conservative treatment. Correlations between scores and Cohen's kappa for agreement (κ) regarding achievement of the minimal clinically important change (MCIC) score on each instrument (ODI, 12.8 points; COMI, 2.2 points) were calculated, and regression models were built. The latter were tested for accuracy in an independent set of registry data from 634 patients (60 ± 15y; 56.8% female).

RESULTS

All pairs of measures were significantly positively correlated (baseline, 0.73; 1y follow-up (FU), 0.84; change-scores, 0.73). MCIC for COMI was achieved in 53.9% patients and for ODI, in 52.4%, with 78% agreement on an individual basis (κ = 0.56). Standard errors for the regression slopes and intercepts were low, indicating excellent prediction at the group level, but root mean square residuals (reflecting individual error) were relatively high. ODI was predicted as COMI × 7.13-4.20 (at baseline), COMI × 6.34 + 2.67 (at FU) and COMI × 5.18 + 1.92 (for change-score); COMI was predicted as ODI × 0.075 + 3.64 (baseline), ODI × 0.113 + 0.96 (FU), and ODI × 0.102 + 1.10 (change-score). ICCs were 0.63-0.87 for derived versus actual scores.

CONCLUSION

Predictions at the group level were very good and met standards justifying the pooling of data. However, we caution against using individual values for treatment decisions, e.g. attempting to monitor patients over time, first with one instrument and then with the other, due to the lower statistical precision at the individual level. The ability to convert scores via the developed mapping function should open up more centres/registries for collaboration and facilitate the combining of data in meta-analyses.

Do detection-based warning strategies improve vehicle yielding behavior at uncontrolled midblock crosswalks?

Pedestrians being the most vulnerable road users account for a large proportion of injuries and fatalities from road traffic crashes. Pedestrians are involved in around one-third of the whole fatalities coming from the road traffic crashes in the state of Qatar. In areas with uncontrolled midblock crosswalks, it is very crucial to improve drivers' alertness and yielding behavior. The objective of this driving simulator study is to investigate the impact of pedestrian detection strategies and pavement markings on driving behavior at high-speed uncontrolled crosswalks. To this end, an untreated condition (i.e. Control) was compared with three treatment conditions. The three treated conditions included two detection strategies, i.e., advance variable message sign (VMS) and LED lights, and road markings with pedestrian encircled. Each condition was tested with a yield/stop controlled marked crosswalk for two situations, i.e. with vs. without a pedestrian present. The experiment was conducted using the driving simulator at Qatar University. In total, 67 volunteers possessing a valid Qatari driving license participated in the study. Different analyses were conducted on vehicle-pedestrian interactions, driving speed, variations in acceleration/deceleration and lateral position. The results showed that both the LED and VMS conditions were helpful in increasing yielding rates up to 98.4 % and reducing the vehicle-pedestrian conflicts significantly. Furthermore, both treatments were effective in motivating drivers to reduce vehicle speed in advance. Considering the findings of this study, we recommend LED and VMS conditions as potentially effective solutions to improve safety at yield/stop controlled crosswalks.

Mapping the Memorial Anxiety Scale for Prostate Cancer to the SF-6D

PURPOSE

To create a crosswalk that predicts Short Form 6D (SF-6D) utilities from Memorial Anxiety Scale for Prostate Cancer (MAX-PC) scores.

METHODS

The data come from prostate cancer patients enrolled in the North Carolina Prostate Cancer Comparative Effectiveness & Survivorship Study (NC ProCESS, N = 1016). Cross-sectional data from 12- to 24-month follow-up were used as estimation and validation datasets, respectively. Participants' SF-12 scores were used to generate SF-6D utilities in both datasets. Beta regression mixture models were used to evaluate SF-6D utilities as a function of MAX-PC scores, race, education, marital status, income, employment status, having health insurance, year of cancer diagnosis and clinically significant prostate cancer-related anxiety (PCRA) status in the estimation dataset. Models' predictive accuracies (using mean absolute error [MAE], root mean squared error [RMSE], Akaike information criterion [AIC] and Bayesian information criterion [BIC]) were examined in both datasets. The model with the highest prediction accuracy and the lowest prediction errors was selected as the crosswalk.

RESULTS

The crosswalk had modest prediction accuracy (MAE = 0.092, RMSE = 0.114, AIC = - 2708 and BIC = - 2595.6), which are comparable to prediction accuracies of other SF-6D crosswalks in the literature. About 24% and 52% of predictions fell within ± 5% and ± 10% of observed SF-6D, respectively. The observed mean disutility associated with acquiring clinically significant PCRA is 0.168 (standard deviation = 0.179).

CONCLUSION

This study provides a crosswalk that converts MAX-PC scores to SF-6D utilities for economic evaluation of clinically significant PCRA treatment options for prostate cancer survivors.

Particulate matter exposure at a densely populated urban traffic intersection and crosswalk

Exposure to elevated particulate matter (PM) pollution is of great concern to both the general public and air quality management agencies. At urban traffic intersections, for example, pedestrians are often at a higher risk of exposure to near-source PM pollution from traffic while waiting on the roadside or while walking in the crosswalk. This study offers an in-depth investigation of pedestrian exposure to PM pollution at an urban traffic intersection. Fixed-site measurements near an urban intersection were conducted to examine the variations in particles of various sizes through traffic signal cycles. This process aids in the identification of major PM dispersion patterns on the roadside. In addition, mobile measurements of pedestrian exposure to PM were conducted across six time intervals that correspond to different segments of a pedestrian's journey when passing through the intersection. Measurement results are used to estimate and compare the cumulative deposited doses of PM by size categories and journey segments for pedestrians at an intersection. Furthermore, comparisons of pedestrian exposure to PM on a sunny day and a cloudy day were analyzed. The results indicate the importance of reducing PM pollution at intersections and provide policymakers with a foundation for possible measures to reduce pedestrian PM exposure at urban traffic intersections.

Interim value set for the EQ-5D-5L in Iran using the Crosswalk method

Background: The EuroQol five-dimensional 5 level (EQ-5D-5L) value set is not currently available for the Iranian general public, while the value set for EuroQol five-dimensional 3 level (EQ-5D-3L) is available. The present study aimed to generate an interim EQ-5D-5L value set for the context of Iran. Methods: The Iranian interim EQ-5D-5L value set was generated using the crosswalk method, which maps EQ-5D-3L and EQ-5D-5L responses. The EQ-5D-3L value set has previously been estimated by Time Trade-Off (TTO) method. The interim value set obtained for EQ-5D-5L was compared with the value set of EQ-5D-3L by using measures of mean, median, and skewness.The analysis was done using STATA version 15. Results: The mean and median scores of the Iranian interim value set were 0.499 and 0.451 for EQ-5D-5L and 0.455 and 0.459 for Iranian EQ-5D-3L, respectively. The range of value for both EQ-5D-3L and interim EQ-5D-5L was -0.113 to 0.919. Data skewness of EQ-5D-3L and interim EQ-5D-5L was-0.099 and -0.114, respectively. In addition, the figure of distribution of value sets for both data sets had a tail extended towards the left. The states of "good health"(i.e., states with value>0.8) for the EQ-5D-3L value set were proportionally more than the Iranian interim EQ-5D-5Lcrosswalk value set (2.47% vs. 0.448%). Conclusion: An EQ-5D-5L value set was generated using the crosswalk method for the Iranian general public, and now researchers and policy-makers can apply it to their economic and clinical analyses.

Interactive Education is Associated With Lower Incidence of Pedestrian-Related Injury in Children

BACKGROUND

Pedestrian-related injuries are a significant contributor to preventable mortality and disability in children. We hypothesized that interactive pedestrian safety education is associated with increased knowledge, safe crosswalk behaviors, and lower incidence of pedestrian-related injuries in elementary school-aged children.

METHODS

An interactive street-crossing simulation was implemented at target elementary schools in Los Angeles County beginning in 2009. Mixed-methods were used to evaluate the impact of this intervention. Multiple-choice examinations were used to test pedestrian safety knowledge, anonymous observations were used to assess street-crossing behaviors, and statewide traffic records were used to report pedestrian injuries in elementary school-aged (4-11 y) children in participating school districts. Pedestrian injury incidence was compared 1 y before and after the intervention, standardized to the incidence in the entire City of Los Angeles.

RESULTS

A total of 1424 and 1522 children completed the pretest and post-test, respectively. Correct answers increased for nine of ten questions (all P < 0.01). Children more frequently looked both ways before crossing the street after the intervention (10% versus 41%, P < 0.001). There were 6 reported pedestrian-related injuries in intervention school districts in the year before the intervention and 2 injuries in the year after the intervention, resulting in a significantly lower injury incidence (standardized rate ratio 0.28; 95% CI, 0.11-0.73).

CONCLUSION

Pedestrian safety education at Los Angeles elementary schools was associated with increased knowledge, safe street-crossing behavior, and lower incidence of pediatric pedestrian-related injury. Formal pedestrian safety education should be considered with injury prevention efforts in similar urban communities.

Behaviors of older pedestrians at crosswalks in South Korea

This paper aims to explore three walking behaviors of older pedestrians that may increase their crash risks when crossing urban streets. Older and younger pedestrians' start-up delay in initiating a crossing and number of head turns during street crossing are observed at 30 pedestrian crossings in Seoul, South Korea, using video recorders. In addition, their estimation of the safe crossing distance to an approaching vehicle is collected in a survey. Our study shows that older pedestrians have a shorter start-up delay time than younger pedestrians, older pedestrians crossing streets turn their heads less frequently, and older pedestrians provide less reliable estimates about the distance of an approaching vehicle. Safety technologies, campaigns and environmental designs should target these behaviors to improve the safety of older pedestrians.

Mapping ISO 19115-1 geographic metadata standards to CodeMeta

The CodeMeta Project recently proposed a vocabulary for software metadata. ISO Technical Committee 211 has published a set of metadata standards for geographic data and many kinds of related resources, including software. In order for ISO metadata creators and users to take advantage of the CodeMeta recommendations, a mapping from ISO elements to the CodeMeta vocabulary must exist. This mapping is complicated by differences in the approaches used by ISO and CodeMeta, primarily a difference between hard and soft typing of metadata elements. These differences are described in detail and a mapping is proposed that includes sixty-four of the sixty-eight CodeMeta V2 terms. The CodeMeta terms have also been mapped to dialects used by twenty-one software repositories, registries and archives. The average number of terms mapped in these cases is 11.2. The disparity between these numbers reflects the fact that many of the dialects that have been mapped to CodeMeta are focused on citation or dependency identification and management while ISO and CodeMeta share additional targets that include access, use, and understanding. Addressing this broader set of use cases requires more metadata elements.

Assessing distress in the community: psychometric properties and crosswalk comparison of eight measures of psychological distress

BACKGROUND

Many measures are available for measuring psychological distress in the community. Limited research has compared these scales to identify the best performing tools. A common metric for distress measures would enable researchers and clinicians to equate scores across different measures. The current study evaluated eight psychological distress scales and developed crosswalks (tables/figures presenting multiple scales on a common metric) to enable scores on these scales to be equated.

METHODS

An Australian online adult sample (N = 3620, 80% female) was administered eight psychological distress measures: Patient Health Questionnaire-4, Kessler-10/Kessler-6, Distress Questionnaire-5 (DQ5), Mental Health Inventory-5, Hopkins Symptom Checklist-25 (HSCL-25), Self-Report Questionnaire-20 (SRQ-20) and Distress Thermometer. The performance of each measure in identifying DSM-5 criteria for a range of mental disorders was tested. Scale fit to a unidimensional latent construct was assessed using Confirmatory Factor Analysis (CFA). Finally, crosswalks were developed using Item Response Theory.

RESULTS

The DQ5 had optimal performance in identifying individuals meeting DSM-5 criteria, with adequate fit to a unidimensional construct. The HSCL-25 and SRQ-20 also had adequate fit but poorer specificity and/or sensitivity than the DQ5 in identifying caseness. The unidimensional CFA of the combined item bank for the eight scales showed acceptable fit, enabling the creation of crosswalk tables.

CONCLUSIONS

The DQ5 had optimal performance in identifying risk of mental health problems. The crosswalk tables developed in this study will enable rapid conversion between distress measures, providing more efficient means of data aggregation and a resource to facilitate interpretation of scores from multiple distress scales.

Analyzing driver-pedestrian interaction in a mixed-street environment using a driving simulator

This paper presents the design, analysis and results of a driving simulator experiment conducted to study the interaction between drivers and pedestrians in a mixed-street environment. Ninety-six students of the American University of Beirut (AUB) participated in the experiment that took place in the Transportation and Infrastructure Laboratory of AUB. The study looked at the driver-pedestrian interaction from the driver's perspective, by quantifying the effects of different scenario variables on the driving behavior of the participants. Kruskall-Wallis test shows that drivers' behavior in proximity of pedestrians tends to be statistically significantly less aggressive when their approach velocity is lower, curb-side parking is not allowed, a crosswalk exists, and the number of pedestrians crossing the street is higher. A discrete choice model for the yielding behavior of the drivers was also developed as a function of different predictor variables. Five out of the six predictors considered (except for gender) had a statistically significant effect on the yielding behavior, particularly the effects of curb-side parking, number of pedestrians crossing, and approach velocity. The model was then used to evaluate the effect of policy variables on the yielding probabilities of the drivers. The results of this study enrich current knowledge and understanding of drivers' behavior and their interaction with pedestrians, especially with studying the effects of scenario variables that were not addressed before; this would help planners propose and evaluate safety measures and traffic calming techniques to reduce the risks on pedestrians. The study also confirms the effectiveness of driving simulators in studying driver-pedestrian interactions.

Evaluation of Orientation Performance of Attention Patterns for Blind Person

Tactile walking surface indicators (TWSIs) are installed on footpath to support independent travel for the blind. There are two types of TWSIs, attention patterns and guiding patterns. The attention pattern is usually installed at the crosswalk entrances. The direction of the crossing can be acquired by the row of the projection of the attention pattern through the soles of the shoes. In addition, truncated domes or cones of the attention pattern were arranged in a square grid, parallel or diagonal at 45 degrees to the principal direction of travel. However, the international standard organization (ISO) allows a wide-ranging size. In this research, the direction indicating performance was compared at the same intervals for the five diameters specified by the international standard. As a result of the experiment, the diagonal array does not indicate the direction of travel, but the projection row does indicate the direction of travel in the parallel array. When the attention pattern is installed at a crosswalk entrance, a parallel array should be installed in the direction of the crossing.

Pedestrian Crosswalk Law: A study of traffic and trajectory factors that affect non-compliance and stopping distance

Walking is encouraged by many transportation agencies as a sustainable mode that contributes to livable downtowns. Since pedestrians are the most vulnerable road users, safe and comfortable crosswalks are essential to ensure that pedestrian travel becomes an appealing alternative. In this context, the goal of this research is to study the traffic and vehicle trajectory factors that affect crosswalk law compliance and stopping distance from the crosswalk. The results of this research provide new insights into the relationships between traffic conditions, vehicle trajectory, and compliance rates. Results indicate that vehicle origin, vehicle type, stopping at upstream traffic lights, and changes in vehicle speed and headways are key factors to predict pedestrian crosswalk law compliance and stopping behavior; changes in vehicle speed and headways have the highest explanatory power.