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Shortening patient-reported outcome measures through optimal test assembly: application to the Social Appearance
Daphna Harel1,2, Sarah D Mills3, Linda Kwakkenbos4
1Applied Statistics, Social Science, Humanities, New York University, New York City, New York, USA.
Objectives:
The Social Appearance Anxiety Scale (SAAS) is a 16-item measure that assesses social anxiety in situations where appearance is evaluated. The objective was to use optimal test assembly (OTA) methods to develop and validate a short-form SAAS based on objective and reproducible criteria.
Design:
This study was a cross-sectional analysis of baseline data from adults enrolled in the Scleroderma Patient-centered Intervention Network (SPIN) Cohort.
Setting:
Adults in the SPIN Cohort in the present study were enrolled at 28 centres in Canada, the USA and the UK.
Participants:
The SAAS was administered to 926 adults with scleroderma.
Primary And Secondary Measures:
The SAAS, Brief Fear of Negative Evaluation II (BFNE II), Brief Satisfaction with Appearance Scale (Brief-SWAP), Patient Health Questionnaire-8 (PHQ8) and Social Interaction Anxiety Scale-6 (SIAS-6) were collected, as well as demographic characteristics.
Results:
OTA methods identified a maximally informative shortened version for each possible form length between 1 and 15 items. The final shortened version was selected based on prespecified criteria for reliability, concurrent validity and statistically equivalent convergent validity with the BFNE II scale. A five-item short version was selected (SAAS-5). The SAAS-5 had a Cronbach's α of 0.95 and had high concurrent validity with the full-length form (r=0.97). The correlation of the SAAS-5 with the BFNE II was 0.66, which was statistically equivalent to that of the full-length form. Furthermore, the correlation of the SAAS-5 with the two subscales of the Brief-SWAP, and the SIAS-6, were statistically equivalent to that of the full-length form.
Conclusions:
OTA was an efficient method for shortening the full-length SAAS to create the SAAS-5.
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