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Objectives: In this study, we investigated the psychometric properties of the International Classification of Functioning, Disability and Health (ICF) core set for low back pain (LBP). Patients and methods: One-hundred outpatients with LBP (73 females, 27 males; mean age 55.3 years; range 24 to 84 years) were assessed by the ICF core set for LBP. The patients also completed the Roland-Morris disability questionnaire (RMDQ) and Short Form-36 (SF-36) questionnaire. The internal construct validity of the ICF core set for LBP was assessed by Rasch analysis and external construct validity by correlations with the RMDQ and SF-36 Health Survey version 1.0. Reliability was tested by internal consistency and person separation index. Results: After rescoring the disordered response categories and deletion of some items, "body functions and body structures" and "activities and participation" item sets satistifed Rasch model expectations with a mean item fit of 0.005 (SD 0.619) and -0.006 (SD 0.730), and person fit of -0.165 (SD 0.561) and -0.084 (SD 0.806) respectively. Both item sets were unidimensional and showed no differential item functioning. Their reliabilities were good with Cronbach's alpha coefficient and person separation index levels above 0.77. Although the mean functionality level of the patients was lower than the mean difficulty level of the items, the distribution of the difficulty level of the items overlapped with the distribution of the functionality level of the patients for both item sets. The presence of the expected level of correlations between both item sets and RMDQ and SF-36 has confirmed the external construct validity. "Environmental factors" did not meet the assumptions of the Rasch analysis. Conclusion: After some modifications, a 15-item "body functions and body structures" set and a 21-item "activities and participation" set from the ICF comprehensive core set were found to be reliable and valid to assess functioning in patients with LBP. [ABSTRACT FROM AUTHOR]

Objectives: To adapt the London Handicap Scale into the Turkish language, and to investigate the scaling properties of this version in a sample of people who have experienced a stroke.Design: After the translation process, the internal construct validity was tested by Rasch analysis and the reliability by internal consistency and intraclass correlation coefficient. The interval scaling properties were assessed by contrasting the raw and weighted London Handicap Scale scores with the Rasch latent estimates. Setting: An outpatient rehabilitation unit of a university hospital.Subjects: One hundred and eighty-eight community-dwelling post-stroke patients (mean age 63 (SD 12) years, 54% male) were assessed by the Turkish version of the London Handicap Scale.Results: After adjustment for local dependency, the data showed good fit to Rasch model expectations with a mean item fit -0.240 (SD 1.868), person fit -0.403 (SD 0.893) and chi-square interaction 8.55 (df 10, P =0.575). The reliability was good with a Cronbach’s α and intraclass correlation coefficient of 0.845. Analysis of the scaling properties showed that either the raw London Handicap Scale score or its weighted score were non-linear with respect to the Rasch latent estimate.Conclusions: The London Handicap Scale is a valid and reliable scale for use in stroke in Turkey. Its unweighted raw scores and weighted scores are equivalent and ordinal, but a linear transformation is possible through Rasch analysis. [ABSTRACT FROM PUBLISHER]

Background: An important aspect of the ‘description’ of a variable is the shape of its distribution, which tells you the frequency of values from different ranges of the variable. Typically, as most of the statistical tests are based on the normality assumption, a researcher is interested in how well the distribution can be approximated by the normal distribution. Unless there are extreme violations of the normality assumptions, approved statistical tests usually provide accurate results. Although simple descriptive statistics can provide some information relevant to this issue, more precise information can be obtained by performing one of the tests of normality to determine whether the sample comes from a normally distributed population or not. Aim: Lilliefors corrected Kolmogorov-Smirnov, Shapiro-Wilk, D'Agostino Pearson and Jarqua-Bera tests were aimed to be compared in terms of Type I error and power of the tests. Materials and Methods: The simulation was run 1000 times for 23 different sample sizes and for 8 different distributions. Lilliefors corrected Kolmogorov-Smirnov, Shapiro-Wilk, D'Agostino Pearson and Jarqua-Bera tests were compared in terms of Type I error and power of the tests. Results: The most powerful results for normal distributions were given by the Jarqua-Bera and for nonnormal distributions by the Shapiro-Wilk test. Conclusions: As it had the lowest Type I error rate, the Jarqua-Bera test was superior for normal and standard normal distributions. For nonnormal distributions, achieving sufficient power at smaller sample sizes, the Shapiro-Wilk was the most powerful. [ABSTRACT FROM AUTHOR]

Background/aim: The multidimensional evaluation of patients with chronic neck pain is important for planning the treatment program. The aim of this study was to investigate the validity and reliability of the Turkish version of the Neck Bournemouth Questionnaire (NBQ)., Materials and Methods: The internal construct validity of the NBQ was examined by the fit of the data to the Rasch measurement model. External validity of the NBQ was evaluated by testing for expected associations of Rasch transformed NBQ score with the corresponding variables through the process of convergent validity. The reliability of the NBQ in terms of both internal consistency and test-retest reliability was assessed by the person separation index (PSI) and differential item functioning (DIF) by time effect., Results: It was determined that the questionnaire has 2 factors. None of the items of Factor 1 (F1) and Factor 2 (F2) showed DIF. The reliability of F1 (Cronbach’s alpha = 0.89, PSI = 0.87) and F2 (Cronbach’s alpha = 0.77, PSI = 0.87) was good with Cronbach’s alpha and PSI. There was a good correlation between NBQ/F1 and the Neck Disability Index (NDI) (r = 0.673) and Neck Pain and Disability Scale (NPDS) (r = 0.709). Also, there was a correlation between NBQ/F2 and the Beck Depression Inventory (BDI) (r = 0.552) and Beck Anxiety Inventory (BAI) (r = 0.410)., Conclusion: The Turkish version of the Neck Bournemouth Questionnaire is valid and reliable., Competing Interests: none declared, (This work is licensed under a Creative Commons Attribution 4.0 International License.)

Aim: To develop a Turkish version of the 25-item Cardiff Visual Ability Questionnaire for Children (CVAQC) and to evaluate the validity and reliability of the questionnaire., Methods: The study involved two main phases. The first phase involved a cross-cultural adaptation of the CVAQC from English into Turkish. The second phase involved the completion of the Turkish version of the CVAQC by 150 partially sighted children (6-18 years old) and validity and reliability checks. Extent and construct validity were investigated using Rasch analysis and reliability by internal consistency and person separation index (PSI)., Results: An adequate conceptual equivalence was achieved following the linguistic adaptation process. The dataset for validation comprised 150 participants, 88 (58.7%) of whom were male. Evidence of disordered thresholds was found for one item (item 17). This item was recorded by collapsing two categories and ordered thresholds were evident. All items of the CVAQC were found to fit the Rasch model (χ² (df)=59.90 (2), p=0.159). The internal construct validity was good (mean item fit (SD) -0.054 (1.132), person fit (SD) -0.629 (2.079)) indicating a single underlying construct. The reliability was good with Cronbach's α of 0.91 and PSI of 0.94. Differential item functioning (DIF) was tested for age, sex, diagnosis, degree of visual impairment, and comorbidity. Evidence of DIF was found on age for one item (item 10, reading the board at school)., Conclusions: The Turkish version of the CVAQC is a valid, reliable, and unidimensional questionnaire for partially sighted children aged 6-18 years., Trial Registration Number: Ankara University Ethics Committees registry number 06-177-12., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)

Introduction: The Fagerström Test for Nicotine Dependence (FTND), modified from Fagerström Tolerance Questionnairre (FTQ), is used to determine whether a smoker trying to quit will need nicotine replacement therapy to treat with drawal symptoms. The FTND has been translated into many languages and has been referred to in the smoking literature worldwide. However, only a few studies have examined the psychometric propertiesof the non-English FTND versions. This study aimed to assess the psychometric properties of the Turkish version of the FTND., Materials and Methods: Confirmatory factor analysis (CFA) was used to test the factor structure of the Turkish version of the questionnaire using a large sample from two smoking cessation clinics in Istanbul, Turkey. Our study comprised 502 smokers who entered one of these smoking cessation clinics between October 1 and December 31, 2011. All subjects gave informed consent to the study. We assessed the validity of the FTND using CFA, and we calculated Cronbach's alpha coefficients to determine reliability., Result: One-factor CFA included all of the items on the FTND. All items loaded on this factor with a score of 0.40 or higher. The goodness of fit statistics were adequate, with a Comparative Fit Index (CFI) of 0.922, a Tucker-Lewis Index (TLI) of 0.902, and a root-mean-square error of approximation (RMSEA) of 0.081. Two-factor CFA comprised the three "morning smoking" items, and the three "smoking pattern" items. The factor loadings and the goodness-of-fit statistics confirmed that the FTND has a two-factor structure., Conclusions: Analyses confirmed that the Turkish version of the FTND has a two-factor structure with moderate reliability. This study found that using a total score as an estimate of nicotine dependence may limit the assessment of specific smoking dependency and tailoring intervention approaches. We suggest that a two-factor FTND in clinical practice would more accurately determine the nicotine dependence of patients.

Abdominal wall hernias are a common problem in the general population. A Western estimate reveals that the lifetime risk of developing a hernia is about 2%. As a result, hernia repairs likely comprise the most frequent general surgery operations. More than 20 million hernias are estimated to be repaired every year around the world. Numerous repair techniques have been described to date however tension-free mesh repairs are widely used today because of their low hernia recurrence rates. Nevertheless, there are some ongoing debates regarding the ideal approach (open or laparoscopic), the ideal anesthesia (general, local, or regional), and the ideal mesh (standard polypropylene or newer meshes).

Purpose(s): To evaluate results of neoadjuvant chemotherapy (NACT) following debulking surgery in patients with extensive metastatic disease and/or poor medical performance, Method(s): Advanced stage epithelial ovarian cancer patients were treated with either NACT followed by debulking surgery or primary surgery followed by adjuvant chemotherapy after assessment of the extent of disease by laparoscopy or laparotomy., Results: Out of 297, 223 patients were in the primary surgery group, whereas 74 of them met NACT criteria. Optimal cytoreduction rates were 63.2% in primary surgery group and 60.8% in NACT group, respectively (p: 0.709). In the primary surgery group, the overall survival was significantly higher (p: 0.002). Mean patient age was more advanced (p: 0.014) and the performance status of patients was poorer (p < 0.001) in NACT group. Only patient group (primary surgery or neoadjuvant chemotherapy) (p: 0.001) retained significance as predictors of survival in multivariate analyses., Conclusion(s): Improved rate of optimal cytoreduction with NACT in advanced ovarian cancer patients does not prolong survival. The extent of disease at diagnosis is the primary determinant of survival. Randomizing patients with equally extensive disease and performance status to either NACT or primary debulking surgery in a future study will better clarify benefits attributed to NACT.

Background: An association between the ABO blood group and the risk of certain malignancies, including pancreatic and gastric cancer, has been reported previously. However, it is unclear whether this association is valid for gastrointestinal stromal tumors (GIST). In this study, ABO blood groups and the Rh factor were investigated in a series of GIST cases., Material and Methods: In 162 patients with GIST, blood group and Rh factor were examined and compared with a control group of 3,022,883 healthy volunteer blood donors of the Turkish Red Crescent between 2004 and 2011. The relationship of blood groups with tumor size, mitotic activity, and age were also evaluated., Results: Overall, the ABO blood group and Rh factor distributions of the 162 patients with GIST were similar to those of the general population. There were no significant differences between both ABO blood types and Rh factor in terms of tumor size, mitotic activity, and age., Conclusion: This is the first study reported on this issue. In our study, we didn't find any relationship between GIST and ABO blood group and Rh factor. However further studies with larger number of patients are needed to establish the role of blood groups in this population.

Objectives: The main aim of this study was to investigate the clinical utility and sensitivity to change of faces pain scale (FPS) in patients with shoulder pain, chosen as a chronic pain model. The secondary aim was to determine the association of FPS with psychologic status and quality of life of these patients., Methods: Thirty Turkish patients with chronic shoulder pain were included in the study. Pain intensity was evaluated by visual analog scale (VAS), which is a commonly used pain scale besides FPS. Depression and quality of life were screened by Beck Depression Inventory (BDI) and Short Form-36 (SF-36). All assessments were done before and after the physical therapy., Results: There was a statistically significant decrease in pain severity after the treatment as indicated by FPS and VAS (P=0.000). The standardized response mean (SRM) value of FPS of 2.35 was accepted as a good responsiveness. The FPS showed a strong correlation with VAS (r=0.62 and 0.73) both before and after the treatment. Also, moderate to strong correlations were detected between the FPS and physical functioning (PF), physical role (PR), bodily pain (BP), emotional role (ER), general health (GH), mental health (MH) subscales of SF-36 (r=-0.58-0.80), and BDI scores (r=0.39) before the treatment. However, there were moderate and weak correlations with FPS and PR and social functioning (SF) subscales of SF-36 only after the treatment (r=-0.52 and r=-0.39)., Conclusions: FPS is a satisfactory tool to assess pain in patients with chronic pain conditions and demonstrates sensitivity to detect changes after the treatment., (Wiley Periodicals, Inc.)

Purpose: The aim of this study was to explore the potential of computerised adaptive testing (CAT) for measuring health status in knee osteoarthritis., Method: Three hundred and fifty-one patients with knee osteoarthritis (OA) answered 118 questions from a range of widely used questionnaires. Three dimensions relevant to knee OA were identified by expert opinion as 'pain, mental and emotional status'; 'self-care and household activities' and 'mobility and social activities'. Confirmatory factor analysis (CFA) was used to test the relationship between the items and their dimensions. After CFA, these dimensions were subjected to Rasch analysis to calibrate the items onto an interval scale. A CAT was developed for each dimension, and the results checked against simulated applications from 10,000 simulees., Results: After CFA and Rasch analysis, 14, 22 and 23 items remained in the first, second and third dimensions, respectively. Items were mostly free of differential item functioning for age, gender and duration of disease. Reliability exceeded 0.87 for each dimension. The health status levels generated using item banks and those obtained from the simulated CAT application were highly correlated (i.e. >0.91 for each dimension). On average, 8, 10 and 10 items were used to estimate the health status levels using the CAT for the first, second and third dimensions respectively., Conclusions: Using a combination approach of CFA and Rasch analysis, this study has shown that it is possible to calibrate items onto a single metric in a way that can be used to provide the basis of a CAT application.