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Aims/Purpose: The aim of this study was to assess vision-related activity difficulties among patients with neovascular AMD using a Swedish version of the mass of activity inventory (MAI). Methods: Participants were patients diagnosed with neovascular AMD receiving treatment for the disease in a hospital in southeast Sweden. Participants completed the Swedish version of the MAI questionnaire. MAI can be used to measure the overall visual ability and visual ability in 4 functional domains: reading, mobility, visual motor function and visual information processing. Best corrected distance and near visual acuity (VA) were also measured. Results: Among the 196 participants (mean age=78.5 years, SD=7.67, 66% female) the median VA in the better seeing eye was 0.18 logMAR (IQR=?0.34), and in the worse eye was 0.54 logMAR (IQR=0.98). The median visual ability for all participants was 1.92 logits (IQR=2.69). There was a significant negative correlation between distance VA in the better eye and visual ability (rho=0.4025, p<0.01). Using ROC curves, we tested the capacity of the MAI to detect cases of any vision impairment (VA worse than 0.3 logMAR in the better seeing eye), the area under the curve (AUC) was 0.717 (95% CI=0.643 - 0.791 p<0.001). When we tested for detection of moderate vision impairment (VA worse than 0.5 logMAR in the better seeing eye) the AUC was 0.738 (95% CI=0.648 - 0.829 p?<0.001). Conclusions: The results indicate that the Swedish version of the MAI produce measures of visual ability that are consistent with clinical measures among patients with nAMD. The Swedish version of the MAI can be used as outcome measure in interventions for people with nAMD. References 1. Macedo, A.F. et al. Predictors of problems reported on the EQ-5D-3L dimensions among people with impaired vision in northern Portugal. Health Qual Life Outcomes 2022; 20: 132.

Varför? Samhällets behov av kunskap om upplevelser, känslor, beteenden och förmågor ökar. Det är viktigt att veta hur personer och samhället mår eller hur en produkt eller tjänst upplevs samt att kunna jämföra hur detta förändras över tid och mellan olika områden, för att exempelvis fatta beslut om prioriteringar, insatser och effekter. För att mätningar av upplevelser, känslor, beteenden och förmågor ska vara användbara och ge tillförlitliga underlag krävs kvalitetssäkrad mätteknik för s.k. kategoribaserade mätningar. Det är alltså nödvändigt att grundläggande mättekniska principer tillämpas, vilket ofta inte är fallet i dag inom detta område. För de fysikaliska storheterna (längd, massa, tid etc.) finns sedan länge en internationellt etablerad mätkvalitetsinfrastruktur. I Sverige är det huvudsakligen RISE som Nationellt Metrologiskt Institut som genom sina riksmätplatser ansvarar för att säkerställa tillgång till kvalitetssäkrade och spårbara mätningar för samhället. Motsvarande mätkvalitetsinfrastruktur saknas dock för kategoribaserade mätningar. Vad? RISE arbetar sedan flera år för att utveckla metoder och arbetssätt för mätkvalitetssäkring av upplevelser, känslor, beteenden och förmågor. Genom dialoger med aktörer på olika nivåer, bland annat inom hälso- och sjukvården och akademin, som pågått under flera års tid har det framkommit att det finns ett stort behov av stöd för denna utveckling. RISE har därför tagit fram ett första utkast för en möjlig hållbar organisering för mätkvalitetssäkring av kategoribaserade mätningar. Ett nationellt centrum för mätkvalitetssäkring av kategoribaserade mätningar skulle ha i uppdrag att samordna och säkerställa tillförlitliga och jämförbara mätningar av upplevelser, känslor, beteenden och förmågor. Ett sådant infrastrukturellt stöd ska tillgängliggöra metodiker för att möjliggöra mätkvalitetssäkring för kategoribaserade mätningar. Organiseringen ska möta samhällets behov av stöd genom att erbjuda tjänster baserade på internat

Why? Society's need for knowledge about experiences, feelings, behaviours and abilities is increasing. It is important to know how people and society feel or how a product or service is perceived, and to be able to compare how these change over time and between different areas, for example when making decisions about priorities, efforts and effects. In order for measurements of experiences, feelings, behaviours and abilities to be useful and provide reliable data, quality-assured measurement is required for socalled category based measurements1. It is therefore necessary that basic measurement principles are applied, which is often not the case today in this field. For the physical quantities (length, mass, time, etc.) there has long been an internationally established measurement quality infrastructure. In Sweden, it is mainly RISE as the National Metrological Institute which, through its national measurement sites, is responsible for ensuring access to quality-assured and traceable measurements for society. However, the corresponding measurement quality infrastructure is so far missing for category based measurements. What? RISE has been working for several years to develop methodology and working methods for measurement quality assurance of experiences, feelings, behaviours and abilities. Through dialogue over several years with actors at various levels, including in health care and academia, it has emerged that there is a great need for support for this development. RISE has therefore produced a first draft of a possible sustainable organization for measurement quality assurance of category based measurements. A national centre for quality assurance of category based measurements would be tasked with coordinating and ensuring reliable and comparable measurements of experiences, feelings, behaviours and abilities. Such infrastructural support must make methodologies available to enable quality assurance for category based measurements. The organization must meet

Both construct specification equations (CSEs) and entropy can be used to provide a specific, causal, and rigorously mathematical conceptualization of item attributes in order to provide fit-for-purpose measurements of person abilities. This has been previously demonstrated for memory measurements. It can also be reasonably expected to be applicable to other kinds of measures of human abilities and task difficulty in health care, but further exploration is needed about how to incorporate qualitative explanatory variables in the CSE formulation. In this paper we report two case studies exploring the possibilities of advancing CSE and entropy to include human functional balance measurements. In case study I, physiotherapists have formulated a CSE for balance task difficulty by principal component regression of empirical balance task difficulty values from Berg’s Balance Scale transformed using the Rasch model. In case study II, four balance tasks of increasing difficulty due to diminishing bases of support and vision were briefly investigated in relation to entropy as a measure of the amount of information and order as well as physical thermodynamics. The pilot study has explored both methodological and conceptual possibilities and concerns to be considered in further work. The results should not be considered as fully comprehensive or absolute, but rather open up for further discussion and investigations to advance measurements of person balance ability in clinical practice, research, and trials.

The justification for making a measurement can be sought in asking what decisions are based on measurement, such as in assessing the compliance of a quality characteristic of an entity in relation to a specification limit, SL. The relative performance of testing devices and classification algorithms used in assessing compliance is often evaluated using the venerable and ever popular receiver operating characteristic (ROC). However, the ROC tool has potentially all the limitations of classic test theory (CTT) such as the non-linearity, effects of ordinality and confounding task difficulty and instrument ability. These limitations, inherent and often unacknowledged when using the ROC tool, are tackled here for the first time with a modernised approach combining measurement system analysis (MSA) and item response theory (IRT), using data from pregnancy testing as an example. The new method of assessing device ability from separate Rasch IRT regressions for each axis of ROC curves is found to perform significantly better, with correlation coefficients with traditional area-under-curve metrics of at least 0.92 which exceeds that of linearised ROC plots, such as Linacre’s, and is recommended to replace other approaches for device assessment. The resulting improved measurement quality of each ROC curve achieved with this original approach should enable more reliable decision-making in conformity assessment in many scenarios, including machine learning, where its use as a metric for assessing classification algorithms has become almost indispensable.

There are different views in the literature about the number and inter-relationships of cognitive domains (such as memory and executive function) and a lack of understanding of the cognitive processes underlying these domains. In previous publications, we demonstrated a methodology for formulating and testing cognitive constructs for visuo-spatial and verbal recall tasks, particularly for working memory task difficulty where entropy is found to play a major role. In the present paper, we applied those insights to a new set of such memory tasks, namely, backward recalling block tapping and digit sequences. Once again, we saw clear and strong entropy-based construct specification equations (CSEs) for task difficulty. In fact, the entropy contributions in the CSEs for the different tasks were of similar magnitudes (within the measurement uncertainties), which may indicate a shared factor in what is being measured with both forward and backward sequences, as well as visuo-spatial and verbal memory recalling tasks more generally. On the other hand, the analyses of dimensionality and the larger measurement uncertainties in the CSEs for the backward sequences suggest that caution is needed when attempting to unify a single unidimensional construct based on forward and backward sequences with visuo-spatial and verbal memory tasks.

Background: eHealth interventions have the potential to increase the efficiency and effectiveness of health care. However, research has shown that implementing eHealth in routine health care practice is difficult. Organizational readiness to change has been shown to be central to successful implementation. This paper describes the development and formative evaluation of a generic self-help tool, E-Ready, designed to be used by managers, project leaders, or others responsible for implementation in a broad range of health care settings. Objective: The aim of this study is to develop and evaluate a tool that could facilitate eHealth implementation in, for example, health care. Methods: A first version of the tool was generated based on implementation theory (E-Ready 1.0). A formative evaluation was undertaken through expert panels (n=15), cognitive interviews (n=17), and assessment of measurement properties on E-Ready items from 3 different workplaces (n=165) using Rasch analyses. E-Ready 1.0 was also field tested among the target population (n=29). Iterative revisions were conducted during the formative evaluation process, and E-Ready 2.0 was generated. Results: The E-Ready Tool consists of a readiness assessment survey and a hands-on manual. The survey measures perceived readiness for change (willingness and capability) at individual and collective levels: perceived conditions for change at the workplace, perceived individual conditions for change, perceived support and engagement among management, perceived readiness among colleagues, perceived consequences on status quo, and perceived workplace attitudes. The manual contains a brief introduction, instructions on how to use the tool, information on the themes of E-Ready, instructions on how to create an implementation plan, brief advice for success, and tips for further reading on implementation theory. Rasch analyses showed overall acceptable measurement properties in terms of fit validity. The subscale Individual, Funding Agencies|Swelife, a strategic innovation program - Swedish government through the Swedish innovation agency, Vinnova

The aim of this study was to investigate the prevalence of dryeye symptoms in the Swedish population using a web-basedversion of the ocular surface disease index (OSDI).Aweb-basedversionoftheOSDIquestionswasimplementedin an online form using a software developed by Artologik. Thelink to the form was distributed via Linnaeus University socialmedia pages. Basic demographic information such as age, sexand county of residence was also collected.A total of 404 complete responses were received, 303 respon-dents (75%) were females, the median age = 39 (interquartilerange = 28–53) years, median OSDI-score = 19 (interquartilerange = 9–32). Crude prevalence of dry eye symptoms (cate-gories mild to severe) was 65% (95% CI = 62–75). The differencein prevalence between males and females was statistically sig-nificant (chi-square test,p=0.007).The current study found that the prevalence of dry eye symp-toms among a sample of the Swedish population was 65%.These results highlight the need to investigate further the preva-lence and risk factors for dry eye disease in the Swedish population., [NO] Symptomer på tørre øyne ved bruk avOcular Surface Disease Index i Sverige: enkort rapport fra en pilotstudieSammendragFormålet med studien var å undersøke prevalens av symptomerpå tørre øyne i den svenske befolkning ved hjelp av en net-tbasert versjon av ocular surface disease index (OSDI).OSDI spørsmålene ble satt inn i et skjema på internett vedhjelp av programvare utviklet av Artologik. Lenken til skjemaetble sent ut via Linnéuniversitetets sosiale media. Bakgrunnsin-formasjon som alder, kjønn og hjemstedsfylke ble også registr-ert.Totalt ble 404 fullstendige svar mottatt, 303 (75%) respon-denter var kvinnelige, median alder = 39 (interkvartilområde= 28–53) år, median OSDI-score = 19 (interkvartilområde = 9–32). Prevalens av symptomer på tørre øyne (kategorier milde tilalvorlige) var 65% (95% CI = 62–75). Forskjellen i prevalens mel-lom kvinner og menn var signifikant (khikvadrattest,p= 0.007).Denne studien fant at prevalensen av symptomer på tørreøyne blant et utvalg av Sveriges befolkning var 65%. Disse re-sultatene belyser behovet for videre undersøkelse av prevalensog risikofaktorer for tørre øyne i den svenske befolkning., Sintomatologia da occhio secco utilizzandol’Ocular Surface Disease Index in Svezia:un breve report da uno studio pilotaRiassuntoLo scopo di questo studio e’ stato quello di investigare laprevalenze della sintomatologia da occhio secco nella popo-lazione svedese utilizzando una versione online dell’ocular sur-face disease index (OSDI).E’ stata utilizzata una versione online dell’OSDI in un for-mato implementato nel software “Survey and report” svilup-pato da Artologik. L’indirizzo online e’ stato distribuito graziealle pagine di social media dell’Universita’ Linnaeus. Anche leinformazioni sulla demografia di base come eta’, sesso e regionedi residenza sono stato raccolte.Un totale di 404 risposte complete sono state ricevute, 303dei rispondenti (75%) erano femmine, con un’eta’ media = 39(rango interquartile = 28–53) anni, un punteggio OSDI medio =19 (rango interquartile = 9–32). La prevalenza cruda di sintomida occhio secco (categoria tra moderato e severo) e’ stata del65% (95% CI = 62–75). La differenza in prevalenza tra maschie femmine e’ stata statisticamente significativa (chi-square test,p= 0.007).Il presente studio riporta che la frequenza di sintomi da oc-chio secco nel campione scelto di popolazione svedese e’ statodel 65%. I risultati sottolineano la necessita’ di investigare laprevalenza e i fattori di rischio dell’occhio secco nella popolazione svedese.

OBJECTIVE: One crucial prerequisite for increased patient empowerment is the willingness among patients to take a more active role. The aim of this study was to develop questionnaires for measuring a patient's willingness to be empowered in general and by using e-health. METHODS: The study was based on a random sample from an online panel. The 800 responders were Swedish citizens and reflected the internet-using population in Sweden regarding age, gender, income, and education. The measurement properties were evaluated according to the Rasch Measurement Theory. RESULTS: The analyses showed two questionnaires with adequate fit to the basic measurement model and with high reliability (PSI 0.84 and 0.89, respectively). CONCLUSION: We conclude that this study generated two questionnaires with an intuitive order of items illustrating an understandable progression of willingness to be empowered in general as well as for e-health. PRACTICE IMPLICATIONS: The suggested questionnaires are valuable tools supporting the effort to tailor empowerment strategies to meet the patient's willingness. Questionnaires will also be valuable for evaluating strategies for supporting willingness, studying factors related to willingness and potential inequalities due to e.g. varying digital literacy, and for enabling identification of patient stereotypes using cluster analyses., We are deeply grateful to the research environment “Learning inand for the new working life,” University West, Sweden and theresearch institute RISE Knowledge Platform “Centre for CategoricallyBased Measures” for sponsoring the costs for using the online paneland services offered by Kantar-Sifo. The study was financed bygrants from the Swedish government under the agreement betweenthe Swedish government and the county councils, the ALF agreement ALFGBG-716581.

I en tidigare SHIC-rapport presenterades hur kvalitetssäkrade mätningar för sociala och hälsomässiga värden kan utvecklasoch bör hanteras. Denna rapport visar hur mätkvalitet påverkar möjligheter att tolka resultat av mätningar och vilka kravsom bör ställs på mätverktyg i form av enkäter.Med hjälp av kvalitetssäkrade mätningar kan vi på ett tillförlitligt sätt mäta och jämföra nyttan av insatser, tjänster ochprodukter, även gällande mjuka sociala och hälsomässiga värden – som upplevelser, förmågor och egenskaper. Sådanamätningar kan utgöra centrala underlag för beslutsfattande kopplat till ekonomiska, sociala och hälsomässiga utfall, ochmedför alltid vissa mätosäkerheter som behöver beaktas.För att kunna bedöma kvaliteten på mätverktyg och mätdata behöver vi efterfråga och förstå några nyckelbegrepp utifrånmättekniska analyser. Som praktisk och verklighetsnära förankring kommer vi att använda ett exempel relaterat tillpsykosocial arbetsmiljö; med andra ord de psykologiska och sociala aspekterna av arbetsmiljön, exempelvis upplevelserav hur samarbetet med kollegor fungerar. Exemplet utgår från ett tänkt samband mellan psykosocial arbetsmiljö,medarbetarengagemang och sjukfrånvaro.

We propose in this report decisive and constructive responses to critical appraisals of the Agenda 2030, the Sustainable Development Goals, and the EU taxonomy. The lack of transparency and accountability plaguing these vitally important efforts can be rectified by means of systematic implementations of the art and science of measurement modelling informed by metrological principles. The aforementioned documents’ vague and all-inclusive language fails to assign responsibilities or aid in goal achievement, but can be replaced with systems of measurements that are effectively and efficiently, meaningfully and usefully, integrated with management objectives. When measurements are welldesigned, managing goals and objectives becomes seamlessly integrated with measurement. Measuring instruments should map the domain of interest, allowing users to locate where they are relative to where they were, where they want to go, and what to do next. But for this to happen, the intention to measure in this way must be acted on. Then, incomparable ordinal ratings and scores must be replaced with qualityassured quantity values. And disconnected reporting systems must be coordinated and aligned. Most importantly, taking the trouble to create fluidly manageable measures makes it possible to identify and harness human-powered energy sources for driving sustainable change, for ramping up efforts to the global scale that must be achieved if we are to succeed in transforming our systems. Entrepreneurs and innovators need scientifically rigorous, meaningful, useful, and convenient tools if they are to succeed in imagining, designing, and deploying effective responses to the pressing challenges we face. Our recommendations are formulated in direct response to criticisms that have been directed at the Agenda 2030 and the EU Taxonomy concerning the transparency, comparability, and accountability of the proposed goals for sustainable development. Neither the goals themselves nor the urgency of t

Objective: To evaluate the Patient Participation in Rehabilitation Questionnaire (PPRQ) according to Rasch measurement theory. Method: Five hundred twenty-two post-discharge patients from a neurological rehabilitation unit were included. The PPRQ questionnaire comprises 20 items rated by a cohort of 522 patients about their experiences of participating in rehabilitation. The measurement properties of the PPRQ were evaluated by Rasch analysis of the responses. Results: The Rasch analysis of 20 items showed some major misfits, particularly three items addressing the involvement of family members. After removing those items, the model fit improved and no significant DIF remained. Despite improvements, person values (−2.96 to 4.86 logits) were not fully matched by the item values (−0.61 to 0.77 logits). Neither did the t test for unidimensionality meet the criterion of 5%, and local dependency was present. The unidimensionality and local dependency could, however, be accommodated for by four testlets. Conclusion: The PPRQ-17 showed that a ruler with a reasonable and clinical hierarchy can be constructed, although the expectations of dimensionality and local dependency need to be evaluated further. Despite room for further development, PPRQ-17 nevertheless shows improved measurement precision in terms of patient leniency compared with previous evaluations with classical test theory. In turn, this can play a crucial role when comparing different rehabilitation programs and planning tailored care development activities.

PURPOSE: To evaluate the psychometric properties of the Patient Participation in Rehabilitation Questionnaire (PPRQ) in neurological rehabilitation using statistical methods taking the ordinal nature of data into account. METHODS: A cross-sectional postal questionnaire study was conducted. In total, 522 patients from a neurological rehabilitation unit completed the 32-item version of the PPRQ. The PPRQ comprises five scales and assesses patients' experiences of participation in their rehabilitation. A confirmatory factor analysis was conducted to evaluate the factor structure according to the hypothetical five-scale model. Internal consistency reliability was evaluated by ordinal α, and test-retest reliability was evaluated by weighted kappa statistics and intraclass correlations (ICC). RESULTS: After omitting 12 items, a 20-item version with the five hypothetical scales showed acceptable fit for the PPRQ (RMSEA = 0.067, CFI = 0.983, TLI = 0.979). For each scale, both internal consistency and test-retest reliability were good to excellent (ordinal α = 0.88-0.93, ICC = 0.83-0.90). CONCLUSIONS: The revised version of the PPRQ shows sound psychometric properties and is a potential questionnaire for the evaluation of patients' experiences of participation in neurological rehabilitation. The PPRQ can provide insight into central aspects that are crucial for the patients' participation, namely Respect and integrity, Planning and decision-making, Information and knowledge, Motivation and encouragement, and Involvement of family. Implications for Rehabilitation Patient participation in rehabilitation is a multidimensional concept that can be assessed by the revised Patient Participation in Rehabilitation Questionnaire (PPRQ). The revised PPRQ shows sound psychometric properties for persons undergone neurological rehabilitation. The revised PPRQ still covers five central aspects of patient participation: Respect and integrity, Planning and decision-making, Information and kn

Women with pre-gestational diabetes face additional challenges after birth as they struggle with breastfeeding and managing unpredictable blood glucose levels. The aim of this study is to validate the Diabetes and Breastfeeding Management Questionnaire (DBM-Q). In total, 142 mothers with type 1 diabetes mellitus answered the questionnaire, which initially consisted of 11 items. The response rate was 82.5% (n = 128) at two months, and 88.4% (n = 137) at six months postpartum. The measurement properties of the Diabetes and Breastfeeding Management Questionnaire were tested according to the Rasch measurement theory (RMT). One item showed both disordered thresholds and several model misfits and was removed. Two items showed disordered thresholds which were resolved by collapsing response categories. This resulted in a 10-item questionnaire with all the fit residuals within the range of +2.5, minor significant dierential item functioning, well-targeted items and a person separation index of 0.73. Evaluating the DBM-Q according to the RMT is a strength, as it evaluates data against strict measurement criteria. This study provides an initial validation of the questionnaire. The DBM-Q shows good measurement properties for measuring diabetes and breastfeeding management postpartum in women with pre-gestational diabetes. Further studies are needed to identify cutos for when professional support is needed., Funding Agencies:Centre for Person-Centered Care at the University of GothenburgHealth and Medical Care Committee of the Regional Executive BoardRegion Västra GötalandInstitute of Health and Care Sciences, together with the Sahlgrenska Academy at the University of Gothenburg, MODAIB-Web