Spinal Cord Injury – Quality of Life Anxiety

Link to instrument: CATs and short forms available at http://ift.tt/1hR3vma (request access through SCI-QOL@udel.edu). Item bank and short form PDFs available through SCI-QOL@udel.edu.

Acronym:

SCI-QOL Anxiety

Purpose:

The SCI-QOL Anxiety instrument is used to assess symptoms of anxiety in individuals with spinal cord injury (SCI).

Description:

The SCI-QOL Anxiety measure is an item response theory (IRT)-calibrated item bank with 25 items that is available for administration as a computer adaptive test (CAT; range 4-12 items) or short form (SF). Many items are shared with the PROMIS (15 of 25 items) and Neuro-QOL (20 of 25 items) Anxiety item banks.

Area of Assessment: Mental Health, Negative Affect, Quality of Life, Stress and Coping

Body Part: Not Applicable

ICF Domain: Body Function

Domain: Emotion

Assessment Type: Patient Reported Outcomes

Length of Test: 05 Minutes or Less

Time to Administer:

<5 Minutes

Number of Items: There are 25 items in the entire item bank. The short form has 9 items. The CAT can present 4-12 items, depending on the user's time vs. accuracy preferences.

Equipment Required:

The Short Form requires only the printed form and a pencil. A CAT administration requires a desktop, laptop, or tablet computer with internet connection and login to AssessmentCenter.net.

 

Access to the short form, and administration of CATs through Assessment Center, is available through SCI-QOL@udel.edu.

Training Required: Yes. SCI-QOL Anxiety article (Kisala et al. 2015) and, if administering CATs, the Assessment Center User Manual.

Type of training required: Reading an Article/Manual

Cost: Free

Actual Cost:

Free

Age Range: Adult: 18-64 years, Elderly adult: 65+

Administration Mode: Computer

Diagnosis: Spinal Cord Injury

Populations Tested:

Spinal Cord Injury

Standard Error of Measurement (SEM):

Depends on the mode of administration:

• Full Item Bank: Mean SEM= 0.22
• 9-Item Fixed-length CAT: Mean SEM= 0.29
• Variable-length CAT (Min 4): Mean SEM= 0.32
• Variable-length CAT (Min 8): Mean SEM= 0.29
• 9-Item Short Form: Mean SEM= 0.33

Minimal Detectable Change (MDC):

Calculated from SEM:

• Full Item Bank: MDC= 0.51
• 9-Item Fixed-length CAT: MDC= 0.63.
• Variable-length CAT: MDC= 0.67

Minimally Clinically Important Difference (MCID):

Not Established

Cut-Off Scores:

Kisala et al. (2015) created a "cross-walk" table to transform SCI-QOL Anxiety scores to scores on the GAD-7, a gold standard measure of anxiety with well-established cut scores.

The SCI-QOL Anxiety scores below are the equivalent of GAD-7 cutoff scores:

• Mild Anxiety: T-score of 49-55
• Moderate Anxiety: T-score of 56-61
• Severe Anxiety: T-Score of 62+

Normative Data:

General population (2000 U.S. Census). The normative data reference the calibration sample from PROMIS, which matches the demographics of the 2000 U.S. Census.

Test-retest Reliability:

Traumatic SCI (Kisala et al., 2015)

Full Item Bank:

• Excellent: (Pearson's r= 0.80)
• Excellent: (ICC = .80)

Interrater/Intrarater Reliability:

Not Applicable

Internal Consistency:

Traumatic SCI (Kisala et al., 2015)

• Full Item Bank - Excellent: (Cronbach's alpha= .95)
• 9-Item Fixed CAT - Excellent: (Cronbach's alpha= .92)
• Variable-length CAT (Min 4) - Excellent: (Cronbach's alpha= .91)
• Variable-length CAT (Min 8) - Excellent: (Cronbach's alpha= .92)
• 9-Item Short Form - Excellent: (Cronbach's alpha= .90)

Criterion Validity (Predictive/Concurrent):

 Traumatic SCI (Kisala et al., 2015)

• Excellent: Predicting GAD-7 scores (r= .67)

Construct Validity (Convergent/Discriminant):

Traumatic SCI (Tulsky et al., in preparation)

The SCI-QOL Anxiety item bank demonstrated good convergent validity by correlating strongly with measures of:

• Depression (PHQ-9 r= .61)
• Life Satisfaction (Satisfaction with Life Scale r= -.53),
• Resilience (SCI-QOL Resilience r= -.68),
• Positive affect (SCI-QOL Positive Affect r= -.59).

The SCI-QOL Anxiety item bank demonstrated good discriminant validity by not correlating with measures of:

• Fine motor functioning (SCI-QOL Fine Motor r= -.046),

Content Validity:

Some SCI-QOL items were derived from the focus groups and cognitive interviews that founded the PROMIS and/or Neuro-QOL measurement systems. The Neuro-QOL focus groups comprised patients with neurological illness (n= 64) and caregivers (n= 19).

Other SCI-QOL items were derived from focus groups and interviews with individuals with traumatic SCI (n=65) and clinicians who specialize in SCI (n=42).

Face Validity:

Not statistically assessed, but content was generated from individuals with SCI and expert clinicians, so face validity is  believed to be strong.

Floor/Ceiling Effects:

Traumatic SCI (Kisala et al., 2015)

 

Full Item Bank:

• Floor Effects: Adequate to Excellent (2.8%)
• Ceiling Effects: Excellent (0.1%)

9-Item Fixed-length CAT:

• Floor Effects: Adequate to Excellent (7.5%)
• Ceiling Effects: Excellent (0.1%)

Variable-length CAT (Min 4):

• Floor Effects: Adequate to Excellent (6.8%)
• Ceiling Effects: Excellent (0.1%)

Variable Length CAT (Min 8):

• Floor Effects: Adequate to Excellent (6.8%)
• Ceiling Effects: Excellent (0.1%)

9-Item Short Form:

• Floor Effects: Adequate to Excellent (6.4%)
• Ceiling Effects: Excellent (0.1%)

Responsiveness:

Not Established

Considerations:

None

Bibliography:

Kisala et al. (2015). Measuring anxiety after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Anxiety item bank and linkage with GAD-7. Journal of Spinal Cord Medicine, 38(3), 315-325.

Year published: 2015

Instrument in PDF Format: Yes

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