Spinal Cord Injury – Quality of Life Depression

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 Depression

Purpose:

The SCI-QOL Depression instrument assess symptoms of depression in individuals with spinal cord injury.

Description:

The SCI-QOL Depression measure is an item response theory (IRT)-calibrated item bank with 28 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 (18 of 28 items) and Neuro-QOL (23 of 28 items) Depression item banks.

Area of Assessment: Depression, Mental Health, Quality of Life

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 28 items in the entire item bank. The short form has 10 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 Depression article (Tulsky 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= 2.1
• 8-Item Fixed-Length CAT: Mean SEM= 2.7
• Variable-length CAT (Min 4): Mean SEM= 3.0
• Variable-length CAT (Min 8): Mean SEM= 3.1
• 4-Item Fixed-length CAT: Mean SEM= 3.4

Minimal Detectable Change (MDC):

Calculated from SEM

• Full Item Bank: MDC= 4.9
• 8-Item Fixed-Length CAT: MDC= 6.3
• Variable-length : MDC= 7.2

Minimally Clinically Important Difference (MCID):

Not Established

Cut-Off Scores:

Holdnack et al. (in preparation) created a "cross-walk" table to transform SCI-QOL Depression scores to scores on the PHQ-9, a gold standard measure of depression with well-established cut scores. The SCI-QOL Depression scores below are the equivalent of PHQ-9 cutoff scores.

• Mild Depression: T-score from 52-58
• Moderate Depression: T-score from 60-64
• Moderate-severe Depression: T-score from 65-67
• Severe Depression: T-score 68+

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.

 

(n=716, mean age = 43.0(15.3); time post injury = 7.1 years (10.0); 45% paraplegia, 54% tetraplegia).

Test-retest Reliability:

 Traumatic SCI (Tulsky et al., 2015)

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

Interrater/Intrarater Reliability:

Not Applicable

Internal Consistency:

Traumatic SCI (Tulsky et al., 2015)

• Excellent: (Cronbach's alpha= .96)

Criterion Validity (Predictive/Concurrent):

Traumatic SCI (Tulsky et al., 2015)

• Excellent concurrent validity predicating the PHQ-9 (r= .76)

Construct Validity (Convergent/Discriminant):

Traumatic SCI (Tulsky et al., in preparation)

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

• Anxiety (GAD-7 r= .59)
• Life Satisfaction: (Satisfaction with Life Scale r= -.62)
• Resilience (SCI-QOL Resilience r = -.73)
• Positive affect (SCI-QOL Positive Affect r= -.68).

The SCI-QOL Depression item bank demonstrated good discriminant validity by weakly correlating with measures of:

• Fine motor functioning (SCI-QOL Fine Motor r= -.16)

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 (Tulsky et al., 2015)

 

Full Item Bank:

• Floor Effect: Excellent (0.1%)
• Ceiling Effect: Adequate to Excellent (3.1%)

8-Item Fixed-length CAT:

• Floor Effect: Adequate to Excellent (4.7%)
• Ceiling Effect: Excellent (0.1%)

Variable-length CAT (Max 12):

• Floor Effect: Adequate to Excellent (3.5%)
• Ceiling Effect: Excellent (0.1%)

Variable-length CAT (Max 8):

• Floor Effect: Adequate to Excellent (4.7%)
• Ceiling Effect: Excellent (0.1%)

4-Item Fixed-length CAT:

• Floor Effect: Adequate to Excellent (7.4%)
• Ceiling Effect: Excellent (0.1%)

Responsiveness:

Not Established

Considerations:

None

Bibliography:

Tulsky et al. (2015). Measuring depression after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Depression item bank and linkage with PHQ-9. Journal of Spinal Cord Medicine, 38(3), 335-346.

Year published: 2015

Instrument in PDF Format: Yes

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