Sistematski pregled sa meta-analizom pouzdanosti i valjanosti psihijatrijskih skala u longitudinalnim studijama

Abstract

Uvod: Psihijatrijske skale omogućavaju da se registruje prisustvo ili odsustvo simptoma psihijatrijskih oboljenja, da se njihov intenzitet izrazi brojevima i upotrebi u kliničke ili istraživačke svrhe. Samim tim, važan aspekt skala u psihijatriji jesu njihove metrijske osobine, odnosno njihova merna adekvatnost što obuhvata pouzdanost i valjanost. Pouzdanost označava do koje mere se metoda merenja (test) konzistentno ili postojano ponaša, a valjanost je odnos između onog što se pretpostavlja da bi instrument (test) trebalo da meri i onog što on stvarno meri. Postoje tri standardna načina za ocenu pouzdanosti: interna konzistentnost, međuposmatračka pouzdanost i test-retest pouzdanost. Tri glavna tipa valjanosti su sadržinska, konstruktivna i kriterijumska. Uobičajeno se pouzdanost i valjanost ocenjuje primenom nekog od koeficijenata u studijama preseka, najčešće jedanput. U longitudinalnim studijama eliminiše se varijabilnost koja je posledica interindividualnih razlika pa se povećava verovatnoća za uočavanje značajne razlike nivoa faktora. Ponovljenim ocenama pouzdanosti i valjanosti dobiće se informacije o stabilnosti tih ocena u vremenu, a samim tim i pouzdanost i valjanosti skorova dobijenih primenom skala. Cilj: Ciljevi ovog istraživanja bili su: (1) Uraditi sistematski pregled literature i metaanalitičko objedinjavanje ocena pouzdanosti i valjanosti psihijatrijskih skala saopštenih u različitim vremenima tokom longitudinalnih studija. (2) Proceniti promene ocena pouzdanosti i valjanosti psihijatrijskih skala saopštenih u različitim vremenima tokom longitudinalnih studija. (3) Generisati moderatore / prediktore prethodno navedenih ocena i njihovih promena. Materijal i metode: Postavljeni cilj ovog istraživanja realizovan je u studiji slučaja sistematskog pregleda i meta-analize ocena pouzdanosti i valjanosti Hamiltonove skale za procenu depresivnosti (HAMD) i Montgomeri–Ašbergove skale za procenu depresivnosti (MADRS). Ove dve skale su odabrane jer su najkorišćeniji psihijatrijski instrumenti koji se koriste od strane ocenjivača...

Introduction: Rating scales in psychiatry make it possible to detect the presence or lack of symptoms of the psychiatric disorders, to express the intensity of symptoms in numbers and to use it for clinical or research purposes. Thus, an important aspect of these scales are their metric characteristics, their measurement adequacy what includes reliability and validity. While reliability indicates the extent to which the method of measurement (test) behaves consistently and steadily, the validity is the ratio between what the instrument (test) is supposed to measure and what it really measures. There are three standard ways of evaluating reliability: internal consistency reliability, inter-rater reliability and testretest reliability. Three main types of validity are content validity, construct validity and criterion-related validity. Commonly reliability and validity are evaluated by using one of the coefficients in the cross-sectional studies, usually once. In longitudinal studies, variability which is a consequence of interindividual differences is eliminated and thus the chance of spotting significant difference in factor levels is increased. By repeated assessments of reliability and validity information on score stability over time will be obtained, and consequently the reliability and validity of the scores obtained by used scales. Aims of study: The aims of this study were to: (1) Conduct a systematic review and metaanalysis of the reliability and validity scores of psychiatric scales used in longitudinal studies at different points in time. (2) Evaluate changes in the reliability and validity scores in longitudinal studies at different points in time. (3) Generate moderators/predictors of mentioned scores and their changes. Material and methods: The aim of research was carried out through case study of systematic review and meta-analysis of the reliability and validity of Hamilton Depression Rating Scale (HAMD) and Montgomery-Asberg Depression Rating Scale (MADRS). These two rating scales were chosen because they are the psychiatric instruments most widely used by the assessors...