Table 1. Clinimetric definitions for a lower limb neurological impairment test.
|
Domain |
Measurement property | Definition |
|---|---|---|
| Reliability | The extent to which repeated scores for a neurological test in a stable child are the same (consistent) [8,10] measuring the proportion of variability that is due to “true”a differences and “free” from measurement error. [8] | |
| Test-retestb | Degree to which an individual achieves the same result on a repeated test(s) without involvement from a health practitioner. [16] | |
| Inter-rater | Degree to which different health practitioners achieve the same result on the same occasion of testing [8] | |
| Intra-rater | Degree to which the same health practitioner achieves the same result on different occasions of testing in a stable child [8] | |
| Validity | Degree in which a neurological test measures what it intends to measure [8] | |
| Face validity | Degree in which the neurological test appears to reflect the items required to measure the intended construct [8] | |
| Content validity | Degree to which the domain, muscle strength, tactile sensitivity or deep tendon reflexes, is comprehensively sampled by the items within the test. | |
| Internal consistency | Degree to which items are correlated, thus measuring the same construct. [7] | |
| Construct validity | Degree in which scores from one test relate to another in a manner that is consistent with a theoretically derived hypothesis. [7,8] | |
| Criterion validityc | Degree in which scores of a neurological test relate to a gold standard, if one exists. [7,8] | |
| Responsiveness | Ability to of a neurological test to detect change over time in the construct being measured, also described in literature as “sensitivity to change” [8] | |
| Clinical Utility | Multi-dimensional concept for use of a test in clinical practice [14] | |
| Appropriate | Evidence of test effectiveness for clinical decision-making or relevance within the clinical setting with minimal impact on existing management of child. [14] | |
| Accessible | Low cost resources for the neurological test, (e.g. equipment) [14]. Neurological test easily procured, including availability and supply of the test, and the quality of test materials. [14] | |
| Practicable | Complete and working administration and scoring instructions, practicable, including suitability for children under 18 years of age and for use in the clinical practice. [14] And whether any training or prior knowledge is required for the tester. | |
| Acceptable | Acceptability of the test to clinicians, children and families (utility vs burden), including ethical and psychological factors [14] |
a Mokkink et al. 2010 [8] explains that “the word ‘true’ must be seen in the context of the classical test theory, which states that any observation is composed of two components–a true score and error associated with the observation. ‘True’ is the average score that would be obtained if the scale were given an infinite number of times. It refers only to the consistency of the score and not to its accuracy”
b Test-retest reliability is reserved for tests repeated on two or more occasions without a direct physical measure by a health practitioner. e.g. A questionnaire.
c Criterion validity is the highest level of validity, however there is no gold standard for a neurological impairment test