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This chapter addresses diagnostic studies, which evaluate the performance of clinical tests and tools used to detect disease. The concepts of sensitivity, specificity, positive predictive value, and negative predictive value are explained in detail, highlighting how these metrics guide clinicians in interpreting test results. The role of prevalence in influencing predictive values is emphasised, underlining the need to consider population context when applying diagnostic tools. Receiver operating characteristic (ROC) curves are introduced as a method to assess test performance across varying thresholds, enabling identification of optimal cut-off points. The chapter also explores likelihood ratios, which integrate sensitivity and specificity into a single measure to support diagnostic decision-making. Strengths of diagnostic studies include their direct clinical relevance and utility in evaluating new technologies or biomarkers. Limitations include potential spectrum bias, verification bias, and challenges in defining an appropriate gold standard. Examples from infectious disease testing and mental health screening illustrate the practical implications of study design and interpretation. The chapter concludes by positioning diagnostic research as critical for improving clinical decision-making, resource allocation, and patient outcomes. This chapter maps to syllabus sections 3.2.5–3.2.8, which cover diagnostic accuracy measures including sensitivity, specificity, predictive values, likelihood ratios, and ROC curves.
This chapter provides a critical overview of how L2 researchers have used measures of lexical and phraseological complexity, with a special focus on their definition and operationalization. Lexical and phraseological complexity are often measured in terms of diversity (the number of different words or multi-word units respectively) and sophistication (the number of ‘sophisticated’ words or multi-word units, with ‘sophisticated’ variously understood as less frequent, more specialized, or in the case of phraseological sophistication, as more strongly associated word combinations). With the development of natural language processing (NLP) tools such as the Lexical Complexity Analyzer (Lu, 2012) or the Tool for the Automatic Analysis of Lexical Sophistication (Kyle et al., 2018), L2 researchers can now analyze lexical complexity in L2 English texts using dozens or even hundreds of measures with a click of a button. However, unresolved questions remain: How accurate, reliable, and valid are these measures across learner samples and research contexts? Can they assess L2 proficiency across registers? How should measures be selected from the many available? By contrast, do the current, limited set of measures of phraseological complexity represent the full construct, or is there a need to develop for further development?
Capability is the informational focus of the theory of justice developed by Sen. This means that, according to this theory, people’s relative advantages and disadvantages should be assessed in terms of their capability. I present and discuss some of the investigational requirements that this entails. A key challenge here is that a capability relates not only to what people actually end up being and doing that is of value to them (achieved functionings) but also to what they are in fact able to do, irrespective of whether they choose to realise such an opportunity. This seems to produce a paradox in Sen’s writings – capability assessment being quite complex on the one hand but surprisingly simple on the other. Drawing on what Sen has to say on the relationship between capability and human rights, I offer a possible explanation for the apparent paradox. Two case studies are given, showing some methods that may be used to assess capability and how the validity and relevance of the resulting evidence can be assessed. I conclude by suggesting that Sen’s capability approach can be considered a realist and non-ideal theory of justice and that specific approaches to capability assessment should be in line with this.
This chapter builds on two papers published in 2016 that were the first to define and operationalise sustainable employability (SE) in a questionnaire (the CSWQ) in terms of the Capability Approach (CA), published by a consortium of the authors of this chapter. In this chapter, we first briefly summarise the research reported in these papers and then present research that has been conducted since then. We update and further develop the relationship between SE and the CA. In reporting follow-up research since 2016, we first present the results of a Delphi survey among experts and discuss some constructive critical remarks that have been published in the scientific literature. We discuss the conceptual and empirical steps taken since 2016. We distinguish between studies with a focus on 1) methodological aspects, both conceptual and measurement properties of the capability instrument, 2) specific target groups and 3) specific contexts and situations. The chapter concludes with a discussion and suggestions for future research in this area. In addition, two appendices have been added with the CSWQ (Appendix 2.1) and a conversation guide for the practical application of the CSWQ in the consultation room (Appendix 2.2).
This chapter offers readers a transparent view into the research methodology used to investigate mathematics anxiety and assess the impact of a targeted pedagogical intervention on students’ reported anxiety and attitudes towards statistics and quantitative research methods. It provides a detailed account of the research participants, ethical considerations, and the multi-mixed methods approach employed. The chapter also critiques the validity, reliability, and trustworthiness of the research design and findings, ensuring methodological rigour. A candid discussion of the study’s limitations further strengthens its credibility. It is an essential reading for educators, researchers, and anyone committed to evidence-based improvements in mathematics education.
This study aimed to develop an amino acid composition table for Japanese foods and evaluate the relative validity of the Meal-based Diet History Questionnaire (MDHQ) in estimating total and meal-specific amino acid intake, using a 4-d weighed dietary record (DR) as the reference. A total of 111 Japanese women and 111 Japanese men completed both online and paper MDHQ, along with a 4-d non-consecutive DR. The amino acid composition table was constructed based on the Standard Tables of Food Composition in Japan 2020. Median amino acid intakes estimated by the online MDHQ were generally lower than those from the DR across all calculation methods (crude, residual, density and %protein) in both sexes, with significant differences observed for most of the eighteen amino acids. Median Spearman’s correlation coefficients between the online MDHQ and DR for total amino acid intake were 0·43–0·44 in women and 0·31–0·37 in men. Concordance correlation coefficients (CCC) were lower than the corresponding Spearman coefficients, and Bland–Altman analyses showed wide limits of agreement with proportional bias. Similar findings were observed for the paper MDHQ. In conclusion, the MDHQ showed limited relative validity for ranking total and individual amino acid intakes at main meals, with weaker performance for snacks and limited ability to estimate absolute individual intakes. Despite these limitations, the MDHQ provides a novel approach for examining meal-specific dietary patterns and may offer useful insights in epidemiological studies when its limitations are appropriately considered.
Defined by DSM-5-TR as a neurodevelopmental disorder, attention-deficit/hyperactivity disorder (ADHD) has attracted ever-mounting attention from the public, coupled with a growing interest from clinicians, researchers, and patients. This is reflected in significantly higher demand for clinical assessments and frequent media reports of a surge in ADHD cases across the lifespan. These trends are puzzling as it is unknown what they truly reflect: an improvement in clinical detection or a concerning degree of overdiagnosis? A key reason for this uncertainty is our limited understanding of the disorder and imprecision of the diagnosis – a long-running subject of criticism. To better understand these issues, in this article, we deconstruct ADHD through the lens of its DSM-5-TR diagnostic criteria – the basis upon which the diagnosis is routinely made. Our in-depth analysis reveals major problems associated with the diagnostic criteria with respect to their arbitrariness, vagueness, redundancy, and context-dependent normality, which together substantially undermine the validity and reliability of the diagnosis, and the ADHD construct itself, blunting the precision of ADHD research, clinical decisions, and the effectiveness of treatment – all of which are contingent on having a robust diagnosis in the first place. Hence, our detailed deconstruction of the diagnosis of ADHD is critical as it provides the necessary groundwork for its accurate reconstruction – an essential step towards developing a valid, reliable, and clinically meaningful diagnostic foundation that will inform research and improve clinical care for patients with attentional and hyperactivity–impulsivity problems.
This study aimed to adapt the Chronic Conditions Physician–Patient Relationship Scale (CC-PPR) into Turkish and to examine its validity and reliability among patients with chronic diseases receiving care from family physicians.
Methods:
A methodological study was conducted with 254 adult patients attending the Family Medicine Centers between May 01-October 01, 2025. The adaptation process followed World Health Organization guidelines. Construct validity was examined using confirmatory factor analysis (CFA), and reliability was assessed through internal consistency (Cronbach’s α, McDonald’s ω) and item–total correlations.
Results:
The CFA supported the original one-factor, 22-item structure with an excellent model fit (χ2[209] = 59.847, p = 1.000; comparative fit index [CFI] = 1.000; Tucker–Lewis index [TLI] = 1.016; root mean square error of approximation [RMSEA] = 0.000; standardized root mean square residual [SRMR] = 0.048). Sampling adequacy was good (Kaiser–Meyer–Olkin [KMO] = 0.970; Bartlett’s χ2[231] = 5934.429, p < 0.001). All standardized factor loadings were high (0.63–0.81, p < 0.001). Internal consistency was excellent (Cronbach’s α = 0.977; McDonald’s ω = 0.976), and corrected item–total correlations ranged from 0.74 to 0.86. Marital status, employment status, and type of health institution were significantly associated with relationship scores (p < 0.05).
Conclusion:
The Turkish version of the CC-PPR is a psychometrically robust, unidimensional, and reliable tool for evaluating the quality of family physician–patient relationships among individuals with chronic conditions. It can be used to assess communication and relational competencies of family physicians, support patient-centred care initiatives in chronic disease management.
Edited by
Daniel Naurin, University of Oslo,Urška Šadl, European University Institute, Florence,Jan Zglinski, London School of Economics and Political Science
The chapter discusses the creation and maintenance of databases offering accurate, research-ready data for multidisciplinary use. It draws on the experience with the IUROPA CJEU Database Project (IUROPA), which has collected data about the decision-makers and the decisions of the Court of Justice of the European Union (CJEU). IUROPA and similar multi-user databases must live up to four criteria for databases, as proposed by Weinshall and Epstein. First, they must address real-world problems. Second, they must be open and accessible. Third, they must deliver reliable and reproducible data. Fourth, they must be ageless and easily calibrated to research purposes unknown at the time of data collection and cleaning. These criteria involve trade-offs: the quest for reliability may, first, precipitate difficult choices such as whether to discard or improve upon ‘imperfect’ data or tempt creators to endlessly postpone publication of ‘incomplete’ data; second, sustainability and human intervention are inversely proportionate when it comes to database maintenance; finally, a fledgling discipline like empirical legal studies in EU law imposes a disproportionate time commitment and financial responsibility on a small group of researchers.
Edited by
Daniel Naurin, University of Oslo,Urška Šadl, European University Institute, Florence,Jan Zglinski, London School of Economics and Political Science
Empirical legal studies in EU law routinely, if not inevitably, engage with text. From the decisions of national courts applying EU law, applicants’ case filings, to the Court’s own jurisprudence, these texts are an invaluable source of information for researchers seeking to understand the dynamics involved in the shaping of EU law and its broader societal impact. Distilling relevant information from legal texts, however, is anything but trivial. Intended to serve as a reference manual, the chapter offers detailed guidelines to researchers of both law and political science interested in employing a text-as-data approach to the study of EU law. To this end, we elaborate on how to conceptualise real-life phenomena in a way that renders them conducive to measurement, providing practical guidance on hand-coding and the use of deep learning classifiers. Further, we address potential challenges arising in the specific context of EU law. This includes limitations to access to relevant documents, as well as ensuring inter-coder reliability in data collection efforts that require specialised legal expertise.
Despite the widely use and multiple validations of the EURO-D scale, its factor structure is still under debate. Exploratory Graph Analysis (EGA), a novel network psychometric method, offers a promising approach to examining dimensionality. Methodology: 45,390 participants (mean age = 71.27, 57.4% women) from 26 European countries. The sample was randomly split into a derivation sample (n = 22,823) and a cross-validation sample (n = 22,567). EGA was applied to the derivation sample to determine the structure of the EURO-D scale, utilizing two estimation methods: Graphical Least Absolute Shrinkage and Selection Operator (GLASSO) and Triangulated Maximally Filtered Graph (TMFG). The identified factor structures were then tested via Confirmatory Factor Analysis (CFA) in the cross-validation sample for model fit. Results: EGA consistently revealed a two-factor structure with minor differences in the placement of suicidality and fatigue items across estimation methods. CFA results confirmed an adequate model fit for both solutions. Conclusion: This study combines exploratory (EGA) and confirmatory (CFA) approaches, supporting a two-factor structure for the EU-RO-D scale with alternative placements for fatigue and suicidality items. Results are discussed in contrast to previous studies reporting two and three-factor solutions with different assignments of these items.
Scholars engaged in comparative research on democratic regimes are in sharp disagreement over the choice between a dichotomous or graded approach to the distinction between democracy and nondemocracy. This choice is substantively important because it affects the findings of empirical research. It is methodologically important because it raises basic issues, faced by both qualitative and quantitative analysts, concerning appropriate standards for justifying choices about concepts. Generic claims that the concept of democracy should inherently be treated as dichotomous or graded are incomplete. The burden of demonstration should instead rest on more specific arguments linked to the goals of research. This chapter thus takes the pragmatic position that how scholars understand and operationalize a concept can and should depend in part on what they are going to do with it. The chapter considers justifications focused on the conceptualization of democratization as an event, the conceptual requirements for analyzing subtypes of democracy, the empirical distribution of cases, normative evaluation, the idea of regimes as bounded wholes, and the goal of achieving sharper analytic differentiation.
The challenge of finding appropriate tools for measurement validation is an abiding concern in political science. This chapter considers four traditions of validation, using examples from cross-national research on democracy: the levels-of-measurement approach, structural-equation modeling with latent variables, the pragmatic tradition, and the case-based method. Methodologists have sharply disputed the merits of alternative traditions. The chapter encourages scholars – and certainly analysts of democracy – to pay more attention to these disputes and to consider strengths and weaknesses in the validation tools they adopt. An appendix summarizes the evaluation of six democracy data sets from the perspective of alternative approaches to validation.
This study assessed the construct validity, predictive validity, and responsiveness of the 4-metre walk test (4MWT) in community-dwelling older Canadians.
Methods
Baseline and 3-year follow-up data from the Canadian Longitudinal Study on Aging were examined, including participants ≥ 65 years with 4MWT assessments. Secondary outcomes included physical and self-report measures and healthcare utilization (e.g., hospitalization and emergency department visits).
Results
Baseline data on 12,433 and follow-up data on 10,107 participants were analysed. For construct validity, low-to-high correlations with the comparator measures (rho = 0.25 [with the Life Space Assessment] to 0.72 [with the Timed-Up and Go]) and known-groups differences of 0.15 m/s (assistive device use) and 0.04 m/s (falls) were found. For predictive validity, areas under the curve ranged from 0.51 to 0.59 for healthcare utilization, indicating poor prediction. For responsiveness, low-to-moderate correlations between change scores were found (rho = 0.01–0.44).
Conclusions
Findings demonstrated partial support for construct validity and responsiveness and no support for predictive validity.
Microaggressions have been a topic of significant debate in the psychological and social sciences. Despite an extensive body of empirical evidence, numerous misconceptions persist. This paper deconstructs common misconceptions surrounding microaggressions and addresses their origins, underlying biases, and empirical refutations. We explain the mechanisms that cause and maintain microaggressions through a CBT lens. We examine widely propagated misconceptions, including claims that microaggressions lack scientific validity, are too subjective to measure, and are not indicative of racism or other forms of prejudice. Drawing on the substantial literature base, including validated psychometric scales, experimental studies, and cross-cultural analyses, we demonstrate that microaggressions are not only real but also have significant psychological and social consequences. Empirical evidence links microaggressions to outcomes such as depression, anxiety, and lower self-esteem, reinforcing their relevance in clinical, educational, and workplace settings. CBT models provide a useful lens for understanding how individuals navigate the psychological complexities associated with microaggressive behaviours, helping explain why some people resist acknowledging microaggressions and their consequences. Lastly, we highlight the importance of education for reducing the prevalence of microaggressions and mitigating their harmful effects. Our goal is to provide clinicians with correct information so that they may skilfully and empathetically help clients experiencing microaggressions, and to no longer accept microaggressions as a harmless, misunderstood, or dismissed phenomenon. By debunking these misconceptions, this work contributes to a more scientifically grounded understanding of microaggressions, emphasizing the necessity of continued research and intervention efforts to address the impact of discrimination in society.
Key learning aims
(1) Build awareness around the various misconceptions associated with microaggressions.
(2) Knowledge of why these misconceptions exist, where they came from, and why they are important to consider and refute.
(3) Refuting misconceptions with scientific explanations and evidence.
(4) Understand how CBT clinicians can better prevent and respond to microaggressions.
This study aimed to culturally adapt the Self-Blame Attributions for Cancer Scale (SBAC) into Turkish and evaluate its psychometric properties, including validity and reliability.
Method
This methodological study enrolled 161 patients from both inpatient and outpatient oncology departments of a university hospital during a 1-year observation period (March 2024–March 2025). Participant data were obtained by using 2 instruments: a demographic questionnaire and the adapted Turkish version of “the SBAC.”
Results
Confirmatory factor analysis revealed strong factor loadings ranging from 0.670 to 0.850, indicating good item reliability. Model fit statistics demonstrated excellent psychometric properties (χ2/df = 2.00; root mean square error of approximation = 0.079; Comparative Fit Index = 0.99; standardized root mean square residual = 0.042; Tucker–Lewis Index = 0.98; root mean square residual = 0.042). The scale showed high internal consistency, with a total Cronbach’s α of 0.93 and subscale α coefficients ranging from 0.85 to 0.90. The original 2-factor structure of the SBAC was supported.
Conclusion
The study confirmed the bidimensional structure (11 items) of SBAC’s Turkish version with excellent validity and reliability indices, supporting its cultural and psychometric adequacy for Turkish samples.
Beginning with the eerie history of Edinburgh’s South Bridge vaults, Chapter 3 investigates how supernatural encounters are often reported in places associated with death, decay, and sensory uncertainty. Here, we explore the connection between electromagnetic fluctuations, ambiguous sensory experiences, and supernatural perceptions. The chapter explores the human tendency to assign meaning to ambiguous stimuli and introduces key concepts in measurement science, such as reliability and validity. It also addresses the limited evidence for human sensitivity to EMF changes. Disruptions in spatial and body awareness in the brain can lead to experiences like feeling a presence or seeing a shadow figure. Together, these ideas offer plausible brain-based explanations for some ghostly encounters and demonstrate how the brain strives to make sense of the unknown when sensory information is unclear.
Bilinguals vary in their daily-life language use and switching behaviours, which are also frequently studied in relation to other processes (e.g., executive control). Measuring daily-life language use and switching often relies on self-reported questionnaires, but little is known about the validity of these questionnaires. Here, we present two studies examining test–retest reliability and validity of language-use questionnaires (relative to Ecological Momentary Assessment, Study 1) and language-switching questionnaires and tasks (relative to recorded daily-life conversations, small-scale Study 2). Test–retest reliability and validity of the LSBQ (Anderson et al., 2018) were high and moderate, respectively, suggesting this questionnaire can capture daily-life language use well. Although only examined with a small sample size, Study 2 suggested relatively low validity of most language-switching questionnaires, with short language-production tasks potentially offering a more valid assessment. Together, these studies suggest that tools are available to reliably capture language use and switching with (a certain degree of) validity.
Mental health conditions among youths are increasing rapidly, taking into consideration their biological, psychological and social development in the time of technological advancement with its associated challenges. Therefore, this study examined the psychometric properties of eight mental health scales among Ghanaian youth. A total of 708 youths (62.1% females; 10–29 years) from junior high schools, senior high schools and a university were recruited to respond to measures on depression, anxiety, somatic symptoms, obsessive–compulsive symptoms, insomnia, smartphone application-based addiction, internet addiction, life satisfaction, stress and cognitive fatigue. Confirmatory factor analysis (CFA) and Pearson’s r were used to analyse the data. The findings indicated acceptable CFA fit for all scales (comparative fit index [CFI] >0.9, Tucker–Lewis index [TLI] >0.9, root mean square error of approximation [RMSEA] <0.08 and standardized root mean square residual [SRMR] <0.08), and internal reliability was satisfactory (Cronbach’s α = 0.774–0.868 and McDonald’s ω = 0.775–0.870). Correlation analyses showed significant relationships between all the measures except for life satisfaction and internet addiction, and stress and life satisfaction. Both the CFA indices and correlation analyses indicate that all the mental health measures demonstrate acceptable initial evidence of reliability and construct validity.
This chapter explores how to get and prepare quantitative data prior to analysis. Use theory to identify the unit of analysis for your study, then determine the population and sample for your study. Be sure to capture appropriate variation in the DV and be alert for selection bias in how cases enter the sample. Issues of validity and reliability can potentially cause major problems with your analysis. Again, use your theory to carefully match indicators to concepts to minimize the risk of these problems. Think through the data collection process and plan ahead to maximize efficiency; gather all data for control variables and robustness checks in a single sweep, if possible. Much data, particularly for standard indicators of common concepts, is freely available online through a variety of sources, and your library probably also subscribes to other quantitative databases. Collecting new data is substantially more time-consuming than using previously-gathered data, but it is often necessary to test novel theories. Whether you use existing data or novel data, be sure to define your data needs list before beginning data collection, allow sufficient time, and document and back up everything.