iSAT於年輕成人之心理計量特性驗證 (1013 renew)

Validation of psychometric properties of an iPad-based Selective Attention Test in young adults 

N=54 (M=28, F=26) mean age=24.4 years; mean education years=16.1 years

1. Test-retest reliability, random measurement error and practice effect: 
(1) Moderate test-retest reliability for all 4 indices
(2) Acceptable random measurement error for the L and LD indices
     Substantial random measurement error for the H and HD indices
(3) Small to moderate practice effect for the L and LD indices
      Moderate to high practice effect for the H and HD indices

Indices	ICC (95% CI)	SEM (SEM%)	MDC (MDC%)	Effect size (s: significant; ns: not significant)
Low load (L)	0.65 (0.44-0.78)	0.04 (6.6%)	0.12 (18.4%)	0.25 (s)
Low load with Distractor (LD)	0.53 (0.30-0.70)	0.05 (8.2%)	0.15 (22.6%)	0.32 (s)
High load (H)	0.58 (0.02-0.81)	0.20 (12.0%)	0.56 (33.2%)	0.70 (s)
High load with Distractor (HD)	0.59 (0.24-0.78)	0.23 (13.2%)	0.62 (36.6%)	0.55 (s)

2. Convergent validity: 
Correlation with T-SDMT: acceptable

L	H	HD
r=0.30	r=0.40	r=0.46

3. Discriminative validity: Yes

For all 4 indices, the scores of participants with scores higher than the highest 25% of data were significantly different than those of participants with scores lower than the lowest 25% of data (p<0.001). 

4. Construct validity: not fitting with perceptual load theory
The results of the iSAT in young adults did not confirm the hypothesis of perceptual load theory.

iSAT於思覺失調症患者之驗證結果 (1020 renew)

Validation of an iPad-based Selective Attention Test in patients with schizophrenia

N=51 (M=25, F=26) mean age=47.2yrs; mean education years=11.2yrs; mean age of onset=24.8yrs; range of CGIS=1-4

1. Test-retest reliability, random measurement error and practice effect: 
Low load indices: good
High load indices: need to be improved due to substantial random measurement error and moderate practice effect

Indices	ICC   (95% CI)	SEM (SEM%)	MDC (MDC%)	Effect size (s: significant; ns: not significant)
Low load (L)	0.89  (0.80-0.94)	0.11  (9.5%)	0.29  (26.3%)	0.14 (s)
Low load with Distractor (LD)	0.88   (0.78-0.93)	0.12  (10.8%)	0.35  (29.8%)	0.15 (s)
High load (H)	0.75   (0.33-0.89)	0.40  (14.6%)	1.11  (40.5%)	0.43 (s)
High load with Distractor (HD)	0.74   (0.41-0.87)	0.47  (16.8%)	1.31  (46.4%)	0.39 (s)

(1) The ICC for the L and LD indices ranged from 0.88 to 0.89, indicating that both low load indices had high test-retest reliability.

(2) The ICC for the H and HD indices ranged from 0.74 to 0.75, indicating that both high load indices had acceptable test-retest reliability.

(3) Our results showed that both low load indices had acceptable random measurement error, whereas both high load indices had substantial random measurement error.
*The criterion for the MDC% was set at 30%. MDC%<30% indicates acceptable random measurement error.

(4) A significant practice effect was shown between repeated assessments for all four indices. For both low load indices, the practice effect was negligible; whereas for both high load indices, the practice effect was around moderate.

2. Convergent validity 
(1) Correlation with MoCA: acceptable

L	LD	H	HD
0.42	0.43	0.48	0.47

All four indices had fair correlations with the MoCA, indicating acceptable convergent validity. (2) Correlation with CGIS: insufficient Only the L and LD indices had weak correlations (r=0.28-0.29) with the CGIS, indicating insufficient convergent validity. 3. Discriminative validity: Yes (1) MoCA≧26 [good global cognition, N=14] vs. <26 [poor global cognition, N=37]: All 4 indices had discriminative validity to discriminate participants with/without poor global cognitive function. (2) Young adult (n=16) vs. middle-aged adult and elderly (n=35): All four indices had discriminative validity to discriminate young adult and middle-aged/elderly adult participants. 4. Ecological validity: partial, correlation with the Personal and Social Performance (PSP) Only the H and HD indices had significant weak correlation (r=0.29-0.31) with the PSP, indicating limited ecological validity. 5. Construct validity: fitting with perceptual load theory The results of the iSAT in patients with schizophrenia confirmed the hypothesis of perceptual load theory.  Participants' response time became slower (>0.04 seconds) when the distractor showed up in the low load condition. However, the distractor did not affect the participants' response time in the high load condition. *How to reduce moderate practice effect in the high load condition: To set up a criterion for response time to reach a plateau phase of selective attention performance.

慢性思覺失調症收案將近尾聲

本週五將收完最後一位慢性思覺失調症患者的再測
2個月的慢性個案收案（接近50位個案）也將告一段落了
接下來就是資料的彙整和跑分析了

這二個月所接觸的精神科個案
應該可以抵三次精神科實習的個案量吧
因為畢業以後接觸的多為小兒和生理的個案
所以一開始評估思覺失調症患者時
真的覺得自己很菜
完全沒有進入狀況的感覺
後來我改變心態
先肯定自己是可以在不熟悉的環境裡完成收案
再來是跟病患/護理師說明自己是ＯＴ老師（不是研究助理）
（因為想讓個案/護理師知道自己也是精神醫療相關專業人員）
同時也盡量配合護理站的時間（11點和16點前完成評估）
和空間使用（只要有桌椅，二道門間的走廊也可以評估）
另外也盡可能在40分鐘內完成一位個案的評估
後來的收案真的變得很專業
當然評估本身就是ＯＴ的專業
只是因為我是外人
我必須要讓評估這件事情更有一定的程序
醫院的人員也才會重視這件事情
不然病人沒有完成評估對醫院來說並沒有任何影響

這次的收案對我來說
就像進入一個新工作
慢慢熟悉新環境的人事物
（需花時間建立關係）
同時也是一個很好的機會
讓我可以一邊做臨床一邊做研究
對一個測驗發展者而言
這真是一個很棒的經歷
能夠親眼看到病人做測驗的所有反應
而且可以得到他們直接的回饋
真的是很難得

iSAT於思覺失調症患者之心理計量驗證收案規畫

桃療：5月8日那週開始，那週會找一天過去確認收案流程。
靜和：8月份開始收案，預計9月底前完成。

iSAT/T-SDMT於年輕成人之再測信度/收斂效度驗證人數小記

第一波收案將於5月初結束

預計收滿26人

10男16女

下一波受試者招募將於下週展開

將再於PTT post招募文宣

T-SDMT不同施測次數之反應性與預測效度比較 0406 renew

一、團體層級反應性

	單一評估	二次平均	三次平均
Post-Pre difference Mean (SD)	3.2 (6.6)	3.2 (5.7)	3.3 (5.6)
ES (95% CI)	0.25       (0.11-0.43)	0.25 (0.14-0.41)	0.25 (0.13-0.40)
SRM  (95% CI)	0.49  (0.24-0.75)	0.57 (0.39-0.85)	0.58 (0.36-0.89)

*團體層級反應性：三種評估方式無顯著差異。

二、個體層級反應性

	單一評估	二次平均	三次平均
顯著進步	20%	16%	16%
進步但不顯著	44%	54%	58%
無進步或退步	30%	28%	22%
顯著退步	6%	2%	4%

*個體層級反應性：三種評估方式無顯著差異(p>0.24)。
進一步分成 進步 vs. 無進步或退步 二群：三種評估方式無顯著差異(p>0.05)。

三、預測效度

	單一評估 Pearson’s r  (95% CI)	二次平均 Pearson’s r (95% CI)	三次平均 Pearson’s r (95% CI)
BI	0.47 (0.22-0.66)	0.45 (0.19-0.65)	0.44 (0.19-0.64)
BI-SS自覺困難	0.46 (0.21-0.66)	0.45 (0.19-0.64)	0.45 (0.19-0.65)
BI-SS執行能力	0.43 (0.17-0.63)	0.40 (0.13-0.61)	0.39 (0.12-0.60)

*預測效度：三種評估方式無顯著差異。

**隨著評估次數增加，相關係數些微遞減。

當reviewer的感覺

近日審查的一篇注意力測驗再測信度驗證論文

依據我的建議改到了R2

看著作者一路修正下來

其實是會被感動的

原來當reviewer是這種感覺~

以前我最怕的就是回response letter

常常不知怎麼應付reviewer

但現在我比較知道怎麼回覆

其實只要站在reviewer的立場去想

思考為什麼reviewer會給這樣的意見

然後在不失自己立場的情況下

給予適切的回覆

一般而言都會有正面的回饋~

我今天看了對方的R2回覆

發現對方全都接受自己的建議

其實還蠻開心的

內心覺得可以給他過了

雖然會再看一次他修改過的全文

但是基本上也已經改得差不多了~

reviewer真的是為他人作嫁衣

花了很多自己的時間

幫別人修改論文

而論文真的會越改越好的

真的是在做功德~