Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Department of Pharmacology, Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu, Malaysia.
Front Endocrinol (Lausanne). 2024 Sep 6;15:1393500. doi: 10.3389/fendo.2024.1393500. eCollection 2024.
This study outlined the development of the barriers, prescribing practices, and guideline adherence for osteoporosis management according to the Clinicians' Osteoporosis Questionnaire (COQ) followed by an assessment of the content validity index and reliability test.
The development of the COQ was performed in two stages. Stage I involved the development of the COQ, and stage II involved judgmental evidence and quantification of the questionnaire. Five panel experts related to the study area and five clinicians participated in the validity of the COQ assessment. Fifty clinicians took part in the reliability test evaluation by filling out the questionnaire twice at 2-week intervals. The content validity index (CVI) and content validity ratio (CVR) were analyzed using Microsoft Excel, while Cohen's kappa statistic was used to determine the test-retest reliability using SPSS version 29.
Forty items and three domains, namely, barriers, prescribing practices, and guideline adherence for osteoporosis management, were identified in the COQ (version 4.0). The scale-level CVI (S-CVI/Ave) for every domain was above 0.9, which is considered acceptable. The CVRs for all the items were above 0.7, except for two items in the barrier domain and two items in the guideline adherence domain. Two items were revised to improve the clarity of the item, and other items were retained based on consensus among the expert panel. Between the test and retest, the reliability of individual items ranged from moderate to almost perfect for the barrier domain (k = 0.42-0.86), prescribing practice domain (k = 0.79-0.87), and guideline adherence domain (k = 0.46-1). None of the items had "fair" or "poor" agreement. Thus, the 40-item COQ (version 4.0) was finalized following the content and face validity analysis.
Through an iterative process, the development and assessment of the COQ showed a high degree of content validity and reliability in measuring the barriers, prescribing practices, and guideline adherence among clinicians managing osteoporosis. Future studies should aim to further validate this instrument across different populations and settings, as well as explore methods to enhance its reliability and validity.
本研究通过临床医生骨质疏松问卷（COQ）概述了骨质疏松症管理的障碍、处方实践和指南依从性的发展，随后评估了内容有效性指数和可靠性测试。
COQ 的开发分两个阶段进行。第一阶段涉及 COQ 的开发，第二阶段涉及问卷的判断性证据和量化。与研究领域相关的五名小组专家和五名临床医生参与了 COQ 评估的有效性。五十名临床医生通过在两周的间隔内两次填写问卷来参与可靠性测试评估。使用 Microsoft Excel 分析内容有效性指数（CVI）和内容有效性比（CVR），而使用 SPSS 版本 29 计算 Cohen 的kappa 统计量来确定测试-再测试的可靠性。
COQ（版本 4.0）确定了 40 个项目和三个领域，即骨质疏松症管理的障碍、处方实践和指南依从性。每个领域的量表级 CVI（S-CVI/Ave）均高于 0.9，这被认为是可接受的。除了障碍域中的两个项目和指南依从性域中的两个项目外，所有项目的 CVR 均高于 0.7。两个项目被修改以提高项目的清晰度，并且根据专家组的共识保留了其他项目。在测试和再测试之间，障碍域（k = 0.42-0.86）、处方实践域（k = 0.79-0.87）和指南依从性域（k = 0.46-1）的个别项目的可靠性从中等到几乎完美。没有任何项目具有“公平”或“较差”的一致性。因此，在内容和表面有效性分析之后，最终确定了 40 项 COQ（版本 4.0）。
通过迭代过程，COQ 的开发和评估显示出在衡量临床医生管理骨质疏松症的障碍、处方实践和指南依从性方面具有高度的内容有效性和可靠性。未来的研究应旨在进一步验证该工具在不同人群和环境中的有效性，并探索增强其可靠性和有效性的方法。
