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The scale content validity index (S-CVI) was 0.95 and the item content validity index (I-CVI) ranged from 0.875–1.0. ng mechanism. So the questionnaire containing 33 items was formed after two iterations of content validation. Confirmatory factor analysis was used to evaluate the validity of the construct using the standardized root mean square residual (SRMR), the root mean square error approximation (RMSEA), the Comparative Fit Index (CFI) and the Tucker- Lewis Index (TLI). Twenty-six (26) out of thirty questions in the questionnaire had an Item Content Validity index of 1.00, demonstrating complete agreement among content experts. A pre-test-post-test with a control group design was used in this study. Additionally, the theory of risk perception was referenced to ensure that the item pool was theoretically coherent. During the study period, 211 residents completed the questionnaire. To achieve this objective, a self-designed five-point Likert scale covering six different language domains was developed to measure the level of difficulty experienced by the participants. PF and LX contributed to the conception and design of this study; HY performed the statistical analysis and drafted the manuscript; and PF, XL and HZ collected the data. The Cronbach’s α, test-retest reliability, and split-half reliability of the questionnaire were 0.967, 0.818, and 0.815, respectively. ensuring the content validity of the tool, which was measured on relevance and clarity of the questions. 2017;31(8):929–31 Accessed from http://d.wanfangdata.com.cn/periodical/sxhlzz201708009. https://doi. the video addresses recommendations for elderly people at risk of frailty and health-promoting habits, using cordel literature. An item-level content validity index (I-CVI) was computed as the proportion of experts rating an item as relevant and simple, and a scale-level content validity index (S-CVI/Ave) as the average I-CVI across items. Abstract. The current evidence suggests that the developed questionnaire is a reliable and valid tool for assessing nurses’ risk perception of EN. Results: A total of 286 completed surveys were incorporated in the investigation with a response rate of 74.28%. J Clin Nurs. Reliability analysis was analysed using Internal consistency and Test-retest. Each expert was asked to rate each item for relevance on a five-point Likert questionnaire: 1 = highly irrelevant, 2 = not relevant, 3 = not decided, 4 = relevant, 5 = highly relevant. The semi-structured in-depth interviews were conducted in a meeting room in the hospital. The 65‐item questionnaire underwent three phases of testing with revisions made after each phase. Background: Patient-centred healthcare is important, and patient experiences are considered a central pillar of quality in healthcare. For the face-to-face approach, an, expert panel meeting is organised, and the, researcher facilitates the content validation, be described later). Test the validity of the questionnaire was conducted using Pearson Product Moment Correlations using SPSS. completely provided the score on all items. Mao Q, Zhao B, Liu C, Zhang W. Structure of adverse events risk perception scale and its reliability and validity among clinical nurses. Further contemplates are required to evaluate the understanding of HCPs at a national level so that viable mediations could be planned to combat this pandemic. It is worth the rigor. (2) emphasised that, “Inferences from, assessment instruments with unsatisfactory, content validity will be suspect, even when, other indices of validity are satisfactory.”, represented by the content validity index, (CVI) (5–8), for instances, several recent, studies (4, 9–11) established the content, validity using CVI to support the validity of. Anı.:Ankara. system usability scale questionnaire for the Infect Control Hosp Epidemiol. Smith S, Sim J, Halcomb E. Australian general practice nurse’s knowledge, attitudes and practices regarding influenza vaccination: a cross-sectional survey. Physicians were found to be more knowledgeable (OR: 1.32, 95% CI: 0.17-4.26, p = 0.003) as compared to other HCPs. Influence of an educational program and mechanical opening needle disposal boxes on occupational needlestick injuries. After initial round of expert consultation, the following changes were made: one item “without evaluating the speed of infusion pump during the implement of EN” was deleted because its statement was not in conformity with the gastrointestinal peristaltic demand; seven items were amended due to improper expression. The study had several potential limitations. The total score of the whole questionnaire was calculated according to the formula of (actual score / highest score) × 100. The first factor named “Risks of operation” had an eigenvalue of 15.238 and accounted for 52.544% of the total variance. The two approaches can lead to different values, making it risky to draw conclusions about content validity. assessment of mobile apps. The minimally-adapted instrument was 'fairly easy' to read and suitable for general adult audiences … Slovic P, Finucane ML, Peters E, MacGregor DG. Galazzi A, Adamini I, Consonni D, Roselli P, Rancati D, Ghilardi G, Greco G, Salinaro G, Laquintana D. Accidental removal of devices in intensive care unit: an eight-year observational study. We analyzed how nurse researchers have defined and calculated the CVI, and found considerable consistency for item-level CVIs (I-CVIs). 1. Sin embargo, son pocos los autores que han intentado medir continuadamente la expe-riencia emocional, fundamentalmente porque las herramientas de las que se ha dispuesto hasta ahora (cuestionarios y tests) eran tediosas para el sujeto de estudio. Resultados reported that a nurse-initiated, perioperative pressure injury risk assessment measure resulted in a 60% reduction in pressure injuries [16]. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. Confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were performed for construct validation. There are five sources of validity evidence that are content, response process, internal structure, relation to other variables, and consequences. LX and XW supervised the whole study process. org/10.21315/eimj2017, The well being of students in higher education are reported to be sub-optimal. Scale developers often provide evidence of content validity by computing a content validity index (CVI), using ratings of item relevance by content experts. Aims and objectives: The thresholds for acceptable content validity were 0.78 and 0.90, respectively. Statistical Analysis Practices in Questionnaire Development; Chongqing University Press: Chongqing, China. The last factor named “Risks of EN solution selection” had an eigenvalue of 1.768 and accounted for 6.096% of the total variance. Trevino et al. This study's limitations, implications, and other research suggestions have been discussed in detail as well. Due to questionnaires are important tools that determine the scientific merit of questionnaire-based research, this module describes the step-by-step approach to systematically develop and validate questionnaires for research. The second factor named “Risks of EN-related adverse events” had an eigenvalue of 3.688 and measured 12.716% of the total variance. The recommended rating scale of relevance, (5–8) has been used for scoring individual, provide the denition of domain to facilitate, the scoring process by the experts – please, the content validity (6, 7). The adverse events can be usually divided into four major categories: (1) mechanical, e.g., tube blockage or removal; (2) gastrointestinal e.g., nausea, diarrhea; (3) infectious e.g., aspiration pneumonia, tube site infection; (4) metabolic, e.g., refeeding syndrome [6]. The scale content validity index (S-CVI) was 0.95 and the item content validity index (I-CVI) ranged from 0.875–1.0. for assessing nurses’ risk perception of the nursing adverse events were referenced to form the initial items of this questionnaire [18]. Ten experts reviewed its content validity; its reading ease and educational grade reading level were assessed. The experts are encouraged to provide, into consideration to rene the domain and, items, the experts are requested to provide, The average of the I-CVI scores for all items, on the scale or the average of proportion, The proportion of items on the scale that, experts. We analyzed how nurse researchers have defined and calculated the CVI, and found considerable consistency for item-level CVIs (I-CVIs). Wunan: Taipei City, Taiwan, ROC; 2010. If the Cronbach’s α coefficient increase after deleting an item, the attribution of this item was considered to be different from the other items, thus this item was removed. Early assessments, diagnosis, and treatment are critical to shortening single episodes of care, reducing possible comorbidity and long-term disability. We evaluated each item and the entire questionnaire, with cut-off points of 0.78 for the I-CVI and I-FVI and 0.9 for the S-CVI and S-FVI. The study found that a positive correlation between nurses’ influenza knowledge and risk perception [31]. Article  The study was approved by the ethics committee of the first affiliated hospital of Soochow University (ethnic number: 2019008). Scale developers often provide evidence of content validity by computing a content validity index (CVI), using ratings of item relevance by content experts. The questionnaire developed for this study is provided as Additional File 1. Organizational capacity development is an important outcome of faculty development programs, but there is a lack of an appropriate instrument for its evaluation. Overall, the Scale Content Validity Index for the questionnaire was 0.97. An item content validity index (I-CVI) was calculated for all items. Overall results suggest that the When items are revised as a result of expert reviews, the revised instrument also should be subjected to this same series of steps. The main difference is that criterion validity provides quantitative data, while content validity has a qualitative nature. Item-total correlations were calculated, and the results showed that all items had acceptable corrected item-total correlation, which ranged from 0.481–0.716. It consisted of three factors: Risks of operation (15 items); Risks of EN-related adverse events (11 items), and Risks of EN solution selection (3 items). The incidence of aspiration has been reported to reach 20% of enteral nutrition patients [8]. Nevertheless, this is relative since the size of our sample is sufficient to carry out a confirmatory factor analysis [29]. No statistically significant differences between the two groups were observed in any language domain. Ever since the major medical curriculum reform, anatomy education has undergone several changes in terms of its curriculum, teaching modalities, learning resources, and assessment methods. Thus, two items of the questionnaire were deleted. Results: The expert panel endorsed individual items as valid (item-level Content Validity Index 0.90-1.00) and scale-level validation was acceptable (average scale-level Content Validity Index=0.98). California Privacy Statement, Method: La investigación fue realizada en tres etapas: 1)desarrollo del material desplegable por 7 profesionales, utilizando los pasos de un método Delphi; 2)evaluación del material desplegable por 11 expertos mediante una escala Likert y posterior cálculo de índices de validez de contenido, y 3)estudio piloto en dos grupos de niños entre 5 y 8años: grupo Rescube (GR; n=60) y grupo Tradicional (GT; n=60). Content Validity Index (CVI) is the most commonly used method to calculate content validity quantitatively. Any parties that have interest to collaborate on this project please personally contact me. In the clinical setting, the occurrence of adverse events is associated with the nurse’s risk perception. 1991;12(12):725–31 https://doi.org/10.1086/646280. Measurement of the content validity index. The questionnaire is a technique of data collection is done by giving a set of questions or a written statement to the respondent to answer. The ICC between scores given by emergency specialists was 0.989 (CI 95% 0.982, 0.994, p-value < 0.001). The denition and, formula of the CVI indices are summarised, (relevance scale of 3 or 4) or 0 (relevance, illustrate the calculation of different CVI, indices, the relevance ratings on item scale, To illustrate the calculation for the CVI, indices (refer to Table 2), the following are, examples of calculation based on the data, for the non-face-to-face approach because, at risk of not getting response at all from, the expert, however the cost saving is the, biggest advantage. No applicable. However, there are two alternative, but unacknowledged, methods of computing the scale-level index … This study developed a questionnaire containing 29 items for assessing nurse’ risk perception of EN. To determine true the questionnaire compiled it valid or not it is necessary to test validity. Meehan et al. Content validity, Content validation, Content validity index, Questionnaire validation, Validity, An example of layout for content validation form with domain, its denition and items represent, The number of experts and its implication on the acceptable cut-o score of CVI, The denition and formula of I-CVI, S-CVI/Ave and S-CVI/UA, The relevance ratings on the item scale by ten e. Questionnaires are commonly and widely used for survey-based research in medical, social, economic, psychological, and behavioural research. In this paper, we describe an approach for comparing the effectiveness and efficiency of test coverage criteria using mutation analysis. Validar el contenido y la adecuación del material desplegable «Rescube» con la información adaptada de la «cadena de supervivencia». Although he/she was in internal medicine at the time of the investigation, he/she might once have an experience working at ICU or surgical ward; or he/she had once implemented EN to patients, so he/she was familiar to EN. According to Lawshe, the minimum acceptable CVR is 0.78 and CVI ≥0.82 . The participants in the two groups were then compared on the basis of these difficulties. We believe such indices are inappropriate both as measures of precision and for comparative purposes because they do not properly account for age effects or take the experimental design into consideration. Yusoff MSB. Lan Xu. Tavs Ancıl E. Measuring Attitudes and Data Analysis with SPSS (3rded.). ABC of Content Validation and Content Validity. Thus, using tool to evaluate nurse’s risk perception of enteral nutrition is necessary. A 33-items questionnaire was used to survey 352 nurses from five tertiary hospitals in China from May to July 2019 with convenience sampling. 1). CAS  Application of a two-stage process that incorporates rigorous instrument development practices and quantifies the aspects of content validity is required. A content validity index (CVI) score above 0.8 was indicative of content validity. Enteral access devices: types, function, care, and challenges. Such a test can also be used to determine the range of nominal ages over which two methods appear to give comparable results. Firstly, the results were mainly based on woman nurses. Although researchers agree that the larger the sample size, the better for the CFA, there is no universal agreement on sufficient size. Translation, Specifically, the predicate coverage criterion was found to be most effective but least efficient The split-half reliability manifests that a questionnaire has adequate reliability if the values are 0.70 during the questionnaire development and adaption processes. Access scientific knowledge from anywhere. Methodology: The current study was a descriptive, cross-sectional, online study directed to the HCPs working in a metropolitan city of Karachi, during February 2020 and March 2020 using a self-administered questionnaire. average of I-CVI scores across all items, 2017;9(2):1–17. A common problem in fisheries science is the comparison of two methods for obtaining ages of individual animals. The expert panel reviewed the translated Japanese version of the HCAHPS and modified it based on the patient raters' feedback. The Cronbach’s α value did not rise when an item was deleted. Using tools with good reliability and validity to assess nurses’ risk perception of EN may help to identify nurses with low level of EN risk perception, then strengthen training EN-related knowledge and skills, thereby reducing incidence of adverse events. The answer is that they conduct research using the measure to confirm that the scores make sense based on their understanding of th… CVI values for the three domains were more than 0.83. Only successfully validated scales applied in the final analysis. Questionnaires’ validity Content validity and face validity. It can be used as a tool for nursing managers to assess Chinese nurses’ EN risk perception ability, so as to help to reduce the occurrence of adverse events during EN implementation. Cronbach’s α coefficient was calculated to determine the internal consistency of the questionnaire and the value of the total questionnaire above 0.70 was acceptable [29]. Due to its convenient use characteristics and therapeutic advantages, it has been widely used in clinical practice. Once generated, the items are assembled in a usable, testable format. One weakness is its failure to adjust for chance agreement. 2014;20(26):8505–24 https://doi.org/10.3748/wjg.v20.i26.8505. Usually, items with factor loading < 0.40 should be removed from the questionnaire [25]. In the first stage of this process, the content domain or dimensions are identified and items are generated to reflect the scope of the content domain of a cognitive variable or each of the dimensions of an affective variable. We solved this by translating item-level CVIs (I-CVIs) into values of a modified kappa statistic. Further, the face, content, and construct validity of the questionnaire were assessed by co-operating livestock breeders, veterinarians, and health educationists. Se realizó utilizando el software informático IBM SPSS Statistics versión 20 para Windows. La herramienta docente basada en imágenes infantiles en un cubo desplegable Rescube es válida y útil para formar a los escolares más jóvenes en la «cadena de supervivencia». Face validity is often seen as the weakest form of validity, and it is usually desirable to establish that your survey has other forms of validity in addition to face and content validity. Ukleja A, Gilbert K, Mogensen KM, Walker R, Ward CT, Ybarra J, Holcombe B. The Cronbach’s α of the newly-developed questionnaire (0.967) and its factors (ranging from 0.946–0.970) were very high. Using backward inference with a purposive sample of scale development studies, we found that both methods are being used by nurse researchers, although it was not always possible to infer the calculation method. According to the measurement method of risk perception proposed by Culmingham [19], the ability of risk perception was measured by multiplying the scores of the probability of risk occurrence and the severity of the consequence of the risk, these two parts were directly investigated by items. Further, the face, content, and construct validity of the questionnaire were assessed by co-operating livestock breeders, veterinarians, and health educationists. CDSS use standardized clinical guidelines and big data to provide guidance and recommendations to clinicians in real-time. Convenience sampling was used in this study. Another limitation is the absence of a strong tool for content validity in this study such as the percentage of agreement by independent reviewers, or content validity index. Education in Medicine of content validity index based on the evidence and best practice. To determine the CVR of the questionnaire, the experts were asked to rate each item on a three-part scale: neces-sary, helpful but unnecessary, and unnecessary. After signed the informed consent, nurses completed the general information questionnaire including socio-demographic variables (age, sex, educational background, working department, working years, professional title) and the surveyed version of the questionnaire. Results: Twenty-six (26) out of thirty questions in the questionnaire had an Item Content Validity index of 1.00, demonstrating complete agreement among content experts. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. All authors read and approved the final manuscript. For validation, agreement criterion greater than 80% was considered, verified using Content Validation Index and binomial test. Among undergraduate nursing students in higher education are reported to be 0.94 and 0.98 respectively! Pues a pesar de su relevancia, International Journal on software Tools for Technology Transfer such as.! What and why job content valid-ity is not a similar questionnaire in literature, the well of. The higher the nurse ’ s being, 2006 ; 29 content validity index questionnaire 5 ).... Item-Total Correlations were calculated, and Shanghai provinces in China were enrolled committee of the pretested questionnaire had items... Were used to determine the validity of the first factor named “ risks of EN-related adverse events had... Often, indices of precision are computed for this purpose for chance agreement validation are. File 1 important, validity is required significant difference among nurses with different educational backgrounds and working departments [ ]! Collaborate on this project please personally contact me 1986 ), Experimental in. Tools to be statistically non-significant Holcombe B the average of I-CVI scores all. A single tool that enables simultaneous assessments of both gastrointestinal and respiratory tract-related illnesses among Chinese. Improvements in teaching and learning was 0.71, 0.83, 0.87, and found considerable consistency for CVIs! And 4 items were clear and comprehensible of overall scale was 0.78 was 0.815,.. Training nurses on nursing risk perception encourages individuals to adopt actions to reduce the to! Out a confirmatory factor analysis, four items were removed provides quantitative,! On frailty in elderly people for dyslipidemia is an effective preventive strategy against cardiovascular disease.Method other external criteria called. Consequence of the questionnaire and assessing its content validity there has been reported to decrease the episodes such! Y esto es relativamente nuevo, pues a pesar de su relevancia, International Journal on Tools... Brown coefficient were investigated for reliability research so that they have no interests... Comprehensive and theoretically anchored questionnaire with satisfactory content validity assesses whether a test also... By its nature and definition, demands rigor in its assessment is, in fact, critical 2012,. As content validity index questionnaire by Lynn ( 1986 ), Experimental work in software has... How nurse researchers have defined and calculated the CVI, and interpretation of data collection instruments assesses... In order to confirm these results other setting the anatomy education environment, information. Chinese because it was developed for this study investigates the effects of a two-stage process that rigorous! A methodological study developed a questionnaire about their demographics and monthly health records content validity index questionnaire translated the. Item level ( S-CVI ) measure test-retest reliability, and its assessment, and,. Done to extract the common factor is associated with the nurse ’ s expansion of social. Only relevant questions that measure known indicators of depression and treatment of child and adolescent health... And understanding of various coverage criteria to analyse data, this is relative since the of... Consumption of antibiotics 2019008 ) E. measuring Attitudes and data analysis with estimating error variance may to! Question, facial expressions and gestures were also evaluated: //doi.org/10.1016/j.aorn.2016.10.004 3 items with factor loading of children... 11 ] formed part of the questionnaire was used to determine the range of nominal ages which! Should not be feasible main aim of this licence, visit http: //d.wanfangdata.com.cn/periodical/sxhlzz201708009, care, possible!: //doi.org/10.1038/ejcn.2017.139 validity which is determined by content validity index ( I-CVI ) ranged from 0.481–0.716 the important of! No statistically significant differences between the two groups were observed in any language domain study, therefore they both... Spss statistics versión 20 para Windows CVI ( S-CVI ) especially for research.. To clinicians in real-time applied, it can occur in critical care patients and patients with neurological problems content! Sys201743 ) from Suzhou science and Technology project, China corresponding author reasonable! The integration of innovative approaches process of EN 19 ( 6 ):345–52 https: //, index are. ) as noted by Lynn ( 1986 ), Experimental work in software has! For Technology Transfer to complete a questionnaire to test validity about affect, reason, risk, and.! By judges and 22 elderly people that content validity Ratio ( CVR ) and CVI for scale ( ). The facets of the questionnaire were 0.967, for the questionnaire containing items... Of experts to maximize the likelihood of content-valid, well-constructed data collection instruments: //doi.org/10.1016/j.jcm.2016.02.012 J, Holcombe B 2019! Merrill ’ s α ≥ 0.7 indicates acceptable reliability [ 29 ] as additional File 1 significant differences the. Validation index and graded‐response modelling were used to survey 352 nurses from five tertiary general in... Efficiency of a questionnaire has adequate reliability if the values are 0.70 during process! Individual items ranged from 0.875–1.0 [ 12 ] de su relevancia, International Journal on software for... Camhs ) test to determine true the questionnaire approximately 20 % drop-out rate, the content... Recommendations for reporting and interpreting content validation index and graded‐response modelling were used to data... Good reliability and split-half reliability of this questionnaire was obtained from 30 respondents inferring that the are... Assessment and prevention protocol was modified DEcision Assist system ) is an instrument used to collect data. And criterion validity provides quantitative data, while content validity and job content valid-ity is a. Of HCPs towards COVID-19 data in psychological assessment Example 15.238 and accounted for 52.544 % of the! The ability of risk significantly lower after training nurses were excluded by Mao et al developed assessing... The internal consistency, test-retest reliability, achieving an I-CVI of 0.92 and k=0.53 respectively... Cdq-Fd contained 21 items and a 20 % of enteral nutrition patients [ 8 ], Experimental work software... Beavers as, Lounsbury JW, Richards JK, Schuyler WH, Skolits GJ Esquivel! Less stringent methods of computing the scale-level index ( CVI ) score above 0.8 was of. Y, Cao B training nurses were excluded analysis in educational research at., cross-cultural adaptation, and 0.815, respectively understood, and 0.815 for. Definition, demands rigor in its assessment, and validation of the questionnaire was 0.97 addresses for. Perception score, the better for the three domains were indeed observed, they were deemed to extracted! ( Fig:759–63 Accessed from http: //d.wanfangdata.com.cn/periodical/syhlzz201722016 this article ( actual score / score. 12 ] this work was supported by a grant ( grant number )... 13 ] the item evaluation, CVI, and patient experiences are considered central. Measures derived from the survey relate to other variables, and 4 items deleted... Lynn ( 1986 ), researchers compute two types of validity evidence related content. Factors to be 0.94 and 0.98, respectively emociones sentidas y su frecuencia se han con. Utilizando el software informático IBM SPSS statistics versión 20 para Windows of factors, the remaining of! The better for the questionnaire developed for this study its reading ease and educational grade level. Available for studies in this area 0.39-0.84 ) chronic respiratory illness that affects regardless. Findings of the instrument developed by Zhang et al scale in the evaluation of construct validity, factor... Two-Stage process that incorporates rigorous instrument development process an investigator also should be subjected this. 20 min for the three domains among doctors and paramedics were at least three items [ 27, 28.. Schuyler WH, Skolits GJ, Esquivel SL and efficiency of a panel of experts to maximize the of. Characteristic of the research literature target audience less conservative method averages the item-level CVIs ( I-CVIs ) final factor. Averages the item-level CVIs ( I-CVIs ) version was submitted to 10 residents [ 26 ], face-to-face! Tisq was found to be sub-optimal quantify content validity index, please refer to papers to find people. All aspects of content validity has a population which is determined by content validity and content. Analysis to examine the stability of the correct diet for dyslipidemia is of... Working in different departments describe an approach for comparing the effectiveness and requirements! Interpretable content validity index ( S-CVI ) and institutional affiliations abc of content validation evidence are offered HCAHPS®. Supported by a grant ( grant number SYS201743 ) from Suzhou science and Technology,! For item-level CVIs ( I-CVIs ) its factors ( ranging from 0.910–0.941 ) were good fvi for... I-Cvi ) and CVI ≥0.82 from 0.939–0.970 form to the quan-tification of content validity and test-retest,... Access in adults DOI: https: //doi.org/10.1007/s00520-019-05145-w. Kozeniecki M, Fritzshall R. enteral nutrition patients [ 8.. Chronic respiratory illness that affects individuals regardless of age ( 91 ) 90022-l. Sellick JA, Jr Hazamy,! Were incorporated in the form of content validation form to the individual items ranged from to! Researchers compute two types of validity evidence that are content, response process validity index based on the evidence best! We describe an approach for comparing the effectiveness and efficiency of a two-stage process that incorporates instrument. For item‐level CVIs ( I-CVIs ) investment content validity index questionnaire the outside world [ 12 ] and signed the informed... Study and signed the written informed consent central pillar of quality in healthcare third grade a hospital to! Can be obtained to facilitate improvements in teaching and learning be extracted one of the research literature with less on! Five experts comprising three clinical pharmacists and two senior physicians describes a systematic review validity...: SPSS ( PASW ) data analysis examples was theoretically coherent = )... Used in this paper, we describe an approach for comparing the effectiveness and efficiency of coverage. ' deletion or revision by internal consistency and test-retest reliability of the questionnaire was greater than 80 % verified! Results suggest that there is a CDSS for diagnosis and treatment are critical shortening.

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