DEVELOPMENT, VALIDATION AND PERFORMANCE OF A PATIENT KNOWLEDGE ASSESSMENT TOOL FOR ASSESSING THE IMMEDIATE AND SHORT-TERM IMPACT OF AN INFORMATION COURSE IN SYSTEMIC LUPUS ERYTHEMATOSUS
Bibliographic record
Abstract
PV146 / #705 Poster Topic: AS17 - Miscellaneous Background/Purpose Long-term outcomes in rheumatic diseases can be improved by improving patients’ knowledge, beliefs and perception about their disease which can help them in coping with the disease better. However, there is a lack of tools/instruments in Systemic Lupus Erythematosus (SLE) to 1. objectively assess patients’ knowledge in various domains & 2. To assess the impact of a patient education program. The aim of the study was to develop, validate and assess the performance of a self-prepared questionnaire for assessing patients’ knowledge about their disease and to use this tool to assess the impact of an information course in improving the above-mentioned elements among patients. Methods A self-prepared questionnaire (Hindi/English) containing 23 multiple choice or true-false type questions with single correct answer assessing patients’ knowledge about SLE in 3 domains (a. etiology, disease process, signs & symptoms b. drug therapy & monitoring c. role of investigations in disease diagnosis and monitoring) was prepared. All questions had an item-level content validity index (I-CVI) of at least 0.9. The scale-level content validity index based on the universal agreement method (S-CVI/UA) was 0.8 for the whole questionnaire as assessed by 6 experts. All questions had an option of ‘I don’t know’ which would prevent patients from guessing the answer from the available options. Each question was given a score of 1 if answered correctly. The questionnaire was applied 3 times: at baseline, immediately after an information course to see the immediate impact and after 6 months to see the retention of the information. Information on demographic features and socioeconomic status was also collected. Frequency data were compared using McNemar test for paired nominal data & kappa statistics for ordinal data. Student’s paired t-test was used for comparison of mean scores to see the impact. A p-value<0.5 was considered significant. Results At baseline, the questionnaire was applied to 56 patients with SLE (F:M=54:2; median age 29 (16-53) years) and the median(range) score was 10(2-19) (Table 1). Among them, 39 patients attended the information course. The option ‘I don’t know’ was exercised 509 times (39.51%) before the information course which reduced to 169 (18.84%) times after the course and 108 (13.04%) times at 6 months. After the information course, median score increased from 10(2-19) to 17(0-23) (p<0.001) which was irrespective of the socioeconomic classes and education status of the patients. A total of 13 questions recorded a higher number of correct responses as compared to baseline after the course and at 6 months and this increase was significant for all 13 questions (Table 1). Upon re-administering the questionnaire after 6 months, 36 patients out of 39 responded. The median score 16(0-23) of the questionnaire (n=37) remained significantly higher (p<0.001) as compared to baseline score with 8 out of 23 questions achieving statistical significance (Table 2). Table - 1 Question-wise assessment of responses before and after the information course and the statistical significance of the change Table - 2 Question-wise assessment of responses before the information course and after 4 months with the statistical significance of the change Conclusions Indian patients with SLE have a poor knowledge base about their disease which 1 may strive to improve by implementing short information courses. The information course was found to be effective across the socioeconomic classes and educational status. The provided information was retained at 6th month of follow-up months without any reinforcement course.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.021 | 0.029 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".