Development of the Japanese Version of the Modified Yale Preoperative Anxiety Scale (<scp>mYPAS</scp>) in Pediatric Anesthesia: A Pilot Study for Psychometric Evaluation
Bibliographic record
Abstract
ABSTRACT Background Preoperative anxiety in children can lead to enduring psychological effects, highlighting the need for validated assessment tools. Although the modified Yale Preoperative Anxiety Scale is internationally recognized for evaluating pediatric anxiety, no validated Japanese version is available. Aims We aimed to develop a Japanese version of the modified Yale Preoperative Anxiety Scale per internationally recognized translation guidelines, and conduct a pilot study to assess its feasibility, psychometric properties, and sample size requirements for future formal psychometric evaluations. Methods After obtaining approval from the original authors, a translation team followed the International Society for Pharmacoeconomics and Outcomes Research Task Force Guidelines, including forward and back translations, cultural adaptation, and cognitive debriefing. This pilot study involved 15 children (aged 5–12 years) undergoing elective surgery under general anesthesia. Reliability (internal consistency, inter‐rater, and intra‐rater) and validity (concurrent validity against the State–Trait Anxiety Inventory for Children) were assessed. The Walter's formula was used to calculate the sample size needed for formal reliability studies. Results Following a successful translation and cultural adaptation process, the Japanese version of the scale demonstrated high internal consistency (Cronbach's α = 0.954) and moderate‐to‐very‐good inter‐rater reliability (weighted Kappa = 0.42–0.92). Intra‐rater reliability was excellent (intraclass correlation coefficient = 0.86–0.97). However, correlations with the STAIC‐State were poor (rs = −0.20 to −0.01), likely reflecting cultural norms of emotional restraint and differences in assessment timings. Sample size calculations indicated that 99 patients would be required for future reliability studies. Conclusions The Japanese version of the scale was successfully developed, and pilot findings indicated its feasibility in Japanese clinical settings; a large multicenter validation is now required to confirm its psychometric properties. Incorporating the developed version of the scale into clinical practice may facilitate earlier identification and management of pediatric preoperative anxiety in Japan. Trial Registration UMIN Clinical Trials Registry: UMIN000047537
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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 | 0.005 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
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".