General Health Questionnaire – 28 (GHQ-28) - Stroke Engine

The General Health Questionnaire – 28 (GHQ-28) is a self-report questionnaire that is used as a screening XTesting for disease in people without ... Skiptocontent GeneralHealthQuestionnaire–28(GHQ-28) BacktoTop Close GeneralHealthQuestionnaire–28(GHQ-28) EvidenceReviewedasofbefore:18-01-2015 Author(s)*:AnnabelMcDermott,OT Editor(s):AnnieRochette,PhDOT Contentconsistency:GabrielPlumier Purpose TheGeneralHealthQuestionnaire–28(GHQ-28)isaself-reportquestionnairethatisusedasascreeningTestingfordiseaseinpeoplewithoutsymptoms.toolforpsychologicalwellbeing. In-DepthReview Purposeofthemeasure TheGeneralHealthQuestionnaire–28(GHQ-28)isself-reportscreeningTestingfordiseaseinpeoplewithoutsymptoms.measureusedtodetectpossiblepsychologicaldisorder.TheGHQ-28identifiestwomainconcerns:(1)theinabilitytocarryoutnormalfunctions;and(2)theappearanceofnewanddistressingphenomena(Goldberg&Hillier,1979). Availableversions TheGHQ-28isderivedfromtheoriginal60-itemGeneralHealthQuestionnaire.Thereisalsoa30-itemversion(GHQ-30)anda12-itemversion(GHQ-12). Featuresofthemeasure Items: TheGHQ-28consistsof28questionsdesignedtoidentifywhetheranindividual’scurrentmentalstatediffersfromhis/hertypicalstate.Questionsinclude: Haveyourecentlybeenfeelingperfectlywellandingoodhealth? Haveyourecentlylostmuchsleepoverworry? Haveyourecentlybeenmanagingtokeepyourselfbusyandoccupied? Haveyourecentlyfeltconstantlyunderstrain? Haveyourecentlyfeltthatlifeisentirelyhopeless? FactoranalysisoftheGHQ-28identifiedfour7-itemsubscales: Somaticsymptoms(items1-7) Anxiety/insomnia(items8-14) Socialdysfunction(items15-21) SeveredepressionIllnessinvolvingthebody,mood,andthoughts,thataffectsthewayapersoneatsandsleeps,thewayonefeelsaboutoneself,andthewayonethinksaboutthings.Adepressivedisorderisnotthesameasapassingbluemoodorasignofpersonalweaknessoraconditionthatcanbewishedaway.Peoplewithadepressivediseasecannotmerely“pullthemselvestogether”andgetbetter.Withouttreatment,symptomscanlastforweeks,months,oryears.Appropriatetreatment,however,canhelpmostpeoplewithdepression.(items22-28). ThereisahighcorrelationTheextenttowhichtwoormorevariablesareassociatedwithoneanother.Acorrelationcanbepositive(asonevariableincreases,theotheralsoincreases–forexampleheightandweighttypicallyrepresentapositivecorrelation)ornegative(asonevariableincreases,theotherdecreases–forexampleasthecostofgasolinegoeshigher,thenumberofmilesdrivendecreases.Thereareawidevarietyofmethodsformeasuringcorrelationincluding:intraclasscorrelationcoefficients(ICC),thePearsonproduct-momentcorrelationcoefficient,andtheSpearmanrank-ordercorrelation.betweentheanxietysubscaleManymeasurementinstrumentsaremultidimensionalandaredesignedtomeasuremorethanoneconstructormorethanonedomainofasingleconstruct.Insuchinstancessubscalescanbeconstructedinwhichthevariousitemsfromascalearegroupedintosubscales.Althoughasubscalecouldconsistofasingleitem,inmostcasessubscalesconsistofmultipleindividualitemsthathavebeencombinedintoacompositescore(NationalMultipleSclerosisSociety).andthetotalscore,showingthatanxietyisacommonsymptomofpsychiatricdisorders(Goldberg&Hillier,1979).Accordingly,subscalesarenotindependentofeachotherandsubscoresshouldnotbeusedtoindicatespecificpsychologicaldiagnoses.Rather,themeasureisusedtoidentifythepresenceofsymptomscomparedtowhatisnormalfortheindividual(Salteretal.,2013). Scoring: Theindividualisaskedtoratehowhe/shefeelsinrelationtoeachquestion,accordingtothefollowingcriteria: Betterthanusual Sameasusual Worsethanusual Muchworsethanusual Differentscoringmethodshavebeenreported.OnescoringmethodadoptsaLikertscaleLikertscalingisonetypeofresponsetoitemsinaquestionnaireortool.Forexample,Likertscalingwouldhaveyourateanitemsuchas“IamsatisfiedwiththecareIreceived”onascaleusinga1-to-5responsescalewhere:•1=stronglydisagree•2=disagree•3=undecided•4=agree•5=stronglyagreeYouwillfindvariousoptionsandscalingmethodsforthenumberofresponsechoices(1-to-7,1-to-9,0-to-4).Odd-numberedscalesusuallyhaveamiddlevaluethatislabelledNeutralorUndecided.Sometoolsusedforced-choiceLikertscalingwithanevennumberofresponsesandnomiddleneutralorundecidedchoice.of0to3,resultinginatotalpossiblescorerangeof0to84.ThisLikertscoringsystemwasusedwiththeoriginal60-itemGHQ(Goldberg&Hillier,1979). Analternativeandmorecommonmethodattributesabinaryscoresystemof0tothefirstandsecondresponseoptions(betterthanusual,sameasusual)andascoreof1tothethirdandfourthresponseoptions(worsethanusual,muchworsethanusual). Somenotethatthisscoringsystemisnotsensitivetoindividualswithchronicconditions,wheretheindividualmayhaveexperiencedasymptomforaprolongedperiodoftime(O’Rourkeetal.,1998).Accordingly,thechronicscoringmethodattributesascoreof0tothefirstitem(betterthanusual)andascoreof1tothethirdandfourthitems,asperthetraditionalscoringmethod.Theseconditem(‘sameasusual’)receivesascoreof0fornegativeitemsandascoreof1forpositiveitems. Responseoption Traditional(acute)scoringmethod Chronicscoringmethod Likertscoringmethod Betterthanusual 0 0(allitems) 0 Sameasusual 0 0(negativeitems)1(positiveitems) 1 Worsethanusual 1 1 2 Muchworsethanusual 1 1 3 Higherscoresindicateagreaterpossibilityofpsychologicaldistress.Ascore≥5hasbeenreportedtoindicateprobablecasesofpsychiatricdisorder(Andersonetal.,1996),howeverthishasnotbeenvalidatedasthemostappropriatescoreforthestrokeAlsocalleda“brainattack”andhappenswhenbraincellsdiebecauseofinadequatebloodflow.20%ofcasesareahemorrhageinthebraincausedbyaruptureorleakagefromabloodvessel.80%ofcasesarealsoknowasa“schemicstroke”,ortheformationofabloodclotinavesselsupplyingbloodtothebrain.population(Salteretal.,2013). Whattoconsiderbeforebeginning: Thechoiceofscoringmethodmayimpactdiagnosis. TheGHQ-28isnotdesignedtodetectchronicmentalhealthconditions. Time: TheGHQ-28takesapproximately5minutestoadminister. Trainingrequirements NotrainingrequirementshavebeenspecifiedfortheGHQ-28,howeveritisadvisedthatcliniciansreadtheassessmentmanualpriortouse. Equipment TheGHQ-28isaself-reportquestionnairethatdoesnotrequirespecificequipment. Clientsuitability Canbeusedwith: IndividualswithstrokeAlsocalleda“brainattack”andhappenswhenbraincellsdiebecauseofinadequatebloodflow.20%ofcasesareahemorrhageinthebraincausedbyaruptureorleakagefromabloodvessel.80%ofcasesarealsoknowasa“schemicstroke”,ortheformationofabloodclotinavesselsupplyingbloodtothebrain. Individualswith cardiacconditions Individualswith spinalcordinjury Individualswithmusculoskeletalconditions Theelderly(RehabilitationMeasuresDatabase,2010) Shouldnotbeusedwith: TheGHQ-28hasnotbeenreportedtobeunsuitableforusewithanyparticularpopulation. Inwhatlanguagesisthemeasureavailable? TheGHQ-28isavailablein38languages(Sterling,2011)andhascross-culturalapplicability(Kilicetal.,1997). Summary Whatdoesthetoolmeasure? Psychologicalwellbeing. Whattypesofclientscanthetoolbeusedfor? TheGHQ-28canbeusedwith,butisnotlimitedto,patientswithstrokeAlsocalleda“brainattack”andhappenswhenbraincellsdiebecauseofinadequatebloodflow.20%ofcasesareahemorrhageinthebraincausedbyaruptureorleakagefromabloodvessel.80%ofcasesarealsoknowasa“schemicstroke”,ortheformationofabloodclotinavesselsupplyingbloodtothebrain.. IsthisascreeningTestingfordiseaseinpeoplewithoutsymptoms.orassessmenttool? ScreeningTestingfordiseaseinpeoplewithoutsymptoms.. Timetoadminister Fiveminutes. ICFDomain BodyFunction. Versions GHQ(original60-itemversion) GHQ-30 GHQ-28 GHQ-12 OtherLanguages TheGHQisavailablein38languages MeasurementProperties ReliabilityReliabilitycanbedefinedinavarietyofways.Itisgenerallyunderstoodtobetheextenttowhichameasureisstableorconsistentandproducessimilarresultswhenadministeredrepeatedly.Amoretechnicaldefinitionofreliabilityisthatitistheproportionof“true”variationinscoresderivedfromaparticularmeasure.Thetotalvariationinanygivenscoremaybethoughtofasconsistingoftruevariation(thevariationofinterest)anderrorvariation(whichincludesrandomerroraswellassystematicerror).Truevariationisthatvariationwhichactuallyreflectsdifferencesintheconstructunderstudy,e.g.,theactualseverityofneurologicalimpairment.Randomerrorrefersto“noise”inthescoresduetochancefactors,e.g.,aloudnoisedistractsapatientthusaffectinghisperformance,which,inturn,affectsthescore.Systematicerrorreferstobiasthatinfluencesscoresinaspecificdirectioninafairlyconsistentway,e.g.,oneneurologistinagrouptendstorateallpatientsasbeingmoredisabledthandootherneurologistsinthegroup.Therearemanyvariationsonthemeasurementofreliabilityincludingalternate-forms,internalconsistency,inter-rateragreement,intra-rateragreement,andtest-retest. InternalconsistencyAmethodofmeasuringreliability.Internalconsistencyreflectstheextenttowhichitemsofatestmeasurevariousaspectsofthesamecharacteristicandnothingelse.Internalconsistencycoefficientscantakeonvaluesfrom0to1.Highervaluesrepresenthigherlevelsofinternalconsistency.: NostudieshavereportedoninternalconsistencyAmethodofmeasuringreliability.Internalconsistencyreflectstheextenttowhichitemsofatestmeasurevariousaspectsofthesamecharacteristicandnothingelse.Internalconsistencycoefficientscantakeonvaluesfrom0to1.Highervaluesrepresenthigherlevelsofinternalconsistency.oftheGHQinasampleofindividualswithstrokeAlsocalleda“brainattack”andhappenswhenbraincellsdiebecauseofinadequatebloodflow.20%ofcasesareahemorrhageinthebraincausedbyaruptureorleakagefromabloodvessel.80%ofcasesarealsoknowasa“schemicstroke”,ortheformationofabloodclotinavesselsupplyingbloodtothebrain.. Test-retest: Onestudyreportedexcellenttest-retestreliabilityAwayofestimatingthereliabilityofascaleinwhichindividualsareadministeredthesamescaleontwodifferentoccasionsandthenthetwoscoresareassessedforconsistency.Thismethodofevaluatingreliabilityisappropriateonlyifthephenomenonthatthescalemeasuresisknowntobestableovertheintervalbetweenassessments.Ifthephenomenonbeingmeasuredfluctuatessubstantiallyovertime,thenthetest-retestparadigmmaysignificantlyunderestimatereliability.Inusingtest-retestreliability,theinvestigatorneedstotakeintoaccountthepossibilityofpracticeeffects,whichcanartificiallyinflatetheestimateofreliability(NationalMultipleSclerosisSociety).oftheGHQ-28inasampleofindividualswithstrokeAlsocalleda“brainattack”andhappenswhenbraincellsdiebecauseofinadequatebloodflow.20%ofcasesareahemorrhageinthebraincausedbyaruptureorleakagefromabloodvessel.80%ofcasesarealsoknowasa“schemicstroke”,ortheformationofabloodclotinavesselsupplyingbloodtothebrain.(timesincestrokeAlsocalleda“brainattack”andhappenswhenbraincellsdiebecauseofinadequatebloodflow.20%ofcasesareahemorrhageinthebraincausedbyaruptureorleakagefromabloodvessel.80%ofcasesarealsoknowasa“schemicstroke”,ortheformationofabloodclotinavesselsupplyingbloodtothebrain.notspecified). Intra-rater: Nostudieshavereportedontheintra-raterreliabilityThisisatypeofreliabilityassessmentinwhichthesameassessmentiscompletedbythesameraterontwoormoreoccasions.Thesedifferentratingsarethencompared,generallybymeansofcorrelation.Sincethesameindividualiscompletingbothassessments,therater’ssubsequentratingsarecontaminatedbyknowledgeofearlierratings.oftheGHQinasampleofindividualswithstrokeAlsocalleda“brainattack”andhappenswhenbraincellsdiebecauseofinadequatebloodflow.20%ofcasesareahemorrhageinthebraincausedbyaruptureorleakagefromabloodvessel.80%ofcasesarealsoknowasa“schemicstroke”,ortheformationofabloodclotinavesselsupplyingbloodtothebrain.. Inter-rater: Nostudieshavereportedontheinter-raterreliabilityAmethodofmeasuringreliability.Inter-raterreliabilitydeterminestheextenttowhichtwoormoreratersobtainthesameresultwhenusingthesameinstrumenttomeasureaconcept.oftheGHQinasampleofindividualswithstrokeAlsocalleda“brainattack”andhappenswhenbraincellsdiebecauseofinadequatebloodflow.20%ofcasesareahemorrhageinthebraincausedbyaruptureorleakagefromabloodvessel.80%ofcasesarealsoknowasa“schemicstroke”,ortheformationofabloodclotinavesselsupplyingbloodtothebrain.. ValidityThedegreetowhichanassessmentmeasureswhatitissupposedtomeasure. Criterion: Concurrent: –OnestudyreportedexcellentconcurrentvalidityTovalidateanewmeasure,theresultsofthemeasurearecomparedtotheresultsofthegoldstandardobtainedatapproximatelythesamepointintime(concurrently),sotheybothreflectthesameconstruct.Thisapproachisusefulinsituationswhenaneworuntestedtoolispotentiallymoreefficient,easiertoadminister,morepractical,orsaferthananothermoreestablishedmethodandisbeingproposedasanalternativeinstrument.Seealso“goldstandard.”betweentheGHQ-28totalscoreandtheZungSelf-RatingDepressionIllnessinvolvingthebody,mood,andthoughts,thataffectsthewayapersoneatsandsleeps,thewayonefeelsaboutoneself,andthewayonethinksaboutthings.Adepressivedisorderisnotthesameasapassingbluemoodorasignofpersonalweaknessoraconditionthatcanbewishedaway.Peoplewithadepressivediseasecannotmerely“pullthemselvestogether”andgetbetter.Withouttreatment,symptomscanlastforweeks,months,oryears.Appropriatetreatment,however,canhelpmostpeoplewithdepression.Scale,HamiltonDepressionIllnessinvolvingthebody,mood,andthoughts,thataffectsthewayapersoneatsandsleeps,thewayonefeelsaboutoneself,andthewayonethinksaboutthings.Adepressivedisorderisnotthesameasapassingbluemoodorasignofpersonalweaknessoraconditionthatcanbewishedaway.Peoplewithadepressivediseasecannotmerely“pullthemselvestogether”andgetbetter.Withouttreatment,symptomscanlastforweeks,months,oryears.Appropriatetreatment,however,canhelpmostpeoplewithdepression.ScaleandthePresentStateExamination. –OnestudyreportednodifferencebetweentheGHQ-30andHADScaletotalscoreswhenidentifyinganyDSM-IVdiagnosis,anxietyordepressionIllnessinvolvingthebody,mood,andthoughts,thataffectsthewayapersoneatsandsleeps,thewayonefeelsaboutoneself,andthewayonethinksaboutthings.Adepressivedisorderisnotthesameasapassingbluemoodorasignofpersonalweaknessoraconditionthatcanbewishedaway.Peoplewithadepressivediseasecannotmerely“pullthemselvestogether”andgetbetter.Withouttreatment,symptomscanlastforweeks,months,oryears.Appropriatetreatment,however,canhelpmostpeoplewithdepression.. Predictive: OnestudyreportedthatpatientswithacutetochronicstrokeAlsocalleda“brainattack”andhappenswhenbraincellsdiebecauseofinadequatebloodflow.20%ofcasesareahemorrhageinthebraincausedbyaruptureorleakagefromabloodvessel.80%ofcasesarealsoknowasa“schemicstroke”,ortheformationofabloodclotinavesselsupplyingbloodtothebrain.whowerediagnosedasdepressedaccordingtoICD-10orDSM-IIIRcriteriaachievedasignificantlyhigherGHQ-28totalscorethanpatientswhowerenotdiagnosedasdepressed;ascore>4ontheGHQ-28correlatedwithdepressionIllnessinvolvingthebody,mood,andthoughts,thataffectsthewayapersoneatsandsleeps,thewayonefeelsaboutoneself,andthewayonethinksaboutthings.Adepressivedisorderisnotthesameasapassingbluemoodorasignofpersonalweaknessoraconditionthatcanbewishedaway.Peoplewithadepressivediseasecannotmerely“pullthemselvestogether”andgetbetter.Withouttreatment,symptomscanlastforweeks,months,oryears.Appropriatetreatment,however,canhelpmostpeoplewithdepression.amongparticipants. Construct: Convergent/Discriminant: –OnestudyreportedadequatecorrelationsbetweentheGHQ-12andtheStrokeAlsocalleda“brainattack”andhappenswhenbraincellsdiebecauseofinadequatebloodflow.20%ofcasesareahemorrhageinthebraincausedbyaruptureorleakagefromabloodvessel.80%ofcasesarealsoknowasa“schemicstroke”,ortheformationofabloodclotinavesselsupplyingbloodtothebrain.andAphasiaAphasiaisanacquireddisordercausedbyaninjurytothebrainandaffectsaperson’sabilitytocommunicate.Itismostoftentheresultofstrokeorheadinjury.Anindividualwithaphasiamayexperiencedifficultyexpressingthemselveswhenspeaking,difficultyunderstandingthespeechofothers,anddifficultyreadingandwriting.Sadly,aphasiacanmaskaperson’sintelligenceandabilitytocommunicatefeelings,thoughtsandemotions.(TheAphasiaInstitute,Canada)QualityofLifescale(SAQOL)andSAQOL-39meanscores;adequatecorrelationsbetweentheGHQ-12andSAQOLsubtests;andadequatetoexcellentcorrelationsbetweentheGHQ-12andSAQOL-39subtests. –OnestudyreportedthatindividualswithstrokeAlsocalleda“brainattack”andhappenswhenbraincellsdiebecauseofinadequatebloodflow.20%ofcasesareahemorrhageinthebraincausedbyaruptureorleakagefromabloodvessel.80%ofcasesarealsoknowasa“schemicstroke”,ortheformationofabloodclotinavesselsupplyingbloodtothebrain.withaBeckDepressionIllnessinvolvingthebody,mood,andthoughts,thataffectsthewayapersoneatsandsleeps,thewayonefeelsaboutoneself,andthewayonethinksaboutthings.Adepressivedisorderisnotthesameasapassingbluemoodorasignofpersonalweaknessoraconditionthatcanbewishedaway.Peoplewithadepressivediseasecannotmerely“pullthemselvestogether”andgetbetter.Withouttreatment,symptomscanlastforweeks,months,oryears.Appropriatetreatment,however,canhelpmostpeoplewithdepression.Inventory(BDI)scoreof11-18(milddepressionIllnessinvolvingthebody,mood,andthoughts,thataffectsthewayapersoneatsandsleeps,thewayonefeelsaboutoneself,andthewayonethinksaboutthings.Adepressivedisorderisnotthesameasapassingbluemoodorasignofpersonalweaknessoraconditionthatcanbewishedaway.Peoplewithadepressivediseasecannotmerely“pullthemselvestogether”andgetbetter.Withouttreatment,symptomscanlastforweeks,months,oryears.Appropriatetreatment,however,canhelpmostpeoplewithdepression.)demonstratedGHQ-28medianscoresof27.0and28.0at1and6monthspost-strokerespectively;individualswithaBDIscore≥19(severedepressionIllnessinvolvingthebody,mood,andthoughts,thataffectsthewayapersoneatsandsleeps,thewayonefeelsaboutoneself,andthewayonethinksaboutthings.Adepressivedisorderisnotthesameasapassingbluemoodorasignofpersonalweaknessoraconditionthatcanbewishedaway.Peoplewithadepressivediseasecannotmerely“pullthemselvestogether”andgetbetter.Withouttreatment,symptomscanlastforweeks,months,oryears.Appropriatetreatment,however,canhelpmostpeoplewithdepression.)demonstratedGHQ-28medianscoresof44.0and48.0at1and6monthspost-strokerespectively. –Nostudieshavereportedoncross-diagnosticvalidityThedegreetowhichanassessmentmeasureswhatitissupposedtomeasure.oftheGHQinasampleofindividualswithstrokeAlsocalleda“brainattack”andhappenswhenbraincellsdiebecauseofinadequatebloodflow.20%ofcasesareahemorrhageinthebraincausedbyaruptureorleakagefromabloodvessel.80%ofcasesarealsoknowasa“schemicstroke”,ortheformationofabloodclotinavesselsupplyingbloodtothebrain.. KnownGroups: Nostudieshavereportedonknown-groupvalidityThedegreetowhichanassessmentmeasureswhatitissupposedtomeasure.oftheGHQinasampleofpatientswithstrokeAlsocalleda“brainattack”andhappenswhenbraincellsdiebecauseofinadequatebloodflow.20%ofcasesareahemorrhageinthebraincausedbyaruptureorleakagefromabloodvessel.80%ofcasesarealsoknowasa“schemicstroke”,ortheformationofabloodclotinavesselsupplyingbloodtothebrain.. Floor/CeilingEffects Nostudieshavereportedonfloor/ceilingeffectsoftheGHQwithinasampleofindividualswithstrokeAlsocalleda“brainattack”andhappenswhenbraincellsdiebecauseofinadequatebloodflow.20%ofcasesareahemorrhageinthebraincausedbyaruptureorleakagefromabloodvessel.80%ofcasesarealsoknowasa“schemicstroke”,ortheformationofabloodclotinavesselsupplyingbloodtothebrain.. Doesthetooldetectchangeinpatients? TheGHQ-28isintendedforuseasascreeningTestingfordiseaseinpeoplewithoutsymptoms.instrumentandthereforeisnotdesignedtomeasurechangeovertime.–Onestudyreported81%sensitivitySensitivityreferstotheprobabilitythatadiagnostictechniquewilldetectaparticulardiseaseorconditionwhenitdoesindeedexistinapatient(NationalMultipleSclerosisSociety).Seealso“Specificity.”and68%specificitySpecificityreferstotheprobabilitythatadiagnostictechniquewillindicateanegativetestresultwhentheconditionisabsent(truenegative).oftheGHQ-28whenusingcutoffscoresof11/12(optimalinrelationtoDSM-IIIRcriteria),or85%sensitivitySensitivityreferstotheprobabilitythatadiagnostictechniquewilldetectaparticulardiseaseorconditionwhenitdoesindeedexistinapatient(NationalMultipleSclerosisSociety).Seealso“Specificity.”and61%specificitySpecificityreferstotheprobabilitythatadiagnostictechniquewillindicateanegativetestresultwhentheconditionisabsent(truenegative).whenusingcutoffscoresof7/8(optimalinrelationtoICD-10criteria).–Onestudyexaminedreported80%sensitivitySensitivityreferstotheprobabilitythatadiagnostictechniquewilldetectaparticulardiseaseorconditionwhenitdoesindeedexistinapatient(NationalMultipleSclerosisSociety).Seealso“Specificity.”and76%specificitySpecificityreferstotheprobabilitythatadiagnostictechniquewillindicateanegativetestresultwhentheconditionisabsent(truenegative).oftheGHQ-30whenusingacutoffscoreof8/9. Acceptability TheGHQ-28isnon-invasiveandquicktoadminister.Cautionshouldbeexercisedwithscoring. Feasibility TheGHQ-28issuitableforadministrationinvarioussettings.Theassessmentisquicktoadministerandrequiresminimalspecialistequipmentortraining. Howtoobtainthetool? https://www.gl-assessment.co.uk/products/general-health-questionnaire-ghq/ PsychometricProperties Overview AliteraturesearchwasconductedtoidentifyallrelevantpublicationsonthepsychometricpropertiesoftheGHQrelevanttothestrokeAlsocalleda“brainattack”andhappenswhenbraincellsdiebecauseofinadequatebloodflow.20%ofcasesareahemorrhageinthebraincausedbyaruptureorleakagefromabloodvessel.80%ofcasesarealsoknowasa“schemicstroke”,ortheformationofabloodclotinavesselsupplyingbloodtothebrain.population.Fivestudieswereidentified.PleasenotethatthreeofthesestudiesusetheGHQ-28(Lincolnetal.,2003;Robinson&Price,1982;Thomas&Lincoln,2006);onestudythatusedtheGHQ-30(O’Rourkeetal.,1998)andonestudythatusedtheGHQ-12(Hilarietal.,2003)werealsoincluded. Floorandceilingeffect NostudieshavereportedonthefloororceilingeffectsoftheGHQinasampleofindividualswithstrokeAlsocalleda“brainattack”andhappenswhenbraincellsdiebecauseofinadequatebloodflow.20%ofcasesareahemorrhageinthebraincausedbyaruptureorleakagefromabloodvessel.80%ofcasesarealsoknowasa“schemicstroke”,ortheformationofabloodclotinavesselsupplyingbloodtothebrain.. Reliability InternalconsistencyAmethodofmeasuringreliability.Internalconsistencyreflectstheextenttowhichitemsofatestmeasurevariousaspectsofthesamecharacteristicandnothingelse.Internalconsistencycoefficientscantakeonvaluesfrom0to1.Highervaluesrepresenthigherlevelsofinternalconsistency.: NostudieshavereportedoninternalconsistencyAmethodofmeasuringreliability.Internalconsistencyreflectstheextenttowhichitemsofatestmeasurevariousaspectsofthesamecharacteristicandnothingelse.Internalconsistencycoefficientscantakeonvaluesfrom0to1.Highervaluesrepresenthigherlevelsofinternalconsistency.oftheGHQinasampleofindividualswithstrokeAlsocalleda“brainattack”andhappenswhenbraincellsdiebecauseofinadequatebloodflow.20%ofcasesareahemorrhageinthebraincausedbyaruptureorleakagefromabloodvessel.80%ofcasesarealsoknowasa“schemicstroke”,ortheformationofabloodclotinavesselsupplyingbloodtothebrain.. Test-retest: RobinsonandPrice(1982)examinedtest-retestreliabilityAwayofestimatingthereliabilityofascaleinwhichindividualsareadministeredthesamescaleontwodifferentoccasionsandthenthetwoscoresareassessedforconsistency.Thismethodofevaluatingreliabilityisappropriateonlyifthephenomenonthatthescalemeasuresisknowntobestableovertheintervalbetweenassessments.Ifthephenomenonbeingmeasuredfluctuatessubstantiallyovertime,thenthetest-retestparadigmmaysignificantlyunderestimatereliability.Inusingtest-retestreliability,theinvestigatorneedstotakeintoaccountthepossibilityofpracticeeffects,whichcanartificiallyinflatetheestimateofreliability(NationalMultipleSclerosisSociety).oftheGHQ-28withasampleof20individuals(timesincestrokeAlsocalleda“brainattack”andhappenswhenbraincellsdiebecauseofinadequatebloodflow.20%ofcasesareahemorrhageinthebraincausedbyaruptureorleakagefromabloodvessel.80%ofcasesarealsoknowasa“schemicstroke”,ortheformationofabloodclotinavesselsupplyingbloodtothebrain.notspecified)andreportedexcellent2-monthtest-retestreliabilityAwayofestimatingthereliabilityofascaleinwhichindividualsareadministeredthesamescaleontwodifferentoccasionsandthenthetwoscoresareassessedforconsistency.Thismethodofevaluatingreliabilityisappropriateonlyifthephenomenonthatthescalemeasuresisknowntobestableovertheintervalbetweenassessments.Ifthephenomenonbeingmeasuredfluctuatessubstantiallyovertime,thenthetest-retestparadigmmaysignificantlyunderestimatereliability.Inusingtest-retestreliability,theinvestigatorneedstotakeintoaccountthepossibilityofpracticeeffects,whichcanartificiallyinflatetheestimateofreliability(NationalMultipleSclerosisSociety).(r=0.90). Intra-rater: Nostudieshavereportedontheintra-raterreliabilityThisisatypeofreliabilityassessmentinwhichthesameassessmentiscompletedbythesameraterontwoormoreoccasions.Thesedifferentratingsarethencompared,generallybymeansofcorrelation.Sincethesameindividualiscompletingbothassessments,therater’ssubsequentratingsarecontaminatedbyknowledgeofearlierratings.oftheGHQinasampleofindividualswithstrokeAlsocalleda“brainattack”andhappenswhenbraincellsdiebecauseofinadequatebloodflow.20%ofcasesareahemorrhageinthebraincausedbyaruptureorleakagefromabloodvessel.80%ofcasesarealsoknowasa“schemicstroke”,ortheformationofabloodclotinavesselsupplyingbloodtothebrain.. Inter-rater: Nostudieshavereportedontheinter-raterreliabilityAmethodofmeasuringreliability.Inter-raterreliabilitydeterminestheextenttowhichtwoormoreratersobtainthesameresultwhenusingthesameinstrumenttomeasureaconcept.oftheGHQinasampleofindividualswithstrokeAlsocalleda“brainattack”andhappenswhenbraincellsdiebecauseofinadequatebloodflow.20%ofcasesareahemorrhageinthebraincausedbyaruptureorleakagefromabloodvessel.80%ofcasesarealsoknowasa“schemicstroke”,ortheformationofabloodclotinavesselsupplyingbloodtothebrain.. Validity Content: TheGHQ-28isascaledversionoftheoriginal60-itemGHQdevelopedbyGoldbergin1978.FactoranalysisoftheoriginalGHQwasconductedinasampleof523individualswhoattendedaprimarycaresetting,resultinginthe28-itemversionwithfour7-itemsubscales(Goldberg&Hillier,1979). Criterion: Concurrent: RobinsonandPrice(1982)examinedconcurrentvalidityTovalidateanewmeasure,theresultsofthemeasurearecomparedtotheresultsofthegoldstandardobtainedatapproximatelythesamepointintime(concurrently),sotheybothreflectthesameconstruct.Thisapproachisusefulinsituationswhenaneworuntestedtoolispotentiallymoreefficient,easiertoadminister,morepractical,orsaferthananothermoreestablishedmethodandisbeingproposedasanalternativeinstrument.Seealso“goldstandard.”oftheGHQ-28inasampleof103individualswithstrokeAlsocalleda“brainattack”andhappenswhenbraincellsdiebecauseofinadequatebloodflow.20%ofcasesareahemorrhageinthebraincausedbyaruptureorleakagefromabloodvessel.80%ofcasesarealsoknowasa“schemicstroke”,ortheformationofabloodclotinavesselsupplyingbloodtothebrain.(timesincestrokeAlsocalleda“brainattack”andhappenswhenbraincellsdiebecauseofinadequatebloodflow.20%ofcasesareahemorrhageinthebraincausedbyaruptureorleakagefromabloodvessel.80%ofcasesarealsoknowasa“schemicstroke”,ortheformationofabloodclotinavesselsupplyingbloodtothebrain.notspecific)bycomparisonwithotherpsychopathologyscales.TheauthorsreportedexcellentconcurrentvalidityTovalidateanewmeasure,theresultsofthemeasurearecomparedtotheresultsofthegoldstandardobtainedatapproximatelythesamepointintime(concurrently),sotheybothreflectthesameconstruct.Thisapproachisusefulinsituationswhenaneworuntestedtoolispotentiallymoreefficient,easiertoadminister,morepractical,orsaferthananothermoreestablishedmethodandisbeingproposedasanalternativeinstrument.Seealso“goldstandard.”betweentheGHQ-28totalscoreandtheZungSelf-RatingDepressionIllnessinvolvingthebody,mood,andthoughts,thataffectsthewayapersoneatsandsleeps,thewayonefeelsaboutoneself,andthewayonethinksaboutthings.Adepressivedisorderisnotthesameasapassingbluemoodorasignofpersonalweaknessoraconditionthatcanbewishedaway.Peoplewithadepressivediseasecannotmerely“pullthemselvestogether”andgetbetter.Withouttreatment,symptomscanlastforweeks,months,oryears.Appropriatetreatment,however,canhelpmostpeoplewithdepression.Scale(r=0.86),HamiltonDepressionIllnessinvolvingthebody,mood,andthoughts,thataffectsthewayapersoneatsandsleeps,thewayonefeelsaboutoneself,andthewayonethinksaboutthings.Adepressivedisorderisnotthesameasapassingbluemoodorasignofpersonalweaknessoraconditionthatcanbewishedaway.Peoplewithadepressivediseasecannotmerely“pullthemselvestogether”andgetbetter.Withouttreatment,symptomscanlastforweeks,months,oryears.Appropriatetreatment,however,canhelpmostpeoplewithdepression.Scale(r=0.88)andthePresentStateExamination(r=0.94). O’Rourkeetal.(1998)examinedconcurrentvalidityTovalidateanewmeasure,theresultsofthemeasurearecomparedtotheresultsofthegoldstandardobtainedatapproximatelythesamepointintime(concurrently),sotheybothreflectthesameconstruct.Thisapproachisusefulinsituationswhenaneworuntestedtoolispotentiallymoreefficient,easiertoadminister,morepractical,orsaferthananothermoreestablishedmethodandisbeingproposedasanalternativeinstrument.Seealso“goldstandard.”oftheGHQ-30inasampleof105individualswithchronicstrokeAlsocalleda“brainattack”andhappenswhenbraincellsdiebecauseofinadequatebloodflow.20%ofcasesareahemorrhageinthebraincausedbyaruptureorleakagefromabloodvessel.80%ofcasesarealsoknowasa“schemicstroke”,ortheformationofabloodclotinavesselsupplyingbloodtothebrain.bycomparisonwiththeHospitalAnxietyandDepressionIllnessinvolvingthebody,mood,andthoughts,thataffectsthewayapersoneatsandsleeps,thewayonefeelsaboutoneself,andthewayonethinksaboutthings.Adepressivedisorderisnotthesameasapassingbluemoodorasignofpersonalweaknessoraconditionthatcanbewishedaway.Peoplewithadepressivediseasecannotmerely“pullthemselvestogether”andgetbetter.Withouttreatment,symptomscanlastforweeks,months,oryears.Appropriatetreatment,however,canhelpmostpeoplewithdepression.(HAD)Scale.TherewasnodifferencebetweentheGHQ-30andHADScaletotalscoreswhenidentifyinganyDSM-IVdiagnosis(p=0.95),anxiety(p=0.25)ordepressionIllnessinvolvingthebody,mood,andthoughts,thataffectsthewayapersoneatsandsleeps,thewayonefeelsaboutoneself,andthewayonethinksaboutthings.Adepressivedisorderisnotthesameasapassingbluemoodorasignofpersonalweaknessoraconditionthatcanbewishedaway.Peoplewithadepressivediseasecannotmerely“pullthemselvestogether”andgetbetter.Withouttreatment,symptomscanlastforweeks,months,oryears.Appropriatetreatment,however,canhelpmostpeoplewithdepression.(p=0.56),usingROCcurves. Note:Thestudyusedtheconventional0-0-1-1formattoscoretheGHQ-30;thisversionoftheGHQisnotsplitintosubscalesfordepressionIllnessinvolvingthebody,mood,andthoughts,thataffectsthewayapersoneatsandsleeps,thewayonefeelsaboutoneself,andthewayonethinksaboutthings.Adepressivedisorderisnotthesameasapassingbluemoodorasignofpersonalweaknessoraconditionthatcanbewishedaway.Peoplewithadepressivediseasecannotmerely“pullthemselvestogether”andgetbetter.Withouttreatment,symptomscanlastforweeks,months,oryears.Appropriatetreatment,however,canhelpmostpeoplewithdepression.andanxiety. Predictive: Lincolnetal.(2003)examinedpredictivevalidityAformofcriterionvaliditythatexaminesameasure’sabilitytopredictsomesubsequentevent.Example:cantheBergBalanceScalepredictfallsoverthefollowing6weeks?Thecriterionstandardinthisexamplewouldbewhetherthepatientfelloverthenext6weeks.oftheGHQ-28inamixedsampleof143strokeAlsocalleda“brainattack”andhappenswhenbraincellsdiebecauseofinadequatebloodflow.20%ofcasesareahemorrhageinthebraincausedbyaruptureorleakagefromabloodvessel.80%ofcasesarealsoknowasa“schemicstroke”,ortheformationofabloodclotinavesselsupplyingbloodtothebrain.patientswithacutetochronicstrokeAlsocalleda“brainattack”andhappenswhenbraincellsdiebecauseofinadequatebloodflow.20%ofcasesareahemorrhageinthebraincausedbyaruptureorleakagefromabloodvessel.80%ofcasesarealsoknowasa“schemicstroke”,ortheformationofabloodclotinavesselsupplyingbloodtothebrain..PatientswhowerediagnosedasdepressedaccordingtotheICD-10orDSM-IIIRachievedasignificantlyhigher(p≤0.01)GHQ-28totalscorethanpatientswhowerenotdiagnosedasdepressed(ICD-10:kappa=0.40,IQRdepressed9-19/notdepressed3-12;DSM-IIIR:kappa=0.12,IQRdepressed12-21/notdepressed5-13).Ascore>4ontheGHQ-28correlatedwithdepressionIllnessinvolvingthebody,mood,andthoughts,thataffectsthewayapersoneatsandsleeps,thewayonefeelsaboutoneself,andthewayonethinksaboutthings.Adepressivedisorderisnotthesameasapassingbluemoodorasignofpersonalweaknessoraconditionthatcanbewishedaway.Peoplewithadepressivediseasecannotmerely“pullthemselvestogether”andgetbetter.Withouttreatment,symptomscanlastforweeks,months,oryears.Appropriatetreatment,however,canhelpmostpeoplewithdepression.amongparticipants. GHQ-28 ICD-10 DSM-IIIR Depressed(42%) Notdepressed(52%) Depressed(15%) Notdepressed(77%) IQR 9-19 3-12 12-21 5-13 Kappa 0.40 0.12 Construct: Convergent/Discriminant: Hilarietal.(2003)examinedconvergentvalidityAtypeofvaliditythatisdeterminedbyhypothesizingandexaminingtheoverlapbetweentwoormoreteststhatpresumablymeasurethesameconstruct.Inotherwords,convergentvalidityisusedtoevaluatethedegreetowhichtwoormoremeasuresthattheoreticallyshouldberelatedtoeachotherare,infact,observedtoberelatedtoeachother.oftheGHQ-12inasampleof83individualswithchronicstrokeAlsocalleda“brainattack”andhappenswhenbraincellsdiebecauseofinadequatebloodflow.20%ofcasesareahemorrhageinthebraincausedbyaruptureorleakagefromabloodvessel.80%ofcasesarealsoknowasa“schemicstroke”,ortheformationofabloodclotinavesselsupplyingbloodtothebrain.andaphasiaAphasiaisanacquireddisordercausedbyaninjurytothebrainandaffectsaperson’sabilitytocommunicate.Itismostoftentheresultofstrokeorheadinjury.Anindividualwithaphasiamayexperiencedifficultyexpressingthemselveswhenspeaking,difficultyunderstandingthespeechofothers,anddifficultyreadingandwriting.Sadly,aphasiacanmaskaperson’sintelligenceandabilitytocommunicatefeelings,thoughtsandemotions.(TheAphasiaInstitute,Canada),bycomparisonwiththeStrokeAlsocalleda“brainattack”andhappenswhenbraincellsdiebecauseofinadequatebloodflow.20%ofcasesareahemorrhageinthebraincausedbyaruptureorleakagefromabloodvessel.80%ofcasesarealsoknowasa“schemicstroke”,ortheformationofabloodclotinavesselsupplyingbloodtothebrain.andAphasiaAphasiaisanacquireddisordercausedbyaninjurytothebrainandaffectsaperson’sabilitytocommunicate.Itismostoftentheresultofstrokeorheadinjury.Anindividualwithaphasiamayexperiencedifficultyexpressingthemselveswhenspeaking,difficultyunderstandingthespeechofothers,anddifficultyreadingandwriting.Sadly,aphasiacanmaskaperson’sintelligenceandabilitytocommunicatefeelings,thoughtsandemotions.(TheAphasiaInstitute,Canada)QualityofLifescale(SAQOL)andtheSAQOL-39.ThestudyyieldedanadequatecorrelationTheextenttowhichtwoormorevariablesareassociatedwithoneanother.Acorrelationcanbepositive(asonevariableincreases,theotheralsoincreases–forexampleheightandweighttypicallyrepresentapositivecorrelation)ornegative(asonevariableincreases,theotherdecreases–forexampleasthecostofgasolinegoeshigher,thenumberofmilesdrivendecreases.Thereareawidevarietyofmethodsformeasuringcorrelationincluding:intraclasscorrelationcoefficients(ICC),thePearsonproduct-momentcorrelationcoefficient,andtheSpearmanrank-ordercorrelation.betweentheGHQ-12andSAQOLmean(r=0.58,p<0.01)andbetweentheGHQ-12andtheSAQOL-39mean(0.53,p<0.01).CorrelationsbetweentheGHQ-12andSAQOLsubtestswereadequate(moodr=0.57,thinkingr=0.41,personalityr=0.57,energyr=0.32,familyrolesr=0.41,socialrolesr=0.41,workr=0.34,p<0.01).CorrelationsbetweentheGHQ-12andSAQOL-39subtestswereadequate(physicalr=0.39,energyr=0.32,p<0.01)toexcellent(psychosocialr=0.62,p<0.01). ThomasandLincoln(2006)reportedonconvergentvalidityAtypeofvaliditythatisdeterminedbyhypothesizingandexaminingtheoverlapbetweentwoormoreteststhatpresumablymeasurethesameconstruct.Inotherwords,convergentvalidityisusedtoevaluatethedegreetowhichtwoormoremeasuresthattheoreticallyshouldberelatedtoeachotherare,infact,observedtoberelatedtoeachother.oftheGHQ-28inasampleof123individualswithstrokeAlsocalleda“brainattack”andhappenswhenbraincellsdiebecauseofinadequatebloodflow.20%ofcasesareahemorrhageinthebraincausedbyaruptureorleakagefromabloodvessel.80%ofcasesarealsoknowasa“schemicstroke”,ortheformationofabloodclotinavesselsupplyingbloodtothebrain.anddepressionIllnessinvolvingthebody,mood,andthoughts,thataffectsthewayapersoneatsandsleeps,thewayonefeelsaboutoneself,andthewayonethinksaboutthings.Adepressivedisorderisnotthesameasapassingbluemoodorasignofpersonalweaknessoraconditionthatcanbewishedaway.Peoplewithadepressivediseasecannotmerely“pullthemselvestogether”andgetbetter.Withouttreatment,symptomscanlastforweeks,months,oryears.Appropriatetreatment,however,canhelpmostpeoplewithdepression.,bycomparisonwiththeBeckDepressionIllnessinvolvingthebody,mood,andthoughts,thataffectsthewayapersoneatsandsleeps,thewayonefeelsaboutoneself,andthewayonethinksaboutthings.Adepressivedisorderisnotthesameasapassingbluemoodorasignofpersonalweaknessoraconditionthatcanbewishedaway.Peoplewithadepressivediseasecannotmerely“pullthemselvestogether”andgetbetter.Withouttreatment,symptomscanlastforweeks,months,oryears.Appropriatetreatment,however,canhelpmostpeoplewithdepression.Inventory(BDI).Measuresweretakenat1monthand6monthspost-stroke.IndividualswhowerediagnosedwithmilddepressionIllnessinvolvingthebody,mood,andthoughts,thataffectsthewayapersoneatsandsleeps,thewayonefeelsaboutoneself,andthewayonethinksaboutthings.Adepressivedisorderisnotthesameasapassingbluemoodorasignofpersonalweaknessoraconditionthatcanbewishedaway.Peoplewithadepressivediseasecannotmerely“pullthemselvestogether”andgetbetter.Withouttreatment,symptomscanlastforweeks,months,oryears.Appropriatetreatment,however,canhelpmostpeoplewithdepression.(BDIscoreof11-18)demonstratedGHQ-28medianscoresof27.0(IQR=21.5-36.0)and28.0(IQR=22.0-37.0)at1and6monthspost-strokerespectively.IndividualswithseveredepressionIllnessinvolvingthebody,mood,andthoughts,thataffectsthewayapersoneatsandsleeps,thewayonefeelsaboutoneself,andthewayonethinksaboutthings.Adepressivedisorderisnotthesameasapassingbluemoodorasignofpersonalweaknessoraconditionthatcanbewishedaway.Peoplewithadepressivediseasecannotmerely“pullthemselvestogether”andgetbetter.Withouttreatment,symptomscanlastforweeks,months,oryears.Appropriatetreatment,however,canhelpmostpeoplewithdepression.(BDIscore≥19)demonstratedGHQ-28medianscoresof44.0(IQR=32.0-54.5)and48.0(IQR=35.0-55.0)at1and6monthspost-strokerespectively. KnownGroup: Nostudieshavereportedonknown-groupvalidityThedegreetowhichanassessmentmeasureswhatitissupposedtomeasure.oftheGHQinasampleofpatientswithstrokeAlsocalleda“brainattack”andhappenswhenbraincellsdiebecauseofinadequatebloodflow.20%ofcasesareahemorrhageinthebraincausedbyaruptureorleakagefromabloodvessel.80%ofcasesarealsoknowasa“schemicstroke”,ortheformationofabloodclotinavesselsupplyingbloodtothebrain.. Responsiveness SensitivitySensitivityreferstotheprobabilitythatadiagnostictechniquewilldetectaparticulardiseaseorconditionwhenitdoesindeedexistinapatient(NationalMultipleSclerosisSociety).Seealso“Specificity.”&SpecificitySpecificityreferstotheprobabilitythatadiagnostictechniquewillindicateanegativetestresultwhentheconditionisabsent(truenegative).: Lincolnetal.(2003)examinedsensitivitySensitivityreferstotheprobabilitythatadiagnostictechniquewilldetectaparticulardiseaseorconditionwhenitdoesindeedexistinapatient(NationalMultipleSclerosisSociety).Seealso“Specificity.”andspecificitySpecificityreferstotheprobabilitythatadiagnostictechniquewillindicateanegativetestresultwhentheconditionisabsent(truenegative).oftheGHQ-28inamixedsampleof143strokeAlsocalleda“brainattack”andhappenswhenbraincellsdiebecauseofinadequatebloodflow.20%ofcasesareahemorrhageinthebraincausedbyaruptureorleakagefromabloodvessel.80%ofcasesarealsoknowasa“schemicstroke”,ortheformationofabloodclotinavesselsupplyingbloodtothebrain.patientswithacutetochronicstrokeAlsocalleda“brainattack”andhappenswhenbraincellsdiebecauseofinadequatebloodflow.20%ofcasesareahemorrhageinthebraincausedbyaruptureorleakagefromabloodvessel.80%ofcasesarealsoknowasa“schemicstroke”,ortheformationofabloodclotinavesselsupplyingbloodtothebrain..ThestudyfoundthatoptimalcutoffscoresfortheGHQ-28inrelationtoDSM-IIIRandICD-10criteriawere11/12(sensitivitySensitivityreferstotheprobabilitythatadiagnostictechniquewilldetectaparticulardiseaseorconditionwhenitdoesindeedexistinapatient(NationalMultipleSclerosisSociety).Seealso“Specificity.”81%,specificitySpecificityreferstotheprobabilitythatadiagnostictechniquewillindicateanegativetestresultwhentheconditionisabsent(truenegative).68%)and7/8(sensitivitySensitivityreferstotheprobabilitythatadiagnostictechniquewilldetectaparticulardiseaseorconditionwhenitdoesindeedexistinapatient(NationalMultipleSclerosisSociety).Seealso“Specificity.”85%,specificitySpecificityreferstotheprobabilitythatadiagnostictechniquewillindicateanegativetestresultwhentheconditionisabsent(truenegative).61%)respectively. GHQ-28cutoffscore ICD-10diagnosis DSM-IIIRdiagnosis SensitivitySensitivityreferstotheprobabilitythatadiagnostictechniquewilldetectaparticulardiseaseorconditionwhenitdoesindeedexistinapatient(NationalMultipleSclerosisSociety).Seealso“Specificity.” SpecificitySpecificityreferstotheprobabilitythatadiagnostictechniquewillindicateanegativetestresultwhentheconditionisabsent(truenegative). SensitivitySensitivityreferstotheprobabilitythatadiagnostictechniquewilldetectaparticulardiseaseorconditionwhenitdoesindeedexistinapatient(NationalMultipleSclerosisSociety).Seealso“Specificity.” SpecificitySpecificityreferstotheprobabilitythatadiagnostictechniquewillindicateanegativetestresultwhentheconditionisabsent(truenegative). 5 0.98 0.35 1.00 0.24 6 0.98 0.44 1.00 0.29 7 0.88 0.55 0.95 0.41 8 0.85 0.61 0.95 0.47 9 0.78 0.63 0.95 0.52 10 0.72 0.68 0.86 0.57 11 0.63 0.72 0.81 0.63 12 0.57 0.73 0.81 0.68 13 0.48 0.76 0.76 0.73 14 0.47 0.80 0.71 0.76 15 0.43 0.84 0.67 0.80 O’Rourkeetal.(1998)examinedsensitivitySensitivityreferstotheprobabilitythatadiagnostictechniquewilldetectaparticulardiseaseorconditionwhenitdoesindeedexistinapatient(NationalMultipleSclerosisSociety).Seealso“Specificity.”andspecificitySpecificityreferstotheprobabilitythatadiagnostictechniquewillindicateanegativetestresultwhentheconditionisabsent(truenegative).oftheGHQ-30inasampleof105individualswithchronicstrokeAlsocalleda“brainattack”andhappenswhenbraincellsdiebecauseofinadequatebloodflow.20%ofcasesareahemorrhageinthebraincausedbyaruptureorleakagefromabloodvessel.80%ofcasesarealsoknowasa“schemicstroke”,ortheformationofabloodclotinavesselsupplyingbloodtothebrain..Usingpreviouslyrecommendedcutoffscoresof4/5yieldedsensitivitySensitivityreferstotheprobabilitythatadiagnostictechniquewilldetectaparticulardiseaseorconditionwhenitdoesindeedexistinapatient(NationalMultipleSclerosisSociety).Seealso“Specificity.”andspecificitySpecificityreferstotheprobabilitythatadiagnostictechniquewillindicateanegativetestresultwhentheconditionisabsent(truenegative).scoresof0.9and0.47(respectively).Theauthorsrecommendedacutoffscoreof8/9,whichachievedsensitivitySensitivityreferstotheprobabilitythatadiagnostictechniquewilldetectaparticulardiseaseorconditionwhenitdoesindeedexistinapatient(NationalMultipleSclerosisSociety).Seealso“Specificity.”andspecificitySpecificityreferstotheprobabilitythatadiagnostictechniquewillindicateanegativetestresultwhentheconditionisabsent(truenegative).scoresof0.8and0.76(respectively). References Anderson,C.,Laubscher,S.,&Burns,R.(1996).ValidationoftheShortForm36(SF-36)healthsurveyquestionnaireamongstrokepatients.Stroke,27,1812-6. Goldberg,D.P.&Hillier,V.F.(1979).AscaledversionoftheGeneralHealthQuestionnaire.PsychologicalMedicine,9,139-45. Hilari,K.,Byng,S.,Lamping,D.L.,&Smith,S.C.(2003).StrokeandAphasiaQualityofLifeScale-39(SAQOL-39):Evaluationofacceptability,reliabilityandvalidity.Stroke,34,1944-50. Kilic,C.,Rezaki,M.,Rezaki,B.,Kaplan,I.,Ozgen,C.,Sagduyu,A.,&Ozturk,M.O.(1997).GeneralHealthQuestionnaire(GHQ12&GHQ28):psychometricpropertiesandfactorstructureofthescalesinaTurkishprimarycaresample.SocialPsychiatryandPsychiatricEpidemiology,32,327-31. Lincoln,N.B.,Nicholl,C.R.,Flannaghan,T.,Leonard,M.,&VanderGucht,E.(2003).Thevalidityofquestionnairemeasuresforassessingdepressionafterstroke.ClinicalRehabilitation,17,840-6. Malakouti,S.M.,Fatollahi,P.,Mirabzadeh,A.,&Zandi,T.(2007).Reliability,validityandfactorstructureoftheGHQ-28usedamongelderlyIranians.InternationalPsychogeriatrics,19(4),623-34. O’Rourke,S.,MacHale,S.,Signorini,D.,&Dennis,M.(1998).Detectingpsychiatricmorbidityafterstroke:ComparisonoftheGHQandHADScale.Stroke,29,980-5. RehabiliationMeasuresDatabase.(2010).GeneralHealthQuestionnaire-28.Retrievedfromhttp://www.rehabmeasures.org/Lists/RehabMeasures/PrintView.aspx?ID=909 Robinson,R.G.&Price,T.R.(1982).Post-strokedepressivedisorders:Afollow-upstudyof103patients.Stroke,13(5),635-40. Salter,K.,Campbell,N.,Richardson,M.,Mehta,S.,Jutai,J.,Zettler,L.,Moses,M.,McClure,A.,Mays,R.,Foley,N.,&Teasell,R.(2013).OutcomeMeasuresinStrokeRehabilitation.Retrievedfromhttp://www.ebrsr.com/sites/default/files/Chapter21_Outcome-Measures_FINAL_16ed.pdf Sterling,M.(2011).GeneralHealthQuestionnaire–28(GHQ-28).JournalofPhysiotherapy,57,259. Thomas,S.A.&Lincoln,N.B.(2006).Factorsrelatingtodepressionafterstroke.BritishJournalofClinicalPsychology,45,49-61. Werneke,U.,Goldberg,D.P.,Yalcin,I.,&Ustun,B.T.(2000).ThestabilityofthefactorstructureoftheGeneralHealthQuestionnaire.PsychologicalMedicine,30,823-9. Willmott,S.A.,Boardman,J.A.P.,Henshaw,C.A.,&Jones,P.W.(2004).UnderstandingGeneralHealthQuestionnaire(GHQ-28)scoreanditsthreshold.SocialPsychiatryandPsychiatricEpidemiology,39,613-7. Seethemeasure HowtoobtaintheGeneralHealthQuestionnaire–28(GHQ-28)? https://www.gl-assessment.co.uk/products/general-health-questionnaire-ghq/ Tableofcontents Theinformationonthiswebsiteisprovidedforinformationalpurposesonlyandisnotasubstituteforprofessionalmedicaladvice.Ifyouhaveorsuspectyouhaveamedicalproblem,promptlycontactyourprofessionalhealthcareprovider. *Theauthorshavenodirectfinancialinterestinanytools,testsorinterventionspresentedinSTROKEENGINE.RelatedAssessmentsAphasicDepressionRatingScale(ADRS)BeckDepressionInventory(BDI,BDI-II)DOCScreenGeriatricDepressionScale(GDS)HospitalAnxietyandDepressionScale(HADS)MontgomeryAsbergDepressionRatingScale(MADRS)PatientHealthQuestionnaire(PHQ-9)StrokeAphasicDepressionQuestionnaire(SADQ) Survey