Page 75 - Portuguese Journal - SPORL - Vol 61. Nº2

eliminate duplicates. Subsequently, we read journals; (2) recommended with caution –
the abstracts and excluded the articles that did evidence of the nine clinimetric properties
not meet the predefined criteria. In addition, of reliability and validity (meeting the criteria)
we read the lists of references in the selected and the remaining criteria described in (1); (3)
articles to obtain additional information. with potential to be recommended – gaps
and/or major shortcomings in the linguistic
Data analysis and cultural adaptation and clinimetric
The clinimetric properties were analyzed properties, and lack of application studies by
according to the recommendations of authors other than those who performed the
COSMIN (Table 1). For the analysis of the adaptation into EP in peer-reviewed journals.

clinical and scientific utility, the international
recommendations were used, e.g., COSMIN : Results
2
(1) recommended – evidence of the 10 Of the 73 potential documents, only 14 articles,
recommended properties (meeting most of six Master’s dissertations, and four doctoral
the criteria) and existence of application studies theses were found to be eligible (Figure
by authors other than those who performed 1). Twelve (50%) were studies on linguistic
the adaptation into EP in peer-reviewed and cultural adaptation and/or validation of

Table 1
Clinimetric properties

Properties Criteria
Internal consistency Cronbach’s alpha ≥0.70 for the overall scale and subscales.
Reliability Test-retest or ICC (intra-class correlation coefficient) or Cohen’s weighted Kappa
is recommended, which should be ≥ 0.70.
reproducibility

the factorial analysis and because a small sample has a higher
Measurement error Standard error of measurement (SEM)/sample >100 (a requirement for
probability of error).
The linguistic and cultural adaptation should consider the analysis by
experts and a pre-test with patients-cognitive interview (same target
Content validity population as the original) and/or a pilot test (population not included
in the subsequent validation study). The adaptation should maintain
the original format.

Factorial analysis in an adequate sample (e.g., item per person equal to
Structural validity or higher than 7 people per item or at least 100 people); the factors
should explain at least 50% of the variance.
Validity Discriminant validity Administration to two distinct groups (e.g., group with dysphonia
and the control group), confirmation of the study hypothesis (p<0.05).
Stability of the measure Degree of performance of the items in a translated or culturally adapted
or validity of the linguistic instrument that adequately reflects the performance of the items of the
and cultural adaptation original version of the instrument (with similar target populations).
Two instruments with similar constructs (one deemed the gold standard)
Concurrent should correlate (p<0.05) and the coefficient of correlation (Spearman
Criterion validity or Pearson) should be ≥0.70.
validity
Predictive Receiver operating characteristic (ROC) analysis with the area under the
validity curve (AUC) value ≥ 0.7 is recommended.
Minimal
Sensitivity important Ability to detect MID over time in a group in which change is expected,
to change difference e.g., after an intervention (clinical group), longitudinal study.
(MID)

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