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On the other hand, high ceiling percentages were encountered in some items (i.e. "Social function: visiting others" and "Driving: driving at night").
Individual analysis of OHS subscales identified postoperative ceiling percentages above 15%, but when observed in conjunction there is only 11% of patients achieving best scores on both measures.
For instance, Garbuz (2006) reported postoperative ceiling percentages of 13.4% for the summary OHS, 25.4% for the pain subscale and 22.6% for the function subscale.
High ceiling percentages were encountered in some items (i.e. 'Color vision: difficulty matching clothes', 'Mental health: Amount true: embarrassment') and moderate skewing of data was detected.
5 Danish and German translation validation studies of the OHS reported varied ceiling percentages, 19.9% for the Danish and no ceiling effect (percentage not given) in the German version.
A further examination of the scale items revealed that they were highly left skewed, with ceiling percentages of 80.4% and 81.5%, leading to 72.7% of the scale scores reaching the plausible maximum of 6 (Table 1).
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The percentage responding at the lowest and highest response category can be considered the floor and ceiling percentage, respectively.
The percentage of people with scores at the ceiling (percentage of subjects with a score of 100) and floor (lowest level) were calculated for each scale.
The floor (percentage of patients with the lowest score) and ceiling (percentage of patients with the highest score) effect were calculated for each one of the ECOS-16 items and for the overall score.
Missing data and floor and ceiling effects (percentages of participants indicating minimum and maximum scores) of the CASP-19 were investigated in order to verify the validity and reliability of scale content (Ware & Gandek, 1998).
Missing items: percentage of patients with any missing items; Missing score: percentage of patients with any missing score; Floor effect: percentage of patients with worst possible score (0); Ceiling effect: percentage of patients with best possible score (100).
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