Four of six indicators with low difficulty indices that led to non-significant differences in the level of understanding highlight characteristics of indicators that are unsupported by the current conditions in the health system.
Two indicators with higher difficulty indices that result in a significant difference in the level of understanding among respondents highlight characteristics of indicators with complete definition yet are easily misunderstood by health workers.
Two indicators with low difficulty indices that led to significant differences in the level of understanding highlight characteristics of incomplete or ambiguous definitions.
However, these indicators showed a relatively low difficulty index with a non-significant discrimination index.
The discrimination index and difficulty index for each item show the current understandability of the definition of indicators.
These thresholds were intended to represent what is maximally attainable by the average practice, and they therefore reflect the anticipated level of difficulty of indicators.
A total of 71 adjustments were performed with the TMS in 24 patients (Table 2), 12 adjustments were problematic due to difficulties placing indicator or locator tool correctly, resulting in a time consuming adjustment process.
Using these three aspects is better than using 'having some difficulty on any indicator' to measure disability (40).
Parenting difficulty is another indicator of problems with parent child interaction that predicted psychopathology in our study and is supported by some previous studies as an important factor in this regard [ 12, 31, 33].
During the second part of the workshop, the distribution of ratings was presented for each of the good practice indicators and major issues related to clarity, policy relevance, appropriateness and content of the good practice indicators, difficulty of rating, appropriateness and completeness of evidence presented were discussed in plenary.
The participants underscored the difficulty in selecting indicators for monitoring.
