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Based on caregiver descriptions, some symptoms seemed to overlap with others and therefore were combined during item development (i.e., difficulty breathing was best described using a combination of loud, noisy breathing and rapid or shallow breathing; shortness of breath was combined with rapid or shallow breathing; congestion (unspecified) was better described as loud, noisy breathing).
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In short, content validity was established by submitting scale items to content experts during the iterative item development process, and face validity was explored during cognitive debriefing conducted during pilot testing with volunteers who meet study eligibility criteria.
However, we did obtain information about the appropriateness of certain item features from teachers both before item development and during our pilot and field-testing steps.
Items were developed using an iterative process of: item development, review and revisions.
A fifth-grade reading level was maintained for item development.
EBIP adoption scale item development (Groccia and Buskist (2011).
This results in considerable costs for item development, pretesting, and item calibration (Veldkamp and Matteucci 2013).
Development was a multi-stage process including item development, item reduction using item-response theory (IRT), psychometric testing and external validation, and assessment of clinical utility.
The assumption underlying item development was the creation of sufficient items to cover each concept revealed during domain identification, but the major approach to factor analysis in this study was exploratory, to determine the underlying structure.
Items were also examined against a structured item development criteria [ 38] (see Table 2).
9 dimensions applicable to all DSTs relate to Information (8 items); Probabilities (8 items); Values (4 items); Decision Guidance (2 items); Development (6 items); Evidence (5 items); Disclosure (2 items); Plain language (1 item); Evaluation (2 items).
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