In this method the two least symptomatic answers score 0 and the two most symptomatic answers score 1 – i.e. 0-0-1-1 0-0-1-1 0-0-1-1 0-0-1-1
The two least symptomatic answers score 0 and the two most symptomatic answers score 1. Scores of four or more indicate a high level of psychological distress.
Mean percentage of symptomatic answers was 40%, and only 3 of the 58 items showed an extreme response pattern with a percentage below 10%.
Statistical analyses refer to the number of missing values per item, percentage of symptomatic answers, age- or gender-related item bias, item total correlations, and resulting scale reliabilities Cronbach's Alpha.
All items matched the criteria for percentage of symptomatic answers (pi), reflecting how "easy" it is to answer an item in a symptomatic way, i.e. to say "yes" in our case (with all items coded towards identity diffusion before analysis).
While in the German sample, the mean percentage of symptomatic answers (pi) was 30% and 20 of the 58 items showed a percentage below 10% [ 19], in the Mexican sample the mean pi was 40% and only 3 items showed an extreme value for "difficulty to be answered with yes" with a pi below 10%.
If there are more than 10% of missing values for any item or if the relevant question is answered mostly in the same way by the subjects, e.g. "completely yes" or "completely no" (i.e. excessively high or low percentage of symptomatic answers and therefore no discrimination between the individuals), this "problematic item" would have to be reconsidered and improved.
Item analyses and selection was based on the criteria: percentage of symptomatic answers (5-95%), effect size f of gender- or age-related item bias < .40, mean item-total correlation rit > .30, and potentially improving scale reliability Cronbach's α by item rejection while avoiding trivial redundancy as well as keeping a broad balance of scale content.
In line with the validation procedure used for the original AIDA[ 18, 19], we defined the following criteria: percentage of symptomatic answers pi between 20-80% with an optimum of 50% and only single outliers of 5-95% per scale, effect size f of gender- or age-related item bias < .40, and item total correlation referring to the items' scale and subscale rit > .30.30
Moreover, dietary supplements are not seen as a symptomatic or palliative answer but as a more satisfying option, an attempt to "cure the cause" of the illness.
Based on the overall low numbers of reported nonunion and symptomatic malunion, we conclude and answer our final question that plate fixation is a safe treatment option for DMCF.
