The COVID‐19 Yorkshire Rehabilitation Scale (C19‐YRS): Application and psychometric analysis in a post‐COVID‐19 syndrome cohort

O’Connor, Rory J; Preston, Nick; Parkin, Amy; Makower, Sophie; Ross, Denise; Gee, Jeremy; Halpin, Stephen; Horton, Mike; Sivan, Manoj

doi:10.1002/jmv.27415

Cited by 73 publications

(72 citation statements)

References 21 publications

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“… 5 26 Existing symptom measures (n=6) with good face validity in the context of long covid were reviewed to establish whether a new instrument for symptom burden that measured patient reported outcomes was needed. 20 27 28 29 30 31 When mapped to the conceptual framework, symptom coverage of these instruments ranged from 27.0% to 60.3%: mean 34.5% (standard deviation 16.2%). Supplementary table S1 presents the concept coverage matrix mapping symptom coverage of the candidate instruments to the conceptual framework.…”

Section: Methodsmentioning

confidence: 99%

“… 16 17 18 Validated instruments to measure patient reported outcomes have recently been developed to measure the global impact of long covid, and several unvalidated screening tools, surveys, and questionnaires are also available. 19 20 However, individuals living with long covid have suggested that existing self-report measures fail to capture the breadth of experienced symptoms. 10 21 22 To address the need for a comprehensive measure of self-reported symptom burden specific to long covid, we used Rasch analysis to develop and validate, in accordance with US Food and Drug Administration guidance, a novel instrument measuring patient reported outcomes, the symptom burden questionnaire for long covid (SBQ-LC).…”

Section: Introductionmentioning

confidence: 99%

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Development and validation of the symptom burden questionnaire for long covid (SBQ-LC): Rasch analysis

Hughes

Haroon

Subramanian

et al. 2022

BMJ

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ObjectiveTo describe the development and validation of a novel patient reported outcome measure for symptom burden from long covid, the symptom burden questionnaire for long covid (SBQ-LC).DesignMultiphase, prospective mixed methods study.SettingRemote data collection and social media channels in the United Kingdom, 14 April to 1 August 2021.Participants13 adults (aged ≥18 years) with self-reported long covid and 10 clinicians evaluated content validity. 274 adults with long covid field tested the draft questionnaire.Main outcome measuresPublished systematic reviews informed development of SBQ-LC’s conceptual framework and initial item pool. Thematic analysis of transcripts from cognitive debriefing interviews and online clinician surveys established content validity. Consensus discussions with the patient and public involvement group of the Therapies for Long COVID in non-hospitalised individuals: From symptoms, patient reported outcomes and immunology to targeted therapies (TLC Study) confirmed face validity. Rasch analysis of field test data guided item and scale refinement and provided initial evidence of the SBQ-LC’s measurement properties.ResultsSBQ-LC (version 1.0) is a modular instrument measuring patient reported outcomes and is composed of 17 independent scales with promising psychometric properties. Respondents rate their symptom burden during the past seven days using a dichotomous response or 4 point rating scale. Each scale provides coverage of a different symptom domain and returns a summed raw score that can be transformed to a linear (0-100) score. Higher scores represent higher symptom burden. After rating scale refinement and item reduction, all scales satisfied the Rasch model requirements for unidimensionality (principal component analysis of residuals: first residual contrast values <2.00 eigenvalue units) and item fit (outfit mean square values within 0.5 -1.5 logits). Rating scale categories were ordered with acceptable category fit statistics (outfit mean square values <2.0 logits). 14 item pairs had evidence of local dependency (residual correlation values >0.4). Across the 17 scales, person reliability ranged from 0.34 to 0.87, person separation ranged from 0.71 to 2.56, item separation ranged from 1.34 to 13.86, and internal consistency reliability (Cronbach’s alpha) ranged from 0.56 to 0.91.ConclusionsSBQ-LC (version 1.0) is a comprehensive patient reported outcome instrument developed using modern psychometric methods. It measures symptoms of long covid important to people with lived experience of the condition and may be used to evaluate the impact of interventions and inform best practice in clinical management.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Development and validation of the symptom burden questionnaire for long covid (SBQ-LC): Rasch analysis

Hughes

Haroon

Subramanian

et al. 2022

BMJ

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“…For example, O'Connor and coworkers used accepted psychometric measures to characterize the COVID‐19 Yorkshire Rehabilitation Scale. 8 The apparent types and severity of post‐COVID‐19 symptoms might differ based on the instruments used. That used in the present study is available online (Supporting Information Data ).…”

Section: Discussionmentioning

confidence: 99%

Post‐sequelae symptoms and comorbidities after COVID‐19

Duggal

Penson

Manley

et al. 2022

Journal of Medical Virology

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The frequency, severity, and forms of symptoms months after coronavirus 2019 are poorly understood, especially in community settings. To better understand and characterize symptoms months after community-based COVID-19, a retrospective cohort analysis was conducted. Three hundred and twentyeight consecutive persons with a positive test for SARS-CoV-2 in the Johns Hopkins Health System, Maryland, March−May 2020, were selected for the study. Symptom occurrence and severity were measured through questionnaires. Of 328 persons evaluated, a median of 242 days (109−478 days) from the initial positive SARS-CoV-2 test, 33.2% reported not being fully recovered and 4.9% reported symptoms that constrained daily activities. Compared to those who reported being fully recovered, those with post-acute sequelae were more likely to report a prior history of heart attack (p < 0.01). Among those reporting long-term symptoms, men and women were equally represented (men = 34.8%, women = 34.6%), but only women reported symptoms that constrained daily activities, and 56% of them were caregivers. The types of new or persistent symptoms varied, and for many, included a deviation from prior COVID-19 health, such as being less able to exercise, walk, concentrate, or breathe. A limitation is that self-report of symptoms might be biased and/or caused by factors other than COVID-19. Overall, even in a community setting, symptoms may persist months after COVID-19 reducing daily activities including caring for dependents.

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“…The C19-YRS possesses internal consistency, content validity and clinical usefulness for use with persons with Long COVID. 67 …”

Section: Methods and Analysismentioning

confidence: 99%

Long COVID and episodic disability: advancing the conceptualisation, measurement and knowledge of episodic disability among people living with Long COVID – protocol for a mixed-methods study

et al. 2022

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IntroductionAs the prevalence of Long COVID increases, there is a critical need for a comprehensive assessment of disability. Our aims are to: (1) characterise disability experiences among people living with Long COVID in Canada, UK, USA and Ireland; and (2) develop a patient-reported outcome measure to assess the presence, severity and episodic nature of disability with Long COVID.Methods and analysisIn phase 1, we will conduct semistructured interviews with adults living with Long COVID to explore experiences of disability (dimensions, uncertainty, trajectories, influencing contextual factors) and establish an episodic disability (ED) framework in the context of Long COVID (n~10 each country). Using the conceptual framework, we will establish the Long COVID Episodic Disability Questionnaire (EDQ). In phase 2, we will examine the validity (construct, structural) and reliability (internal consistency, test–retest) of the EDQ for use in Long COVID. We will electronically administer the EDQ and four health status criterion measures with adults living with Long COVID, and readminister the EDQ 1 week later (n~170 each country). We will use Rasch analysis to refine the EDQ, and confirm structural and cross-cultural validity. We will calculate Cronbach’s alphas (internal consistency reliability), and intraclass correlation coefficients (test–retest reliability), and examine correlations for hypotheses theorising relationships between EDQ and criterion measure scores (construct validity). Using phase 2 data, we will characterise the profile of disability using structural equation modelling techniques to examine relationships between dimensions of disability and the influence of intrinsic and extrinsic contextual factors. This research involves an academic–clinical–community partnership building on foundational work in ED measurement, Long COVID and rehabilitation.Ethics and disseminationThis study was approved by the University of Toronto Research Ethics Board. Knowledge translation will occur with community collaborators in the form of presentations and publications in open access peer-reviewed journals and presentations.

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The COVID‐19 Yorkshire Rehabilitation Scale (C19‐YRS): Application and psychometric analysis in a post‐COVID‐19 syndrome cohort

Cited by 73 publications

References 21 publications

Development and validation of the symptom burden questionnaire for long covid (SBQ-LC): Rasch analysis

Development and validation of the symptom burden questionnaire for long covid (SBQ-LC): Rasch analysis

Post‐sequelae symptoms and comorbidities after COVID‐19

Long COVID and episodic disability: advancing the conceptualisation, measurement and knowledge of episodic disability among people living with Long COVID – protocol for a mixed-methods study

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