Part 1:
1. Choose a paper describing the development or validation of a measure of relevance in health disparities research (please give the full citation and/or upload the paper if that's possible).
https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1000273
The Malawi Developmental Assessment Tool (MDAT): The Creation, Validation, and Reliability of a tool to assess child development in rural African settings
2. What was the definition of the construct?
Childhood development (4 domains: gross motor, fine motor, language, social) to identify early sign of childhood disability in a lower SES, rural population of children in Malawi
3. How did the authors provide evidence on the validity of the measure? Could you think of additional approaches to validating the measure?
Gladstone et al identified that there are few culturally appropriate development assessment tools to assess children in lower resource countries. They created a draft developmental tool based on the Denver, a common developmental screen used in Western countries, after some initial qualitative assessments. Face and content validity of the draft tool was assessed and the content of the tool was finalized. Then they assessed ~1400 rural children ages 0-6 who were believed to be otherwise healthy and developmentally on track per their caregivers assessment. They examined performance of each content item in the four domains using logistic regression. They assessed reliability via kappa statistics. Then they removed items that were found to be poor performers or who were too cumbersome for the users to perform. Then the tool was validated comparing normal health controls with children with a known history of malnutrition or neurodisabilities using a pass/fail approach for each content item. This appears to be a reasonable, step wise approach to tool validation.
4. How did the authors provide evidence on the reliability of the measure? Could you think of additional approaches to evaluating the reliability of the measure?
See above.
5. Describe the implications of a lack of measurement validity or reliability for future research applications.
In this example, content validity is crucial for the development of a new tool. Otherwise, you are not actually assessing childhood disability/developmental delay appropriately and your tool is meaningless. Reliability is helpful as children will likely be assessed multiple times over their early childhood. It would be important that results are reproducible in order to track actual improvement in the different developmental domains.
Part 2:
1. Find a paper describing a health disparity (please give the full citation or, even better, upload the paper so everyone else can look at it too)
http://pediatrics.aappublications.org/content/140/3/e20170918
Racial/Ethnic Disparity in NICU Quality of Care Delivery
2. Summarize the construct and measurement of the dimension of disparity (e.g., racial inequalities?, SES inequalities?) and the outcome measured (e.g., self-rated health).
Racial inequalities in very low birth weight infants (< 1500 g) admitted to NICU in California
3. What is the evidence for the validity and reliability of the measures?
http://pediatrics.aappublications.org/content/134/1/74.long
Link above is paper that describes the creation of Baby- monitor a composite indicator of NICU quality. The 9 measures of quality were determined by a panel of experts and this tool was validated using data from the same California Perinatal Quality Care database. The original tool was validated using a sample of ~ 9000 very low birth weight infants from the same regional hospitals. Risk adjusted composite scores were derived to assess for differences in hospital performance. The subsequent sensitivity analysis was done to determine approaches to normalization, weighting and aggregation of individual measures.
4. What is the reference category used for the disparity measure (ie, who is the comparison group)? Why does this reference category make sense (or not) for this research question?
The study compared baby monitor score to baby monitor score with the reference category being overall score.
5. How is the disparity quantified or measured? Is this an absolute or relative measure or are both provided? Describe which type of measure you would prefer for this research area, or, if both, why.
This study calculated an overall composite baby MONITOR score for each hospital in the network and compared it to a race adjusted score using the same scale. Then they did a subcomponent analysis comparing African American VLBW infants to white infants.
Part 3:
1. Read someone else's response to part 1 above (identifying a construct) and comment, specifically noting whether you can see any additional implications of measurement quality for future research or whether you agree with those noted by your classmate.
Overall, I agree with the description of the Afulani et al paper on the Development of a tool to measure person centered maternity care in developing settings. One additional area that Ashley briefly discusses in her assessment is the study may have provided a limited view of SES using rural vs urban as a proxy. I would like further research to consider the possible biases in this assumption and consider collecting additional information to determine SES. Commonly, other studies in similar settings, have looked at education level, information about housing material, access to specific services (water, electricity etc), number of individuals living in the household, and household income.