Background: There is a growing interest in studying the effects of arthritis on a person's work productivity using a growing variety of outcome indicators. Objectives:To develop a valid and reliable shortened version of the Workplace Activity Limitation Scale 12 (WALS-12) for assessing work productivity limitations in rheumatoid arthritis (RA) patients. Methods:A cross-sectional study involving 277 RA patients was conducted. An exploratory factor analysis on WALS-12 was used for item reduction on the first sample. Then confirmatory factor analysis (CFA) was run to establish the best fit indices of the reduced version. On the second sample, CFA and linear discriminant analysis were performed to assess the diagnostic performance and discriminant ability of the reduced form. A Bland-Altman method was used to find the agreement between the WALS-12 and the reduced one. Results:The WALS-12 was reduced to 5 items. The Cronbach α was 0.817, with a composite reliability of 0.715. The Spearman rho correlation coefficient ranged between 0.675 and 0.795 for WALS-5, which was higher for the scale items with their domains than the correlation of WALS-5 with the domains of Work Limitations Questionnaire-25. Also, the root square of the average variant extracted from WALS-5 was 0.802. WALS-5 showed excellent discriminant ability with an area under the curve of 0.98 (P < .001), sensitivity of 97%, specificity of 82%, and accuracy of 94%.The reduced version WALS-5 was in agreement with the original version WALS-12.Conclusions: WALS-5 is a valid and reliable tool to assess the work productivity limitations in RA patients.
Breast cancer is a common malignancy worldwide. It is considered top cancer in women and about 13% of women in the general population will develop breast cancer sometimes during their lives, with a gradual increase in incidence as survival increases. Primary prevention of breast cancer is directed toward promoting a healthy lifestyle and reversing modifiable risk factors; these factors include smoking cessation, physical activity, alcohol, and dietary modification. Imaging plays an important role in the diagnosis and management of breast cancer, it is also considered the most valuable tool in screening breast cancer. Mammogram is the most widely used method; it is recommended by many societies and committees as a useful method for early detection of breast cancer. False-positive and over-diagnosis constitute a problem in using screening mammogram. The implementation of a screening program faces many issues that may adversely affect its success such as personal factors, social factors, and accessibility issues. These issues should be identified as the initial step in program implementation. The role of Magnetic Resonance Imaging and Ultrasound is mainly in high-risk patients. The introduction of Artificial Intelligence in Mammogram may add beneficial effects in time and efforts improving its efforts.
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