Cross-cultural validation of the stroke riskometer using generalizability theory

Abstract The Stroke Riskometer mobile application is a novel, validated way to provide personalized stroke risk assessment for individuals and motivate them to reduce their risks. Although this app is being used worldwide, its reliability across different countries has not yet been rigorously invest...

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Main Authors: Oleg Medvedev, Quoc Truong, Alexander Merkin, Robert Borotkanics, Rita Krishnamurthi, Valery Feigin
Format: Article
Language:English
Published: Nature Publishing Group 2021-09-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-021-98591-8
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spelling doaj-3e689f7fb5b948f99fbc831aa61105852021-09-26T11:28:50ZengNature Publishing GroupScientific Reports2045-23222021-09-0111111010.1038/s41598-021-98591-8Cross-cultural validation of the stroke riskometer using generalizability theoryOleg Medvedev0Quoc Truong1Alexander Merkin2Robert Borotkanics3Rita Krishnamurthi4Valery Feigin5School of Psychology, Faculty of Arts and Social Sciences, University of WaikatoSchool of Psychology, Faculty of Arts and Social Sciences, University of WaikatoAuckland University of Technology, School of Clinical SciencesAuckland University of Technology, School of Clinical SciencesAuckland University of Technology, School of Clinical SciencesAuckland University of Technology, School of Clinical SciencesAbstract The Stroke Riskometer mobile application is a novel, validated way to provide personalized stroke risk assessment for individuals and motivate them to reduce their risks. Although this app is being used worldwide, its reliability across different countries has not yet been rigorously investigated using appropriate methodology. The Generalizability Theory (G-Theory) is an advanced statistical method suitable for examining reliability and generalizability of assessment scores across different samples, cultural and other contexts and for evaluating sources of measurement errors. G-Theory was applied to the Stroke Riskometer data sampled from 1300 participants in 13 countries using two-facet nested observational design (person by item nested in the country). The Stroke Riskometer demonstrated strong reliability in measuring stroke risks across the countries with coefficients G relative and absolute of 0.84, 95%CI [0.79; 0.89] and 0.82, 95%CI [0.76; 0.88] respectively. D-study analyses revealed that the Stroke Riskometer has optimal reliability in its current form in measuring stroke risk for each country and no modifications are required. These results suggest that the Stroke Riskometer’s scores are generalizable across sample population and countries permitting cross-cultural comparisons. Further studies investigating reliability of the Stroke Riskometer over time in longitudinal study design are warranted.https://doi.org/10.1038/s41598-021-98591-8
collection DOAJ
language English
format Article
sources DOAJ
author Oleg Medvedev
Quoc Truong
Alexander Merkin
Robert Borotkanics
Rita Krishnamurthi
Valery Feigin
spellingShingle Oleg Medvedev
Quoc Truong
Alexander Merkin
Robert Borotkanics
Rita Krishnamurthi
Valery Feigin
Cross-cultural validation of the stroke riskometer using generalizability theory
Scientific Reports
author_facet Oleg Medvedev
Quoc Truong
Alexander Merkin
Robert Borotkanics
Rita Krishnamurthi
Valery Feigin
author_sort Oleg Medvedev
title Cross-cultural validation of the stroke riskometer using generalizability theory
title_short Cross-cultural validation of the stroke riskometer using generalizability theory
title_full Cross-cultural validation of the stroke riskometer using generalizability theory
title_fullStr Cross-cultural validation of the stroke riskometer using generalizability theory
title_full_unstemmed Cross-cultural validation of the stroke riskometer using generalizability theory
title_sort cross-cultural validation of the stroke riskometer using generalizability theory
publisher Nature Publishing Group
series Scientific Reports
issn 2045-2322
publishDate 2021-09-01
description Abstract The Stroke Riskometer mobile application is a novel, validated way to provide personalized stroke risk assessment for individuals and motivate them to reduce their risks. Although this app is being used worldwide, its reliability across different countries has not yet been rigorously investigated using appropriate methodology. The Generalizability Theory (G-Theory) is an advanced statistical method suitable for examining reliability and generalizability of assessment scores across different samples, cultural and other contexts and for evaluating sources of measurement errors. G-Theory was applied to the Stroke Riskometer data sampled from 1300 participants in 13 countries using two-facet nested observational design (person by item nested in the country). The Stroke Riskometer demonstrated strong reliability in measuring stroke risks across the countries with coefficients G relative and absolute of 0.84, 95%CI [0.79; 0.89] and 0.82, 95%CI [0.76; 0.88] respectively. D-study analyses revealed that the Stroke Riskometer has optimal reliability in its current form in measuring stroke risk for each country and no modifications are required. These results suggest that the Stroke Riskometer’s scores are generalizable across sample population and countries permitting cross-cultural comparisons. Further studies investigating reliability of the Stroke Riskometer over time in longitudinal study design are warranted.
url https://doi.org/10.1038/s41598-021-98591-8
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