The modified COVID‐19 Yorkshire Rehabilitation Scale (C19‐YRSm) patient‐reported outcome measure for Long Covid or Post‐COVID‐19 syndrome

  1. Manoj Sivan
  2. Nick Preston
  3. Amy Parkin
  4. Sophie Makower
  5. Jeremy Gee
  6. Denise Ross
  7. Rachel Tarrant
  8. Jennifer Davison
  9. Stephen Halpin
  10. Rory J. O'Connor
  11. Mike Horton

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Abstract

Background

The C19‐YRS is the literature's first condition‐specific, validated scale for patient assessment and monitoring in Post‐COVID‐19 syndrome (PCS). The 22‐item scale's subscales (scores) are symptom severity (0–100), functional disability (0–50), additional symptoms (0–60), and overall health (0–10).

Objectives

This study aimed to test the scale's psychometric properties using Rasch analysis and modify the scale based on analysis findings, emerging information on essential PCS symptoms, and feedback from a working group of patients and professionals.

Methods

Data from 370 PCS patients were assessed using a Rasch Measurement Theory framework to test model fit, local dependency, response category functioning, differential item functioning, targeting, reliability, and unidimensionality. The working group undertook iterative changes to the scale based on the psychometric results and including essential symptoms.

Results

Symptom severity and functional disability subscales showed good targeting and reliability. Post hoc rescoring suggested that a 4‐point response category structure would be more appropriate than an 11‐point response for both subscales. Symptoms with binary responses were placed in the other symptoms subscale. The overall health single‐item subscale remained unchanged.

Conclusion

A 17‐item C19‐YRSm was developed with subscales (scores): symptom severity (0–30), functional disability (0–15), other symptoms (0–25), and overall health (0–10).

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  1. Version published to 10.1002/jmv.27878
  2. ScreenIT

    SciScore for 10.1101/2022.03.24.22272892: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: A favourable ethical opinion was received from the University of Leeds School of Medicine Research Ethics Committee in January 2021 (reference MREC 20-041 - Secondary analysis of C19-YRS (COVID-19 Yorkshire Rehabilitation Scale) and approved by Leeds Community Healthcare Research and Innovation department.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    A favourable ethical opinion was received from the University of Leeds School of Medicine Research Ethics Committee in January 2021 (reference MREC 20-041 - Secondary analysis of C19-YRS (COVID-19 Yorkshire Rehabilitation Scale) and approved by Leeds Community Healthcare Research and Innovation department.
    Community Healthcare
    suggested: None

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    The NIHR-funded project Long Covid Multidisciplinary Consortium for Optimising treatments and services acrOss the NHS (LOCOMOTION) is a platform of >5000 patients in the UK whose symptoms and functional limitations will be captured using the modified C19-YRS at regular 3-monthly intervals.24 We will have the opportunity to assess the construct and criterion validity of the scale, responsiveness and ability to monitor effect of interventions, along with picking up the natural daily and weekly fluctuations of the condition. This can also estimate how effectively the measure captures differences between individuals, and changes over time within the individual. The floor and ceiling effects of the measure will be assessed to establish the active measurement range of the scale, and we will estimate how effectively the measure captures small differences between individuals at either end of the clinical spectrum of the condition. We will also evaluate the respondent burden of completing the measure within the population, and we will assess the use of digital tools, which can be challenging in certain cohorts (such as those with cognitive problems and those who do not use smartphones). The scale will undergo further Rasch analysis to validate the scale and determine its validity as an outcome measure in LC. Additionally, when the assumptions of the Rasch model are satisfied, it is possible to transform the ordinal-level scale raw scores to an interval-level score, due to the sufficie...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

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  3. Version published to 10.1101/2022.03.24.22272892v1 on medRxiv