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Good survey research depends on asking the right questions; it is the only way to ensure that the information collected from respondents is suitable for providing good answers to our research questions. The article discusses and advocates a comprehensive consideration of qualitative-interpretive methodology in open forms of pretesting for the evaluation of draft survey questionnaires. We outline an approach we call Qualitative Pretest Interview (QPI). It transfers the idea of negotiated common understanding in everyday communication to the clarification of meaning in draft survey questions and similar stimuli. The QPI involves ascribing interview partners the role of co-experts in this process and employing methodically integrated communication strategies. This paper focusses on how QPIs are conducted. Using an example interview, we illustrate how the particular way of qualitative pretest interviewing aims at a dialogic clarification of meaning in order to reach intersubjective understanding between participant and interviewer. In the process, we gain detailed insights into how and why a certain questionnaire might not work as intended, and ideally how this might be alleviated. QPIs pursue similar goals as Cognitive Interviews but rely more systematically on qualitative-interpretive methodology.

Background In the current scholarly landscape, predatory journals have increasingly emerged along with open-access journals. These journals aim for profit rather than trusted science. Therefore, the main purpose of the current study is to assess the impact of an educational intervention on physicians' and researchers' knowledge, practices, and perceptions regarding predatory journals. Methods This is an interventional, randomized, pretest–posttest, control group study. Physicians and researchers from King Fahad Medical City were randomly assigned either to an intervention group (received educational training) or a control group without training. A structured questionnaire was developed and validated to assess knowledge, practices, and perceptions toward predatory journals was used. Results A total of 304 participants enrolled in the study at baseline were allocated equally to intervention and control groups ( n  = 152, each). The distributions of baseline characteristics were similar in both groups. Post-intervention, participants in the intervention group showed significantly higher adjusted mean knowledge scores compared to the control group (10.26 ± 2.9 vs. 7.12 ± 4.1; p <  0.001) with moderate effect size; = 0.095. Post-intervention practice scores were also significantly higher in the intervention group (45.81 ± 10.3) than in the control group (40.61 ± 12.1; p =  0.001), although the effect size was small (ƞₚ 2  = 0.0048). Perception scores showed no significant difference between groups post-intervention (32.83 ± 3.9 vs. 33.55 ± 3.8; p =  0.316; ƞₚ 2  = 0.005). Conclusions The educational intervention significantly improved participants’ knowledge and practices but not their perceptions. Moreover, the post-intervention knowledge and practice scores reflected a moderate to small effect size, suggesting a room for further enhancement through sustained educational efforts.

Interpreting positive and negative predictive values of diagnostic tests is crucial for clinical decision-making as they quantify the clinician's confidence in an individual's disease status after testing. For a given diagnostic test, these values depend on the pretest probability (ie, the probability that an individual has the disease before testing), which differs across individuals. Therefore, they should not be presented as a single pair for clinical use. To account for this individual variability in pretest probability and the minimum confidence level required to conclude on an individual's disease status, we propose the use of the minimum and maximum pretest probabilities (“PTP+conf” and “PTP-conf”). These thresholds depend on the test's sensitivity and specificity, as well as the clinician's predefined confidence level. They represent the pretest probability above (or below) which a positive (or negative) test result allows the clinician to reach that minimum confidence level (“conf”) regarding the presence or absence of disease. These “PTP+conf” and “PTP-conf” values can be considered as intrinsic characteristics of a diagnostic test for a given confidence threshold. Clinicians then only need to compare their bedside estimate of the individual's pretest probability with “PTP+conf” (if positive result) or “PTP-conf” (if negative result) to determine whether they can conclude with sufficient confidence after obtaining the test result. •Predictive values guide decisions only if based on pretest probability.•Predictive values do not depend only on disease prevalence in clinical medicine.•Clinicians must estimate pretest probability from the full clinical picture.•Minimum and maximum pretest probabilities allow conclusion with predefined confidence.•Pretest probabilities are intrinsic to each diagnostic test for a given confidence.

Background Many of the conditions of the COVID-19 pandemic were consistent with factors shown to be predictive of parental stress and burnout. The purpose of the current study was to use a retrospective pretest method to gain an understanding of the effects of the COVID-19 pandemic on levels of parental burnout and on parenting practices. Method A brief survey was conducted using a retrospective pretest method to examine parental burnout (The Parental Burnout Assessment, Roskam et al, 2018) and parenting practices (The Alabama Parenting Questionnaire, Frick, 1991). The survey asked parent participants to answer questions about their experiences before and during the pandemic. Results Findings indicated that the pandemic had a significant impact on parents, increasing overall levels of parental burnout and impacting parenting practices by reducing use of positive parenting strategies and increasing use of inconsistent discipline and corporal punishment. These changes in parenting practices were even more pronounced for parents whose levels of parental burnout moved from “normal” levels before the pandemic to clinical levels during the pandemic. Conclusion The findings of the current study suggest that the COVID-19 pandemic has had a negative impact on levels of parental burnout and parenting practices. Although additional research is needed, the results suggest that there is a need for clinicians to understand the effects that the pandemic may have had on parents and families with an understanding that families may be at ongoing risk despite a relaxation of COVID-19 restrictions.

Among the alternative solutions being tested to improve access to genetic services, chatbots (or conversational agents) are being increasingly used for service delivery. Despite the growing number of studies on the accessibility and feasibility of chatbot genetic service delivery, limited attention has been paid to user interactions with chatbots in a real-world health care context. We examined users' interaction patterns with a pretest cancer genetics education chatbot as well as the associations between users' clinical and sociodemographic characteristics, chatbot interaction patterns, and genetic testing decisions. We analyzed data from the experimental arm of Broadening the Reach, Impact, and Delivery of Genetic Services, a multisite genetic services pragmatic trial in which participants eligible for hereditary cancer genetic testing based on family history were randomized to receive a chatbot intervention or standard care. In the experimental chatbot arm, participants were offered access to core educational content delivered by the chatbot with the option to select up to 9 supplementary informational prompts and ask open-ended questions. We computed descriptive statistics for the following interaction patterns: prompt selections, open-ended questions, completion status, dropout points, and postchat decisions regarding genetic testing. Logistic regression models were used to examine the relationships between clinical and sociodemographic factors and chatbot interaction variables, examining how these factors affected genetic testing decisions. Of the 468 participants who initiated a chat, 391 (83.5%) completed it, with 315 (80.6%) of the completers expressing a willingness to pursue genetic testing. Of the 391 completers, 336 (85.9%) selected at least one informational prompt, 41 (10.5%) asked open-ended questions, and 3 (0.8%) opted for extra examples of risk information. Of the 77 noncompleters, 57 (74%) dropped out before accessing any informational content. Interaction patterns were not associated with clinical and sociodemographic factors except for prompt selection (varied by study site) and completion status (varied by family cancer history type). Participants who selected ≥3 prompts (odds ratio 0.33, 95% CI 0.12-0.91; P=.03) or asked open-ended questions (odds ratio 0.46, 95% CI 0.22-0.96; P=.04) were less likely to opt for genetic testing. Findings highlight the chatbot's effectiveness in engaging users and its high acceptability, with most participants completing the chat, opting for additional information, and showing a high willingness to pursue genetic testing. Sociodemographic factors were not associated with interaction patterns, potentially indicating the chatbot's scalability across diverse populations provided they have internet access. Future efforts should address the concerns of users with high information needs and integrate them into chatbot design to better support informed genetic decision-making.

Background A pretest probability must be selected to calculate data to help clinicians, guideline boards and policy makers interpret diagnostic accuracy parameters. When multiple analyses for the same target condition are compared, identical pretest probabilities might be selected to facilitate the comparison. Some pretest probabilities may lead to exaggerations of the patient harms or benefits, and guidance on how and why to select a specific pretest probability is minimally described. Therefore, the aim of this study was to assess the data sources and methods used in Cochrane diagnostic test accuracy (DTA) reviews for determining pretest probabilities to facilitate the interpretation of DTA parameters. A secondary aim was to assess the use of identical pretest probabilities to compare multiple meta-analyses within the same target condition. Methods Cochrane DTA reviews presenting at least one meta-analytic estimate of the sensitivity and/or specificity as a primary analysis published between 2008 and January 2018 were included. Study selection and data extraction were performed by one author and checked by other authors. Observed data sources (e.g. studies in the review, or external sources) and methods to select pretest probabilities (e.g. median) were categorized. Results Fifty-nine DTA reviews were included, comprising of 308 meta-analyses. A pretest probability was used in 148 analyses. Authors used included studies in the DTA review, external sources, and author consensus as data sources for the pretest probability. Measures of central tendency with or without a measure of dispersion were used to determine the pretest probabilities, with the median most commonly used. Thirty-two target conditions had at least one identical pretest probability for all of the meta-analyses within their target condition. About half of the used identical pretest probabilities were inside the prevalence ranges from all analyses within a target condition. Conclusions Multiple sources and methods were used to determine (identical) pretest probabilities in Cochrane DTA reviews. Indirectness and severity of downstream consequences may influence the acceptability of the certainty in calculated data with pretest probabilities. Consider: whether to present normalized frequencies, the influence of pretest probabilities on normalized frequencies, and whether to use identical pretest probabilities for meta-analyses in a target condition.

This study aims to address the existing concerns for mediation meta-analysis (MMA) conducted under pretest–posttest-control-group (PPCG) designs. These issues include the validity of meta-analytic structural equation modeling with a binary independent variable, heterogeneously defined treatment doses, and potential violations of the homogeneous variance assumption. Moreover, an open question remains regarding whether effect sizes in MMA over PPCG designs should be computed from posttest scores (PSMMA) or from pretest–posttest change scores (CSMMA). This study employs theoretical discussions and Monte Carlo simulations to demonstrate the feasibility of MMA under PPCG designs and to compare CSMMA and PSMMA. Furthermore, the procedures for computing effect sizes are summarized, and an empirical example is presented.

There are inconsistent findings concerning the efficacy of consensus messages to persuade individuals to hold scientifically supported positions on climate change. In this experiment, we tested the impact of consensus messages on skeptics’ climate beliefs and attitudes and investigated how the decision to pretest initial climate beliefs and attitudes prior to consensus message exposure may influence results. We found that although consensus messages led individuals to report higher scientific agreement estimates, total effects on key variables were likely an artifact of study design; consensus messages only affected climate attitudes and beliefs when they were measured both before and after message exposure. In the absence of a pretest, we did not observe significant total effects of consensus messages on climate outcomes. These results highlight the limitations of consensus messaging strategies at reducing political polarization and the importance of experimental designs that mimic real-world contexts.

Purpose Antimicrobial resistance poses a major threat to human health globally and antibiotic overuse is a main driver of resistance. Antimicrobial stewardship (AMS) was developed to improve the rationale use of antibiotics. The Choosing Wisely campaign was initiated to ameliorate medical practice through avoidance of unnecessary diagnostic and therapeutic procedures. Our objective was to give an overview on the Choosing Wisely recommendations related to AMS practices from a selection of different countries in order to define future needs. Methods We evaluated the seven countries already analyzed for Choosing Wisely recommendations related to topics of infectious medicine before. Finally, we included five of the former countries (Australia/New Zealand, Canada, Italy, Switzerland, and USA) and Germany with easily accessible recommendations and selected those related to six categories of AMS as following: diagnostics, indication, choice of antiinfective drugs, dosing, application and duration of therapy. Results In total, 213 recommendations could be extracted related to AMS for the six countries and were matched to the chosen categories. Interestingly, no recommendations were found for the category “dosing.” Topics related to indication and diagnostics were most frequently found with 85 and 78 recommendations, respectively. Perioperative prophylaxis was a frequently addressed issue – both related to application, indication and duration. Avoiding antibiotic treatment of asymptomatic bacteriuria and upper respiratory tract infections were central topics of all countries. Conclusion AMS is an important strategy to fight increasing resistance and is frequently addressed by Choosing Wisely recommendations of different countries. Similar issues are considered important in the selected countries.

Objectives To conduct the first outcome evaluation of pre-service academy training instruction on newly hired correctional officers’ custodial and rehabilitative orientations toward those serving time in prisons. Method A quasi-experimental design involving 505 pre-service correctional officers from three states was conducted. Officers were surveyed prior to and immediately after their academy training instruction. Changes in their orientations were assessed with t -tests and are displayed graphically. Results Basic academy training affects rehabilitative orientations insofar as officers are subjected to more hours of specific training. Changes were observed among officers whose training consisted of 8 hours of rehabilitation training. Conclusions Our results suggest training academies may be an effective vehicle for changing correctional officers’ orientations toward rehabilitation. State governments should take heed and consider whether training regimens should include a greater emphasis on rehabilitation.