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"documento" => "simple-article" "crossmark" => 1 "subdocumento" => "dis" "cita" => "Enferm Clin. 2017;27:327-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Evidence-based nursing</span>" "titulo" => "Variability of nursing care by APR-DRG and by severity of illness in a sample of nine Belgian hospitals" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "327" "paginaFinal" => "329" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Variabilidad de los cuidados de enfermería según APR-GRD y severidad de la enfermedad en una muestra de nueve hospitales belgas" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Víctor M. 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"apellidos" => "González-Chordá" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1130862117300785" "doi" => "10.1016/j.enfcli.2017.05.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130862117300785?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2445147917300929?idApp=UINPBA00004N" "url" => "/24451479/0000002700000005/v1_201710150045/S2445147917300929/v1_201710150045/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Reliability and effect size: A forgotten relationship" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "330" "paginaFinal" => "331" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Sergio Dominguez-Lara" "autores" => array:1 [ 0 => array:3 [ "nombre" => "Sergio" "apellidos" => "Dominguez-Lara" "email" => array:2 [ 0 => "sdominguezmpcs@gmail.com" 1 => "sdominguezl@usmp.pe" ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Universidad de San Martín de Porres, Lima, Peru" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Fiabilidad y magnitud del efecto: una relación olvidada" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In moderate or small sample sizes (n), be it due to actual characteristics of the population under study or limitations inherent to research, the use of the null hypothesis of statistical testing (NHST) is frequently used, leading to biased conclusions. This is because the NHST, which is normally based on the <span class="elsevierStyleItalic">p</span>-value tends to accept the null hypothesis when n is small, and reject it when n is large, even if its descriptors (e.g. mean and standard deviation) are similar in both circumstances.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> It is therefore recommended that magnitude of effect means (ME) be calculated<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> to complement the mean produced by the NHST.</p><p id="par0010" class="elsevierStylePara elsevierViewall">It is well known that for comparative purposes between groups, one of the most used forms of ME measurement is Cohen's <span class="elsevierStyleItalic">d</span>, which provides information on the magnitude of the difference: <span class="elsevierStyleItalic">insignificant difference</span> (<0.20), <span class="elsevierStyleItalic">small</span> (between 0.20 and 0.50), <span class="elsevierStyleItalic">medium</span> (between 0.50 and 0.80) or large (>0.80) instead of only providing information on the existence of this difference (which is what NHST does). Despite this, on occasions it is not considered that the ME observed depends on 2 factors: (a) the true ME, i.e. the indicator in absence of error of measurement of the variables, and (b) the reliability of scores.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> This is important because it is possible that the low reliability affects statistical estimations and consequently concludes erroneously based on a lower ME.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> Given this situation, an alternative is to compare the observed and true ME.</p><p id="par0015" class="elsevierStylePara elsevierViewall">In a recent study by Carrillo-García et al.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> 2 groups were compared, <span class="elsevierStyleItalic">nurses</span> (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>66) and <span class="elsevierStyleItalic">nurse's aides</span> (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>23), about the working stress perceived indicating that there were statistically significant differences, but without indicating their magnitude or discussing these results and their relevance in the area of study. Furthermore, analysis is based on the NHST, concluding that there were only statistically significant differences in the dimensions of <span class="elsevierStyleItalic">psychological demands</span> and control (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05), but not in <span class="elsevierStyleItalic">support</span> (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0.05). Faced with this situation, a re-analysis of ME could provide additional information.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Thus, considering the data presented in the before-mentioned study (differences of means), <span class="elsevierStyleItalic">d</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">observed</span></span> and <span class="elsevierStyleItalic">d</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">true</span></span><a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> were calculated using the following expression: dtrue=dobservedrxx where <span class="elsevierStyleItalic">r</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">xx</span></span> corresponds to the reliability of scores (e.g. coefficient <span class="elsevierStyleItalic">α</span> of the dimensions). In addition to this, it is possible to calculate an attenuation rate as: dtrue−dobserveddtrue∗100 to find out the percentage of <span class="elsevierStyleItalic">d</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">true</span></span> not quantified in the presence of an error of measurement. It should be noted that when points of reference do not exist to evaluate the magnitude of the attenuation, a moderate percentage (e.g. >30%) could be of interest to the researcher because it would imply that around one third of <span class="elsevierStyleItalic">d</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">true</span></span> was not taken into consideration in the <span class="elsevierStyleItalic">d</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">observed</span></span>.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Study findings (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>) in addition to the report of Carrillo-García et al.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> suggest that there is a <span class="elsevierStyleItalic">small</span> difference between nurses and nurses’ aides in the <span class="elsevierStyleItalic">support</span> dimension, although it would be pending discussion as to whether that magnitude (0.23) has any practical relevance in the working context studied, given the importance attached to the support in the study discussion.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> However, the differences found in the 2 remaining dimensions should be considered for further analysis since both occupational groups share jobs, and a differential perception regarding <span class="elsevierStyleItalic">demands</span> and <span class="elsevierStyleItalic">control</span> could affect performance. In addition, even though the magnitudes of reliability are only <span class="elsevierStyleItalic">acceptable</span> (0.70<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">α</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>80) and the lower limit of their confidence<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> is low (<0.70), they do not significantly attenuate the <span class="elsevierStyleItalic">d</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">true</span></span> since they do not substantially differ from the <span class="elsevierStyleItalic">d</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">observed</span></span> (<20%).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">To conclude, the report of ME measurements is crucial in all empirical research, since they provide relevant information which could be analysed to enrich study contribution. Moreover, when the indicators of reliability are of low magnitude, attenuation needs to be quantified, because estimations could be affected.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Dominguez-Lara S. Fiabilidad y magnitud del efecto: una relación olvidada. Enferm Clin. 2017;27:330–331.</p>" ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">SD: standard deviation; <span class="elsevierStyleItalic">M</span>: mean.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Dimension (<span class="elsevierStyleItalic">α</span>; 95% CI) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col">Group \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Descriptive statistics</th><th class="td" title="table-head " colspan="5" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Magnitude of the effect</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">M</span> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">SD \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">d</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">observed</span></span> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Category \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">d</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">true</span></span> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Category \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Attenuation percentage \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " rowspan="2" align="left" valign="top">Support (0.78; 0.683–0.850)</td><td class="td" title="table-entry " align="left" valign="top">Nurse \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.39 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Small \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.26 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Small \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Nurse's aide \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.39 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " rowspan="2" align="left" valign="top">Demands (0.71; 0.589–0.800)</td><td class="td" title="table-entry " align="left" valign="top">Nurse \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.19 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.35 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.01 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Large \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Large \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Nurse's aide \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.84 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.33 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " rowspan="2" align="left" valign="top">Control (0.74; 0.629–0.822)</td><td class="td" title="table-entry " align="left" valign="top">Nurse \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.04 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.38 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.75 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Medium \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.87 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Large \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Nurse's aide \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.73 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1536487.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Comparison of working stress between nurses and nurse's aides.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sobre el uso de la prueba de significación de la hipótesis nula en la investigación psicológica" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S. 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Journal Information
Vol. 27. Issue 5.
Pages 330-331 (September - October 2017)
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Vol. 27. Issue 5.
Pages 330-331 (September - October 2017)
Letter to the Editor
Reliability and effect size: A forgotten relationship
Fiabilidad y magnitud del efecto: una relación olvidada
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Sergio Dominguez-Lara
Universidad de San Martín de Porres, Lima, Peru
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