La scoliose idiopathique (SI) est une déformation tridimensionnelle (3D) de la colonne vertébrale et de la cage thoracique à potentiel évolutif pendant la croissance. Cette déformation 3D entraîne des asymétries de la posture. La correction de la posture est un des objectifs du traitement en physiothérapie chez les jeunes atteints d’une SI afin d’éviter la progression de la scoliose, de réduire les déformations morphologiques et leurs impacts sur la qualité de vie. Les outils cliniques actuels ne permettent pas de quantifier globalement les changements de la posture attribuables à la progression de la scoliose ou à l’efficacité des interventions thérapeutiques. L’objectif de cette thèse consiste donc au développement et à la validation d’un nouvel outil clinique permettant l’analyse quantitative de la posture auprès de personnes atteintes d’une SI. Ce projet vise plus spécifiquement à déterminer la fidélité et la validité des indices de posture (IP) de ce nouvel outil clinique et à vérifier leur capacité à détecter des changements entre les positions debout et assise. Suite à une recension de la littérature, 34 IP représentant l’alignement frontal et sagittal des différents segments corporels ont été sélectionnés. L’outil quantitatif clinique d’évaluation de la posture (outil 2D) construit dans ce projet consiste en un logiciel qui permet de calculer les différents IP (mesures angulaires et linéaires). L’interface graphique de cet outil est conviviale et permet de sélectionner interactivement des marqueurs sur les photographies digitales. Afin de vérifier la fidélité et la validité des IP de cet outil, la posture debout de 70 participants âgés entre 10 et 20 ans atteints d'une SI (angle de Cobb: 15º à 60º) a été évaluée à deux occasions par deux physiothérapeutes. Des marqueurs placés sur plusieurs repères anatomiques, ainsi que des points de référence anatomique (yeux, lobes des oreilles, etc.), ont permis de mesurer les IP 2D en utilisant des photographies. Ces mêmes marqueurs et points de référence ont également servi au calcul d’IP 3D obtenus par des reconstructions du tronc avec un système de topographie de surface. Les angles de Cobb frontaux et sagittaux et le déjettement C7-S1 ont été mesurés sur des radiographies. La théorie de la généralisabilité a été utilisée pour déterminer la fidélité et l’erreur standard de la mesure (ESM) des IP de l’outil 2D. Des coefficients de Pearson ont servi à déterminer la validité concomitante des IP du tronc de l’outil 2D avec les IP 3D et les mesures radiographiques correspondantes. Cinquante participants ont été également évalués en position assise « membres inférieurs allongés » pour l’étude comparative de la posture debout et assise. Des tests de t pour échantillons appariés ont été utilisés pour détecter les différences entre les positions debout et assise. Nos résultats indiquent un bon niveau de fidélité pour la majorité des IP de l’outil 2D. La corrélation entre les IP 2D et 3D est bonne pour les épaules, les omoplates, le déjettement C7-S1, les angles de taille, la scoliose thoracique et le bassin. Elle est faible à modérée pour la cyphose thoracique, la lordose lombaire et la scoliose thoraco-lombaire ou lombaire. La corrélation entre les IP 2D et les mesures radiographiques est bonne pour le déjettement C7-S1, la scoliose et la cyphose thoracique. L’outil est suffisamment discriminant pour détecter des différences entre la posture debout et assise pour dix des treize IP. Certaines recommandations spécifiques résultents de ce projet : la hauteur de la caméra devrait être ajustée en fonction de la taille des personnes; la formation des juges est importante pour maximiser la précision de la pose des marqueurs; et des marqueurs montés sur des tiges devraient faciliter l’évaluation des courbures vertébrales sagittales. En conclusion, l’outil développé dans le cadre de cette thèse possède de bonnes propriétés psychométriques et permet une évaluation globale de la posture. Cet outil devrait contribuer à l’amélioration de la pratique clinique en facilitant l’analyse de la posture debout et assise. Cet outil s’avère une alternative clinique pour suivre l’évolution de la scoliose thoracique et diminuer la fréquence des radiographies au cours du suivi de jeunes atteints d’une SI thoracique. Cet outil pourrait aussi être utile pour vérifier l’efficacité des interventions thérapeutiques sur la posture. / Idiopathic scoliosis (IS) is characterized by three-dimensional (3D) deformity of the spine and rib cage which can increase during growth. The morphologic changes of the trunk result in posture asymmetries. Correction of posture is an important goal of physiotherapy interventions among persons with IS to prevent scoliosis progression, to reduce morphologic deformities and their impact on quality of life. Currently, there are no tools that globally quantify changes in posture that may be attributable to scoliosis progression or to treatment effectiveness, that are usable in a clinical setting. The objective of this thesis was thus to develop and validate a new clinical quantitative posture assessment tool among persons with IS. More specifically, this project aims to determine reliability and concurrent validity of posture indices (PI) of this new tool and to verify their capacity to detect changes between standing and sitting positions. We conducted a literature review and selected 34 PI representing frontal and sagittal alignment of the different body segments. We constructed a software-based quantitative posture assessment tool to calculate different PI (angular and linear measurements). The software has a user-friendly graphical interface and allows calculation of PI from a set of markers selected interactively on digital photographs. For the reliability and validity studies, standing posture of 70 participants aged 10 to 20 years old with IS (Cobb angle: 15º to 60º) was assessed on two occasions by two physiotherapists. Markers placed on several bony landmarks as well as natural reference points (eyes, ear lobe, etc.) were used to measure the PI from photographs with the 2D tool and to calculate 3D PI obtained from trunk reconstructions with a surface topography system. Frontal and sagittal Cobb angles and trunk list were also calculated on radiographs. The generalizability theory was used to estimate the reliability and standard error of measurement (SEM) of PI of the 2D tool. Pearson correlation coefficients served to estimate concurrent validity of the 2D trunk PI with corresponding 3D PI and with those obtained from radiographs. Fifty participants were assessed for the comparative study between standing and sitting positions. We compared the average values of each PI in standing and long sitting positions using paired t-tests. Our results show a good level of reliability for the majority of PI of the 2D tool. Correlation between 2D and 3D PI was good for shoulder, scapula, trunk list, waist angles, thoracic scoliosis and pelvis but fair to moderate for thoracic kyphosis, lumbar lordosis and thoracolumbar or lumbar scoliosis. The correlation between 2D and radiograph measurements was good for trunk list, thoracic scoliosis and thoracic kyphosis. Our tool can detect differences between standing and sitting posture for ten out of thirteen PI. A few recommendations specific to this work are: camera height should be adjusted according to the subject’s height; training of judges is important to maximize accuracy in placement of markers; and measurement of sagittal vertebral curves may be facilitated by using markers mounted on pins. In conclusion, the tool developed in this thesis has good psychometric properties to evaluate posture. This tool should contribute to clinical practice by facilitating the analysis of standing and sitting posture. This tool may also be a good alternative to monitor thoracic scoliosis progression in a clinical setting and may contribute to a reduction in the use of x-rays in the follow-up of youths with thoracic IS. It may also be useful to verify the effectiveness of therapeutic interventions on posture.

This study investigated how 2 different rating conditions, the controlled rating condition (CRC) and the uncontrolled rating condition (URC), effected rater behavior and the reliability of a performance assessment (PA) known as the Missionary Teaching Assessment (MTA). The CRC gives raters the capability to manipulate (pause, rewind, fast-forward) video recordings of an examinee's performance as they rate while the URC does not give them this capability (i.e., the rater must watch the recording straight through without making any manipulations). Few studies have compared the effect of these two rating conditions on ratings. Ryan et al. (1995) analyzed the impact of the CRC and URC on the accuracy of ratings, but few, if any, have analyzed its impact on reliability. The Missionary Teaching Assessment is a performance assessment used to assess the teaching abilities of missionaries for the Church of Jesus Christ of Latter-day Saints at the Missionary Training Center. In this study, 32 missionaries taught a 10-minute lesson that was recorded and later rated by trained raters based on a rubric containing 5 criteria. Each teaching sample was rated by 4 of 6 raters. Two of the 4 ratings were rated using the CRC and 2 using the URC. Camtasia Studio (2010), a screen capture software, was used to record when raters used any type of manipulation. The recordings were used to analyze if raters manipulated the recordings and if so, when and how frequently. Raters also performed think-alouds following a random sample of the ratings that were performed using the CRC. These data revealed that when raters had access to the CRC they took advantage of it the majority of the time, but they differed in how frequently they manipulated the recordings. The CRC did not add an exorbitant amount of time to the rating process. The reliability of the ratings was analyzed using both generalizability theory (G theory) and many-facets Rasch measurement (MFRM). Results indicated that, in general, the reliability of the ratings obtained from the 2 rating conditions were not statistically significantly different from each other. The implications of these findings are addressed.

Although classroom assessment is one of the most frequent practices carried out by teachers in all educational programs, limited research has been conducted to investigate the dependability and validity of criterion-referenced tests (CRTs). The main purpose of this study is to develop a criterion-referenced test for first-year Japanese university students in a general English program. To this end, four research questions are formulated: (a) To what extent do the criterion-referenced items function effectively?; (b) To what extent do the facets of persons, items, sections, classes, and subtests contribute to the total score variation in two CRT forms?; (c) To what extent are two CRT forms dependable when administered as pretests and posttests?; and (d) To what extent are two CRT forms valid when administered as pretests and posttests? Two CRT forms made up of vocabulary (k = 25), listening (k = 20), and reading (k = 25) subtests were administered to 249 students using a counterbalanced design. Criterion-referenced item analyses showed that most items were working well for criterion-referenced purposes. Both univariate and multivariate generalizability studies indicated that the most of the variance was accounted for by the interaction effect, followed by the items effect, and then by the persons effect. FACETS analyses showed the separation for all the facets accounted for in the analyses and showed that item separation was greater than person separation. This indicated that the students' ability estimates were similar due to their having taken a placement test, whose results were used to form proficiency-based classes. Both univariate and multivariate decision studies indicated that the CRT forms were moderately to highly dependable. The content validity of the CRT forms was supported because the test content was strongly linked to what was taught in class. The construct validity was supported mainly because a fair amount of score gain was observed. This study elucidates how the statistical analyses used in this study can be applied to CRT development, and how CRT development can be carried out as part of curriculum development. / Educational Administration

La fraction d’éjection du ventricule gauche est un excellent marqueur de la fonction cardiaque. Plusieurs techniques invasives ou non sont utilisées pour son calcul : l’angiographie, l’échocardiographie, la résonnance magnétique nucléaire cardiaque, le scanner cardiaque, la ventriculographie radioisotopique et l’étude de perfusion myocardique en médecine nucléaire. Plus de 40 ans de publications scientifiques encensent la ventriculographie radioisotopique pour sa rapidité d’exécution, sa disponibilité, son faible coût et sa reproductibilité intra-observateur et inter-observateur. La fraction d’éjection du ventricule gauche a été calculée chez 47 patients à deux reprises, par deux technologues, sur deux acquisitions distinctes selon trois méthodes : manuelle, automatique et semi-automatique. Les méthodes automatique et semi-automatique montrent dans l’ensemble une meilleure reproductibilité, une plus petite erreur standard de mesure et une plus petite différence minimale détectable. La méthode manuelle quant à elle fournit un résultat systématiquement et significativement inférieur aux deux autres méthodes. C’est la seule technique qui a montré une différence significative lors de l’analyse intra-observateur. Son erreur standard de mesure est de 40 à 50 % plus importante qu’avec les autres techniques, tout comme l’est sa différence minimale détectable. Bien que les trois méthodes soient d’excellentes techniques reproductibles pour l’évaluation de la fraction d’éjection du ventricule gauche, les estimations de la fiabilité des méthodes automatique et semi-automatique sont supérieures à celles de la méthode manuelle. / Left ventricular ejection fraction is an excellent indicator of cardiac function. Many invasive and non-invasive techniques can be used for its assessment: angiography, echocardiography, cardiac MRI, computed tomography of the heart, multigated radionuclide angiography and myocardial perfusion imaging. More than 40 years of scientific publication praise the multigated radionuclide angiography for its execution speed, its availability, its low cost and intrarater and interrater reproducibility. The left ventricular ejection fraction was calculated twice for 47 patients, using two raw data acquisitions, two technologists and three software platforms: one fully manual, one semi-automatic and one fully automatic. In general, the automatic and semi-automatic methods showed greater reproducibility, a smaller standard error of measurement and minimal detectable change than the manual method, whereas the manual method systematically gave a significantly lower quality of result. It was the only technique that showed significant intrarater difference, and its standard error of measurement and minimal detectable change were 40% to 50% higher than those of automatic and semi-automatic methods. Even though all three techniques are all excellent and reliable options, reliability coefficient estimations were superior using automatic and semi-automatic methods as compared to the manual method.

Mit der wachsenden Verbreitung empirischer Schulleistungsleistungen im Large-Scale Assessment gehen eine Reihe methodischer Herausforderungen einher. Die vorliegende Arbeit untersucht, welche Konsequenzen Modellverletzungen in eindimensionalen Item-Response-Modellen (besonders im Rasch-Modell) besitzen. Insbesondere liegt der Fokus auf vier methodischen Herausforderungen von Modellverletzungen. Erstens, implizieren Positions- und Kontexteffekte, dass gegenüber einem eindimensionalen IRT-Modell Itemschwierigkeiten nicht unabhängig von der Position im Testheft und der Zusammenstellung des Testheftes ausgeprägt sind und Schülerfähigkeiten im Verlauf eines Tests variieren können. Zweitens, verursacht die Vorlage von Items innerhalb von Testlets lokale Abhängigkeiten, wobei unklar ist, ob und wie diese in der Skalierung berücksichtigt werden sollen. Drittens, können Itemschwierigkeiten aufgrund verschiedener Lerngelegenheiten zwischen Schulklassen variieren. Viertens, sind insbesondere in low stakes Tests nicht bearbeitete Items vorzufinden. In der Arbeit wird argumentiert, dass trotz Modellverletzungen nicht zwingend von verzerrten Schätzungen von Itemschwierigkeiten, Personenfähigkeiten und Reliabilitäten ausgegangen werden muss. Außerdem wird hervorgehoben, dass man psychometrisch häufig nicht entscheiden kann und entscheiden sollte, welches IRT-Modell vorzuziehen ist. Dies trifft auch auf die Fragestellung zu, wie nicht bearbeitete Items zu bewerten sind. Ausschließlich Validitätsüberlegungen können dafür Hinweise geben. Modellverletzungen in IRT-Modellen lassen sich konzeptuell plausibel in den Ansatz des Domain Samplings (Item Sampling; Generalisierbarkeitstheorie) einordnen. In dieser Arbeit wird gezeigt, dass die statistische Unsicherheit in der Modellierung von Kompetenzen nicht nur von der Stichprobe der Personen, sondern auch von der Stichprobe der Items und der Wahl statistischer Modelle verursacht wird. / Several methodological challenges emerge in large-scale student assessment studies like PISA and TIMSS. Item response models (IRT models) are essential for scaling student abilities within these studies. This thesis investigates the consequences of several model violations in unidimensional IRT models (especially in the Rasch model). In particular, this thesis focuses on the following four methodological challenges of model violations. First, position effects and contextual effects imply (in comparison to unidimensional IRT models) that item difficulties depend on the item position in a test booklet as well as on the composition of a test booklet. Furthermore, student abilities are allowed to vary among test positions. Second, the administration of items within testlets causes local dependencies, but it is unclear whether and how these dependencies should be taken into account for the scaling of student abilities. Third, item difficulties can vary among different school classes due to different opportunities to learn. Fourth, the amount of omitted items is in general non-negligible in low stakes tests. In this thesis it is argued that estimates of item difficulties, student abilities and reliabilities can be unbiased despite model violations. Furthermore, it is argued that the choice of an IRT model cannot and should not be made (solely) from a psychometric perspective. This also holds true for the problem of how to score omitted items. Only validity considerations provide reasons for choosing an adequate scoring procedure. Model violations in IRT models can be conceptually classified within the approach of domain sampling (item sampling; generalizability theory). In this approach, the existence of latent variables need not be posed. It is argued that statistical uncertainty in modelling competencies does not only depend on the sampling of persons, but also on the sampling of items and on the choice of statistical models.