Development, validity, and reliability of the band and loop radiographic assessment scoring system (BRASS)
Purpose: The purpose of this study was to develop a radiographic evaluation scale which, when combined with clinical criteria, could help reduce the failure rate of the conventional band and loop (CBL) space maintainer.
Materials and Methods: The Band and Loop Radiographic Assessment Scoring System (BRASS) was developed following best practices for scale development in healthcare. The process began with data collection through a literature review, followed by face and content validity assessment of the items generated using the sum-score decision rule and content validity ratio. Pre-testing of the scale was conducted through item-total correlation and factor analysis using the Tucker-Lewis Index, which facilitated item reduction. Pilot testing of the scale was subsequently carried out, and test-retest reliability, predictive validity, and two measures of construct validity were evaluated.
Results: The initial pool of 20 items was reduced to 10, distributed across three criteria based on the results of the goodness-of-fit test. The mean accuracy of the scale, based on predictive validity, was 89%. Test-retest reliability, measured by Cronbach’s Alpha, was 0.87. Construct validity revealed a significant difference (p < 0.05) in evaluations conducted with and without the use of BRASS. Finally, multiple linear regression analysis indicated a strong model fit (Rsquared = 0.991), further supporting the construct validity of the BRASS.
Conclusion: The development of BRASS, supported by strong validity and reliability metrics, presents it as a promising tool to enhance the clinical success of the conventional band and loop (CBL) space maintainer.