title: The Dutch Activity Card Sort institutional version was reproducible, but biased against women.
abstract: OBJECTIVE
  To examine the reproducibility of the institutional version of the Dutch Activity Card Sort (ACS-NL) and the possible presence of gender bias.
  
  
  METHODS
  Older rehabilitation inpatients (N = 52) were included. Intra- and inter-rater agreement for the ACS-NL total and subscale scores was examined by intraclass correlations (ICC), and agreement of individual items by the κ coefficient (k). Gender bias was examined by the proportion of men and women selecting an ACS item.
  
  
  RESULTS
  ICC for inter-rater agreement of the ACS total score ranged between 0.78 and 0.87, ICC for intra-rater agreement ranged between 0.79 and 0.89. Median inter-rater κ for ACS-NL items was 0.72 (interquartile scores; 0.62-0.80). The inter-rater agreement (k = 0.43) and intra-rater agreement (k = 0.39) for the five most important activities was lower. Twenty ACS activities favoured men and seven activities favoured women. As a result, men scored systematically higher on the ACS-NL than women. Logistic regression analysis correcting for activity engagement level confirmed our findings.
  
  
  CONCLUSIONS
  The reproducibility of the ACS-NL was high. The ACS-NL institutional version score may be biased in favour of men.
authors.affiliation: Master Evidence Based Practice, Academic Medical Centre, University of Amsterdam and Slotervaart ziekenhuis, Amsterdam, Netherlands. annemieke.jong@hotmail.com
authors.forename: A M
authors.initials: AM
authors.lastname: Jong
authors.forename: F A
authors.initials: FA
authors.lastname: van Nes
authors.forename: R
authors.initials: R
authors.lastname: Lindeboom
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007297:Inpatients; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D015588:Observer Variation; D012046:Rehabilitation; D012047:Rehabilitation Centers; D015203:Reproducibility of Results; D012737:Sex Factors; D063507:Sexism