Dataset Information

Modern psychometrics applied in rheumatology--a systematic review.

ABSTRACT:

Background

Although item response theory (IRT) appears to be increasingly used within health care research in general, a comprehensive overview of the frequency and characteristics of IRT analyses within the rheumatic field is lacking. An overview of the use and application of IRT in rheumatology to date may give insight into future research directions and highlight new possibilities for the improvement of outcome assessment in rheumatic conditions. Therefore, this study systematically reviewed the application of IRT to patient-reported and clinical outcome measures in rheumatology.

Methods

Literature searches in PubMed, Scopus and Web of Science resulted in 99 original English-language articles which used some form of IRT-based analysis of patient-reported or clinical outcome data in patients with a rheumatic condition. Both general study information and IRT-specific information were assessed.

Results

Most studies used Rasch modeling for developing or evaluating new or existing patient-reported outcomes in rheumatoid arthritis or osteoarthritis patients. Outcomes of principle interest were physical functioning and quality of life. Since the last decade, IRT has also been applied to clinical measures more frequently. IRT was mostly used for evaluating model fit, unidimensionality and differential item functioning, the distribution of items and persons along the underlying scale, and reliability. Less frequently used IRT applications were the evaluation of local independence, the threshold ordering of items, and the measurement precision along the scale.

Conclusion

IRT applications have markedly increased within rheumatology over the past decades. To date, IRT has primarily been applied to patient-reported outcomes, however, applications to clinical measures are gaining interest. Useful IRT applications not yet widely used within rheumatology include the cross-calibration of instrument scores and the development of computerized adaptive tests which may reduce the measurement burden for both the patient and the clinician. Also, the measurement precision of outcome measures along the scale was only evaluated occasionally. Performed IRT analyses should be adequately explained, justified, and reported. A global consensus about uniform guidelines should be reached concerning the minimum number of assumptions which should be met and best ways of testing these assumptions, in order to stimulate the quality appraisal of performed IRT analyses.

SUBMITTER: Siemons L

PROVIDER: S-EPMC3517453 | biostudies-literature | 2012 Oct

REPOSITORIES: biostudies-literature

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Publications

Modern psychometrics applied in rheumatology--a systematic review.

Siemons Liseth L Ten Klooster Peter M PM Taal Erik E Glas Cees Aw CA Van de Laar Mart Afj MA

BMC musculoskeletal disorders 20121031

<h4>Background</h4>Although item response theory (IRT) appears to be increasingly used within health care research in general, a comprehensive overview of the frequency and characteristics of IRT analyses within the rheumatic field is lacking. An overview of the use and application of IRT in rheumatology to date may give insight into future research directions and highlight new possibilities for the improvement of outcome assessment in rheumatic conditions. Therefore, this study systematically r ...[more]

PMID: 23114105

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Project description:Background: Applied health science research commonly measures concepts via multiple-item tools (scales), such as self-reported questionnaires or observation checklists. They are usually validated in more detail in separate psychometric studies or very cursorily in substantive studies. However, methodologists advise that, as validity is a property of the inferences based on measurement in a context, psychometric analyses should be performed in substantive studies as well. Until recently, performing comprehensive psychometrics required expert knowledge of different, often proprietary, software. The increasing availability of statistical techniques in the R environment now makes it possible to integrate such analyses in applied research. Methods: In this tutorial, I introduce a 6-step protocol which allows detailed diagnosis of core psychometric properties (e.g. structural validity, internal consistency) for scales with binary and ordinal response options aiming to measure differences in degree or quantity, the most common in applied research. The protocol includes investigations of (1) item distributions and summary statistics, item properties via (2) non-parametric and (3) parametric item response theory, (4) scale structure using factor analysis, (5) reliability via classical test theory, and (6) calculation and description of global scores. I illustrate the procedure on a measure of self-reported disability, the 24-item Sickness Impact Profile Roland Scale (RM-SIP), administered in a survey of 222 chronic pain sufferers. An R Markdown script is provided that generates reproducible reports. Results: In this sample, 15 of 24 RM-SIP items formed a unidimensional ordinal scale with good homogeneity (H = 0.43) and reliability (α = .86[.84-.89]; ω = .87[.85-.88]). The two versions were highly correlated (r = .96), and regression models predicting RM-SIP disability produced comparable results. Conclusions: The example analysis illustrates how psychometric properties may be assessed in substantive studies and identify avenues for measure improvement. Applied researchers can adapt this script to perform and communicate these analyses as part of questionnaire validation and substantive studies.

Dataset Information

Modern psychometrics applied in rheumatology--a systematic review.

Background

Methods

Results

Conclusion

Publications

Modern psychometrics applied in rheumatology--a systematic review.

Similar Datasets

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