Interpretation of a self-esteem subscale for erectile dysfunction by cumulative logit model

A content-based interpretation of a health status measure uses an item, along with its response choices, internal to the measure to understand the meaning of its scores. We applied a cumulative logit model to content-based interpretation of a validated self-esteem subscale (four items) for men with erectile dysfunction (score range: 0 to 100, where higher scores indicate a more favorable response). Data were obtained from a nontreatment cross-sectional study with 98 men with erectile dysfunction and 94 controls. The ordinal response item I had good self-esteem over the past 4 weeks (1 = Almost never/never, 2 = A few times, 3 = Sometimes, 4 = Most times, 5 = Almost always/Al-ways) was regressed on the self-esteem subscale score to which the item belongs. The proportional odds assumption was not refuted (P = .085) and supported graphically. At relatively high self-esteem scores (65+), the estimated probability of reporting good self-esteem (ie, good self-esteem most of the time or almost always/always) was 68% or more. For a 10-point increase (eg, 65 to 75), the odds of reporting good self-esteem increased slightly more than threefold (3.2). A content-based interpretation using a cumulative logit model can increase sensitivity, enhance meaning, and provide succinct and simple interpretation to scores of a health status measure.