期刊
JOURNAL OF CLINICAL EPIDEMIOLOGY
卷 61, 期 1, 页码 17-33出版社
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.jclinepi.2006.06.025
关键词
item response theory; computerized adaptive test; physical function; health status; questionnaire
资金
- NIAMS NIH HHS [U01 AR 052158-01] Funding Source: Medline
- NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES [U01AR052158] Funding Source: NIH RePORTER
Objective: The Patient-Reported Outcomes Measurement Information System (PROMIS) was initiated to improve precision, reduce respondent burden, and enhance the comparability of health outcomes measures. We used item response theory (IRT) to construct and evaluate a preliminary item bank for physical function assuming four subdomains. Study Design and Setting: Data from seven samples (N = 17,726) using 136 items from nine questionnaires were evaluated. A generalized partial credit model was used to estimate item parameters, which were normed to a mean of 50 (SD = 10) in the US population. Item bank properties were evaluated through Computerized Adaptive Test (CAT) simulations. Results: IRT requirements were fulfilled by 70 items covering activities of daily living, lower extremity, and central body functions. The original item context partly affected parameter stability. Items on upper body function, and need for aid or devices did not fit the IRT model. In simulations, a 10-item CAT eliminated floor and decreased ceiling effects, achieving a small standard error (<2.2) across scores from 20 to 50 (reliability >0.95 for a representative US sample). This precision was not achieved over a similar range by any comparable fixed length item sets. Conclusion: The methods of the PROMIS project are likely to substantially improve measures of physical function and to increase the efficiency of their administration using CAT. (C) 2008 Elsevier Inc. All rights reserved.
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