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Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2014

Open Access 01-12-2014 | Research

Item response theory and factor analysis as a mean to characterize occurrence of response shift in a longitudinal quality of life study in breast cancer patients

Authors: Amélie Anota, Caroline Bascoul-Mollevi, Thierry Conroy, Francis Guillemin, Michel Velten, Damien Jolly, Mariette Mercier, Sylvain Causeret, Jean Cuisenier, Olivier Graesslin, Zeinab Hamidou, Franck Bonnetain

Published in: Health and Quality of Life Outcomes | Issue 1/2014

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Abstract

Background

The occurrence of response shift (RS) in longitudinal health-related quality of life (HRQoL) studies, reflecting patient adaptation to disease, has already been demonstrated. Several methods have been developed to detect the three different types of response shift (RS), i.e. recalibration RS, 2) reprioritization RS, and 3) reconceptualization RS. We investigated two complementary methods that characterize the occurrence of RS: factor analysis, comprising Principal Component Analysis (PCA) and Multiple Correspondence Analysis (MCA), and a method of Item Response Theory (IRT).

Methods

Breast cancer patients (n = 381) completed the EORTC QLQ-C30 and EORTC QLQ-BR23 questionnaires at baseline, immediately following surgery, and three and six months after surgery, according to the “then-test/post-test” design. Recalibration was explored using MCA and a model of IRT, called the Linear Logistic Model with Relaxed Assumptions (LLRA) using the then-test method. Principal Component Analysis (PCA) was used to explore reconceptualization and reprioritization.

Results

MCA highlighted the main profiles of recalibration: patients with high HRQoL level report a slightly worse HRQoL level retrospectively and vice versa. The LLRA model indicated a downward or upward recalibration for each dimension. At six months, the recalibration effect was statistically significant for 11/22 dimensions of the QLQ-C30 and BR23 according to the LLRA model (p ≤ 0.001). Regarding the QLQ-C30, PCA indicated a reprioritization of symptom scales and reconceptualization via an increased correlation between functional scales.

Conclusions

Our findings demonstrate the usefulness of these analyses in characterizing the occurrence of RS. MCA and IRT model had convergent results with then-test method to characterize recalibration component of RS. PCA is an indirect method in investigating the reprioritization and reconceptualization components of RS.
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Metadata
Title
Item response theory and factor analysis as a mean to characterize occurrence of response shift in a longitudinal quality of life study in breast cancer patients
Authors
Amélie Anota
Caroline Bascoul-Mollevi
Thierry Conroy
Francis Guillemin
Michel Velten
Damien Jolly
Mariette Mercier
Sylvain Causeret
Jean Cuisenier
Olivier Graesslin
Zeinab Hamidou
Franck Bonnetain
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2014
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-12-32

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