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Quality of Life Research
Published in: Quality of Life Research 11/2017

Open Access 01-11-2017

Measuring everyday functional competence using the Rasch assessment of everyday activity limitations (REAL) item bank

Authors: Martijn A. H. Oude Voshaar, Peter M. ten Klooster, Harald E. Vonkeman, Mart A. F. J. van de Laar

Published in: Quality of Life Research | Issue 11/2017

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Abstract

Objective

Traditional patient-reported physical function instruments often poorly differentiate patients with mild-to-moderate disability. We describe the development and psychometric evaluation of a generic item bank for measuring everyday activity limitations in outpatient populations.

Study design and setting

Seventy-two items generated from patient interviews and mapped to the International Classification of Functioning, Disability and Health (ICF) domestic life chapter were administered to 1128 adults representative of the Dutch population. The partial credit model was fitted to the item responses and evaluated with respect to its assumptions, model fit, and differential item functioning (DIF). Measurement performance of a computerized adaptive testing (CAT) algorithm was compared with the SF-36 physical functioning scale (PF-10).

Results

A final bank of 41 items was developed. All items demonstrated acceptable fit to the partial credit model and measurement invariance across age, sex, and educational level. Five- and ten-item CAT simulations were shown to have high measurement precision, which exceeded that of SF-36 physical functioning scale across the physical function continuum. Floor effects were absent for a 10-item empirical CAT simulation, and ceiling effects were low (13.5%) compared with SF-36 physical functioning (38.1%). CAT also discriminated better than SF-36 physical functioning between age groups, number of chronic conditions, and respondents with or without rheumatic conditions.

Conclusion

The Rasch assessment of everyday activity limitations (REAL) item bank will hopefully prove a useful instrument for assessing everyday activity limitations. T-scores obtained using derived measures can be used to benchmark physical function outcomes against the general Dutch adult population.
Appendix
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Metadata
Title
Measuring everyday functional competence using the Rasch assessment of everyday activity limitations (REAL) item bank
Authors
Martijn A. H. Oude Voshaar
Peter M. ten Klooster
Harald E. Vonkeman
Mart A. F. J. van de Laar
Publication date
01-11-2017
Publisher
Springer International Publishing
Published in
Quality of Life Research / Issue 11/2017
Print ISSN: 0962-9343
Electronic ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-017-1627-0

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