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Published in: Health and Quality of Life Outcomes 1/2004

Open Access 01-12-2004 | Research

Predicting gender differences as latent variables: summed scores, and individual item responses: a methods case study

Authors: Ricardo Pietrobon, Marcus Taylor, Ulrich Guller, Laurence D Higgins, Danny O Jacobs, Timothy Carey

Published in: Health and Quality of Life Outcomes | Issue 1/2004

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Abstract

Background

Modeling latent variables such as physical disability is challenging since its measurement is performed through proxies. This poses significant methodological challenges. The objective of this article is to present three different methods to predict latent variables based on classical summed scores, individual item responses, and latent variable models.

Methods

This is a review of the literature and data analysis using "layers of information". Data was collected from the North Carolina Back Pain Project, using a modified version of the Roland Questionnaire.

Results

The three models are compared in relation to their goals and underlying concepts, previous clinical applications, data requirements, statistical theory, and practical applications. Initial linear regression models demonstrated a difference in disability between genders of 1.32 points (95% CI 0.65, 2.00) on a scale from 0–23. Subsequent item analysis found contradictory results across items, with no clear pattern. Finally, IRT models demonstrated three items were demonstrated to present differential item functioning. After these items were removed, the difference between genders was reduced to 0.78 points (95% CI, -0.99, 1.23). These results were shown to be robust with re-sampling methods.

Conclusions

Purported differences in the levels of a latent variable should be tested using different models to verify whether these differences are real or simply distorted by model assumptions.
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Literature
1.
go back to reference Davis AM, Sennik S, Griffin AM, Wunder JS, O'Sullivan B, Catton CN, Bell RS: Predictors of functional outcomes following limb salvage surgery for lower-extremity soft tissue sarcoma. J Surg Oncol 2000, 73: 206–211. 10.1002/(SICI)1096-9098(200004)73:4<206::AID-JSO4>3.0.CO;2-5PubMedCrossRef Davis AM, Sennik S, Griffin AM, Wunder JS, O'Sullivan B, Catton CN, Bell RS: Predictors of functional outcomes following limb salvage surgery for lower-extremity soft tissue sarcoma. J Surg Oncol 2000, 73: 206–211. 10.1002/(SICI)1096-9098(200004)73:4<206::AID-JSO4>3.0.CO;2-5PubMedCrossRef
2.
go back to reference Enneking WF: American Orthopaedic Association. In Limb salvage in musculoskeletal oncology. New York: Churchill Livingstone; 1987. Enneking WF: American Orthopaedic Association. In Limb salvage in musculoskeletal oncology. New York: Churchill Livingstone; 1987.
3.
go back to reference Enneking WF, Dunham W, Gebhardt MC, Malawar M, Pritchard DJ: A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin Orthop 1993, 286: 241–246.PubMed Enneking WF, Dunham W, Gebhardt MC, Malawar M, Pritchard DJ: A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin Orthop 1993, 286: 241–246.PubMed
4.
go back to reference Davis AM, Wright JG, Williams JI, Bombardier C, Griffin A, Bell RS: Development of a measure of physical function for patients with bone and soft tissue sarcoma. Qual Life Res 1996, 5: 508–516.PubMedCrossRef Davis AM, Wright JG, Williams JI, Bombardier C, Griffin A, Bell RS: Development of a measure of physical function for patients with bone and soft tissue sarcoma. Qual Life Res 1996, 5: 508–516.PubMedCrossRef
5.
go back to reference Ware JE Jr, Sherbourne CD: The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992, 30: 473–483.PubMedCrossRef Ware JE Jr, Sherbourne CD: The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992, 30: 473–483.PubMedCrossRef
6.
go back to reference Bandeen-Roche K, Huang GH, Munoz B, Rubin GS: Determination of risk factor associations with questionnaire outcomes: a methods case study. Am J Epidemiol 1999, 150: 1165–1178.PubMedCrossRef Bandeen-Roche K, Huang GH, Munoz B, Rubin GS: Determination of risk factor associations with questionnaire outcomes: a methods case study. Am J Epidemiol 1999, 150: 1165–1178.PubMedCrossRef
7.
go back to reference Mangione CM, Phillips RS, Seddon JM, Lawrence MG, Cook EF, Dailey R, Goldman L: Development of the 'Activities of Daily Vision Scale'. A measure of visual functional status. Med Care 1992, 30: 1111–1126.PubMedCrossRef Mangione CM, Phillips RS, Seddon JM, Lawrence MG, Cook EF, Dailey R, Goldman L: Development of the 'Activities of Daily Vision Scale'. A measure of visual functional status. Med Care 1992, 30: 1111–1126.PubMedCrossRef
8.
go back to reference Teresi JA, Kleinman M, Ocepek-Welikson K: Modern psychometric methods for detection of differential item functioning: application to cognitive assessment measures. Stat Med 2000, 19: 1651–1683. 10.1002/(SICI)1097-0258(20000615/30)19:11/12<1651::AID-SIM453>3.3.CO;2-8PubMedCrossRef Teresi JA, Kleinman M, Ocepek-Welikson K: Modern psychometric methods for detection of differential item functioning: application to cognitive assessment measures. Stat Med 2000, 19: 1651–1683. 10.1002/(SICI)1097-0258(20000615/30)19:11/12<1651::AID-SIM453>3.3.CO;2-8PubMedCrossRef
9.
go back to reference Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR: A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol 1996, 49: 1373–1379. 10.1016/S0895-4356(96)00236-3PubMedCrossRef Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR: A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol 1996, 49: 1373–1379. 10.1016/S0895-4356(96)00236-3PubMedCrossRef
10.
go back to reference Freedman LS, Pee D: Return to note on screening regression equations. Am Statistician 1989, 43: 279–282. Freedman LS, Pee D: Return to note on screening regression equations. Am Statistician 1989, 43: 279–282.
11.
go back to reference Reise SP, Yu J: Parameter recovery in the graded response model using MULTILOG. Journal of Educational Measurement 1990, 27: 133–144.CrossRef Reise SP, Yu J: Parameter recovery in the graded response model using MULTILOG. Journal of Educational Measurement 1990, 27: 133–144.CrossRef
12.
go back to reference Rubin DB: Estimating causal effects from large data sets using propensity scores. Ann Intern Med 1997, 127: 757–763.PubMedCrossRef Rubin DB: Estimating causal effects from large data sets using propensity scores. Ann Intern Med 1997, 127: 757–763.PubMedCrossRef
13.
go back to reference Alcouffe J, Manillier P, Brehier M, Fabin C, Faupin F: Analysis by sex of low back pain among workers from small companies in the Paris area: severity and occupational consequences. Occup Environ Med 1999, 56: 696–701.PubMedCentralPubMedCrossRef Alcouffe J, Manillier P, Brehier M, Fabin C, Faupin F: Analysis by sex of low back pain among workers from small companies in the Paris area: severity and occupational consequences. Occup Environ Med 1999, 56: 696–701.PubMedCentralPubMedCrossRef
14.
go back to reference Fillingim RB, Doleys DM, Edwards RR, Lowery D: Clinical characteristics of chronic back pain as a function of gender and oral opioid use. Spine 2003, 28: 143–150. 10.1097/00007632-200301150-00010PubMedCrossRef Fillingim RB, Doleys DM, Edwards RR, Lowery D: Clinical characteristics of chronic back pain as a function of gender and oral opioid use. Spine 2003, 28: 143–150. 10.1097/00007632-200301150-00010PubMedCrossRef
15.
go back to reference Bolton JE: Psychological distress and disability in back pain patients: evidence of sex differences. J Psychosom Res 1994, 38: 849–858. 10.1016/0022-3999(94)90072-8PubMedCrossRef Bolton JE: Psychological distress and disability in back pain patients: evidence of sex differences. J Psychosom Res 1994, 38: 849–858. 10.1016/0022-3999(94)90072-8PubMedCrossRef
16.
go back to reference Jensen I, Nygren A, Gamberale F, Goldie I, Westerholm P: Coping with long-term musculoskeletal pain and its consequences: is gender a factor? Pain 1994, 57: 167–172. 10.1016/0304-3959(94)90220-8PubMedCrossRef Jensen I, Nygren A, Gamberale F, Goldie I, Westerholm P: Coping with long-term musculoskeletal pain and its consequences: is gender a factor? Pain 1994, 57: 167–172. 10.1016/0304-3959(94)90220-8PubMedCrossRef
17.
go back to reference Carey TS, Garrett J, Jackman A, McLaughlin C, Fryer J, Smucker DR: The outcomes and costs of care for acute low back pain among patients seen by primary care practitioners, chiropractors, and orthopedic surgeons. The North Carolina Back Pain Project. N Engl J Med 1995, 333: 913–917. 10.1056/NEJM199510053331406PubMedCrossRef Carey TS, Garrett J, Jackman A, McLaughlin C, Fryer J, Smucker DR: The outcomes and costs of care for acute low back pain among patients seen by primary care practitioners, chiropractors, and orthopedic surgeons. The North Carolina Back Pain Project. N Engl J Med 1995, 333: 913–917. 10.1056/NEJM199510053331406PubMedCrossRef
18.
go back to reference Roland M, Morris R: A study of the natural history of back pain. Part I: development of a reliable and sensitive measure of disability in low-back pain. Spine 1983, 8: 141–144.PubMedCrossRef Roland M, Morris R: A study of the natural history of back pain. Part I: development of a reliable and sensitive measure of disability in low-back pain. Spine 1983, 8: 141–144.PubMedCrossRef
19.
go back to reference Patrick DL, Deyo RA, Atlas SJ, Singer DE, Chapin A, Keller RB: Assessing health-related quality of life in patients with sciatica. Spine 1995, 20: 1899–1908. discussion 1909PubMedCrossRef Patrick DL, Deyo RA, Atlas SJ, Singer DE, Chapin A, Keller RB: Assessing health-related quality of life in patients with sciatica. Spine 1995, 20: 1899–1908. discussion 1909PubMedCrossRef
Metadata
Title
Predicting gender differences as latent variables: summed scores, and individual item responses: a methods case study
Authors
Ricardo Pietrobon
Marcus Taylor
Ulrich Guller
Laurence D Higgins
Danny O Jacobs
Timothy Carey
Publication date
01-12-2004
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2004
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-2-59

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