Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2006

Open Access 01-12-2006 | Research

Assessment of health-related quality of life in arthritis: conceptualization and development of five item banks using item response theory

Authors: Jacek A Kopec, Eric C Sayre, Aileen M Davis, Elizabeth M Badley, Michal Abrahamowicz, Lesley Sherlock, J Ivan Williams, Aslam H Anis, John M Esdaile

Published in: Health and Quality of Life Outcomes | Issue 1/2006

Login to get access

Abstract

Background

Modern psychometric methods based on item response theory (IRT) can be used to develop adaptive measures of health-related quality of life (HRQL). Adaptive assessment requires an item bank for each domain of HRQL. The purpose of this study was to develop item banks for five domains of HRQL relevant to arthritis.

Methods

About 1,400 items were drawn from published questionnaires or developed from focus groups and individual interviews and classified into 19 domains of HRQL. We selected the following 5 domains relevant to arthritis and related conditions: Daily Activities, Walking, Handling Objects, Pain or Discomfort, and Feelings. Based on conceptual criteria and pilot testing, 219 items were selected for further testing. A questionnaire was mailed to patients from two hospital-based clinics and a stratified random community sample. Dimensionality of the domains was assessed through factor analysis. Items were analyzed with the Generalized Partial Credit Model as implemented in Parscale. We used graphical methods and a chi-square test to assess item fit. Differential item functioning was investigated using logistic regression.

Results

Data were obtained from 888 individuals with arthritis. The five domains were sufficiently unidimensional for an IRT-based analysis. Thirty-one items were deleted due to lack of fit or differential item functioning. Daily Activities had the narrowest range for the item location parameter (-2.24 to 0.55) and Handling Objects had the widest range (-1.70 to 2.27). The mean (median) slope parameter for the items ranged from 1.15 (1.07) in Feelings to 1.73 (1.75) in Walking. The final item banks are comprised of 31–45 items each.

Conclusion

We have developed IRT-based item banks to measure HRQL in 5 domains relevant to arthritis. The items in the final item banks provide adequate psychometric information for a wide range of functional levels in each domain.
Appendix
Available only for authorised users
Literature
1.
McHorney CA: Generic health measurement: past accomplishments and a measurement paradigm for the 21st century. Ann Intern Med 1997, 15: 743–750.CrossRef
2.
Hays RD, Morales LS, Reise SP: Item response theory and health outcomes measurement in the 21st century. Med Care 2000, (Suppl 9):II28–42.
3.
Fries JF, Bruce B, Cella D: The promise of PROMIS: using item response theory to improve assessment of patient-reported outcomes. Clin Exp Rheumatol 2005, 23: S53–57.PubMed
4.
Ware JE Jr, Kosinski M, Bjorner JB, Bayliss MS, Batenhorst A, Dahlof CG, Tepper S, Dowson A: Applications of computerized adaptive testing (CAT) to the assessment of headache impact. Qual Life Res 2003, 12: 935–952. 10.1023/A:1026115230284PubMedCrossRef
5.
Bjorner JB, Kosinski M, Ware JE Jr: Calibration of an item pool for assessing the burden of headaches: an application of item response theory to the headache impact test (HIT). Qual Life Res 2003, 12: 913–933. 10.1023/A:1026163113446PubMedCrossRef
6.
Fliege H, Becker J, Walter OB, Bjorner JB, Klapp BF, Rose M: Development of a Computer-adaptive Test for Depression (D-CAT). Qual Life Res 2005, 14: 2277–2291. 10.1007/s11136-005-6651-9PubMedCrossRef
7.
Becker J, Walter OB, Fliege H, Bjorner JB, Kocalevent RD, Klapp BF, Rose M: Validating the German computerized adaptive test for anxiety [abstract]. Qual Life Res 2004, 13: 1515.
8.
Kocalevent RD, Walter OB, Becker J, Fliege H, Klapp BF, Bjorner JB, Rose M: Perceived stress – measured by a computerized adaptive test (STRESS-CAT) [abstract]. Qual Life Res 2004, 13: 1515.
9.
Lai JS, Cella D, Dineen K, Bode R, Von Roenn J, Gershon RC, Shevrin D: An item bank was created to improve the measurement of cancer-related fatigue. J Clin Epidemiol 2005, 58: 190–197. 10.1016/j.jclinepi.2003.07.016PubMedCrossRef
10.
Lai JS, Dineen K, Reeve BB, Von Roenn J, Shervin D, McGuire M, Bode RK, Paice J, Cella D: An item response theory-based pain item bank can enhance measurement precision. J Pain Symptom Manage 2005, 30: 278–288. 10.1016/j.jpainsymman.2005.03.009PubMedCrossRef
11.
Bode RK, Lai JS, Dineen K, Heinemann AW, Shevrin D, Von Roenn J, Cella D: Expansion of a physical function item bank and development of an abbreviated form for clinical research. J Appl Meas 2006, 7: 1–15.PubMed
12.
Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19–22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948
13.
Ware JE: The status of health assessment. Annu Rev Public Health 1995, 16: 327–354. 10.1146/annurev.pu.16.050195.001551PubMedCrossRef
14.
Cella DF: Quality of life: concepts and definition. J Pain Symptom Manage 1994, 9: 186–192. 10.1016/0885-3924(94)90129-5PubMedCrossRef
15.
Ware JE, Sherbourne CD: The MOS 36-item Short-Form Health Survey (SF-36). Med Care 1992, 30: 473–483.PubMedCrossRef
16.
Furlong WJ, Feeny DH, Torrance GW, Barr RD: The Health Utilities Index (HUI) system for assessing health-related quality of life in clinical studies. Ann Med 2001, 33: 375–384.PubMedCrossRef
17.
EQ-5D The EuroQol Group: EuroQol – a new facility for the measurement of health-related quality of life. Health Policy 1990, 16: 199–208. 10.1016/0168-8510(90)90421-9CrossRef
18.
Ustun TB, Chatterji S, Bickenbach J, Kostanjsek N, Schneider M: The International Classification of Functioning, Disability and Health: a new tool for understanding disability and health. Disabil Rehabil 2003, 25: 565–571. 10.1080/0963828031000137063PubMedCrossRef
19.
20.
Spilker B, Molinek FR Jr, Johnston KA, Simpson RL Jr, Tilson HH: Quality of life bibliography and indexes. Med Care 1990,28(12 Suppl):DS1–77.PubMed
21.
Spilker B, Ed: Quality of Life and Pharmacoeconomics in Clinical Trials. Edited by: 2. New York: Lippincott-Raven; 1996.
22.
MacDowell I, Newell C: Measuring Health: a guide to rating scales and questionnaires. 2nd edition. N York: Oxford University Press; 1996.
23.
Bowling A: Measuring disease: a review of disease-specific quality of life measurement scales. Philadelphia: Open University Press; 1995.
24.
Mason JH, Anderson JJ, Meenan RF: A model of health status for rheumatoid arthritis. A factor analysis of the Arthritis Impact Measurement Scales. Arthritis Rheum 1988, 31: 714–720.PubMedCrossRef
25.
Streiner DL, Norman GR: Health Measurement Scales. A Practical Guide to Their Development and Use. Edited by: 2. Oxford: Oxford University Press; 1995.
26.
Nunnally JC, Bernstein IH: Elements of statistical description and estimation. In Psychometric Theory. 3rd edition. Edited by: Nunnally JC, Bernstein IH. New York: McGraw-Hill; 1994:127.
27.
Cattell RB: The screen test for the number of factors. Multivariate Behav Res 1966, 1: 629–637.
28.
Tabachnick DG, Fidell LS: Using multivariate statistics. 3rd edition. New York, New York: Harper Collins; 1996.
29.
Rasch G: Probabilistic Models for Some Intelligence and Attainment Tests. Denmark; 1960, University of Chicago Press; 1980.
30.
Muraki E: A Generalized Partial Credit Model. In Handbook of Modern Item Response Theory. Edited by: van der Linden WJ, Hambleton RK. New York: Springer; 1996:153–164.
31.
Ramsay JO: Testgraf. A Program for the Graphical Analysis of Multiple Choice Test and Questionnaire Data. McGill University, Montreal, Canada; 1995.
32.
Muraki E, Bock RD: Parscale: IRT based test scoring and item analysis for graded open-ended exercises and performance tasks. Chicago: Scientific Software Int; 1993.
33.
Muraki E: A Generalized Partial Credit Model: application of an EM algorithm. Appl Psych Meas 1992, 16: 159–176.CrossRef
34.
Embretson S, Reise SP: Item Response Theory for Psychologists. Mahwah, NJ: Lawrence Erlbaum Associates; 2000.
35.
Ryan TA: Multiple comparisons in psychological research. Psychol Bull 1959, 56: 26–47. 10.1037/h0042478PubMedCrossRef
36.
Kelderman H, Macready GB: The use of loglinear models for assessing differential item functioning across manifest and latent examinee groups. J Ed Meas 1990, 27: 307–327. 10.1111/j.1745-3984.1990.tb00751.xCrossRef
37.
Swaminathan H, Rogers HJ: Detecting differential item functioning using logistic regression procedures. J Ed Meas 1990, 27: 361–370. 10.1111/j.1745-3984.1990.tb00754.xCrossRef
38.
Nagelkerke NJD: Miscellanea. A note on a general definition of the coefficient of determination. Biometrika 1991, 78: 691–692. 10.2307/2337038CrossRef
39.
Wainer H: Computerized Adaptive Testing: A primer. Hillsdale, NJ: Lawrence Erlbaum Associates; 1990.
40.
Caroll JB: The effect of difficulty and chance success on correlations between items or between tests. Psychometrika 1945, 10: 1–19. 10.1007/BF02289789CrossRef
41.
Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, Silberman M, Yellen SB, Winicour P, Brannon J, Eckberg K, Lloyd S, Purl S, Blendowski C, Goodman M, Barnicle M, Stewart I, McHale M, Bonomi P, Kaplan E, Taylor S IV, Thomas CR, Harris J: The functional assessment of Cancer Therapy Scale: development and validation of the general measure. J Clin Oncol 1993, 11: 570–579.PubMed
42.
Meenan RF, Gertman PM, Mason JH: Measuring health status in arthritis. The Arthritis Impact Measurement Scales. Arthritis Rheum 1980, 23: 146–152.PubMedCrossRef
43.
Radloff LS: The CES-D scale: a self-report depression scale for research in the general population. Appl Psych Meas 1977, 1: 385–401.CrossRef
44.
Bieling PJ, Antony MM, Swinson RP: The State-Trait Anxiety Inventory, Trait version: structure and content re-examined. Behav Res Ther 1998, 36: 777–788. 10.1016/S0005-7967(98)00023-0PubMedCrossRef
45.
Zigmond AS, Snaith RP: The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica 1983, 67: 361–370.PubMedCrossRef
46.
Hattie JA: Methodology review: assessing unidimensionality of tests and items. Appl Psych Meas 1985, 9: 139–164.CrossRef
47.
Drasgow F, Levine MV, Tsien S, Williams BA, Mead AD: Fitting polytomous item response theory models to multiple-choice tests. Appl Psych Meas 1995, 19: 143–165.CrossRef
48.
Tay-Lim BSH, Zhang J, Davis S, Tang C: The impact of item treatments on NEAP reporting scale scores. Paper presented at the Annual Meeting of National Council on Measurement in Education (NCME), Chicago April 22–24 2003
49.
Crane PK, van Belle G, Larson EB: Test bias in a cognitive test: differential item functioning in the CASI. Stat Med 2004, 23: 241–256. 10.1002/sim.1713PubMedCrossRef
50.
Fries JF, Spitz P, Kraines RG, Holman HR: Measurement of patient outcome in arthritis. Arthritis Rheum 1980, 23: 137–145.PubMedCrossRef
51.
Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW: Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 1988, 15: 1833–1840.PubMed
52.
Sloan J, Wilson M: Item response theory: when is it useful and where does classical test theory fit in? Qual Life Res 2005, 14: 1982.
53.
Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J: An inventory for measuring depression. Arch Gen Psychiatry 1961, 4: 561–71.PubMedCrossRef
54.
Schag CA, Heinrich RL: Development of a comprehensive quality of life measurement tool: CARES. Oncology (Williston Park) 1990, 4: 135–8.
55.
Ruta DA, Garratt AM, Wardlaw D, Russell IT: Developing a valid and reliable measure of health outcome for patients with low back pain. Spine 1994, 19: 1887–96.PubMedCrossRef
56.
Hudak PL, Amadio PC, Bombardier C: Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med 1996, 29: 602–8. Publisher Full Text 10.1002/(SICI)1097-0274(199606)29:6<602::AID-AJIM4>3.0.CO;2-LPubMedCrossRef
57.
Salen BA, Spangfort EV, Nygren AL, Nordemar R: The Disability Rating Index: an instrument for the assessment of disability in clinical settings. J Clin Epidemiol 1994, 47: 1423–35. 10.1016/0895-4356(94)90086-8PubMedCrossRef
58.
Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC, Kaasa S, Klee M, Osoba D, Razavi D, Rofe PB, Schraub S, Sneeuw K, Sullivan M, Takeda F: The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 1993, 85: 365–76.PubMedCrossRef
59.
Schipper H, Clinch J, McMurray A, Levitt M: Measuring quality of life of cancer patients: the Functional Living Index-Cancer, development and validation. J Clin Oncol 1984, 2: 472–483.PubMed
60.
Goldberg DP, Hillier VF: A scaled version of the General Health Questionnaire. Psychol Med 1979, 9: 139–45.PubMedCrossRef
61.
Martin DP, Engelberg R, Agel J, Snapp D, Swiontkowski MF: Development of a musculoskeletal extremity health status instrument: the Musculoskeletal Function Assessment instrument. J Orthop Res 1996, 14: 173–81. 10.1002/jor.1100140203PubMedCrossRef
62.
Tugwell P, Bombardier C, Buchanan WW, Goldsmith CH, Grace E, Hanna B: The MACTAR Patient Preference Disability Questionnaire – an individualized functional priority approach for assessing improvement in physical disability in clinical trials in rheumatoid arthritis. J Rheumatol 1987, 14: 446–51.PubMed
63.
Chambers LW, Macdonald LA, Tugwell P, Buchanan WW, Kraag G: The McMaster Health Index Questionnaire as a measure of quality of life for patients with rheumatoid disease. J Rheumatol 1982, 9: 780–4.PubMed
64.
Chung KC, Pillsbury MS, Walters MR, Hayward RA: Reliability and validity testing of the Michigan Hand Outcomes Questionnaire. J Hand Surg [Am] 1998, 23: 575–87.CrossRef
65.
Pincus T, Swearingen C, Wolfe F: Toward a Multidimensional Health Assessment Questionnaire (MDHAQ): assessment of advanced activities of daily living and psychological status in the patient-friendly health assessment questionnaire format. Arthritis Rheum 1999, 42: 2220–30. Publisher Full Text 10.1002/1529-0131(199910)42:10<2220::AID-ANR26>3.0.CO;2-5PubMedCrossRef
66.
67.
Daltroy LH, Cats-Baril WL, Katz JN, Fossel AH, Liang MH: The North American Spine Society lumbar spine outcome assessment instrument: reliability and validity tests. Spine 1996, 21: 741–9. 10.1097/00007632-199603150-00017PubMedCrossRef
68.
Hunt SM, McKenna SP, McEwen J, Backett EM, Williams J, Papp E: A quantitative approach to perceived health status: a validation study. J Epidemiol Community Health 34: 281–6.
69.
Tait RC, Pollard CA, Margolis RB, Duckro PN, Krause SJ: The Pain Disability Index: psychometric and validity data. Arch Phys Med Rehabil 1987, 68: 438–41.PubMed
70.
McNair DM, Lorr M, Droppleman LF: Manual for the Profile of Mood States. San Diego: Educational and Industrial Testing Service; 1971.
71.
Fairbank JC, Couper J, Davies JB, O'Brien JP: The Oswestry low back pain disability questionnaire. Physiotherapy 1980, 66: 271–3.PubMed
72.
de Jong Z, van der Heijde D, McKenna SP, Whalley D: The reliability and construct validity of the RAQoL: a rheumatoid arthritis-specific quality of life instrument. Br J Rheumatol 1997, 36: 878–83. 10.1093/rheumatology/36.8.878PubMedCrossRef
73.
de Haes JC, van Knippenberg FC, Neijt JP: Measuring psychological and physical distress in cancer patients: structure and application of the Rotterdam Symptom Checklist. Br J Cancer 1990, 62: 1034–8.PubMedCentralPubMedCrossRef
74.
Bergner M, Bobbitt RA, Carter WB, Gilson BS: The Sickness Impact Profile: development and final revision of a health status measure. Med Care 1981, 19: 787–805.PubMedCrossRef
75.
Metadata
Title
Assessment of health-related quality of life in arthritis: conceptualization and development of five item banks using item response theory
Authors
Jacek A Kopec
Eric C Sayre
Aileen M Davis
Elizabeth M Badley
Michal Abrahamowicz
Lesley Sherlock
J Ivan Williams
Aslam H Anis
John M Esdaile
Publication date
01-12-2006
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2006
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-4-33

Other articles of this Issue 1/2006

Health and Quality of Life Outcomes 1/2006 Go to the issue

Research

Gender associated differences in determinants of quality of life in patients with COPD: a case series study

Research

Measuring health-related quality of life in young adolescents: Reliability and validity in the Norwegian version of the Pediatric Quality of Life Inventory™ 4.0 (PedsQL) generic core scales

Research

Pain in cancer. An outcome research project to evaluate the epidemiology, the quality and the effects of pain treatment in cancer patients

Research

Psychometric evaluation of the Osteoporosis Patient Treatment Satisfaction Questionnaire (OPSAT-Q™), a novel measure to assess satisfaction with bisphosphonate treatment in postmenopausal women

Research

Influence of Interferon beta treatment on quality of life in multiple sclerosis patients

Research

Japanese version of the Dermatology Life Quality Index: validity and reliability in patients with acne