Department of Psychology, Health & Technology, University of Twente, Faculty of Behavioral Sciences, P.O. Box 217, 7500 AE Enschede, The Netherlands.
J Clin Epidemiol. 2013 Oct;66(10):1175-83. doi: 10.1016/j.jclinepi.2013.05.010. Epub 2013 Aug 17.
Development of an item pool to construct a future computerized adaptive test (CAT) for fatigue in rheumatoid arthritis (RA). The item pool was based on the patients' perspective and examined for face and content validity previously. This study assessed the fit of the items with seven predefined dimensions and examined the item pool's dimensionality structure in statistical terms.
A total of 551 patients with RA participated in this study. Several steps were conducted to come from an explorative item pool to a psychometrically sound item bank. The item response theory (IRT) analysis using the generalized partial credit model was conducted for each of the seven predefined dimensions. Poorly fitting items were removed. Finally, the best possible multidimensional IRT (MIRT) model for the data was identified.
In IRT analysis, 49 items showed insufficient item characteristics. Items with a discriminative ability below 0.60 and/or model misfit effect sizes greater than 0.10 were removed. Factor analysis on the 196 remaining items revealed three dimensions, namely severity, impact, and variability of fatigue. The dimensions were further confirmed in MIRT model analysis.
This study provided an initially calibrated item bank and showed which dimensions and items can be used for the development of a multidimensional CAT for fatigue in RA.
开发一个项目库，以构建类风湿关节炎（RA）疲劳的未来计算机自适应测试（CAT）。该项目库基于患者的观点，并在此前对其进行了表面和内容效度检验。本研究评估了项目与七个预设维度的拟合度，并从统计学角度检验了项目库的维度结构。
共有 551 名 RA 患者参与了这项研究。通过几个步骤，从探索性项目库到心理测量学上健全的项目库。对每个七个预设维度进行了项目反应理论（IRT）分析，使用广义部分信用模型。剔除拟合不良的项目。最后，确定了数据的最佳多维IRT（MIRT）模型。
在 IRT 分析中，49 个项目显示出项目特征不足。具有低于 0.60 的区分能力和/或模型不拟合效应量大于 0.10 的项目被剔除。对 196 个剩余项目进行因子分析，揭示了疲劳的三个维度，即严重程度、影响和变异性。在 MIRT 模型分析中进一步证实了这些维度。
本研究提供了一个初步校准的项目库，并显示了哪些维度和项目可用于开发 RA 疲劳的多维 CAT。
