Vernon-Roberts Angharad, Otley Anthony, Frampton Chris, Gearry Richard B, Day Andrew S
Department of Pediatrics, Otago University, Christchurch, New Zealand.
Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.
J Paediatr Child Health. 2020 Jan;56(1):155-162. doi: 10.1111/jpc.14547. Epub 2019 Jun 26.
Paediatric inflammatory bowel disease (IBD) is a chronic relapsing condition requiring adherence to complex treatment regimens to achieve best outcomes. Adherence is frequently low in this population but can be improved by increasing disease- and treatment-related knowledge. The IBD-knowledge inventory device (IBD-KID) is a knowledge assessment tool specifically developed and validated for children with IBD. To analyse IBD-KID participant response patterns in order to review the strength of the tool.
A cohort of children with IBD completed IBD-KID, and their responses were used to assess the tool's validity and feasibility. Item response analysis assessed the item difficulty and the ability of items to discriminate between high/low scorers. The analysis considered item structure, readability and the effectiveness of multiple choice items.
A total of 105 completed IBD-KID assessments showed that 12 items (52%) had an acceptable difficulty level, and 17 (74%) were effective at discriminating between high/low scorers. Nine (61%) had good readability, but comprehension levels ranged from 5 to 18 years. Seven (30%) had elevated 'don't know' responses, highlighting the need for content and construction review. Of the 10 multiple choice items, 9 were complex and not functioning efficiently. Internal consistency was acceptable but could be improved by removing two items.
The response analysis metrics were reviewed by an expert panel and provided a framework for IBD-KID improvements with the aim of increasing discrimination and reducing difficulty without adversely affecting reliability. The proposed revisions will address components that may have caused children to answer incorrectly due to confusion rather than lack of knowledge.
儿童炎症性肠病（IBD）是一种慢性复发性疾病，需要坚持复杂的治疗方案以取得最佳疗效。该人群的依从性通常较低，但可通过增加疾病和治疗相关知识来提高。IBD知识量表（IBD-KID）是一种专门为IBD患儿开发并验证的知识评估工具。分析IBD-KID参与者的回答模式，以评估该工具的优势。
一组IBD患儿完成了IBD-KID测试，其回答用于评估该工具的有效性和可行性。项目反应分析评估了项目难度以及项目区分高分/低分者的能力。该分析考虑了项目结构、可读性和多项选择题的有效性。
总共105份完成的IBD-KID评估显示，12个项目（52%）具有可接受的难度水平，17个项目（74%）在区分高分/低分者方面有效。9个项目（61%）具有良好的可读性，但理解水平从5岁到18岁不等。7个项目（30%）的“不知道”回答比例较高，凸显了内容和结构审查的必要性。在10个多项选择题中，9个复杂且功能不佳。内部一致性可接受，但删除两个项目可有所改善。
专家小组对反应分析指标进行了审查，并为IBD-KID的改进提供了一个框架，目的是在不影响可靠性的情况下提高区分度并降低难度。提议的修订将解决可能因混淆而非知识不足导致儿童回答错误的部分。
