Department of Trauma Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, 1081 HV, the Netherlands.
Physical Therapy Sciences, Program in Clinical Health Sciences, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
BMC Musculoskelet Disord. 2020 Mar 16;21(1):170. doi: 10.1186/s12891-020-3178-8.
The Dutch-Flemish PROMIS® Upper Extremity (DF-PROMIS-UE) V2.0 item bank was recently developed using Item Response Theory (IRT). Unknown for this bank are: (1) if it is legitimate to calculate IRT-based scores for short forms and Computerized Adaptive Tests (CATs), which requires that the items meet the assumptions of and fit the IRT-model (Graded Response Model [GRM]);(2) if it is legitimate to compare (sub) groups of patients using this measure, which requires measurement invariance; and (3) the precision of the estimated patients' scores for patients with different levels of functioning and compared to legacy measures. Aims were to evaluate (1) the assumptions of and fit to the GRM, (2) measurement invariance and (3) (comparative) precision of the DF-PROMIS-UE v2.0.
Cross-sectional data were collected in Dutch patients with upper extremity disorders. Assessed were IRT-assumptions (unidimensionality [bi-factor analysis], local independence [residual correlations], monotonicity [coefficient H]), GRM item fit, measurement invariance (absence of Differential Item Functioning [DIF] due to age, gender, center, duration, and location of complaints) and precision (standard error of IRT-based scores across levels of functioning). To study measurement invariance for language [Dutch vs. English], additional US data were used. Legacy instruments were the Disability of the Arm, Shoulder and Hand (DASH), the QuickDASH and the Michigan Hand Questionnaire (MHQ).
In total 521 Dutch (mean age ± SD = 51 ± 17 years, 49% female) and 246 US patients (mean age ± SD = 48 ± 14 years, 69% female) participated. The DF-PROMIS-UE v2.0 item bank was sufficiently unidimensional (Omega-H = 0.80, Explained Common Variance = 0.68), had negligible local dependence (four out of 1035 correlations > 0.20), good monotonicity (H = 0.63), good GRM fit (no misfitting items) and demonstrated sufficient measurement invariance. Precise estimates (Standard Error < 3.2) were obtained for most patients (7-item short form, 88.5%; standard CAT, 91.3%; and, fixed 7-item CAT, 87.6%). The DASH displayed better reliability than the DF-PROMIS-UE short form and standard CAT, the QuickDASH displayed comparable reliability. The MHQ-ADL displayed better reliability than the DF-PROMIS-UE short form and standard CAT for T-scores between 28 and 50. For patients with low function, the DF-PROMIS-UE measures performed better.
The DF-PROMIS-UE v2.0 item bank showed sufficient psychometric properties in Dutch patients with UE disorders.
荷兰-佛兰芒 PROMIS®上肢（DF-PROMIS-UE）V2.0 项目库是最近使用项目反应理论（IRT）开发的。该项目库存在以下未知问题：（1）是否可以为短式和计算机自适应测试（CAT）计算基于 IRT 的分数，这需要项目符合 IRT 模型（等级反应模型 [GRM]）的假设并拟合该模型；（2）是否可以使用该测量方法对（亚）组患者进行比较，这需要测量不变性；（3）对于不同功能水平的患者以及与传统测量方法相比，IRT 估计的患者分数的精度。目的是评估（1）GRM 的假设和拟合度，（2）测量不变性和（3）DF-PROMIS-UE v2.0 的（比较）精度。
在荷兰上肢障碍患者中进行了横断面数据收集。评估了 IRT 假设（单维性[双因子分析]、局部独立性[剩余相关性]、单调性[H 系数]）、GRM 项目拟合度、测量不变性（由于年龄、性别、中心、疾病持续时间和部位而不存在差异项目功能[DIF]）和精度（功能水平的 IRT 得分的标准误差）。为了研究语言[荷兰语与英语]的测量不变性，还使用了美国的附加数据。传统的测量工具有手臂、肩部和手的残疾（DASH）、快速 DASH 和密歇根手问卷（MHQ）。
共有 521 名荷兰（平均年龄±标准差=51±17 岁，49%为女性）和 246 名美国（平均年龄±标准差=48±14 岁，69%为女性）患者参与了研究。DF-PROMIS-UE v2.0 项目库具有足够的单维性（Omega-H=0.80，解释共同方差=0.68），具有可忽略的局部依赖性（1035 个相关系数中只有四个大于 0.20），良好的单调性（H=0.63），良好的 GRM 拟合度（没有不适合的项目），并且具有足够的测量不变性。对于大多数患者（7 项短式、88.5%；标准 CAT、91.3%；以及固定的 7 项 CAT、87.6%），都获得了精确的估计值（标准误差<3.2）。DF-PROMIS-UE 短式和标准 CAT 的信度优于 DASH，DF-PROMIS-UE 短式和标准 CAT 的信度与快速 DASH 相当。对于 T 分数在 28 到 50 之间的患者，MHQ-ADL 的信度优于 DF-PROMIS-UE 短式和标准 CAT。对于功能水平较低的患者，DF-PROMIS-UE 测量方法表现更好。
DF-PROMIS-UE v2.0 项目库在荷兰上肢障碍患者中具有足够的心理计量学特性。
