University of Manchester and Manchester Academic Health Sciences Centre, Manchester, UK.
University of Twente, Enschede, The Netherlands.
Arthritis Care Res (Hoboken). 2021 Jul;73(7):947-954. doi: 10.1002/acr.24204. Epub 2021 Jun 4.
As young people enter adulthood, the interchangeable use of child and adult outcome measures may inaccurately capture changes over time. This study aimed to use item response theory (IRT) to model a continuous score for functional ability that can be used no matter which questionnaire is completed.
Adolescents (ages 11-17 years) in the UK Childhood Arthritis Prospective Study (CAPS) self-completed an adolescent Childhood Health Assessment Questionnaire (CHAQ) and a Health Assessment Questionnaire (HAQ). Their parents answered the proxy-completed CHAQ. Those children with at least 2 simultaneously completed questionnaires at initial presentation or 1 year were included. Psychometric properties of item responses within each questionnaire were tested using Mokken analyses to assess the applicability of IRT modeling. A previously developed IRT model from the Pharmachild-NL registry from The Netherlands was validated in CAPS participants. Agreement and correlations between IRT-scaled functional ability scores were tested using intraclass correlations and Wilcoxon's signed rank tests.
In 303 adolescents, the median age at diagnosis was 13 years, and 61% were female. CHAQ scores consistently exceeded HAQ scores. Mokken analyses demonstrated high scalability, monotonicity, and the fact that each questionnaire yielded reliable scores. There was little difference in item response characteristics between adolescents enrolled in CAPS and Pharmachild-NL (maximum item residual 0.08). Significant differences were no longer evident between IRT-scaled HAQ and CHAQ scores.
IRT modeling allows the direct comparison of function scores regardless of different questionnaires being completed by different people over time. IRT modeling facilitates the ongoing assessment of function as adolescents transfer from pediatric clinics to adult services.
随着年轻人步入成年期，儿童和成人结果测量指标的可互换使用可能无法准确捕捉随时间的变化。本研究旨在使用项目反应理论（IRT）为功能能力构建一个连续评分，无论使用哪种问卷都可以使用。
英国儿童关节炎前瞻性研究（CAPS）中的青少年（11-17 岁）自行完成青少年儿童健康评估问卷（CHAQ）和健康评估问卷（HAQ）。他们的父母回答了代理完成的 CHAQ。那些在初次就诊或 1 年内至少同时完成 2 份问卷的儿童被纳入研究。使用 Mokken 分析测试每个问卷内的项目反应的心理测量特性，以评估 IRT 建模的适用性。来自荷兰 Pharmachild-NL 登记处的先前开发的 IRT 模型在 CAPS 参与者中进行了验证。使用组内相关系数和 Wilcoxon 符号秩检验测试 IRT 规模功能能力评分之间的一致性和相关性。
在 303 名青少年中，诊断时的中位年龄为 13 岁，61%为女性。CHAQ 评分始终高于 HAQ 评分。Mokken 分析表明，可扩展性、单调性和每个问卷产生可靠分数的事实都很高。在 CAPS 和 Pharmachild-NL 注册中心招募的青少年中，项目反应特征几乎没有差异（最大项目残差为 0.08）。IRT 规模的 HAQ 和 CHAQ 评分之间不再存在显著差异。
IRT 建模允许直接比较功能评分，无论不同的人在不同的时间使用不同的问卷。IRT 建模便于随着青少年从儿科诊所转移到成人服务，持续评估功能。
