School of Health and Related Research, University of Sheffield, Sheffield, UK.
Optum Patient Insights, Rhode Island, United States and University of Copenhagen, Copenhagen, Denmark.
Qual Life Res. 2021 Jan;30(1):267-276. doi: 10.1007/s11136-020-02622-2. Epub 2020 Sep 9.
ReQoL-10 and ReQoL-20 have been developed for use as outcome measures with individuals aged 16 and over, experiencing mental health difficulties. This paper reports modelling results from the item response theory (IRT) analyses that were used for item reduction.
From several stages of preparatory work including focus groups and a previous psychometric survey, a pool of items was developed. After confirming that the ReQoL item pool was sufficiently unidimensional for scoring, IRT model parameters were estimated using Samejima's Graded Response Model (GRM). All 39 mental health items were evaluated with respect to item fit and differential item function regarding age, gender, ethnicity, and diagnosis. Scales were evaluated regarding overall measurement precision and known-groups validity (by care setting type and self-rating of overall mental health).
The study recruited 4266 participants with a wide range of mental health diagnoses from multiple settings. The IRT parameters demonstrated excellent coverage of the latent construct with the centres of item information functions ranging from - 0.98 to 0.21 and with discrimination slope parameters from 1.4 to 3.6. We identified only two poorly fitting items and no evidence of differential item functioning of concern. Scales showed excellent measurement precision and known-groups validity.
The results from the IRT analyses confirm the robust structure properties and internal construct validity of the ReQoL instruments. The strong psychometric evidence generated guided item selection for the final versions of the ReQoL measures.
ReQoL-10 和 ReQoL-20 已被开发用于衡量 16 岁及以上患有心理健康障碍的个体的结果。本文报告了为进行项目删减而进行的项目反应理论(IRT)分析的建模结果。
通过包括焦点小组和先前的心理测量调查在内的几个预备阶段,开发了一组项目。在确认 ReQoL 项目池具有足够的一维性以进行评分后,使用 Samejima 的分级反应模型(GRM)估计 IRT 模型参数。对所有 39 个心理健康项目进行了项目拟合和与年龄、性别、种族和诊断有关的项目功能差异的评估。对量表进行了整体测量精度和已知群体有效性的评估(通过护理环境类型和对整体心理健康的自我评估)。
本研究招募了来自多个环境的 4266 名患有各种心理健康诊断的参与者。IRT 参数很好地涵盖了潜在结构,信息函数的中心范围从-0.98 到 0.21,区分斜率参数从 1.4 到 3.6。我们只发现了两个拟合不良的项目,没有发现令人担忧的项目功能差异的证据。量表显示出很好的测量精度和已知群体有效性。
IRT 分析的结果证实了 ReQoL 工具的稳健结构特性和内部结构有效性。生成的强大心理测量证据指导了 ReQoL 测量最终版本的项目选择。