Department of Biomedical Sciences for Health, Università Degli Studi Di Milano, Milan, Italy.
IRCCS, Istituto Auxologico Italiano, Department of Neurorehabilitation Sciences, Ospedale San Luca, Milan, Italy.
Disabil Rehabil. 2024 Feb;46(3):591-603. doi: 10.1080/09638288.2023.2169771. Epub 2023 Feb 5.
The present article summarises the characteristics of Rasch's theory, providing an original metrological model for persons' measurements. Properties describing the person "as a whole" are key outcome variables in Medicine. This is particularly true in Physical and Rehabilitation Medicine, targeting the person's interaction with the outer world. Such variables include independence, pain, fatigue, balance, and the like. These variables can only be observed through behaviours of various complexity, deemed representative of a given "latent" person's property. So how to infer its "quantity"? Usually, behaviours (items) are scored ordinally, and their "raw" scores are summed across item lists (questionnaires). The limits and flaws of scores (i.e., multidimensionality, non-linearity) are well known, yet they still dominate the measurement in Medicine. Through Rasch's theory and statistical analysis, scores are transformed and tested for their capacity to respect fundamental measurement axioms. Rasch analysis returns the linear measure of the person's property ("ability") and the item's calibrations ("difficulty"), concealed by the raw scores. The difference between a person's ability and item difficulty determines the probability that a "pass" response is observed. The discrepancy between observed scores and the ideal measures (i.e., the residual) invites diagnostic reasoning. In a companion article, advanced applications of Rasch modelling are illustrated. Implications for rehabilitationQuestionnaires' ordinal scores are poor approximations of measures. The Rasch analysis turns questionnaires' scores into interval measures, provided that its assumptions are respected.Thanks to the Rasch analysis, accurate measures of independence, pain, fatigue, cognitive capacities and other whole person's variables of paramount importance in rehabilitation are available.The current work is addressed to rehabilitation professionals looking for an introduction to interpreting published results based on Rasch analysis.The first of a series of two, the present article illustrates the most common graphic and numeric outputs found in published papers presenting the Rasch analysis of questionnaires.
本文总结了 Rasch 理论的特点,为人员测量提供了原始的计量模型。描述“整体”人的特征的属性是医学的关键结果变量。这在物理和康复医学中尤其如此,其目标是针对人的与外部世界的相互作用。此类变量包括独立性、疼痛、疲劳、平衡等。这些变量只能通过各种复杂程度的行为来观察,这些行为被认为代表了给定的“潜在”人的属性。那么如何推断其“数量”呢?通常,行为(项目)按顺序评分,并且它们的“原始”分数在项目列表(问卷)中相加。分数的局限性和缺陷(即多维性、非线性)是众所周知的,但它们仍然主导着医学中的测量。通过 Rasch 理论和统计分析,对分数进行转换并测试其是否符合基本测量公理。Rasch 分析返回人的属性的线性度量(“能力”)和项目的校准(“难度”),这些隐藏在原始分数中。人的能力和项目难度之间的差异决定了观察到“通过”反应的概率。观察到的分数与理想测量值之间的差异(即残差)邀请进行诊断推理。在一篇配套文章中,说明了 Rasch 建模的高级应用。对康复的影响问卷的顺序分数是对测量值的粗略近似。Rasch 分析将问卷的分数转换为区间测量值,前提是其假设得到尊重。得益于 Rasch 分析,可获得独立性、疼痛、疲劳、认知能力等对康复至关重要的整体人的变量的准确测量值。这项工作针对正在寻找解释基于 Rasch 分析的已发表结果的康复专业人员。这一系列文章的第一篇,本文说明了在发表的介绍问卷的 Rasch 分析的论文中常见的图形和数字输出。