Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Dornsife Center for Self-Report Science, University of Southern California, Los Angeles, USA.
Qual Life Res. 2023 Oct;32(10):2839-2852. doi: 10.1007/s11136-023-03446-6. Epub 2023 Jun 2.
To calibrate the item parameters of the German PROMIS® Pain interference (PROMIS PI) items using an item-response theory (IRT) model and investigate psychometric properties of the item bank.
Forty items of the PROMIS PI item bank were collected in a convenience sample of 660 patients, which were recruited during inpatient rheumatological treatment or outpatient psychosomatic medicine visits in Germany. Unidimensionality, monotonicity, and local independence were tested as required for IRT analyses. Unidimensionality was examined using confirmatory factor analyses (CFA) and exploratory factor analysis (EFA). Unidimensional and bifactor graded-response IRT models were fitted to the data. Bifactor indices were used to investigate whether multidimensionality would lead to biased scores. To evaluate convergent and discriminant validity, the item bank was correlated with legacy pain instruments. Potential differential item functioning (DIF) was examined for gender, age, and subsample. To investigate whether U.S. item parameters may be used to derive T-scores in German patients, T-scores based on previously published U.S. and newly estimated German item parameters were compared with each other after adjusting for sample specific differences.
All items were sufficiently unidimensional, locally independent, and monotonic. Whereas the fit of the unidimensional IRT model was not acceptable, a bifactor IRT model demonstrated acceptable fit. Explained common variance and Omega hierarchical suggested that using the unidimensional model would not lead to biased scores. One item demonstrated DIF between subsamples. High correlations with legacy pain instruments supported construct validity of the item bank. T-scores based on U.S. and German item parameters were similar suggesting that U.S. parameters could be used in German samples.
The German PROMIS PI item bank proved to be a clinically valid and precise instrument for assessing pain interference in patients with chronic conditions.
使用项目反应理论（IRT）模型校准德国 PROMIS®疼痛干扰（PROMIS PI）项目的项目参数，并研究项目库的心理测量特性。
在德国便利样本的 660 名患者中收集了 40 个 PROMIS PI 项目库的项目，这些患者是在住院风湿治疗或门诊身心医学就诊期间招募的。根据 IRT 分析的要求，测试了单维性、单调性和局部独立性。使用验证性因子分析（CFA）和探索性因子分析（EFA）检验单维性。将单维和双因素等级反应 IRT 模型拟合到数据中。使用双因素指标来研究多维性是否会导致分数偏差。为了评估收敛和区分效度，将项目库与传统疼痛仪器相关联。检验了性别、年龄和子样本的潜在差异项目功能（DIF）。为了研究美国项目参数是否可用于得出德国患者的 T 分数，在调整样本特定差异后，比较了基于先前发表的美国和新估计的德国项目参数的 T 分数。
所有项目在单维性、局部独立性和单调性方面都足够。尽管单维 IRT 模型的拟合度不可接受，但双因素 IRT 模型的拟合度尚可。解释的共同方差和 Omega 层次结构表明，使用单维模型不会导致分数偏差。一个项目在子样本之间表现出 DIF。与传统疼痛仪器的高相关性支持了项目库的结构效度。基于美国和德国项目参数的 T 分数相似，表明可以在美国样本中使用德国参数。
德国 PROMIS PI 项目库被证明是一种用于评估慢性疾病患者疼痛干扰的临床有效且精确的工具。
