School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, Jiangsu, China.
Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
Eur J Phys Rehabil Med. 2023 Dec;59(6):731-742. doi: 10.23736/S1973-9087.23.08003-6.
Despite the growing interest of the item response theory (IRT) in assessment of person abilities and functioning difficulties in screening tools, there is scarcity of research using IRT on ICF-based tools for persons with low back pain (LBP).
To generate and validate a parsimonious core set of ICF (PCSI) for LBP based on the IRT modelling.
A cross-sectional study.
Nine hospitals in Jiangsu Province, China.
We recruited patients with LBP.
All participants completed the 78 items of the comprehensive ICF Core Set for LBP. The five-point scoring system was converted to dichotomous data with 1 as functioning/independent and 0 as impairment/dependent. Psychometric properties of the data were examined using Mokken Scale analysis and parametric item response modelling.
This study recruited 306 participants (185 females and 121 males) with LBP. The overall median age of the study participants was 50.28 (95% CI 23.34; 82.05) years. We constructed a three-parameter logistic model with 28 ICF categories (8 of body function, 18 of activities and participation, and two of body structures). The internal consistency was good with Cronbach's alpha = 0.927 and latent class reliability coefficient (LCRC) = 0.955. The model was validated by significant correlations (P<0.001) of its estimated person abilities with the Oswestry Disability Index (ODI, r=-0.41), the Roland-Morris Disability Questionnaire (RMDQ, r=-0.57), the Physical Component Summary (PCS, r=0.63), and the Mental Component Summary (MCS, r = 0.46) of 12-Item Short Form Survey (SF-12). The person abilities and item difficulties were integrated into a Wright map that offered a background for making individualized clinical decisions.
The PCSI of LBP with 28 categories has good construct validity and internal consistency, and is a convenient instrument for assessing functioning among persons with LBP. The IRT model provided theoretical and algorithmic support for deriving a simplified model for functioning assessment hence serving a basis for formulating rehabilitation plans in clinical practice and research.
A parsimonious core set of ICF (PCSI) for LBP based on the IRT modelling provides a background for making individualized clinical decisions based on item difficulties.
尽管项目反应理论（IRT）在评估个体能力和筛选工具中的功能障碍方面越来越受到关注，但在基于 ICF 的腰痛（LBP）工具上使用 IRT 的研究却很少。
基于 IRT 模型生成和验证一个简洁的基于 ICF 的 LBP 核心集（PCSI）。
一项横断面研究。
中国江苏省的 9 家医院。
我们招募了腰痛患者。
所有参与者都完成了 78 项全面的 ICF 腰痛核心集。五分制评分系统转换为二分类数据，1 表示功能/独立，0 表示损伤/依赖。使用莫肯尺度分析和参数项目反应建模来检验数据的心理测量特性。
这项研究招募了 306 名腰痛患者（185 名女性和 121 名男性）。研究参与者的总体中位年龄为 50.28 岁（95%CI 23.34；82.05）。我们构建了一个三参数逻辑模型，其中包含 28 个 ICF 类别（8 个身体功能、18 个活动和参与以及 2 个身体结构）。内部一致性良好，克朗巴赫的 alpha 值为 0.927，潜在类别可靠性系数（LCRC）为 0.955。该模型通过与 Oswestry 残疾指数（ODI，r=-0.41）、Roland-Morris 残疾问卷（RMDQ，r=-0.57）、身体成分综合量表（PCS，r=0.63）和 12 项简短形式调查的心理成分综合量表（MCS，r=0.46）的显著相关性（P<0.001）得到验证。个人能力和项目难度被整合到 Wright 图中，为制定个性化临床决策提供了背景。
包含 28 个类别的 LBP PCSI 具有良好的结构效度和内部一致性，是一种评估腰痛患者功能的便捷工具。IRT 模型为简化功能评估模型提供了理论和算法支持，为制定临床实践和研究中的康复计划提供了依据。
基于 IRT 模型的 LBP 简洁核心集（PCSI）为基于项目难度制定个性化临床决策提供了背景。
