Evaluating Differential Item Functioning in the English General Practice Patient Survey Comparison of South Asian and White British Subgroups
Evaluating Differential Item Functioning in the English General Practice Patient Survey Comparison of South Asian and White British Subgroups
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DOI：
10.1097/mlr.0000000000000397
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发表时间：
2015-09-01
期刊：
影响因子：
3
通讯作者：
Campbell, John
中科院分区：
文献类型：
--
作者：
Setodji, Claude M.;Elliott, Marc N.;Campbell, John
目的：评估英国全科医学（GP）患者调查中的两个5项患者体验量表，以获得不同项目功能（DIF）的证据，并给出南亚人与英国白色受访者相比报告的医疗保健体验显著更差的先前证据。设置：英国患者的初级保健体验的全国调查。方法：我们使用经典测试和项目反应理论分析来检查患者种族DIF的可能性。结果：南亚人和英国白人受访者的医疗保健体验显著更差，而英国白人受访者的医疗保健体验显著更差。结论：南亚人和英国白人受访者的医疗保健体验显著更差，而英国白人受访者的医疗保健体验显著更差（南亚人，白色英国人）在控制了2011/2012年进行的英国GP患者调查中的年龄、性别、健康状况和生活质量后。873，051名受访者（818，219名白色英国人/54，832名南亚人，来自7795名英国人）回答了与全科医生或护士护理经验相关的项目。内部一致性可靠性高，南亚和白色英国患者相似。白色英国患者报告更好的平均经验比南亚人，但没有证据表明DIF或不同的项目反应曲线为白色英国和南亚受访者，即使在敏感性分析使用匹配samples.Conclusions：所有通信项目在英国GP患者调查显示类似的南亚与白色英国的差异，没有证据表明DIF。相比之下，由于规模使用或期望的差异通常是可变的，而不是恒定的跨规模。虽然其他可能性仍然存在，但这些发现增加了南亚患者对这项全国调查的负面反应反映其护理经历真实差异的可能性。
Objective:To evaluate two 5-item patient experience scales from the English General Practice (GP) Patient Survey for evidence of differential item functioning (DIF) given prior evidence of substantially worse reported health care experiences for South Asian compared with white British respondents.Setting:A national survey of English patients' primary care experiences.Method:We used classic test and item response theory analysis to examine the possibility of DIF by patient ethnicity (South Asian, white British) after controlling for age, sex, health status, and quality of life in the English GP Patient Survey conducted in 2011/2012.Results:Data were available for 873,051 respondents (818,219 white British/54,832 South Asian from 7795 English practices) who answered items relating to experiences of GP or nurses' care. Internal consistency reliability was high and similar for South Asian and white British patients. White British patients reported better average experiences than South Asians, but there was no evidence of DIF or different item response curves for white British and South Asian respondents, even in sensitivity analyses using matched samples.Conclusions:All communication items in the English GP Patient Survey showed similar South Asian versus white British differences, with no evidence of DIF. In contrast, differences due to scale use or expectations are typically variable rather than constant across scales. While other possibilities remain, these findings increase the likelihood that the observed negative responses of South Asian patients to this national survey reflect true differences in their experiences of care.