The feasibility of applying item response theory to measures of migraine impact: A re-analysis of three clinical studies
The feasibility of applying item response theory to measures of migraine impact: A re-analysis of three clinical studies
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DOI：
10.1023/a:1026175112538
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发表时间：
2003-12-01
影响因子：
3.5
通讯作者：
Ware, JE
中科院分区：
文献类型：
--
作者：
Bjorner, JB;Kosinski, M;Ware, JE
背景资料：项目反应理论（IRT）是分析多项目量表的一个强有力的框架，是实施计算机化自适应测试的核心。目的：解释使用IRT检查测量属性，并将IRT应用于测量偏头痛影响的问卷-偏头痛特异性问卷（MSQ）。研究方法：采用MSQ第1版的三项临床研究的数据进行了分类数据的验证性因素分析和IRT模型分析。结果：验证性因素分析显示，由原始测试结构假设的因素之间有很高的相关性。此外，一个共同因素的高项目负荷表明，偏头痛的影响可以充分评估只有一个分数。项目反应理论分析MSQ是可行的，并提供了一些建议，如何改善项目，特别是响应的选择。在15个项目中，有13个项目显示出与IRT模型的适当拟合。一般来说，IRT分数与原始测试开发者提出的分数以及项目总分密切相关。反应一致性分析表明，超过90%的患者回答一致，根据一维IRT模型。对于其余患者，情绪功能维度的评分与主要反映角色限制的总体IRT评分的相关性较低。这样的响应模式可以很容易地检测到使用响应一致性指数。测试精度跨评分水平的分析表明，MSQ是最精确的一个标准差比平均影响水平的偏头痛患者，没有在治疗。因此，可以通过开发针对偏头痛影响程度较轻的项目来实现测试精度的提高。结论：IRT对MSQ的分析是有效的。这种方法保证了在一个更全面的项目库中进一步测试头痛的影响，这将使计算机化的自适应测试。
Background: Item response theory (IRT) is a powerful framework for analyzing multiitem scales and is central to the implementation of computerized adaptive testing. Objectives: To explain the use of IRT to examine measurement properties and to apply IRT to a questionnaire for measuring migraine impact - the Migraine Specific Questionnaire (MSQ). Methods: Data from three clinical studies that employed the MSQ-version 1 were analyzed by confirmatory factor analysis for categorical data and by IRT modeling. Results: Confirmatory factor analyses showed very high correlations between the factors hypothesized by the original test constructions. Further, high item loadings on one common factor suggest that migraine impact may be adequately assessed by only one score. IRT analyses of the MSQ were feasible and provided several suggestions as to how to improve the items and in particular the response choices. Out of 15 items, 13 showed adequate fit to the IRT model. In general, IRT scores were strongly associated with the scores proposed by the original test developers and with the total item sum score. Analysis of response consistency showed that more than 90% of the patients answered consistently according to a unidimensional IRT model. For the remaining patients, scores on the dimension of emotional function were less strongly related to the overall IRT scores that mainly reflected role limitations. Such response patterns can be detected easily using response consistency indices. Analysis of test precision across score levels revealed that the MSQ was most precise at one standard deviation worse than the mean impact level for migraine patients that are not in treatment. Thus, gains in test precision can be achieved by developing items aimed at less severe levels of migraine impact. Conclusions: IRT proved useful for analyzing the MSQ. The approach warrants further testing in a more comprehensive item pool for headache impact that would enable computerized adaptive testing.