Demographic variation in SF-12 scores: True differences or differential item functioning?
Demographic variation in SF-12 scores: True differences or differential item functioning?
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DOI：
10.1097/01.mlr.0000076052.42628.cf
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发表时间：
2003-07-01
期刊：
影响因子：
3
通讯作者：
Lawrence, WF
中科院分区：
文献类型：
--
作者：
Fleishman, JA;Lawrence, WF
背景资料。人口统计学差异已被报道在基于SF-12工具的身心健康综合测量中。本研究考察了不同项目功能(DIF)对观察到的亚组健康状况差异的影响程度。差异是指物品的心理测量学特性在不同的组中并不是一成不变的情况。DIF的存在混淆了对亚组差异的解释。SUBJECTS：2000年医疗费用小组调查中的11,626名成年受访者的全国样本，他们完成了一份自我管理的问卷。除了SF-12，我们还收集了人口统计特征(年龄、性别、教育程度和种族/民族)以及个人是否曾被诊断患有六种慢性疾病的数据。结果：多指标多原因潜在变量模型显示性别、年龄和教育程度在身体健康方面存在显著差异。对DIF的调整减少了，但并没有消除年龄和教育程度的差异。然而，对于心理健康，调整DIF会导致黑人和白人的差异变得不显著，并且对年龄最大的年龄组的影响从积极转变为消极。种族/民族与身体健康状况无关。结论：心理健康的年龄组比较可能特别受DIF的影响。在进行群体比较时，需要控制教育程度以及年龄和性别的差异。还需要做更多的工作来了解导致报告健康状况的人口统计学差异的因素。
BACKGROUND. Demographic differences have been reported in summary measures of physical and mental health based on the SF-12 instrument.OBJECTIVES. This study examines the extent to which differential item functioning (DIF) contributes to observed subgroup differences in health status. DIF refers to situations in which the psychometric properties of items are not invariant across different groups. The presence of DIF confounds interpretation of subgroup differences.SUBJECTS. A national sample of 11,626 adult respondents in the 2000 Medical Expenditure Panel Survey who completed a self-administered questionnaire.MEASURES. In addition to the SF-12, we collected data on demographic characteristics (age, gender, education, and race/ethnicity) and whether the person had ever been diagnosed with six chronic medical conditions.RESULTS. Multiple-indicator multiple-cause latent variable models showed significant differences in physical health by gender, age, and education. Adjusting for DIF reduced but did not eliminate age and education differences. However, for mental health, adjusting for DIF resulted in Black-White differences becoming nonsignificant, and the effect for the oldest age group switched from positive to negative. Race/ethnicity was not associated with physical health status.CONCLUSIONS. Age group comparisons of mental health may be particularly affected by DIF. Differences in education, as well as age and gender, need to be controlled when making group comparisons. Additional work is needed to understand factors that give rise to demographic differences in reported health status.