Scalability of the Positive and Negative Syndrome Scale in first-episode schizophrenia assessed by Rasch models.
Scalability of the Positive and Negative Syndrome Scale in first-episode schizophrenia assessed by Rasch models.
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Rasch模型评估首发精神分裂症阳性和阴性症状量表的可测量性
DOI：
10.1111/acps.13434
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发表时间：
2022-07
影响因子：
6.7
通讯作者：
Glenthoj, Birte Y.
中科院分区：
文献类型：
--
作者：
Baandrup, Lone;Allerup, Peter;Nielsen, Mette O.;Duering, Signe W.;Bojesen, Kirsten B.;Leucht, Stefan;Galderisi, Silvana;Mucci, Armida;Bucci, Paola;Arango, Celso;Diaz-Caneja, Covadonga M.;Dazzan, Paola;McGuire, Philip;Demjaha, Arsime;Ebdrup, Bjorn H.;Fleischhacker, Wolfgang W.;Kahn, Rene S.;Glenthoj, Birte Y.
从历史上看，对阳性与阴性症状量表(PANSS)的心理测量学性质的评估有几个重点：(1)信度指数的计算，(2)从量表中提取子维度，(3)评估总分的有效性。在这项研究中，我们的目的是检验30项PANSS总分的可扩展性，并评估PANSS总分的临床表现以及PANSS-6的简化版的可扩展性。对1073例首发精神分裂症或精神分裂症谱系障碍患者的基础资料和4-6 周的随访资料进行RASCH分析。Rasch模型的中心匹配性检验未能满足PANSS-30和PANSS-6总分项目同质性背后的统计要求。对于PANSS-30，在7分Likert量表评级类别和将评级类别一分为二时，项目功能都明显不同。随后，使用二分项背景下的Rasch结构分析来分离和估计由于项的不同质性引起的系统误差以及随机误差。PANSS-30总分的综合误差源的大小接近20%，这通常被认为是有反应和无反应的临床分界点。结果表明，缺乏统计拟合的Rasch模型的操作后果，并建议在使用PANSS-30总分时，需要考虑计算的不确定性度量。
Historically, assessment of the psychometric properties of the Positive and Negative Syndrome Scale (PANSS) has had several foci: (1) calculation of reliability indexes, (2) extraction of subdimensions from the scale, and (3) assessment of the validity of the total score. In this study, we aimed to examine the scalability and to assess the clinical performance of the 30‐item PANSS total score as well as the scalability of a shorter version (PANSS‐6) of the scale. A composite data set of 1073 patients with first‐episode schizophrenia or schizophrenia spectrum disorder was subjected to Rasch analysis of PANSS data from baseline and 4–6 weeks follow‐up. The central tests of fit of the Rasch model failed to satisfy the statistical requirements behind item homogeneity for the PANSS‐30 as well as the PANSS‐6 total score. For the PANSS‐30, Differential Item Functioning was pronounced both for the 7‐point Likert scale rating categories and when dichotomizing the rating categories. Subsequently, the Rasch structure analysis in the context of dichotomized items was used to isolate and estimate a systematic error because of item inhomogeneity, as well as a random error. The size of the combined sources of error for the PANSS‐30 total score approximated 20% which is often regarded as clinical cut‐off between response versus no‐response. The results demonstrate the operational consequences of a lack of statistical fit of the Rasch model and suggest that the calculated measure of uncertainty needs to be considered when using the PANSS‐30 total score.
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影响因子：
4.4
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Lindenmayer JP
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