An analytic strategy for modeling multiple-item responses: a breast cancer symptom example.
An analytic strategy for modeling multiple-item responses: a breast cancer symptom example.
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多项目反应建模的分析策略：乳腺癌症状示例。
DOI：
10.1097/00006199-200507000-00004
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发表时间：
2005
期刊：
影响因子：
2.5
通讯作者：
Given,CharlesW
中科院分区：
文献类型：
--
作者：
Doorenbos,ArdithZ;Verbitsky,Natalya;Given,Barbara;Given,CharlesW
项目反应理论（IRT）是一种将多个项目反应中的信息进行联合收割机组合的理论，在健康研究中得到越来越多的应用。IRT假定一个人对症状的易感性是由症状和人的特征的相互作用驱动的。本文介绍了将IRT纳入一个多层次的框架和扩展这种方法的纵向健康结果，自我报告的方法是用来构建一个多项目scale.MethodsA二次分析的数据从2个描述性纵向研究的统计背景。这些数据包括350名乳腺癌妇女在不同时间报告的21种症状。采用3水平分层线性模型（HLM）进行分析。第1级模拟项目反应，包括症状存在或不存在。2级模拟每个个体的轨迹，代表IRT创建的潜变量症状体验随时间的变化。第3级使用个人特定特征（如年龄和护理地点）解释该轨迹。分析的目的是检查，如果老年和年轻女性乳腺癌不同的症状经验轨迹后，控制位置的carry.ResultsFatigue和疼痛是最常见的症状。发现乳腺癌妇女的症状经历随着时间的推移而改善。无论是年龄还是护理的位置显着相关的症状经验trajectory.DiscussionEmbedding IRT到HLM框架产生了几个好处。所提供的示例通过创建潜在症状体验变量（可用作另一模型中的结果或协变量）、检查潜在症状体验轨迹及其与个体水平协变量的关系以及管理症状无应答来证明益处。
BackgroundItem Response Theory (IRT) is increasingly applied in health research to combine information from multiple-item responses. IRT posits that a person's susceptibility to a symptom is driven by the interaction of the characteristics of the symptom and person. This article describes the statistical background of incorporating IRT into a multilevel framework and extends this approach to longitudinal health outcomes, where the self-report method is used to construct a multi-item scale.MethodsA secondary analysis of data from 2 descriptive longitudinal studies is performed. The data include 21 symptoms reported across time by 350 women with breast cancer. A 3-level hierarchical linear model (HLM) was used for the analysis. Level 1 models the item responses, consisting of symptom presence or absence. Level 2 models the trajectory of each individual, representing change over time of the IRT-created latent variable symptom experience. Level 3 explains that trajectory using person-specific characteristics such as age and location of care. The purpose of the analysis is to examine if older and younger women with breast cancer differ in their symptom experience trajectory after controlling for location of care.ResultsFatigue and pain were the most prevalent symptoms. The symptom experience of women with breast cancer was found to improve over time. Neither age nor location of care was significantly associated with the symptom experience trajectory.DiscussionEmbedding IRT into an HLM framework produces several benefits. The example provided demonstrates benefits through the creation of a latent symptom experience variable that can be used either as an outcome or as a covariate in another model, examining the latent symptom experience trajectory and its relationship with covariates at the individual level, and managing symptom nonresponse.