基于IRT和CTT模型的癌症生存者营养素养测评工具构建与应用研究

膳食营养问题是影响我国癌症生存者预后及生存质量的一个重要因素，目前的膳食评估方法因涉及内容繁多，在癌症生存者预后相关流行病学调查研究应用中存在诸多局限性。营养素养被认为是导致饮食结构和膳食质量差异的关键因素，然而目前缺乏针对癌症生存者的营养素养测评工具，其在癌症治疗和预后中的作用有待深入研究。因此，本研究拟基于已完成一次随访的癌症康复俱乐部和京津冀慢性病队列中的癌症生存者群体，通过德尔菲法、经典测量理论（CTT）和项目反应理论（IRT）模型对量表条目进行筛选，构建我国癌症生存者营养素养测评体系；通过对癌症生存者的随访实证研究，分析癌症生存者营养素养水平及其影响因素，采用倾向值匹配、结构方程及相关模型分析癌症生存者营养素养对其营养状况、生命质量、复发、转移等预后相关结局的影响。本研究的实施可为营养流行病学提供一种新的实用工具和评估方法，也为我国癌症早期诊断的有效干预方案制定提供参考和依据。

Dietary nutrition is an important factor affecting the prognosis and quality of life of cancer survivors in China. The current dietary assessment methods have many limitations in the application of epidemiological investigations related to the prognosis of cancer survivors due to their various contents. Nutrition literacy is considered to be a key factor causing differences in dietary patterns and dietary quality, but little was known about the role of nutrition literacy in the process of cancer prognosis and treatment, and the assessment tool of nutrition literacy for Chinese cancer survivors are currently unavailable. Therefore, we are intended to develop nutrition literacy scale which is suitable for Chinese cancer survivors and analyze its effectiveness in the process of cancer prognosis and rehabilitation based on cancer survivors from the Cancer Rehabilitation Club and the Cohort study of chronic disease on community natural population in Beijing-Tianjin-Hebei region who had completed at least one year follow-up visit. We use the methods of Delphi, Classical Test Theory (CTT) and Item Response Theory (IRT) to screen the items and develop nutrition literacy scale that suitable for evaluating the nutrition literacy of Chinese cancer survivors. Through the empirical study on the follow-up of cancer survivors, we evaluate the level of nutritional literacy in cancer survivors and analyze its influencing factors. Propensity Score Model, Structural Equation Model and regression model will be used to analyze the effect of nutrition literacy on cancer survivors’ nutrition status, quality of life, relapse, metastasis and other prognostic outcomes. The implementation of this study can provide a new practical tool and assessment method for nutritional epidemiology, and also provide reference and basis for the development of effective intervention programs for early diagnosis cancer survivors in China.