This article presents a discussion and illustration of Mokken scale analysis (MSA), a nonparametric form of item response theory (IRT), in relation to common IRT models such as Rasch and Guttman scaling. The procedure can be used for dichotomous and ordinal polytomous data commonly used with questionnaires. The assumptions of MSA are discussed as well as characteristics that differentiate a Mokken scale from a Guttman scale. MSA is illustrated using the mokken package with R Studio and a data set that included over 3,340 responses to a modified version of the Statistical Anxiety Rating Scale. Issues addressed in the illustration include monotonicity, scalability, and invariant ordering. The R script for the illustration is included.
Development of grading scales of pedal sensory loss using Mokken scale analysis on the Rotterdam Diabetic Foot Study Test Battery data
