Measuring the impact of multiple sclerosis: Enhancing the measurement performance of the Multiple Sclerosis Impact Scale (MSIS-29) using Rasch Measurement Theory (RMT)

AbstractThis paper examines the impact of an educational programme developed in Senegal with university students and designed to encourage entrepreneurship by influencing personal attitudes toward enterprise. The instrument to measure the entrepreneurial potential of young people has been applied in different socio-demographic contexts in some previous empirical research. Improvements in students’ perception of attitudinal factors associated with leadership, creativity, achievement and intuition can be inferred from the results of the longitudinal analysis conducted. Moreover, a positive and significant relationship between students’ perceived behavioural control and their attitudes toward starting a business at the end of the entrepreneurial programme is confirmed. Rasch Measurement Theory is applied to analyse the validity of the measurements and findings suggest that the scale used seems to be a reliable and valid tool for measuring entrepreneurial attitude in a university setting. Results confirm that entrepreneurship programmes have the potential to improve the entrepreneurial attitudes of students in a developing country.

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Addressing the targeting range of the ABILHAND-56 in relapsing–remitting multiple sclerosis: A mixed methods psychometric study

Multiple Sclerosis Journal - Experimental Translational and Clinical ◽

10.1177/2055217318776990 ◽

2018 ◽

Vol 4 (2) ◽

pp. 205521731877699 ◽

Cited By ~ 1

Author(s):

Sophie Cleanthous ◽

Sara Strzok ◽

Farrah Pompilus ◽

Stefan Cano ◽

Patrick Marquis ◽

...

Keyword(s):

Multiple Sclerosis ◽

Clinical Trials ◽

Mixed Methods ◽

Measurement Theory ◽

Measurement Range ◽

Rasch Measurement ◽

Rasch Measurement Theory ◽

Outcome Instrument ◽

Multiple Sclerosis Patients ◽

Higher Functioning

Background ABILHAND, a manual ability patient-reported outcome instrument originally developed for stroke patients, has been used in multiple sclerosis clinical trials; however, psychometric analyses indicated the measure’s limited measurement range and precision in higher-functioning multiple sclerosis patients. Objective The purpose of this study was to identify candidate items to expand the measurement range of the ABILHAND-56, thus improving its ability to detect differences in manual ability in higher-functioning multiple sclerosis patients. Methods A step-wise mixed methods design strategy was used, comprising two waves of patient interviews, a combination of qualitative (concept elicitation and cognitive debriefing) and quantitative (Rasch measurement theory) analytic techniques, and consultation interviews with three clinical neurologists specializing in multiple sclerosis. Results Original ABILHAND was well understood in this context of use. Eighty-two new manual ability concepts were identified. Draft supplementary items were generated and refined with patient and neurologist input. Rasch measurement theory psychometric analysis indicated supplementary items improved targeting to higher-functioning multiple sclerosis patients and measurement precision. The final pool of Early Multiple Sclerosis Manual Ability items comprises 20 items. Conclusion The synthesis of qualitative and quantitative methods used in this study improves the ABILHAND content validity to more effectively identify manual ability changes in early multiple sclerosis and potentially help determine treatment effect in higher-functioning patients in clinical trials.

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Development of a gait module to complement the 12-item Multiple Sclerosis Walking Scale: a mixed methods study

Multiple Sclerosis Journal - Experimental Translational and Clinical ◽

10.1177/2055217318783766 ◽

2018 ◽

Vol 4 (2) ◽

pp. 205521731878376 ◽

Cited By ~ 1

Author(s):

Sara Strzok ◽

Sophie Cleanthous ◽

Farrah Pompilus ◽

Stefan J Cano ◽

Patrick Marquis ◽

...

Keyword(s):

Multiple Sclerosis ◽

Mixed Methods ◽

Measurement Theory ◽

Rasch Measurement ◽

Mixed Methods Study ◽

Walking Ability ◽

Rasch Measurement Theory ◽

Outcome Instrument ◽

Multiple Sclerosis Patients ◽

Higher Functioning

Background and objective The 12-item Multiple Sclerosis Walking Scale (MSWS-12) is a patient-reported outcome instrument that quantifies the progressive loss of walking ability from the patient perspective. However, previous psychometric analyses indicated floor and ceiling effects across the multiple sclerosis severity spectrum. This study aimed to address floor effects by creating a gait module that can be used in conjunction with the MSWS-12 for better measurement of treatment benefit in the higher functioning multiple sclerosis population. Methods We used a step-wise mixed methods study design, with relapsing–remitting multiple sclerosis patients (wave 1, n=88; wave 2, n=30), combining qualitative (concept elicitation and cognitive debriefing interviews) and quantitative (Rasch Measurement Theory) data collection and analytical techniques and consultation interviews with three neurologists specializing in multiple sclerosis. Results Thirty-seven walking ability concepts were identified, and a five-domain conceptual framework was created. Draft items were generated and refined with patient and neurologist input. Draft items covered gait-related concepts such as dragging, shuffling, limping, tripping and falling. Rasch measurement theory psychometric analysis indicated administering MSWS-12 plus gait items improved measurement precision in targeted populations with better walking ability. Conclusion Study findings indicate that new gait items could improve sensitivity to detect clinical change in walking ability for higher functioning multiple sclerosis patients.

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Disease progression in multiple sclerosis: combining physicians’ and patients’ perspectives?

Multiple Sclerosis Journal ◽

10.1177/1352458510385505 ◽

2010 ◽

Vol 17 (2) ◽

pp. 234-240 ◽

Cited By ~ 13

Author(s):

JJ Kragt ◽

JM Nielsen ◽

FAH van der Linden ◽

CH Polman ◽

BMJ Uitdehaag

Keyword(s):

Multiple Sclerosis ◽

Clinical Outcome ◽

Disease Progression ◽

Outcome Measures ◽

Added Value ◽

Impact Scale ◽

Disability Status ◽

The Impact ◽

Nine Hole Peg Test ◽

Combine Outcome

Background: To assess disease progression in multiple sclerosis (MS) several outcome measures are available. The interrelation of changes on different scales has not been studied extensively and the concept of combining scales has only recently been introduced in MS. Objective: To explore combining different clinical outcome measures in the evaluation of disease progression in MS. Methods: In 553 patients we studied the presence of relevant changes according to standard definitions on the Expanded Disability Status Scale (EDSS), Nine-Hole Peg Test (9HPT), Timed 25-Foot Walk (T25FW) and the Multiple Sclerosis Impact Scale (MSIS-29). We examined ‘exclusive worsening’ (worsening on one measure while not worsening on any other measure) and ‘opposing changes’ (worsening on one measure while improving on another measure). Finally, we investigated the impact of combining assessments. Results: Based on the EDSS alone, 140 patients progressed. However, almost twice as many (275) showed worsening on any of the clinical outcome measures. Exclusive worsening was observed in 37 patients on the EDSS, 13 on the 9HPT, 39 on the T25FW and 44 on the MSIS physical. Of all worsened patients 76 (28%) showed opposing changes, a phenomenon predominantly observed when combining physician-based and patient-derived outcome measures. Conclusion: When assessing disease progression in MS, sensitivity to change can be increased by combining different outcome measures. The added value is especially present when combining measures from different perspectives. However, further research is needed to evaluate the optimal way to combine outcome measures before implementing this strategy in clinical studies.

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Do patient and proxy agree? Long-term changes in multiple sclerosis physical impact and walking ability on patient-reported outcome scales

Multiple Sclerosis Journal ◽

10.1177/1352458514529173 ◽

2014 ◽

Vol 20 (12) ◽

pp. 1616-1623 ◽

Cited By ~ 4

Author(s):

Judith M Sonder ◽

Lisanne J Balk ◽

Libertje VAE Bosma ◽

Chris H Polman ◽

Bernard MJ Uitdehaag

Keyword(s):

Multiple Sclerosis ◽

Patient Reported Outcome ◽

Study Data ◽

Walking Ability ◽

Impact Scale ◽

Patient Reported ◽

Proxy Responses ◽

Physical Impact ◽

The Impact

Background: Patient-reported outcome scales (PROs) are useful in monitoring changes in multiple sclerosis (MS) over time. Although these scales are reliable and valid measures in longitudinal studies in MS patients, it is unknown what the impact is when obtaining longitudinal data from proxies. Objective: The objective of this paper is to compare longitudinal changes in patient and proxy responses on PROs assessing physical impact of MS and walking ability. Methods: In a prospective observational study, data on the Multiple Sclerosis Impact Scale (MSIS-29 physical) and Multiple Sclerosis Walking Scale (MSWS-12) were obtained from 137 patient-proxy couples at baseline and at two-year follow-up. Demographic and disease-related variables explaining agreement or disagreement between patients and proxies were investigated using linear regression analyses. Results: Full agreement was found in 56% (MSIS) and 62% (MSWS) of the patient-proxy couples. Complete disagreement was very rare for both scales (2% MSIS, 5% MSWS). When patients were more positive than proxies, a higher age, longer disease duration, longer patient-proxy relationship and increased levels of depression, anxiety and caregiver burden in proxies were observed. Conclusion: In the majority of the patient-proxy couples there was agreement. Proxies can serve as a valuable source of information, but caution remains essential when using scores from proxies.

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Predicting Operational Rater‐Type Classifications Using Rasch Measurement Theory and Random Forests: A Music Performance Assessment Perspective

Journal of Educational Measurement ◽

10.1111/jedm.12227 ◽

2019 ◽

Vol 56 (3) ◽

pp. 610-625

Author(s):

Brian C. Wesolowski

Keyword(s):

Performance Assessment ◽

Random Forests ◽

Measurement Theory ◽

Music Performance ◽

Rasch Measurement ◽

Rasch Measurement Theory

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The necessity of applying Rasch measurement theory in questionnaire-based public health research

European Journal of Public Health ◽

10.1093/eurpub/ckz185.612 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

H S Finbråten ◽

A L Kleppang ◽

A M Steigen

Keyword(s):

Public Health ◽

Psychometric Properties ◽

Health Research ◽

Measurement Theory ◽

Classical Test Theory ◽

Public Health Research ◽

Rasch Measurement ◽

Test Theory ◽

Rasch Measurement Theory ◽

Classical Test

Abstract Background Questionnaires are frequently used in public health research. In order to provide valid and reliable results to generate recommendations for practice and policies, scales with sound psychometric properties are required. Classical test theory such as factor analysis is most frequently used to assess the psychometric properties of scales. However, classical test theory may have limitations in confirming the validity of scales. Only Rasch measurement theory meet the requirements of fundamental measurement, such as additivity, invariance, sufficiency and specific objectivity. The objective is to exemplify how Rasch measurement theory can be used to evaluate the psychometric properties of a scale. Validation of the Hopkins Symptom Checklist-10 is used as an example. Methods This study is based on cross-sectional data from the Youth Data Survey. In total, 6777 adolescents responded to a web-based questionnaire. Data collection was carried out in lower and upper secondary schools in Norway during 2018. The data were analysed using the partial credit parameterization of the unidimensional Rasch model. Results Preliminary results indicated that the scale had acceptable reliability (person separation index: 0.82). However, one pair of items shows response dependence. The targeting could have been better (mean person location: -1.445). All items had ordered thresholds. Three items under-discriminated. Several items displayed differential item functioning with regard to gender and school level. Conclusions Applying Rasch measurement theory measurement problems that would go undetected using classical test theory approaches were observed. Scales used in public health research should be thoroughly validated applying Rasch measurement theory before the data are used to support claims about public health and used to provide recommendations for policy and practice. Key messages Public health practice and policy should be based on information from valid and reliable scales. Rasch measurement theory should be used to evaluate psychometric properties of scales used in public health research.

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Reduction in Fatigue Symptoms Following the Administration of Nutritional Supplements in Patients with Multiple Sclerosis

Medical Sciences ◽

10.3390/medsci9030052 ◽

2021 ◽

Vol 9 (3) ◽

pp. 52

Author(s):

Pasquale Ferorelli ◽

Francesco Antonelli ◽

Anna Shevchenko ◽

Carlo Mischiati ◽

Manfred Doepp ◽

...

Keyword(s):

Multiple Sclerosis ◽

Dietary Supplements ◽

Nutritional Supplements ◽

Therapeutic Interventions ◽

Inflammatory Parameters ◽

Impact Scale ◽

Fatigue Severity ◽

The Individual ◽

Two Parameters ◽

The Impact

Despite recent advances in immune-modulatory drugs, pharmacological therapies have been proven ineffective in severe presentations of multiple sclerosis (MS), including secondary progressive MS. At present, therapeutic interventions’ performance is primarily focused on ameliorating symptoms to improve the patient’s quality of life (QOL). Among complementary treatments, nutrition has been considered a decisive factor to control symptoms and enhance the wellness of MS patients. Although no special diets are associated with MS, the impact of diet and dietary supplements on the course of progressive forms of the disease has been studied during the last few years. Fatigue is among the most common and disabling symptoms reported by MS patients. Fatigue has been defined in the Multiple Sclerosis Council for Clinical Practice Guidelines (MSCCPG, 1998) as a “subjective lack of physical and/or mental energy that the individual perceives as an interference with habitual and desired activities”. This study aimed to compare the psychometric functioning of the “Fatigue Severity Scale” (FSS) and the “Modified Fatigue Impact Scale” (MFIS) in our sample of people with MS. Specifically, during chronic treatment, the change in these two parameters with two vitamin-rich dietary supplements (Citozym® and Ergozym®) was evaluated. The impact of these nutritional supplements revealed differences in antioxidant and anti-inflammatory parameters among the volunteers in the treatment group, with a subsequent improvement in fatigue. In conclusion, the results obtained have confirmed the effectiveness of complementary nutritional therapies, evaluated essentially based on hematological biomarkers, through which it is possible to act on disability to improve the QOL of MS patients.

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