Comparing the use of sum-scores and Item Response Theory’s person location scores as measures of Functional Somatic Symptoms

Purpose: This study aims to compare the use of sum-scores and person location scores from Item Response Theory (IRT) as outcome measures of Functional Somatic Symptoms (FSS) in an epidemiological study. Method: Data from 1247 participants (60% female) from the Tracking Adolescents' Individual Lives Survey (TRAILS) general population cohort study at the fifth (mean age = 22.2, SD = 0.64) and sixth (mean age = 25.6, SD = 0.6) measurement waves was employed. We fitted the Graded Response Model (GRM) from IRT to the 12 items of the “physical complaints” subscale of the Adult Self-Report (ASR) to calculate item and person location parameters. We performed bootstrapped multiple linear regressions to analyze the relationship between Positive Affect (PA) and FSS using person location scores and compared the results to results obtained using sum-scores. Results: The items “nausea” and “abdominal pain” were most discriminative. ASR sum-scores and person location scores were highly correlated, although the latter captured more variability. Using sum-scores and person location scores to study the association between PA and FSS did not result in relevant differences. Conclusion: Although person location scores capture more variability, we did not find added value in the longitudinal analyses of the association between PA and FSS.

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Item Response Theory for Psychometric Properties of the SNOT-22 (22-Item Sinonasal Outcome Test)

Otolaryngology ◽

10.1177/01945998211018383 ◽

2021 ◽

pp. 019459982110183

Author(s):

David T. Liu ◽

Katie M. Philips ◽

Marlene M. Speth ◽

Gerold Besser ◽

Christian A. Mueller ◽

...

Keyword(s):

Item Response Theory ◽

Psychometric Properties ◽

Item Response ◽

Chronic Rhinosinusitis ◽

Facial Pain ◽

Item Discrimination ◽

High Quality ◽

Graded Response ◽

Sinonasal Outcome Test ◽

Snot 22

Objective The SNOT-22 (22-item Sinonasal Outcome Test) is a high-quality outcome measure that assesses chronic rhinosinusitis–specific quality of life. The aim of this study was to gain greater insight into the information provided by the SNOT-22 by determining its item-based psychometric properties. Study Design Retrospective cohort study. Setting Tertiary care academic centers. Methods This study used a previously described data set of the SNOT-22 completed by 800 patients with chronic rhinosinusitis. Item response theory graded response models were used to determine parameters reflecting item discrimination, difficulty, and information provided by each item toward the SNOT-22 subdomain to which it belonged. Results The unconstrained graded response model fitted the SNOT-22 data best. Item discrimination parameters and total information provided showed the greatest variability within the nasal subdomain, and the item related to sense of smell/taste demonstrated the lowest discrimination and provided the least amount of information overall. The dizziness item provided disparately lower total information and discrimination in the otologic/facial pain subdomain. Items in the sleep and emotional subdomains generally provided high discrimination. While items in the nasal, sleep, and otologic/facial pain subdomains spanned all levels of difficulty, emotional subdomain items covered higher levels of difficulty, indicating greater information provided at higher levels of disease severity. Conclusion The item-specific psychometric properties of the SNOT-22 support it as a high-quality instrument. Our results suggest the need and possibility for revision of the smell/taste dysfunction item, for example its wording, to improve its ability to discriminate among the different levels of disease burden.

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Leveraging Existing Data from CMS-Linked Cohort Studies for the Advancement and Translation of Frailty Research

Innovation in Aging ◽

10.1093/geroni/igaa057.2810 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 777-777

Author(s):

Qian-Li Xue ◽

Kristine Ensrud ◽

Shari Lin

Keyword(s):

Cohort Studies ◽

Healthcare Utilization ◽

Risk Adjustment ◽

Healthcare Services ◽

Self Report ◽

Added Value ◽

Care Organization ◽

Frailty Phenotype ◽

Frailty Assessment ◽

The Impact

Abstract As population aging is accelerating rapidly, there is growing concern on how to best provide patient-centered care for the most vulnerable. Establishing a predictable and affordable cost structure for healthcare services is key to improving quality, accessibility, and affordability. One such effort is the “frailty” adjustment model implemented by the Centers for Medicare & Medicaid Services (CMS) that adjusts payments to a Medicare managed care organization based on functional impairment of its beneficiaries. Earlier studies demonstrated added value of this frailty adjuster for prediction of Medicare expenditures independent of the diagnosis-based risk adjustment. However, we hypothesize that further improvement is possible by implementing more rigorous frailty assessment rather than relying on self-report of ADL difficulties as used for the frailty adjuster. This is supported by the consensus and clinical observations that neither multimorbidity nor disability alone is sufficient for frailty identification. This symposium consists of four talks that leverage data from three CMS-linked cohort studies to investigate the utility of assessment of the frailty phenotype for predicting healthcare utilization and costs. Talk 1 and 2 use data from the NHATS cohort to assess healthcare utilization by frailty status in the general population and the homebound subset. Talk 3 and 4 use data from the MrOS study and the SOF study to investigate the impact of frailty phenotype on healthcare costs. Taken together, their findings highlight the potential of incorporating phenotypic frailty assessment into CMS risk adjustment to improve the planning and management of care for frail older adults.

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A Multidimensional Item Response Theory Model for Continuous and Graded Responses With Error in Persons and Items

Educational and Psychological Measurement ◽

10.1177/0013164421998412 ◽

2021 ◽

pp. 001316442199841

Author(s):

Pere J. Ferrando ◽

David Navarro-González

Keyword(s):

Item Response Theory ◽

Item Response ◽

Theory Model ◽

Response Model ◽

Response Theory ◽

Continuous Response ◽

Graded Responses ◽

Graded Response ◽

Continuous Responses ◽

Differential Measurement Error

Item response theory “dual” models (DMs) in which both items and individuals are viewed as sources of differential measurement error so far have been proposed only for unidimensional measures. This article proposes two multidimensional extensions of existing DMs: the M-DTCRM (dual Thurstonian continuous response model), intended for (approximately) continuous responses, and the M-DTGRM (dual Thurstonian graded response model), intended for ordered-categorical responses (including binary). A rationale for the extension to the multiple-content-dimensions case, which is based on the concept of the multidimensional location index, is first proposed and discussed. Then, the models are described using both the factor-analytic and the item response theory parameterizations. Procedures for (a) calibrating the items, (b) scoring individuals, (c) assessing model appropriateness, and (d) assessing measurement precision are finally discussed. The simulation results suggest that the proposal is quite feasible, and an illustrative example based on personality data is also provided. The proposals are submitted to be of particular interest for the case of multidimensional questionnaires in which the number of items per scale would not be enough for arriving at stable estimates if the existing unidimensional DMs were fitted on a separate-scale basis.

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Psychometric evaluation of a newly developed measure of emotionalism after stroke (TEARS-Q)

Clinical Rehabilitation ◽

10.1177/0269215520981727 ◽

2020 ◽

pp. 026921552098172

Author(s):

Niall M Broomfield ◽

Robert West ◽

Allan House ◽

Theresa Munyombwe ◽

Mark Barber ◽

...

Keyword(s):

Item Response ◽

Psychometric Evaluation ◽

Self Report ◽

Stroke Survivors ◽

Reference Standard ◽

Stroke Units ◽

Post Stroke ◽

Response Variance ◽

Mild Stroke ◽

Functional Outcome Measures

Objective: To evaluate, psychometrically, a new measure of tearful emotionalism following stroke: Testing Emotionalism After Recent Stroke – Questionnaire (TEARS-Q). Setting: Acute stroke units based in nine Scottish hospitals, in the context of a longitudinal cohort study of post-stroke emotionalism. Subjects: A total of 224 clinically diagnosed stroke survivors recruited between October 1st 2015 and September 30th 2018, within 2 weeks of their stroke. Measures: The measure was the self-report questionnaire TEARS-Q, constructed based on post-stroke tearful emotionalism diagnostic criteria: (i) increased tearfulness, (ii) crying comes on suddenly, with no warning (iii) crying not under usual social control and (iv) crying episodes occur at least once weekly. The reference standard was presence/absence of emotionalism on a diagnostic, semi-structured post-stroke emotionalism interview, administered at the same assessment point. Stroke, mood, cognition and functional outcome measures were also completed by the subjects. Results: A total of 97 subjects were female, with a mean age 65.1 years. 205 subjects had sustained ischaemic stroke. 61 subjects were classified as mild stroke. TEARS-Q was internally consistent (Cronbach’s alpha 0.87). TEARS-Q scores readily discriminated the two groups, with a mean difference of −7.18, 95% CI (−8.07 to −6.29). A cut off score of 2 on TEARS-Q correctly identified 53 of the 61 stroke survivors with tearful emotionalism and 140 of the 156 stroke survivors without tearful emotionalism. One factor accounted for 57% of the item response variance, and all eight TEARS-Q items acceptably discriminated underlying emotionalism. Conclusion: TEARS-Q accurately diagnoses tearful emotionalism after stroke.

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Using Item Response Theory Models to Evaluate the Practice Environment Scale

Journal of Nursing Measurement ◽

10.1891/1061-3749.22.2.323 ◽

2014 ◽

Vol 22 (2) ◽

pp. 323-341 ◽

Cited By ~ 6

Author(s):

Dheeraj Raju ◽

Xiaogang Su ◽

Patricia A. Patrician

Keyword(s):

Item Response Theory ◽

Item Response ◽

Information Criterion ◽

Partial Credit Model ◽

Practice Environment ◽

Partial Credit ◽

Response Theory ◽

Environment Scale ◽

Graded Response ◽

Item Response Theory Models

Background and Purpose: The purpose of this article is to introduce different types of item response theory models and to demonstrate their usefulness by evaluating the Practice Environment Scale. Methods: Item response theory models such as constrained and unconstrained graded response model, partial credit model, Rasch model, and one-parameter logistic model are demonstrated. The Akaike information criterion (AIC) and Bayesian information criterion (BIC) indices are used as model selection criterion. Results: The unconstrained graded response and partial credit models indicated the best fit for the data. Almost all items in the instrument performed well. Conclusions: Although most of the items strongly measure the construct, there are a few items that could be eliminated without substantially altering the instrument. The analysis revealed that the instrument may function differently when administered to different unit types.

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Self-Report Depression Scales in the Elderly: The Relationship between the CES-D and ZUNG

The International Journal of Psychiatry in Medicine ◽

10.2190/8xgr-yufh-0gvm-k4xb ◽

1989 ◽

Vol 18 (4) ◽

pp. 325-338 ◽

Cited By ~ 22

Author(s):

Bruce R. Deforge ◽

Jeffery Sobal

Keyword(s):

Mental Health ◽

Sex Differences ◽

Mental Health Problems ◽

Psychological Symptoms ◽

Somatic Symptoms ◽

The Elderly ◽

Self Report ◽

Common Mental Health Problems ◽

Depression Scales ◽

The Relationship

Depression is one of the most common mental health problems in the elderly, but there is little consensus about the best way to assess depression in the aged. The relationship between the CES-D and the ZUNG self-report depression scales was investigated in seventy-eight elderly people with osteoarthritis (mean age 71). The correlation between the scales was r = .69, with the CES-D classifying 15 percent of the participants as depressed, as compared to 6 percent by the ZUNG. Psychological symptoms had the strongest relationship with overall depression scores on both scales. No sex differences were found on psychological items on either scale, but females reported more somatic symptoms on the ZUNG. People over age seventy-four reported more psychological symptoms than their younger counterparts.

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Konvergenz von Skalen zur Erfassung sozialer Ängste: Ein IRT-Linking Ansatz

PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie ◽

10.1055/a-1519-7259 ◽

2021 ◽

Author(s):

Fabio Cardace ◽

Julian Rubel ◽

Uwe Altmann ◽

Martin Merkler ◽

Brian Schwartz ◽

...

Keyword(s):

Social Anxiety ◽

Social Phobia ◽

Item Response ◽

Brief Symptom Inventory ◽

Anxiety Scale ◽

Symptom Inventory ◽

Psychiatrische Patienten ◽

Graded Response ◽

Liebowitz Social Anxiety Scale

Zusammenfassung Ziel der Studie Bei der Untersuchung von sozialer Ängstlichkeit haben sich die Fragebögen Liebowitz Social Anxiety Scale (LSAS) und das Social Phobia-Inventory (SPIN) etabliert. Außerdem wird zum Screening sozialer Ängstlichkeit häufig die Subskala Unsicherheit im Sozialkontakt des Brief Symptom Inventory (BSI-53) eingesetzt. Alle drei Skalen geben vor dasselbe Konstrukt zu erfassen. Somit stellt sich die Frage der Konvergenz dieser Skalen. Um Forschungsergebnisse zu sozialer Ängstlichkeit, welche diese Instrumente nutzen, über einen fragebogenübergreifenden Faktor (Common-Faktor) vergleichbar zu machen, wird in der vorliegenden Studie ein Item Response Theorie (IRT) Linking Ansatz verwendet. Methodik 64 deutschsprachige psychiatrische Patienten und 295 Probanden aus der deutschen Normalbevölkerung füllten die drei Fragebögen aus. Verschiedene IRT-Modelle – darunter Graded Response Modelle (GRM) – wurden an die Daten angepasst und verglichen. Basierend auf dem Modell mit dem besten Fit wurden Regressionsanalysen durchgeführt. Der Common-Faktor wurde dabei jeweils von den Fragebogensummenwerten vorhergesagt. Ergebnisse Der Zusammenhang zwischen den verschiedenen Skalen wird am besten durch ein Bi-Faktor GRM erklärt (RMSEA=0,036; CFI=0,977; WRMR=1,061). Anhand der Ergebnisse der Regressionsanalysen lassen sich drei Gleichungen zur Transformation von Fragebogensummenwerten ableiten. Schlussfolgerung Durch den IRT Linking Ansatz konnte ein fragebogenübergreifender genereller Faktor Sozialer Ängstlichkeit abgeleitet werden. Gemeinsamkeiten und Unterschiede wurden dabei berücksichtigt. Dies hat sowohl für die Forschung als auch für die Praxis Vorteile. Eine Replikation dieser Studie sowie die Implementierung weiterer Instrumente wird empfohlen, um die Gültigkeit dieses Ansatzes zu überprüfen und die Ergebnisse zu generalisieren.

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Measurement Invariant but Non-Normal Treatment Responses in Guided Internet Psychotherapies for Depressive and Generalized Anxiety Disorders

Assessment ◽

10.1177/10731911211062500 ◽

2021 ◽

pp. 107319112110625

Author(s):

Tom H. Rosenström ◽

Ville Ritola ◽

Suoma Saarni ◽

Grigori Joffe ◽

Jan-Henry Stenberg

Keyword(s):

Anxiety Disorder ◽

Treatment Response ◽

Generalized Anxiety Disorder ◽

Health Assessment ◽

Psychotherapy Research ◽

Self Report ◽

Generalized Anxiety ◽

Equivalence Testing ◽

Sum Scores ◽

Normally Distributed

Assessment of treatment response in psychotherapies can be undermined by lack of longitudinal measurement invariance (LMI) in symptom self-report inventories, by measurement error, and/or by wrong model assumptions. To understand and compare these threats to validity of outcome assessment in psychotherapy research, we studied LMI, sum scores, and Davidian Curve Item Response Theory models in a naturalistic guided internet psychotherapy treatment register of 2,218 generalized anxiety disorder (GAD) patients and 3,922 depressive disorder (DD) patients (aged ≥16 years). Symptoms were repeatedly assessed by Generalized Anxiety Disorder Assessment-7 (GAD-7) or Beck Depression Inventory. The symptom self-reports adhered to LMI under equivalence testing, suggesting sum scores are reasonable proxies for disorder status. However, the standard LMI assumption of normally distributed latent factors did not hold and inflated treatment response estimates by 0.2 to 0.3 standard deviation units compared with sum scores. Further methodological research on non-normally distributed latent constructs holds promise in advancing LMI and mental health assessment.

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An Assessment of Observed and Simulated Temperature Variability in Sierra de Guadarrama (Spain)

10.5194/egusphere-egu21-6358 ◽

2021 ◽

Author(s):

Cristina Vegas Cañas ◽

J. Fidel González Rouco ◽

Jorge Navarro Montesinos ◽

Elena García Bustamante ◽

Etor E. Lucio Eceiza ◽

...

Keyword(s):

Western Europe ◽

Climate Model ◽

Regional Climate ◽

Monitoring Network ◽

Horizontal Resolution ◽

Temperature Variability ◽

Added Value ◽

Seasonal Temperature ◽

Temperature Trends ◽

Highly Correlated

This work provides a first assessment of temperature variability from interannual to multidecadal timescales in Sierra de Guadarrama, located in central Spain, from observations and regional climate model (RCM) simulations. Observational data are provided by the Guadarrama Monitoring Network (GuMNet; www.ucm.es/gumnet) at higher altitudes, up to 2225 masl, and by the Spanish Meteorological Agency (AEMet) at lower sites. An experiment at high horizontal resolution of 1 km using the Weather Research and Forecasting (WRF) RCM, feeding from ERA Interim inputs, is used. Through model-data comparison, it is shown that the simulations are annually and seasonally highly representative of the observations, although there is a tendency in the model to underestimate observational temperatures, mostly at high altitudes. Results show that WRF provides an added value in relation to the reanalysis, with improved correlation and error metrics relative to observations.The analysis of temperature trends shows a warming in the area during the last 20 years, very significant in autumn. When spanning the analysis to the whole observational period, back to the beginning of the 20th century at some sites, significant annual and seasonal temperature increases of 1&#8451;/decade develop, most of them happening during de 1970s, although not as intense as during the last 20 years.The temporal variability of temperature anomalies in the Sierra de Guadarrama is highly correlated with the temperatures in the interior of the Iberian Peninsula. This relationship can be extended broadly over south-western Europe.

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