Article: Use of Rasch analysis in the evaluation of the oropharyngeal mucositis quality of life scale

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TitleUse of Rasch analysis in the evaluation of the oropharyngeal mucositis quality of life scale
AuthorsCheng, KKF1
Lee, J7
Leung, SF3
Liang, RHS2
Tai, JWM5
Yeung, RMW4
Thompson, DR6
Issue Date2011
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.nursingresearchonline.com
CitationNursing Research, 2011, v. 60 n. 4, p. 256-263 [How to Cite?]
DOI: http://dx.doi.org/10.1097/NNR.0b013e318221f731
AbstractBackground: Oropharyngeal mucositis (OM) is a significant clinical problem causing profound impairment of health-related quality of life (HQoL) for patients undergoing cancer therapy. The Oropharyngeal Mucositis-Specific Health-Related Quality of Life Measure (OMQoL) was developed using classical test theory to measure the self-perceived HQoL of patients with mucositis. Objectives: The aim of this study was to analyze the OMQoL according to the Rasch model and, on the basis of results, determine whether improvements could be made. METHOD: A multicenter approach was used, and 210 patients treated with stomatotoxic chemotherapy (36%), high-dose myeloablative chemotherapy ± total body irradiation (10%), or head and neck irradiation ± chemotherapy (54%) completed the OMQoL. The Partial Credit Model of Rasch analysis was applied to evaluate the 31-item OMQoL using WINSTEPS and R software. Unidimensionality (measurement of a single construct), item fit, response category performance, person separation reliability, targeting of item difficulty to person ability, and differential item functioning (DIF) were examined. Results: Of 31 items, 5 were removed due to misfit; the OMQoL was reduced to 26 items with acceptable information weighted fit/outlier-sensitive fit indices (within 0.7-1.3) and eigenvalue units (≤2.0), confirming the unidimensionality of the reduced OMQoL. The OMQoL and its four subscales showed ordered category thresholds, and the person separation reliability was high (person separation index >0.2 with reliability >.8). Nevertheless, some of the items in the OMQoL might not be targeted effectively to patients with low levels of OM. Significant uniform and nonuniform DIFs were not found for gender (uniform DIF, p = .26; nonuniform DIF, p= .24) and age (uniform DIF, p = .95; nonuniform DIF, p = .65). Discussion: Rasch analysis reveals that the reduced 26-item OMQoL is unidimensional and is adequate to measure HQoL for patients with OM regardless of gender and age group. This improved version can provide a common platform for nurses to use in their assessment, caring, and treatment of patients with OM. Copyright © 2011 Lippincott Williams & Wilkins.
ISSN0029-6562
2011 Impact Factor: 1.402
2011 SCImago Journal Rankings: 0.089
DOIhttp://dx.doi.org/10.1097/NNR.0b013e318221f731
ReferencesReferences in Scopus
DC Field
Value
dc.contributor.authorCheng, KKF
dc.contributor.authorLee, J
dc.contributor.authorLeung, SF
dc.contributor.authorLiang, RHS
dc.contributor.authorTai, JWM
dc.contributor.authorYeung, RMW
dc.contributor.authorThompson, DR
dc.date.accessioned2012-09-05T05:30:43Z
dc.date.available2012-09-05T05:30:43Z
dc.date.issued2011
dc.description.abstractBackground: Oropharyngeal mucositis (OM) is a significant clinical problem causing profound impairment of health-related quality of life (HQoL) for patients undergoing cancer therapy. The Oropharyngeal Mucositis-Specific Health-Related Quality of Life Measure (OMQoL) was developed using classical test theory to measure the self-perceived HQoL of patients with mucositis. Objectives: The aim of this study was to analyze the OMQoL according to the Rasch model and, on the basis of results, determine whether improvements could be made. METHOD: A multicenter approach was used, and 210 patients treated with stomatotoxic chemotherapy (36%), high-dose myeloablative chemotherapy ± total body irradiation (10%), or head and neck irradiation ± chemotherapy (54%) completed the OMQoL. The Partial Credit Model of Rasch analysis was applied to evaluate the 31-item OMQoL using WINSTEPS and R software. Unidimensionality (measurement of a single construct), item fit, response category performance, person separation reliability, targeting of item difficulty to person ability, and differential item functioning (DIF) were examined. Results: Of 31 items, 5 were removed due to misfit; the OMQoL was reduced to 26 items with acceptable information weighted fit/outlier-sensitive fit indices (within 0.7-1.3) and eigenvalue units (≤2.0), confirming the unidimensionality of the reduced OMQoL. The OMQoL and its four subscales showed ordered category thresholds, and the person separation reliability was high (person separation index >0.2 with reliability >.8). Nevertheless, some of the items in the OMQoL might not be targeted effectively to patients with low levels of OM. Significant uniform and nonuniform DIFs were not found for gender (uniform DIF, p = .26; nonuniform DIF, p= .24) and age (uniform DIF, p = .95; nonuniform DIF, p = .65). Discussion: Rasch analysis reveals that the reduced 26-item OMQoL is unidimensional and is adequate to measure HQoL for patients with OM regardless of gender and age group. This improved version can provide a common platform for nurses to use in their assessment, caring, and treatment of patients with OM. Copyright © 2011 Lippincott Williams & Wilkins.
dc.description.natureLink_to_subscribed_fulltext
dc.identifier.citationNursing Research, 2011, v. 60 n. 4, p. 256-263 [How to Cite?]
DOI: http://dx.doi.org/10.1097/NNR.0b013e318221f731
dc.identifier.doihttp://dx.doi.org/10.1097/NNR.0b013e318221f731
dc.identifier.epage263
dc.identifier.issn0029-6562
2011 Impact Factor: 1.402
2011 SCImago Journal Rankings: 0.089
dc.identifier.issue4
dc.identifier.pmid21691240
dc.identifier.scopuseid_2-s2.0-79959976478
dc.identifier.spage256
dc.identifier.urihttp://hdl.handle.net/10722/163382
dc.identifier.volume60
dc.languageeng
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.nursingresearchonline.com
dc.publisher.placeUnited States
dc.relation.ispartofNursing Research
dc.relation.referencesReferences in Scopus
dc.subject.meshAdult
dc.subject.meshAged
dc.subject.meshAged, 80 And Over
dc.subject.meshChemotherapy, Adjuvant - Adverse Effects
dc.subject.meshFemale
dc.subject.meshHead And Neck Neoplasms - Complications - Therapy
dc.subject.meshHumans
dc.subject.meshMale
dc.subject.meshMiddle Aged
dc.subject.meshModels, Statistical
dc.subject.meshPsychometrics - Methods
dc.subject.meshQuality Of Life
dc.subject.meshQuestionnaires
dc.subject.meshRadiotherapy, Adjuvant - Adverse Effects
dc.subject.meshStomatitis - Etiology - Psychology
dc.subject.meshYoung Adult
dc.titleUse of Rasch analysis in the evaluation of the oropharyngeal mucositis quality of life scale
dc.typeArticle
Author Affiliations
  1. Yong Loo Lin School of Medicine
  2. The University of Hong Kong
  3. Prince of Wales Hospital Hong Kong
  4. Pamela Youde Nethersole Eastern Hospital
  5. Queen Mary Hospital Hong Kong
  6. Australian Catholic University
  7. Chinese University of Hong Kong