Use of item response theory to develop a shortened version of the EORTC QLQ-BR23 scales

Juan Xia, Zheng Tang, Peng Wu, Jiwei Wang, Jinming Yu, Juan Xia, Zheng Tang, Peng Wu, Jiwei Wang, Jinming Yu

Abstract

It is important that questionnaires are as short as possible while still capturing the scope of problems relevant in an effective and reliable manner, to minimize the response burden. The purpose of our study was to develop a shortened version of the EORTC QLQ-BR23 for using in breast cancer survivors. Our data come from 10794 breast cancer survivors who completed the EORTC QLQ-BR23. Two-thirds of the sample was randomly selected from the original sample for development, and the remaining was used for validation. Item response theory methods were applied to shorten scales. The graded response model of Samejima was used to fit the item responses. The shortened scale was evaluated with the validation set by examining the mean difference, the proportion of respondents correctly predicted, correlation and weighted kappa between the shortened form and the original observed scores. Results reveal that a three-item BRBI, a four-item BRST, a three-item BRBS and a two-item BRAS forecast the scores on the original scales with wonderful consistency and are alike in measurement precision with no loss or only little loss in detecting group differences. Prospective validation on new diagnosed breast cancer patients and with poor QOL is needed.

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Item characteristic curves – Item 11.
Figure 2
Figure 2
Item characteristic curves – Item 18.
Figure 3
Figure 3
Item characteristic curves – Item 4.
Figure 4
Figure 4
Item information functions for BRBI.
Figure 5
Figure 5
Test information functions for BRBI.
Figure 6
Figure 6
Item information functions for BRST.
Figure 7
Figure 7
Test information functions for BRST.
Figure 8
Figure 8
Item information functions for BRBS.
Figure 9
Figure 9
Test information functions for BRBS.
Figure 10
Figure 10
Item information functions for BRAS.
Figure 11
Figure 11
Test information functions for BRAS.

References

    1. Lord, B. & Frederic, M. Applications of Item Response Theory to Practical Testing Problems. 1–274 (1980).
    1. Hambleton R. K. & Swaminathan H. Item response theory: principles and applications (1985).
    1. Downing SM. Item response theory: applications of modern test theory in medical education. J. Medical Education. 2003;37(8):739–745. doi: 10.1046/j.1365-2923.2003.01587.x.
    1. Timms M. J. Using Item Response Theory (IRT) to select hints in an ITS. In: Artificial Intelligence in Education, Building Technology Rich Learning Contexts ThatWork, Proceedings of the International Conference on Artificial Intelligence in Education, Aied 2007, July 9–13, 2007, Los Angeles, California, Usa: 2007; 213–221 (2007).
    1. Ames AJ, Penfield RD. An NCME Instructional Module on Item-Fit Statistics for Item Response Theory Models. Educational Measurement Issues & Practice. 2015;34(3):39–48. doi: 10.1111/emip.12067.
    1. Fayers P. Item Response Theory for Psychologists. Quality of Life Research. 2004;13(3):715–716. doi: 10.1023/B:QURE.0000021503.45367.f2.
    1. Reise SP, Ainsworth AT, Haviland MG. Item Response Theory: Fundamentals, Applications, and Promise in Psychological Research. Current Directions in Psychological Science. 2010;14(2):95–101. doi: 10.1111/j.0963-7214.2005.00342.x.
    1. Reise S. P, Moore T. M, Haviland M. G. Applying unidimensional item response theory models to psychological data. 101–119 (2013).
    1. Fajrianthi ZRA. Development of a psychological test to measure ability-based emotional intelligence in the Indonesian workplace using an item response theory. Psychology Research & Behavior Management. 2017;10:339–352. doi: 10.2147/PRBM.S143113.
    1. Hardouin, J. B. et al. Interest of health-related quality of life scores validated using Item Response Theory (IRT) in clinical research. In: SOFMER: 2013 (2013).
    1. Hays RD, Morales LS, Reise SP. Item response theory and health outcomes measurement in the 21st century. Medical Care. 2000;38(9 Suppl):II28.
    1. Hays RD, Lipscomb J. Next steps for use of item response theory in the assessment of health outcomes. Quality of Life Research An International Journal of Quality of Life Aspects of Treatment Care & Rehabilitation. 2007;16(1):195–199. doi: 10.1007/s11136-007-9175-7.
    1. Steffl M, et al. Assessment of diagnostics tools for sarcopenia severity using the item response theory (IRT) Journal of Nutrition Health & Aging. 2016;20(10):1051. doi: 10.1007/s12603-016-0713-2.
    1. Sekely, A., Taylor G. J. & Bagby, R. M. Developing a short version of the Toronto Structured Interview for Alexithymia using item response theory. Psychiatry Research (2018).
    1. Hambleton R, Swaminathan H. Applications of Item Response Theory to Practical Testing Problems - Lord,Fm. Critical Care. 1981;13(4):R121.
    1. Embretson SE. The new rules of measurement. Psychological Assessment. 1996;8(4):341–349. doi: 10.1037/1040-3590.8.4.341.
    1. Hambleton R. K. Applications of item response theory to improve health outcomes assessment: Developing item banks, linking instruments, and computer-adaptive testing (2005).
    1. Dorans NJ. Linking scores from multiple health outcome instruments. Quality of Life Research. 2007;16(1):85–94. doi: 10.1007/s11136-006-9155-3.
    1. Nguyen J, et al. EORTC QLQ-BR23 and FACT-B for the assessment of quality of life in patients with breast cancer: a literature review. Journal of Comparative Effectiveness Research. 2015;4(2):157–166. doi: 10.2217/cer.14.76.
    1. Xia J, et al. Predictors of the quality of life in Chinese breast cancer survivors. Breast Cancer Research & Treatment. 2018;6:1–9.
    1. Sprangers MA, et al. The European Organization for Research and Treatment of Cancer breast cancer-specific quality-of-life questionnaire module: first results from a three-country field study. Journal of Clinical Oncology Official Journal of the American Society of Clinical Oncology. 1996;14(10):2756. doi: 10.1200/JCO.1996.14.10.2756.
    1. Fayers, P., Aaronson, N. K., Bjordal, K., Curran, D. & Gronvold, M. EORTC QLQ-C30 Scoring Manual (2nd edition) (2014).
    1. Samejima F. Estimation of Latent Ability Using a Response Pattern of Graded Scores1. Psychometrika. 1968;1968(1):i–169.
    1. Folk VG, Green BF. Adaptive Estimation When the Unidimensionality Assumption of IRT Is Violated. Applied Psychological Measurement. 1989;13(4):373–390. doi: 10.1177/014662168901300404.
    1. Yang, Z., Yan-Bo, Q. I. & Wan, C. H. Analysis on items of general module of quality of life instrument for chronic diseases by item response theory. Chinese Journal of Public Health (2012).
    1. Yu J. Xiangmu Fanying Lilun Jiqi Yingyong: Jiangsu Education Publishing House (1992).
    1. Edelen MO, Reeve BB. Applying item response theory (IRT) modeling to questionnaire development, evaluation, and refinement. Quality of Life Research. 2007;16(1):5. doi: 10.1007/s11136-007-9198-0.
    1. Stark S, Chernyshenko OS, Lancaster AR, Drasgow F, Fitzgerald LF. Toward standardized measurement of sexual harassment: Shortening the SEQ-DoD using item response theory. Military Psychology. 2002;14(1):49–72. doi: 10.1207/S15327876MP1401_03.
    1. Kim Y, Pilkonis PA. Selecting the most informative items in the IIP scales for personality disorders: an application of item response theory. Journal of Personality Disorders. 2011;13(2):157. doi: 10.1521/pedi.1999.13.2.157.
    1. Pilkonis PA, Kim Y, Lan Y, Morse JQ. Adult Attachment Ratings (AAR): An Item Response Theory Analysis. Journal of Personality Assessment. 2014;96(4):417–425. doi: 10.1080/00223891.2013.832261.
    1. Solari A, et al. Development of a shortened version of the MSQOL-54 using factor analysis and item response theory. Journal of the Neurological Sciences. 2015;357(1):e318–e319. doi: 10.1016/j.jns.2015.08.1117.
    1. Petersen MA, et al. Item response theory was used to shorten EORTC QLQ-C30 scales for use in palliative care. Journal of Clinical Epidemiology. 2006;59(1):36–44. doi: 10.1016/j.jclinepi.2005.04.010.
    1. Bjorner JB, et al. Use of item response theory to develop a shortened version of the EORTC QLQ-C30 emotional functioning scale. Quality of Life Research. 2004;13(10):1683–1697. doi: 10.1007/s11136-004-7866-x.
    1. Nowak Ł, Pasławska-Południak M, Twardowska K. The development of the EORTC QLQ-C15-PAL: A shortened questionnaire for cancer patients in palliative care. European Journal of Cancer. 2006;42(1):55–64. doi: 10.1016/j.ejca.2005.06.022.

Source: PubMed

3
Abonneren