Format

Send to

Choose Destination
Qual Life Res. 2017 Nov;26(11):2949-2959. doi: 10.1007/s11136-017-1627-0. Epub 2017 Jun 21.

Measuring everyday functional competence using the Rasch assessment of everyday activity limitations (REAL) item bank.

Author information

1
Arthritis Center Twente, Department of Psychology, Health and Technology, University of Twente, PO Box 217, 7500 AE, Enschede, The Netherlands. a.h.oudevoshaar@utwente.nl.
2
Arthritis Center Twente, Department of Psychology, Health and Technology, University of Twente, PO Box 217, 7500 AE, Enschede, The Netherlands.
3
Arthritis Center Twente, Department of Rheumatology and Clinical Immunology, Medical Spectrum Twente, Enschede, The Netherlands.

Abstract

OBJECTIVE:

Traditional patient-reported physical function instruments often poorly differentiate patients with mild-to-moderate disability. We describe the development and psychometric evaluation of a generic item bank for measuring everyday activity limitations in outpatient populations.

STUDY DESIGN AND SETTING:

Seventy-two items generated from patient interviews and mapped to the International Classification of Functioning, Disability and Health (ICF) domestic life chapter were administered to 1128 adults representative of the Dutch population. The partial credit model was fitted to the item responses and evaluated with respect to its assumptions, model fit, and differential item functioning (DIF). Measurement performance of a computerized adaptive testing (CAT) algorithm was compared with the SF-36 physical functioning scale (PF-10).

RESULTS:

A final bank of 41 items was developed. All items demonstrated acceptable fit to the partial credit model and measurement invariance across age, sex, and educational level. Five- and ten-item CAT simulations were shown to have high measurement precision, which exceeded that of SF-36 physical functioning scale across the physical function continuum. Floor effects were absent for a 10-item empirical CAT simulation, and ceiling effects were low (13.5%) compared with SF-36 physical functioning (38.1%). CAT also discriminated better than SF-36 physical functioning between age groups, number of chronic conditions, and respondents with or without rheumatic conditions.

CONCLUSION:

The Rasch assessment of everyday activity limitations (REAL) item bank will hopefully prove a useful instrument for assessing everyday activity limitations. T-scores obtained using derived measures can be used to benchmark physical function outcomes against the general Dutch adult population.

KEYWORDS:

Activity limitations; Computerized adaptive testing; Item bank; Item response theory; Physical function; Rasch

PMID:
28638966
PMCID:
PMC5655561
DOI:
10.1007/s11136-017-1627-0
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Springer Icon for PubMed Central
Loading ...
Support Center