Articlehybrid2018

Evaluating the Longitudinal Item and Category Stability of the SF-36 Full and Summary Scales Using Rasch Analysis

Reinie Cordier · Ted Brown · Lindy Maxted Clemson · Julie Byles

28 citations0/0 files storedBioMed Research International

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Psychometric Methodologies and Testing Health Systems, Economic Evaluations, Quality of Life Medical Practices and Rehabilitation

Abstract

INTRODUCTION: The Medical Outcome Study Short Form 36 (SF-36) is widely used for measuring Health-Related Quality of Life (HRQoL) and has undergone rigorous psychometric evaluation using Classic Test Theory (CTT). However, Item Response Theory-based evaluation of the SF-36 has been limited with an overwhelming focus on individual scales and cross-sectional data. PURPOSE: This study aimed to examine the longitudinal item and category stability of the SF-36 using Rasch analysis. METHOD: Using data from the 1921-1926 cohort of the Australian Longitudinal Study on Women's Health, responses of the SF-36 from six waves of data collection were analysed. Rasch analysis using Winsteps version 3.92.0 was performed on all 36 items of the SF-36 and items that constitute the physical health and mental health scales. RESULTS: Rasch analysis revealed issues with the SF-36 not detected using classical methods. Redundancy was seen for items on the total measure and both scales across all waves of data. Person separation indexes indicate that the measure lacks sensitivity to discriminate between high and low performances in this sample. The presence of Differential Item Functioning suggests that responses to items were influenced by locality and marital status. CONCLUSION: Previous evaluations of the SF-36 have relied on cross-sectional data; however, the findings of the current study demonstrate the longitudinal efficacy of the measure. Application of the Rasch Measurement Model indicated issues with internal consistency, generalisability, and sensitivity when the measure was evaluated as a whole and as both physical and mental health summary scales. Implications for future research are discussed.

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2010The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes 2007The Rasch measurement model in rheumatology: What is it and why use it? When should it be applied, and what should one look for in a Rasch paper?2007Applying item response theory (IRT) modeling to questionnaire development, evaluation, and refinement 1993An NCME Instructional Module on 2005Cohort Profile: The Australian Longitudinal Study on Women's Health 1999Women's Health Australia: Recruitment for a National Longitudinal Cohort Study 1999Investigating rating scale category utility.1998Using item mean squares to evaluate fit to the Rasch model.

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