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Using item response theory improved responsiveness of patient-reported outcomes measures in carpal tunnel syndrome

In English

Författare

Summary, in English

Objective: To compare responsiveness based on item response theory (IRT) with that based on conventional scoring for two patient-reported outcomes measures in carpal tunnel syndrome (CTS); the short disabilities of the arm, shoulder, and hand (QuickDASH) measure, and the 6-item CTS symptoms scale (CTS-6). Study Design and Setting: Prospective cohort study of patients with CTS undergoing carpal tunnel release at one orthopedic department. Of 455 consecutive patients, 343 completed the QuickDASH and the CTS-6 before and within 1 year after surgery. IRT-based and conventional scores were compared in subgroups according to global rating of change in hand status and treatment satisfaction. The effect size (ES) and the area under the receiver operating characteristic (ROC) curve were used as measures of responsiveness. Results: The mean value for the IRT-based QuickDASH estimate was -0.09 (standard deviation [SD] = 1.13) preoperatively and -2.14 (SD = 1.79) postoperatively (ES = -1.8) and for the CTS-6 estimate was 0.29 (SD = 1.36) preoperatively and -3.87 (SD = 2.3) postoperatively (ES = -3.1), indicating very large improvement. The ES for the QuickDASH and CTS-6 were very large (-2.4 and -3.8), respectively, in the group with the largest perceived improvement and decreased with lower perceived improvement. The ES was consistently larger with IRT-based scoring than conventional scoring. The AUC for the QuickDASH and CTS-6 exceeded 0.85. Conclusion: IRT-based scoring showed high responsiveness for the QuickDASH and CTS-6, and the ES were larger than those estimated using conventional scoring. (C) 2012 Elsevier Inc. All rights reserved.

Avdelning/ar

Publiceringsår

2012

Språk

Engelska

Sidor

325-334

Publikation/Tidskrift/Serie

Journal of Clinical Epidemiology

Volym

65

Issue

3

Dokumenttyp

Artikel i tidskrift

Förlag

Elsevier

Ämne

  • Public Health, Global Health, Social Medicine and Epidemiology

Nyckelord

  • Carpal tunnel syndrome
  • QuickDASH
  • CTS symptoms scale
  • Item response
  • theory
  • Patient-reported outcomes
  • Effect size
  • AUC

Status

Published

ISBN/ISSN/Övrigt

  • ISSN: 1878-5921