131 research outputs found

    Item response theory for weighted summed scores

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    Tests composed of multiple sections are routinely weighted by section. Methods for weighting have existed perhaps as long as there have been tests; however, computing and evaluating the quality of weights has not evolved with recent advances in test theory (Item Response Theory (IRT)). While IRT may be used to compute accurate estimates of ability based on a variety of information (e.g., pattern responses or summed scores), there has been little research on the computation of scale score estimates for tests with arbitrary item or test section weights. The present work provides an extension to a recursive algorithm for the computation of IRT-scale scores from weighted summed scores

    Logistic Approximations of Marginal Trace Lines for Bifactor Item Response Theory Models

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    Bifactor item response theory models are useful when item responses are best represented by a general, or primary, dimension and one or more secondary dimensions that account for relationships among subsets of items. Understanding slope parameter estimates in multidimensional item response theory models is often challenging because interpretation of a given slope parameter must be made conditional on the item's other parameters. The present work provides a method of computing marginal trace lines for an item loading on more than one dimension. The marginal trace line provides the relationship between the item response and the primary dimension, after accounting for all other dimensions. Findings suggest that a logistic function, common in many applications of item response theory, closely approximates the marginal trace line in a variety of model related conditions. Additionally, a method of IRT-based scoring is proposed that uses the logistic approximation marginal trace lines in a unidimensional fashion to compute scaled scores and standard deviation estimates for the primary dimension. The utility of the logistic approximation for marginal trace lines is considered across a wide range of varying bifactor parameter estimates, and under each condition the marginal is closely approximated by a logistic function. In addition, it is shown that use of the logistic approximations to conduct item response theory-based scoring should be restricted to selecting a single item from each secondary dimension in order to control for local dependence. Under this restriction, scaled scores and posterior standard deviations are nearly equivalent to other MIRT-based scoring procedures. Finally, a real-data application is provided which illustrates the utility of logistic approximations of marginal trace lines in item selection and scale development scenarios.Doctor of Philosoph

    O ral H ealth L iteracy A ssessment: development of an oral health literacy instrument for S panish speakers

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    Objective To develop an oral health literacy instrument for S panish‐speaking adults, evaluate its psychometric properties, and determine its comparability to an E nglish version. Methods The O ral H ealth L iteracy A ssessment in S panish ( OHLA ‐ S ) and E nglish ( OHLA ‐ E ) are designed with a word recognition section and a comprehension section using the multiple‐choice format developed by an expert panel. Validation of OHLA ‐ S and OHLA ‐ E involved comparing the instrument with other health literacy instruments in a sample of 201 S panish‐speaking and 204 E nglish‐speaking subjects. Comparability between S panish and E nglish versions was assessed by testing for differential item functioning ( DIF ) using item response theory. Results We considered three OHLA ‐ S scoring systems. Based on validity and reliability comparisons, 24 items were retained in the OHLA ‐ S instrument. OHLA ‐ S was correlated with another health literacy instrument, S panish T est of F unctional H ealth L iteracy in A dults ( P  < 0.05). Significant correlations were also found between OHLA ‐ S and years of schooling, oral health knowledge, overall health, and an understanding of written health‐care materials ( P  < 0.05). OHLA ‐ S displayed satisfactory reliability with a Cronbach Alpha of 0.70‐0.80. DIF results suggested that OHLA ‐ S and OHLA ‐ E scores were not comparable at a given level of oral health literacy. Conclusions OHLA ‐ S has acceptable reliability and validity. OHLA ‐ S and OHLA ‐ E are two different measurement tools and should not be used to compare oral health literacy between E nglish‐ and S panish‐speaking populations.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/96765/1/jphd12000.pd

    Development of the Two‐Stage Rapid Estimate of Adult Literacy in Dentistry

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    Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/86828/1/j.1600-0528.2011.00619.x.pd

    Development of the Two Stage Rapid Estimate of Adult Literacy in Dentistry (TS-REALD)

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    This work proposes a revision of the 30 item Rapid Estimate of Adult Literacy in Dentistry (REALD-30), into a more efficient and easier-to-use two-stage scale. Using a sample of 1,405 individuals (primarily women) enrolled in a Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), the present work utilizes principles of item response theory and multi-stage testing to revise the REALD-30 into a two-stage test of oral health literacy, named Two-Stage REALD or TS-REALD, which maximizes score precision at various levels of participant ability. Based on the participant’s score on the 5-item first-stage (i.e., routing test), one of three potential stage-two tests is administered: a 4-item Low Literacy test, a 6-item Average Literacy test, or a 3-item High Literacy test. The reliability of scores for the TS-REALD is greater than .85 for a wide range of ability. The TS-REALD was found to be predictive of perceived impact of oral conditions on well-being, after controlling for educational level, overall health, dental health, and a general health literacy measure. While containing approximately one-third of the items on the original scale, the TS-REALD was found to maintain similar psychometric qualities

    Development of six PROMIS pediatrics proxy-report item banks

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    <p>Abstract</p> <p>Background</p> <p>Pediatric self-report should be considered the standard for measuring patient reported outcomes (PRO) among children. However, circumstances exist when the child is too young, cognitively impaired, or too ill to complete a PRO instrument and a proxy-report is needed. This paper describes the development process including the proxy cognitive interviews and large-field-test survey methods and sample characteristics employed to produce item parameters for the Patient Reported Outcomes Measurement Information System (PROMIS) pediatric proxy-report item banks.</p> <p>Methods</p> <p>The PROMIS pediatric self-report items were converted into proxy-report items before undergoing cognitive interviews. These items covered six domains (physical function, emotional distress, social peer relationships, fatigue, pain interference, and asthma impact). Caregivers (n = 25) of children ages of 5 and 17 years provided qualitative feedback on proxy-report items to assess any major issues with these items. From May 2008 to March 2009, the large-scale survey enrolled children ages 8-17 years to complete the self-report version and caregivers to complete the proxy-report version of the survey (n = 1548 dyads). Caregivers of children ages 5 to 7 years completed the proxy report survey (n = 432). In addition, caregivers completed other proxy instruments, PedsQL™ 4.0 Generic Core Scales Parent Proxy-Report version, PedsQL™ Asthma Module Parent Proxy-Report version, and KIDSCREEN Parent-Proxy-52.</p> <p>Results</p> <p>Item content was well understood by proxies and did not require item revisions but some proxies clearly noted that determining an answer on behalf of their child was difficult for some items. Dyads and caregivers of children ages 5-17 years old were enrolled in the large-scale testing. The majority were female (85%), married (70%), Caucasian (64%) and had at least a high school education (94%). Approximately 50% had children with a chronic health condition, primarily asthma, which was diagnosed or treated within 6 months prior to the</p> <p>interview. The PROMIS proxy sample scored similar or better on the other proxy instruments compared to normative samples.</p> <p>Conclusions</p> <p>The initial calibration data was provided by a diverse set of caregivers of children with a variety of common chronic illnesses and racial/ethnic backgrounds. The PROMIS pediatric proxy-report item banks include physical function (mobility n = 23; upper extremity n = 29), emotional distress (anxiety n = 15; depressive symptoms n = 14; anger n = 5), social peer relationships (n = 15), fatigue (n = 34), pain interference (n = 13), and asthma impact (n = 17).</p

    Short Assessment of Health Literacy-Spanish and English: A Comparable Test of Health Literacy for Spanish and English Speakers: Short Assessment of Health Literacy

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    The intent of the study was to develop and validate a comparable health literacy test for Spanish-speaking and English-speaking populations

    Using the PedsQL™ 3.0 asthma module to obtain scores comparable with those of the PROMIS pediatric asthma impact scale (PAIS)

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    The National Institutes of Health's Patient-Reported Outcomes Measurement Information System (PROMIS) has developed several scales measuring symptoms and function for use by the clinical research community. One advantage of PROMIS is the ability to link other scales to the PROMIS metric
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